White House Coronavirus Task Force member Dr. Anthony Fauci said he was undergoing surgery and not in the August 20 task force meeting for the discussion on updated US Centers for Disease Control and Prevention guidelines that suggest asymptomatic people may not need to be tested for Covid-19, even if they’ve been in close contact with an infected person.
“I was under general anesthesia in the operating room and was not part of any discussion or deliberation regarding the new testing recommendations” at that meeting, Fauci told CNN Chief Medical Correspondent Dr. Sanjay Gupta.
“I am concerned about the interpretation of these recommendations and worried it will give people the incorrect assumption that asymptomatic spread is not of great concern. In fact it is,” said Fauci, director of the National Institute of Allergy and Infectious Diseases.
Fauci’s comments undercut claims by Adm. Brett Giroir, the administration’s coronavirus testing point person, who told reporters on Wednesday that the new guidelines had the White House coronavirus task force’s stamp of approval. Asked whether Fauci signed off on the guidelines, Giroir said, “Yes, all the docs signed off on this before it even got to the task force level.”
“We worked on this all together to make sure that there was absolute consensus that reflected the best possible evidence, and the best public health for the American people,” Giroir also said earlier in the call, pushing back on the notion that the new guidelines were the result of political pressure. “I worked on them, Dr. Fauci worked on them, Dr. (Deborah) Birx worked on them. Dr. (Stephen) Hahn worked on them.”
The new CDC guidelines appeared to be the result of an idea raised to the task force by CDC Director Robert Redfield a month earlier, when a surge of coronavirus cases strained US testing resources and some members were looking for new messaging on how to stem excess testing.
Rather than continue to encourage anyone in close contact with a coronavirus-positive individual to get tested, Redfield suggested the CDC could relax the guidance, deeming a test unnecessary for otherwise healthy individuals not experiencing any symptoms, two sources familiar with the matter said. Experts worry that this will discourage the widespread testing of asymptomatic individuals that could help bring the pandemic under control.
The idea was met with immediate resistance from several task force members. In a coronavirus task force meeting Thursday, members debated the guidelines in-depth and in person, when Fauci was absent.
The new guidelines were quietly published on the CDC website on Monday, catching media attention Tuesday evening and drawing a deluge of criticism from the public health community.
The new guidelines stunned some federal health officials who are generally briefed on coronavirus matters, and many state health officials had also not been briefed on the change. Many federal health officials were scrambling on Wednesday to understand the impact of the new guidelines and who pushed through the change.
President Donald Trump has repeatedly lamented widespread testing in the US, falsely claiming it is responsible for surges of cases in the US and suggesting the US should slow down testing. Those comments and the surprising CDC guidelines led to allegations that the CDC’s new guidelines were political and not scientific in origin.
“It’s coming from the top down,” a federal health official told CNN of the new directives.
Giroir insisted the decision was science and evidence-based and said there was “no direction from President Trump, the Vice President, or the [HHS] Secretary about what we need to do when.”
“This is evidence-based decisions that are driven by the scientists and physicians, both within the CDC with my office in the lab Task Force, and certainly among the task force members,” Giroir said.
“These updated guidelines, coordinated in conjunction with the White House Coronavirus Task Force, received appropriate attention, consultation and input from task force experts,”
Redfield said in a statement released to CNN later Wednesday that “these updated guidelines, coordinated in conjunction with the White House Coronavirus Task Force, received appropriate attention, consultation and input from task force experts.”
“We are placing an emphasis on testing individuals with symptomatic illness, individuals with a significant exposure, vulnerable populations including nursing homes or long term care facilities, critical infrastructure workers, healthcare workers and first responders, or those individuals who may be asymptomatic when prioritized by medical and public health officials,” he said.
Previous CDC testing guidance said anyone who had close contact with someone with coronavirus should get tested, whether they have symptoms or not.
The site was changed to say: “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 health care provider or State or local public health officials recommend you take one.”
Redfield said in his statement that anyone who has been in close contact with a confirmed or probable Covid-19 patient should monitors their symptoms, wear a mask and stay at least 6 feet away from others, wash their hands, and talk to a health care provider or public health “to determine if (a) test is needed.”
“Testing is meant to drive actions and achieve specific public health objectives. Everyone who needs a COVID-19 test, can get a test. Everyone who wants a test does not necessarily need a test; the key is to engage the needed public health community in the decision with the appropriate follow-up action,” Redfield said, adding: “Testing may be considered for all close contacts of confirmed or probable COVID-19 patients.”
Dr. Carlos del Rio, infectious disease specialist and associate dean of Emory University School of Medicine, said on CNN Newsroom earlier Wednesday that the CDC has not provided evidence to explain the changes. “I mean, the evidence that I’m aware of as of today is that close to 40% of the cases of the infections are asymptomatic and asymptomatic people transmit the infection,” del Rio said.
“So, not testing – I mean, if you have been in contact with somebody for a few minutes, that’s okay. But if you have been in contact for 15 minutes and that people doesn’t have a mask, I think you need to be tested regardless if you have symptoms or not,” he added.
American Medical Association President Dr. Susan Bailey called on CDC and HHS to “release the scientific justification” for the changes.
“Months into this pandemic, we know COVID-19 is spread by asymptomatic people. Suggesting that people without symptoms, who have known exposure to COVID-positive individuals, do not need testing is a recipe for community spread and more spikes in coronavirus,” Bailey said in a statement.
California, meanwhile, will not abide by new guidelines, Gov. Gavin Newsom said in a news conference.
“I don’t agree with the new CDC guidance period, full stop, and it’s not the policy in the state of California,” Newsom, a Democrat, said. “We will not be influenced by that change. We’re influenced by those that are experts in the field that feel very differently.”
This story has been updated with additional developments Wednesday.