CDC rolls back controversial advisory, asks everyone to get tested if they got exposed to someone with Covid-19
After facing a lot of criticism from public health experts and scientists, the US Centers for Disease Control and Prevention (CDC) has reversed its earlier guidance and is now advising that any person who has been within 6 feet of an individual infected with Covid-19, should get tested for the virus even if they are not showing any symptoms. The agency called this a ‘clarification’ and explained that due to the significance of asymptomatic and pre-symptomatic transmission, this guidance “further reinforces” the need to test asymptomatic persons, including close contacts of a person with documented Covid-19 infection. It explains that viral tests are recommended to diagnose acute Covid-19 infection of both symptomatic and asymptomatic individuals, to guide contact tracing, treatment options, and isolation requirements.
“If you have been in close contact, such as within 6 feet of a person with documented SARS-CoV-2 infection for at least 15 minutes and do not have symptoms, you need a test. Please consult with your healthcare provider or public health official. Testing is recommended for all close contacts of persons with SARS-CoV-2 (the virus that causes Covid-19) infection. Because of the potential for asymptomatic and pre-symptomatic transmission, it is important that contacts of individuals with SARS-CoV-2 infection be quickly identified and tested. Pending test results, you should self-quarantine/isolate at home and stay separated from household members to the extent possible and use a separate bedroom and bathroom, if available,” the guidelines recommend. It adds, “A single negative test does not mean you will remain negative at any time point after that test. Even if you have a negative test, you should still self-isolate for 14 days. If you cannot self-isolate, or you are a critical infrastructure worker that must work, wear a mask, physically distance, avoid crowds and indoor crowded places, wash your hands frequently, and monitor yourself for symptoms.”
Testing asymptomatic people is critical because the CDC estimates that up to 40% of people infected with the coronavirus show no symptoms. Such people may still be infectious and spread the virus, according to experts. “It is important to realize that you can be infected and spread the virus but feel totally well and have no symptoms,” cautions the CDC.
The current guidelines, issued on September 18, is in line with what the CDC had recommended initially, that is testing for all individuals exposed to the virus before it was changed in late August to say that people without symptoms, who were exposed to an infected person, might not need to be screened. The August 24 advisory said: “If you have been in close contact (within 6 feet) of a person with a Covid-19 infection for at least 15 minutes but do not have symptoms, you do not necessarily need a test unless you are a vulnerable individual or your healthcare provider or state or local public health officials recommend you take one.” This move was severely criticized by scientists and doctors.
The agency’s latest advisory also stipulates that if a person does not have Covid-19 symptoms and has not been in close contact with someone known to have coronavirus infection, they do not need a test unless recommended or required by their healthcare provider or public health official. “If you are in a high SARS-CoV-2 transmission zone and attended a public or private gathering of more than 10 people (without universal mask-wearing and/or physical distancing), your healthcare provider or public health official may advise a SARS-CoV-2 test,” suggests the CDC.
Commenting on the change, the National Association of County and City Health Officials (NACCHO) and the Big Cities Health Coalition said in a joint statement that it helps ensure that the national guidelines are based on the best available science and data. “Local public health departments rely on asymptomatic testing of close contacts, in particular, to find hidden infection, inform case investigation efforts, trace contacts, and contain clusters of outbreaks. This had been the policy until a reversal last month that removed the recommendation for asymptomatic people, including close contacts of a person with a documented Covid-19 infection, to be tested. This caused great confusion for the general public, but also for public health professionals who noted that CDC’s own research suggested that as many as 40% of COVID-19 cases are attributable to asymptomatic transmission,” reads the statement. It adds, “We are hopeful that CDC will work quickly to update any other documents to ensure that this clarification is understood and adopted across the country.”