在数周鼓励人们在可能接触过新冠肺炎的情况下接受检测后，疾病控制和预防中心本周突然改变了方针，现在告诉公众检测可能没有必要。
指导意见的改变虽然是自愿的，但可能会大幅减少在美国进行的检测次数。目前，公共卫生官员表示，他们非常担心没有症状的年轻人会传播病毒。
医疗专业人士和公共卫生专家迅速予以回击，称这一举动令人困惑且危险，因为它会在流感季节到来之前降低该国对该病毒的关注度。
一位白宫冠状病毒工作小组的工作人员告诉美国广播公司首席新闻记者乔纳森·卡尔:“战壕里的人们对此感到震惊。”“它给人的印象是无症状的人不能传播疾病，这是不正确的。社区传播是由无症状的人推动的。”
特朗普政府的测试协调员布雷特·吉尔洛上将为此举辩护，称此举是为了防止一些人在测试结果呈阴性后产生“虚假的安全感”。
在周三与记者的通话中，吉尔洛也断然否认与该决定有任何政治牵连。他说，新的检测指南来自疾病预防控制中心，没有唐纳德·特朗普总统的干预或指导。
Giroir说:“让我告诉你，就在前面，新的指导方针是疾控中心的行动。”
他指的是美国副总统迈克·彭斯和卫生与公众服务部部长。他说:“特朗普总统、副总统或部长都没有指示我们需要在什么时候做什么。”Alex Azar。当记者追问他这一变化时，吉尔洛继续说道:“这是基于证据的决定，是由科学家和医生推动的，无论是在疾控中心内部，还是在我的实验室工作小组办公室内，当然也包括工作小组成员。”
亚历克斯·王/盖蒂图像，文件
2020年7月8日，华盛顿，助理卫生部长布雷特·吉尔洛上将在冠状病毒特别工作组新闻发布会上发言。
这一新的指导方针与疾病预防控制中心主任罗伯特·雷德菲尔德上个月告诉美国广播公司的内容直接矛盾:“任何认为自己可能被感染的人——不管症状如何——都应该接受检测。”
雷德菲尔德发表上述言论之际，美国的病例数量正在上升，卫生官员担心，参加抗议和竞选集会、派对和酒吧的年轻人正在推动这种传播。此后，他拒绝置评或确认他支持新指南;疾控中心已将所有问题提交给HHS。
理查德·贝瑟在2009年担任疾控中心代理主任，他告诉美国广播公司新闻，该机构应该“站在最前面”解释这一变化的科学原理。贝瑟说，他认为这些变化来自HHS，而不是疾控中心。
贝瑟说:“鉴于大量的感染者不会出现症状，因此对接触过病毒的人进行检测是至关重要的。”“在信任至关重要的时候，指南及其发布方式的这一变化将降低人们对我国公共卫生机构的信任。”
Giroir坚持认为这种改变的到来是因为在一个没有传播证据的地区进行测试没有多大好处。测试结果也只在当天有效。
“获得三天的阴性测试并不是完全没有意义，但已经非常接近了。它不应该给你自信，你会是消极的。它不应该给你一种虚假的安全感，你不应该从事危险的行为。”
他说，一个月内可能有20份指南草案，还有来自其他特别工作组医生的“大量编辑”，包括美国最高传染病专家安东尼·福奇博士;黛博拉·比克斯博士，白宫冠状病毒协调员;斯蒂芬·哈恩，美国食品和药物管理局局长;和总统的新顾问斯科特·阿特拉斯博士。
“我研究过它们。福西博士研究过它们。Birx博士研究过它们。哈恩博士研究过它们。阿特拉斯博士提供了投入。所以，现在很难知道一个人写了多少，但这是疾控中心的产品，需要大量的编辑。大量的投入可能需要大约一个月的时间。”
Giroir指出，在政治领导人看到之前，“我们都在文件上签了名。”
不过，福西说，他并没有亲自签署新的指南。这些修改在8月20日的特别工作组会议上获得批准——同一天，福西正在接受手术的全身麻醉，以摘除声带息肉。
纽约州长安德鲁·科莫周三在与记者的电话会议上说，美国疾病控制与预防中心的转变“令人难以置信。”
库莫说:“唯一合理的理由是，他们希望参加考试的人少一些。”
亚历克斯·布兰登/美联社
2020年8月14日，华盛顿特区卫生部的一名护士在华盛顿的F街进行新冠肺炎测试。
白宫和疾病预防控制中心没有回答关于这一变化的问题，这一变化是本周在疾病预防控制中心网站上悄悄提出的。问题被提交给了吉尔洛和疾病预防控制中心的上级机构——由阿扎尔管理的卫生与公众服务部，阿扎尔作为内阁秘书直接向特朗普汇报。
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特朗普曾表示，他认为美国进行了太多的测试，并错误地声称测试是导致美国病例激增的原因。去年6月，特朗普在俄克拉荷马州塔尔萨市对支持者表示:“当你进行到那个程度的测试时，你会发现更多的人，你会发现更多的病例。”所以我对我的人说，“请放慢测试速度。”"
凯文·迪特施/泳池/法新社
(档案)在这张档案照片中，疾病控制和预防中心(疾控中心)主任罗伯特·雷德菲尔德，在2020年7月31日DC国会山举行的众议院冠状病毒危机小组委员会听证会上，就遏制新冠肺炎大流行的国家计划发表了讲话。——美国卫生当局于2020年8月4日警告说，一种罕见的神经系统疾病可能会在未来几周和几个月内爆发，这种疾病主要影响儿童，每两年就会神秘地复发。
纽约市卫生部的一名女发言人告诉美国广播公司新闻，纽约市不会改变其检测政策:“我们在没有任何联邦政府支持的情况下，拼命争取扩大检测范围，我们不会在短期内放缓速度!”
