CDC *boggling*

[magnus]

the CDC changed their testing guidelines for close contacts of known cases on Monday.

From get tested,  to maybe not. 

https://www.cdc.gov/coronavirus/2019-nco...rview.html

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.
  
  • A negative test does not mean you will not develop an infection from the close contact or contract an infection at a later time.
    
• You should monitor yourself for symptoms. If you develop symptoms, you should evaluate yourself under the considerations set forth above.
  
• You should strictly adhere to CDC mitigation protocols, especially if you are interacting with a vulnerable individual. You should adhere to CDC guidelines to protect vulnerable individuals with whom you live.
  

What is the motivation behind this change? This was kind of the recommendation early on when our testing was overwhelmed but i haven't heard as much pub about long wait times for results recently.

This does not seem to be a change that will help prevent asymptomatic spread.

[magnus]

CNN is quoting an inside source that says it's from pressure in the White House. 

https://www.cnn.com/2020/08/26/politics/...index.html

[Goose]

the CDC changed their testing guidelines for close contacts of known cases on Monday.

From get tested,  to maybe not. 

https://www.cdc.gov/coronavirus/2019-nco...rview.html

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.
  
  • A negative test does not mean you will not develop an infection from the close contact or contract an infection at a later time.
    
• You should monitor yourself for symptoms. If you develop symptoms, you should evaluate yourself under the considerations set forth above.
  
• You should strictly adhere to CDC mitigation protocols, especially if you are interacting with a vulnerable individual. You should adhere to CDC guidelines to protect vulnerable individuals with whom you live.
  

What is the motivation behind this change? This was kind of the recommendation early on when our testing was overwhelmed but i haven't heard as much pub about long wait times for results recently.

This does not seem to be a change that will help prevent asymptomatic spread.

If you have been in close contact with a person who test positive for COVID-19, you are supposed to quarantine in any case, so spread of any kind should be minimal (quarantine is not isolate, so you may spread it to people you are in quarantine with). You and your "family" are not supposed to interact with others until your quarantine is up. The "problem" with immediate testing is that if you come up negative at the time of test, you could become positive (and asymptomatic/symptomatic) at any time during your quarantine. It isn't going to matter much in that case.

Testing close contacts who are asymptomatic helps if they show up positive right away. Then, they must isolate (instead of quarantine) and their contacts also must also be traced. I guess the CDC has decided the probability of that happening is low enough it just isn't worth doing. It may also be because so few people actually quarantine/isolate if they are asymptomatic (independent of their test status) it just doesn't matter. If so, that is a big ouch.

[dabigv13]

I guess the White House has decided the probability of that happening is low enough it just isn't worth doing. It may also be because so few people actually quarantine/isolate if they are asymptomatic (independent of their test status) it just doesn't matter. If so, that is a big ouch.

Fixed it for you. Good thing Trump has such a big brain he knows about all this stuff.

[OutsiderFan]

No health experts will be guided by these new guidelines.  

Everyone with a functioning brain knows more testing leads to reduced virus spread and less testing leads to more virus spread.

[Goose]

No health experts will be guided by these new guidelines.  

Everyone with a functioning brain knows more testing leads to reduced virus spread and less testing leads to more virus spread.

Unless the asymptomatic people who test positive behave as if they don't have a functioning brain.

[dabigv13]

No health experts will be guided by these new guidelines.  

Everyone with a functioning brain knows more testing leads to reduced virus spread and less testing leads to more virus spread.

CDC guidance matters. Hospitals, schools, workplaces will be using these guidelines.

[OutsiderFan]

No health experts will be guided by these new guidelines.  

Everyone with a functioning brain knows more testing leads to reduced virus spread and less testing leads to more virus spread.

CDC guidance matters. Hospitals, schools, workplaces will be using these guidelines.

Well then, prepare for a mass explosion of virus spread in a few weeks.

[Goose]

No health experts will be guided by these new guidelines.  

Everyone with a functioning brain knows more testing leads to reduced virus spread and less testing leads to more virus spread.

CDC guidance matters. Hospitals, schools, workplaces will be using these guidelines.

Well then, prepare for a mass explosion of virus spread in a few weeks.

OF, why do you believe that? IF all close contacts are in quarantine anyway, it will have minimal effect at most. If OTOH the close contact has chosen to disregard the necessity to quarantine, why do you believe a positive test (although he feels fine) will change his behavior? Couple that with the fact the contact may not yet test positive because the incubation period is not yet up and you probably don't have a "mass" anything. In fact, a negative test may cause somebody who actually was quarantining to decide "Screw it, I tested negative, I feel fine, I am going to work", even though two days later they are still asymptomatic but shedding virus like mad.

