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This award-winning blog supplements the articles in Hospital Infection Control & Prevention.

Rebellion Brewing Against CDC COVID-19 Testing Changes

By Gary Evans, Medical Writer

Amid the worst pandemic in a century, the Centers for Disease Control and Prevention (CDC) is dispensing advice to those who say they will not follow it – the very definition of failed leadership. How did we get here? Painfully.

In a move widely seen as further evidence that the pandemic response has been politicized, the CDC recently revised SARS-CoV-2 testing guidelines, de-emphasizing the need to test asymptomatic people who have been in contact with a confirmed or possible case of COVID-19 as of August 24, 2020.

“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 health care provider or state or local public health officials recommend you take one,” the CDC states.

Despite the qualifiers and caveats in the guidance, the infection control and public health community was not having it. Retreating from the cardinal public health principle of contact tracing was met with criticism and open rebellion.

“I don’t think it will have much impact at all, and the reason is states are going to ignore the CDC guidance,” says Will Humble, MPH, executive director for the Arizona Public Health Association. “Our county health departments resoundingly said, ‘pound sand.’ We are going to keep testing, we are going to encourage testing of asymptomatic contacts, and when they are positive we are going get them in [quarantine], and we are going try to continue to find their contacts.”

After a surge of COVID-19 cases undermined contact tracing efforts in June and July, Arizona has gotten back up to speed.

“Now we are finally in a position where our counties do case investigations and do follow-ups and have effective contact tracing,” he says. “I just don’t see discouraging [testing] now that we have that in place. This makes zero sense to us.”

Connie Steed, MSN, RN, CIC, FAPIC, director of infection prevention and control at Prisma Health in Greenville, SC, said her organization is continuing to offer drive-by testing for the community.

“Testing continues to be encouraged in our community because I think public health and infection preventionists still feel that testing is helpful,” she says. “We have drive-by testing that is done most times seven days a week for our community. We are going to continue that. We are not going to de-emphasize it.”

Steed is president of the Association of Professionals in Infection Control and Epidemiology (APIC), which was one of 235 organizations that signed a letter to the White House task force calling for the testing changes to be reversed.

For more on this story, see the October issue of Hospital Infection Control & Prevention.