Shift on virus-test guidelines is defended
WASHINGTON — Brett Giroir, a top Trump administration official, fired back against criticism over the Centers for Disease Control and Preven- tion’s shift on corona- virus test- ing during a Wednesday briefing, saying it is intended to clarify to the public the limitations of such screenings, not to reduce how many tests are conducted.
“I’m really not sure how
people could interpret that if they actually read them [the guidelines] because what we’ve tried to do is put more responsibility on public health officials,” said Giroir, the Health and Human Services Department assistant secretary for health.
The new guidance says it’s not necessary for people who have been in close contact with infected people but don’t feel sick to get tested. The CDC previously advised local health departments to test people who have been within 6 feet of an infected person for more than 15 minutes.
Giroir said that in areas with high virus rates, many people without symptoms will be tested at surge screening sites, which he contrasted with someone in a “place where it’s 1% positive saying I want to get tested today, tomorrow and the next day.”
CNN reported Wednesday that the CDC guidance change was a result of pressure from Trump administration officials, citing an unidentified official.
But Giroir said the change was made without input from President Donald Trump or Vice President Mike Pence. “There was no weight on the scales by the president or the vice president” or by Health and Human Services Secretary Alex Azar, Giroir said.
Giroir said the guidelines had been a joint effort, with the involvement of top administration health officials including Drs. Anthony Fauci, Deborah Birx and Stephen Hahn.
However, Fauci, the country’s top infectious-disease expert, said Wednesday that he wasn’t part of the discussion that green-lighted the change.
Fauci told CNN he was undergoing surgery when the new guidance was discussed last week, adding he was “worried it will give people the incorrect assumption that asymptomatic spread is not of great concern. In fact, it is.”
The guidance reflects a shift in tone by the federal government and some states that began earlier this summer, as lengthy delays in getting test results made headlines.
In mid-July, for instance, Giroir recommended testing only people with symptoms and front-line workers, and Florida asked labs to prioritize tests for symptomatic people. Major commercial labs report that test results have become speedier in recent weeks, with turnarounds of a few days on average.
PLENTY OF PUSHBACK
Yet public health experts said the new guidance, released as part of an unpublicized update to the CDC’s website, could in fact cut down on testing.
“This makes no sense,” wrote Leana Wen, a physician who formerly led Planned Parenthood and currently serves as visiting professor of health policy and management at George Washington University, in a tweet late Tuesday. “We need more testing, not less.”
Howard Forman, director of the Yale School of Public Health’s health care management program, called the shift “insane and counter to all the best evidence that we have about how testing is supposed to work and appears to work.”
“We need to identify asymptomatic infected individuals as soon as feasible and isolate them and begin contact tracing when feasible,” he said in an email.
The American Medical Association called the change “a recipe for community spread.” The Association of American Medical Colleges called it “a step backward in fighting the pandemic.”
The governors of California, New York, Washington and Kentucky — all Democrats — also criticized the new recommendations.
Gov. Andrew Cuomo said New York won’t follow the new guidelines and called the move “political propaganda” and an effort by the president to bring down the number of cases.
“The only plausible rationale is they want fewer people taking tests because, as the president has said, if we don’t take tests, you won’t know that people are covid-positive, and the number of covid-positive people will come down,” Cuomo said. “But it totally violates public health standards and rationale and just fosters his failed policy of denial.”
Washington Gov Jay Inslee said on Twitter that the changes are likely to cause thousands of infections in his state to go unrecognized, and allow the virus to spread even more. Kentucky Gov. Andy Beshear called the new guidance “reckless.”
“We will not be influenced by that change,” said California Gov. Gavin Newsom. “We’re influenced by the folks that are experts in the field who feel very differently.”
“Why would you reverse yourself on the quarantine order?” Cuomo told reporters on a conference call. “Because they don’t want publicity that there is a covid problem. Because the president’s politics are, ‘Covid isn’t a problem We’re past covid.’”
NURSING HOME INQUIRY
Separately, the Justice Department on Wednesday sent letters to the governors of New York and three other Democratic-led states, seeking data on whether they violated federal law by ordering public nursing homes to accept recovering covid-19 patients from hospitals — actions that have been criticized for potentially fueling the spread of the virus.
Prosecutors said the fact-finding letters also sent to New Jersey, Pennsylvania and Michigan were aimed at determining whether the orders “may have resulted in the deaths of thousands of elderly nursing home residents.”
“We must ensure they are adequately cared for with dignity and respect and not unnecessarily put at risk,” said Eric Dreiband, assistant attorney general in the Justice Department’s civil-rights division.
Cuomo’s March 25 order, for example, specifically told homes they could not refuse to accept recovering covid-19 patients as long as the patients were “medically stable.” The order barred homes from even testing such patients to see if they still had the virus. Some homes said they feared they would lose their licenses if they didn’t comply.
Cuomo, who said he was following guidelines from the CDC, reversed the order under pressure May 10, long after New York’s death toll in care homes had climbed to among the nation’s highest.
In its statement announcing its request for data, the Justice Department said hospital patients were sent “often without adequate testing” to ensure they would not spread the virus to residents. It also cited federal data showing New York, with nearly 32,600 dead, leads the nation in covid-19 deaths, and is second only to New Jersey in the number of deaths relative to population.
The Justice Department’s civil-rights division said it is evaluating whether to initiate investigations under a federal law called the Civil Rights of Institutionalized Persons Act that protects the rights of people in state-run nursing homes and other facilities.
The news was welcomed by Republican lawmakers, including Rep. Steve Scalise of Louisiana, who is pursuing a congressional inquiry into Cuomo’s handling of nursing homes.
Scalise called Wednesday’s announcement “the right step toward holding Gov. Cuomo and other Democratic governors accountable for issuing deadly ‘must admit’ orders at nursing homes.”
“These orders resulted in the deaths of tens of thousands of nursing home patients,” he said. “Our nation’s seniors and their loved ones deserve better.”
TRAVEL RESTRICTIONS EASED
Elsewhere, Germany will end mandatory coronavirus tests for travelers returning from high-risk areas abroad and again focus its testing strategy on people with symptoms or possible exposure to covid-19 patients, the country’s health minister said Wednesday.
Travelers returning from high-risk areas, which include most countries outside the European Union and some regions inside the bloc, will in the future be required to go into mandatory quarantine for at least five days before taking a test, which may no longer be free unless ordered by a doctor.
In Russia, the mayor of Moscow on Wednesday invited residents to join trials of a coronavirus vaccine that the nation approved for use earlier this month, in what officials described as a breakthrough on par with the Soviet Union’s launch of the world’s first satellite in 1957.
The world’s first vaccine against the coronavirus to receive a government go-ahead has caused unease among international medical experts, who called Russia’s fasttracked approval and failure to share any data supporting claims of the vaccine’s efficacy a major breach of scientific protocol.
Scientists around the world say any widely used vaccine should be tested in advanced trials involving tens of thousands of people to prove it is safe and effective before being licensed.
Information for this article was contributed by Emma Court and Jacquie Lee of Bloomberg News; and by Mike Stobbe, Bernard Condon, Ricardo Alonso-Zaldivar, Michael Hill, Michelle R. Smith, Michael Balsamo, Jim Mustian, Marina Villeneuve, David Eggert, Mike Cataliniand, Kirsten Grieshaber, Frank Jordans, Vladimir Isachenkov and Carla K. Johnson of The Associated Press.