Editorial: Retargeting testing: Political or practical?

The Centers for Disease Control and Prevention has quietly revised testing guidelines for COVID-19.

Regarding people who have come into contact with an infected person, the recommendations now read: “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 move has kicked off a political firestorm.

Democratic leaders allege that the White House is deliberately steering people away from taking tests, pointing to President Donald Trump’s public comments about the link between the country’s high case count and high rates of testing. Numerous public health officials have denounced or questioned the change, including Dr. Anthony Fauci, the nation’s top infectious disease expert.

Meanwhile, officials at the CDC and Health and Human Services say the move is intended to allow testing to target the most vulnerable populations, where lagging testing has hindered effective containment efforts.

The CDC has reversed and updated policy throughout the pandemic, but there’s a feeling of foul play this time given the president’s recent fulminations.

Still, let’s take a step back.

First, the new guidance does not discourage or prevent those exposed to the coronavirus from seeking a test. It merely downplays the urgency of doing so in favor of focusing testing on more at-risk individuals.

Second, the CDC released a study in July suggesting that the actual number of coronavirus cases could be anywhere from six to 24 times higher than current testing reveals.

The U.S. is laughably shorthanded in terms of testing capacity. Targeting its limited resources toward more vulnerable populations, such as nursing homes and health care workers and school teachers, is a reasonable proposal.

If testing was coming anywhere close to keeping up with current numbers the shift would indeed seem nefarious. But it’s not. The U.S. has been testing between 600,000 and 800,000 people per day in recent weeks, with a steadily falling positivity rate, currently down to about 6%. Some experts suggest that the country would need to test 4 million people per day to actually keep up with the rate of transmission.

Of course the country should be worried about asymptomatic individuals spreading the virus unknowingly. Some officials argue that asymptomatic people who test negative could still be positive and transmit the virus depending on how soon after exposure they are tested.

The CDC and HHS are continuing to emphasize masking and social distancing and hand-washing — and self-quarantining in the case of exposure.

Democratic Gov. Andrew Cuomo of New York sums up the more conspiratorial take: “The only plausible rationale is that they want fewer people taking tests, because as the president has said, if we don’t take tests, you won’t know the number of people who are COVID-positive.”

His assertion isn’t entirely unfounded, but it ignores plausible reasons for the shift. The fact remains, there isn’t enough testing in the country to keep up with the spread of the virus. Until there is, it is not unreasonable to prioritize testing for high-risk individuals.