What happened: In a process that completely sidelined scientists at the Centers for Disease Control and Prevention (CDC), the White House’s Coronavirus Task Force and Department of Health and Human Services (HHS) changed the novel coronavirus testing guidelines on the CDC website to fall out of line with the best available science. The CDC website was changed by HHS officials to say that people without symptoms “do not necessarily need a test” for the novel coronavirus, even if they have been in close contact with someone who tested positive for the virus. Due to public outcry, the text was taken down by the CDC three weeks later and was revised to say that people should get tested when they’ve been in contact with an asymptomatic person.
Why it matters: All of us depend heavily on the CDC’s COVID-19 recommendations during the pandemic, from decisionmakers trying to slow the spread of the virus to ordinary people trying to keep themselves and their loved ones safe. When the CDC website is altered due to political considerations and over the objections of scientists, this not only promotes unscientific information but it erodes the public’s trust in science-based agencies right when we need agencies like the CDC to help protect people’s health and safety during the pandemic.
Political officials at the White House and the Department of Health and Human Services (HHS) developed a set of dangerous, unscientific testing recommendations for the novel coronavirus on the Centers for Disease Control and Prevention (CDC) website. The new recommendations stated that there was not necessarily a need to get tested for the novel coronavirus if you’ve been in contact with someone who was infected. The process to alter the website’s language thwarted the CDC’s normally strict scientific review process and a number of CDC scientists raised major concerns with the new text.
The revised testing guidelines, which were released with no public notice, say it is up to state and local public health officials and health providers to decide whether people without symptoms or underlying risk factors need a coronavirus test after high-risk situations — such as coming into contact with an infected person for more than 15 minutes. The changed guidelines also stated that it was up to local public health experts to decide whether testing was needed for people who attended a public or private gathering of more than ten individuals when masks were not worn and social-distancing guidelines were not followed.
Many scientists and public experts expressed alarm at the change, since people without symptoms (i.e. pre-symptomatic and asymptotic individuals) are believed to play a major role in spreading COVID-19 around the world. Dr. Anthony Fauci told CNN that “I'm worried it will give people the incorrect assumption that asymptomatic spread is not of great concern. In fact, it is.” Fauci also stated that he was not part of any deliberation on the issue. The White House Coronavirus Task Force had met to develop and approve this new guidance while Fauci was under anesthesia for vocal cord surgery.
Initially, administration officials tried to place sole responsibility on the CDC for altering the website’s text. For instance, Brett P. Giroir, the administration’s coronavirus testing czar, called it a “CDC action,” written with input from the agency’s director, Dr. Robert Redfield. But later on administration officials acknowledged that the idea came from the White House’s Coronavirus Task Force and involved a number of key HHS officials, including Giroir.
Three weeks later, the New York Times reviewed a set of internal documents and found that the new testing guidelines were not written by CDC scientists. Instead HHS officials had flouted the CDC’s strict scientific review process by “dropping” the text into the CDC website. Normally, the CDC’s process for reviewing potential recommendations involves 12 to 20 people within the agency and is considered a very detail-oriented and careful process. However, in the eight versions of the new guidance that were circulated within the agency, the objections raised by numerous CDC scientists were ignored. One staff scientist wrote in an email at the time, “We do not have the ability to make substantial edits.” Another CDC scientist, noting that the language of the recommendations fell out of line with how infectious disease experts talk about COVID-19, said that, “We just looked so sloppy. That’s what kills me is it didn’t come from the inside.”
The revised testing recommendation, which was posted on August 24, was changed back to the recommendations that are more in line with the scientific consensus on September 18. Instead of saying that people “do not necessarily need a test” after contact with asymptomatic people, the September recommendation on the CDC’s website now say “you need a test.”
This attempt to change CDC guidelines by political officials greatly undermined our response to the COVID-19 pandemic. It spread massive public confusion, undermined the message from public health officials for people to get tested, impeded contact tracing efforts, and may have led to more COVID-19 cases. Because of the White House and HHS’ actions, the public’s trust in the CDC’s public information on COVID-19 has now been damaged, which could have serious long-term consequences in whether people trust and follow future CDC recommendations.