After widespread criticism from the medical community, the Centers for Disease Control and Prevention (CDC) dropped a controversial recommendation that de-emphasized the importance of testing asymptomatic contacts of COVID-19 cases.1

The CDC also recently issued guidance warning about airborne spread of the virus indoors, then quickly withdrew it as a “draft,” drawing more concerns about mixed messaging and politicization of the agency.2

“As a career public health guy, my perspective from the very beginning is that the CDC has an untarnished brand,” says Will Humble, MPH, executive director for the Arizona Public Health Association. “They were the most trusted brand within the federal government. We knew we could trust the CDC for evidence-based recommendations and analysis. That has changed over the last six months. I think even public health people think the reputation of the agency is tarnished.”

In a clarification issued Sept. 18, the CDC stated 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 SARS-CoV-2 infection.”

The previous version that caused the uproar — particularly since the CDC had emphasized the importance of contact tracing because 40% of cases are asymptomatic — included this guidance on Aug. 24: “If you are in a high COVID-19 transmission area and have attended a public or private gathering of more than 10 people (without widespread mask-wearing or physical distancing): 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.”

The revised version drops the “not necessarily” qualifier, now reading, “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.
  • If you are tested, you should self-isolate at home until your test results are known, and then adhere to your healthcare provider’s advice. A 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 wear a mask, physically distance, avoid crowds and indoor crowded places, wash your hands frequently, and monitor yourself for symptoms.
  • Take special precautions in the home to protect any person(s) with increased risk of severe illness according to CDC.”1,3

REFERENCES

  1. Centers for Disease Control and Prevention. Overview of testing for SARS-CoV-2 (COVID-19). Updated Sept. 18, 2020. https://www.cdc.gov/coronavirus/2019-ncov/hcp/testing-overview.html
  2. Gumbrecht J, Christensen J, Cohen E, et al. CDC abruptly removes guidance about airborne coronavirus transmission, says update ‘was posted in error.’ CNN. Sept. 22, 2020. https://www.cnn.com/2020/09/21/health/cdc-reverts-airborne-transmission-guidance/index.html
  3. Centers for Disease Control and Prevention. Caring for someone sick at home: Advice for caregivers in non-healthcare settings. Updated May 8, 2020. https://www.cdc.gov/coronavirus/2019-ncov/if-you-are-sick/care-for-someone.html