I have no idea why the CDC changed their recommendations. Obviously, some believe it is political influence. That is what makes Trump's behavior so reprehensible. If the CDC is doing it for political reasons, that is bad, and if people believe it is being done for political reasons, even though it is not. that is also bad. Unfortunately, because of Trump, we don't know.

[Genuine Realist]

CNN is quoting an inside source that says it's from pressure in the White House. 

https://www.cnn.com/2020/08/26/politics/...index.html

The usual 'anonymous source'? Meaningless.

[oregontim]

One very real underlying problem here is that the all-about-me president has so thoroughly politicized and personalized federal institutions that we don’t trust the CDC and FDA. Whether or not he actually influenced their decisions, we all know he wanted to, and could have; so the trust is lost. We are left hanging in the wind, wondering what to believe. 

[Goose]

One very real underlying problem here is that the all-about-me president has so thoroughly politicized and personalized federal institutions that we don’t trust the CDC and FDA. Whether or not he actually influenced their decisions, we all know he wanted to, and could have; so the trust is lost. We are left hanging in the wind, wondering what to believe. 

Totally agree. The idea that a POTUS would publicly let it be known what he wants his "honest broker" to do boggles the mind.

[oldalum]

more transparency about the evidence and reasoning supporting the change would help. Is there any valid reason for lack of transparency? (could it have to do with long wait times to get the results, due to an embarrassing shortage of testing capacity 6 months into the pandemic?) The lack of transparency lends credence to the "political influence" theory.

[Goose]

more transparency about the evidence and reasoning supporting the change would help. Is there any valid reason for lack of transparency? (could it have to do with long wait times to get the results, due to an embarrassing shortage of testing capacity 6 months into the pandemic?) The lack of transparency lends credence to the "political influence" theory.

FWIW, the FDA isn't the one responsible for the lack of testing. Not their job, even a little bit. Lack of transparency is the hallmark of the FDA. There are many reasons for this, some good, some not so good. However, asking the FDA for "transparency" is like asking a priest for transparency of the confessional.

[OutsiderFan]

I don't care what the CDC says, it is just pure logic that more testing identifies more cases of infection, which allows more to be isolated, which reduces spread.  And if that is the case, then less testing by definition increases spread.

And we also know this virus can't be kept under a lid. It spreads very easily when not properly contained or taken seriously. I saw a Dr. on ESPN yesterday saying he expects the virus to come back with ferocity in the Fall, when the weather gets cooler and people spend more time inside. Tracks with all the experts I've heard or read.

[Goose]

I don't care what the CDC says, it is just pure logic that more testing identifies more cases of infection, which allows more to be isolated, which reduces spread.

And it is also pure logic that if those cases are already quarantined it won't make much difference, period.

And if that is the case, then less testing by definition increases spread.

No OF, testing may increase knowledge. Not testing will not increase knowledge. Actions (or lack thereof) increase spread. There is some marginal knowledge to be gained from testing all close contacts as a matter of routine. However, those tests may increase delay in getting results of other tests. If the knowledge gained doesn't materially affect what actions will be taken, and the extra testing slows down results of more useful testing (i.e. people not in quarantine anyway), it may make sense to not do those tests. Pure logic.

For all you and I know the CDC has already looked at the numbers to date and the percent positive for asymptomatic contacts is so minuscule it is nugatory. I would hope they at least looked. This is not to say that asymptomatic spread isn't significant. However, it may be that finding it by testing contacts ASAP just isn't working.

[oldalum]

However, asking the FDA for "transparency" is like asking a priest for transparency of the confessional.

I was referring to the CDC, which I think ought to be transparent, and positing a possible explanation for the change in guidance that would explain a lack of transparency for the reason for the change.

[Goose]

However, asking the FDA for "transparency" is like asking a priest for transparency of the confessional.

I was referring to the CDC, which I think ought to be transparent, and positing a possible explanation for the change in guidance that would explain a lack of transparency for the reason for the change.

I totally agree the CDC should be transparent. I had convalescent plasma on the brain.

[oldalum]

 I had convalescent plasma on the brain.

An underestimated side effect, no doubt.

[fullmetal]

A. The recommendations are so out of touch with common sense that I hope no medical staff takes them seriously.

B. Anthony Fauci was under general anesthesia when these recommendations were discussed by the task force.  They literally waited til he was knocked out to push this through.
https://www.businessinsider.com/fauci-su...nes-2020-8