宽松的指导方针有可能为其他传播广泛的州提供掩护。尽管疾控中心的指导方针是自愿的，但许多地方官员利用这些指导方针坚持要求人们离开教室或工作岗位，等待检测结果。新的规定可以被用来允许人们，比如老师，即使在已知的暴露之后，仍然留在教室里。
在新指南疾病预防控制中心说，只要一个人没有表现出症状，测试就没有必要。
疾控中心现在说:“你不一定需要测试，除非你是一个脆弱的个人或你的医疗保健提供者或国家或地方公共卫生官员建议你采取一个。”
去年6月，福奇和吉尔洛告诉国会，特朗普从未要求他们减缓测试工作。Giroir当时说他正朝着相反的方向前进。
6月23日，吉尔洛对一个众议院委员会说:“我领导的目的是增加测试的次数。”“我们能够了解谁感染了这种疾病，谁被感染了，谁能够传播这种疾病，以及进行接触者追踪的唯一方法，就是尽可能适当、灵活地进行测试。”
这一悄然的变化正值人们质疑政治是否已经渗透到公共卫生指南中。
亚历克斯·布兰登/美联社
2020年8月23日，华盛顿，美国食品和药物管理局局长斯蒂芬·哈恩在白宫詹姆斯·布雷迪简报室听取媒体简报时，唐纳德·特朗普总统在讲话。
本周，美国食品和药物管理局局长斯蒂芬·哈恩承认他夸大了恢复期血浆的益处。唐纳德·特朗普(Donald Trump)总统在他身边，他宣布授权这项治疗——这让一些研究人员感到沮丧，他们说，他们希望继续进行安慰剂对照临床试验，看看是否有效。
特朗普后来吹嘘说，他让食品和药物管理局采取了行动，尽管该机构坚持认为政治并没有影响其决定。
周三，哈恩说他想在疫苗试验之前努力建立公众的信任。
他周三在推特上写道:“我们FDA认识到我们必须建立公众信任，以便对未来关于#COVID19疫苗的决定有信心。”“当我看到公众调查显示许多人会拒绝接种疫苗时，我很担心。”
In stunning reversal, CDC abruptly changes position on when to get tested
After weeks of encouraging people to get tested if they may have been exposed to COVID-19, the Centers for Disease Control and Prevention abruptly changed course this week and is now telling the public testing might not be necessary.
The change in guidance, while voluntary, could dramatically decrease the number of tests conducted in the U.S. at a time when public health officials have said they are seriously concerned about young people without symptoms transmitting the virus.
Medical professionals and public health experts swiftly pushed back, calling the move baffling and dangerous because it would reduce the country's visibility on the virus ahead of flu season.
"The people in the trenches are horrified by this," a person who works with the White House coronavirus task force told ABC News Chief White House Correspondent Jonathan Karl. "It gives the impression that asymptomatic people cannot transmit the disease, which is not true. Community spread is driven by asymptomatic people."
The Trump administration's testing coordinator, Adm. Brett Giroir, defended the move as trying to prevent a "false sense of security" that some people have after getting a negative test result.
On a call with reporters Wednesday, Giroir also flatly denied any political involvement in the decision. He said the new testing guidelines came from the CDC with no intervention or direction from President Donald Trump.
"Let me tell you, right up front that the new guidelines are a CDC action," Giroir said.
"There is no direction from President Trump, the vice president or the secretary, about what we need to do, when," he said, referring to Vice President Mike Pence and Health and Human Services SecretaryAlex Azar. "This is evidence-based decisions that are driven by the scientists and physicians, both within the CDC, within my office in the lab task force, and certainly amongst the task force members," Giroir continued, as reporters grilled him on the change.
Admiral Brett Giroir, Assistant Secretary for Health, speaks during a Coronavirus Task Force press briefing in Washington, July 8, 2020.
The new guidance directly contradicts what CDC Director Robert Redfield told ABC News last month: "Anyone who thinks they may be infected -- independent of symptoms -- should get a test."
Redfield's comments came as case numbers in the U.S. were on the rise and health officials worried that younger people -- attending protests and campaign rallies, as well as parties and bars -- were driving the transmission. He has since declined to comment or confirm that he supports the new guidance; the CDC has referred all questions to HHS.
Richard Besser, who served as acting CDC director in 2009, told ABC News that the agency should be "out in front" on explaining the scientific rationale for the change. Besser said he believes the changes are coming from HHS and not CDC.
"Given that a larger number of people who get infected will not have symptoms, it is essential that people who have been exposed are tested," Besser said. "This change in guidance and the way it was released will decrease trust in our nation's public health agency at a time when trust is essential."
Giroir insisted the change comes because it doesn't do much good to have tests done in an area where there is no evidence of spread. A test result also is only valid for the day it's taken.
"Getting a negative test that three days is not totally meaningless, but pretty close to it. It should not give you a self assurance that you will be negative. It should not give you a false sense of security, you should not engage in risky behavior," Giroir said.
He said there were probably 20 drafts of the guidelines in a month and "lots of editing" from other task force doctors, including Dr. Anthony Fauci, the nation's top infectious disease expert; Dr. Deborah Birx, the White House coordinator on coronavirus; Stephen Hahn, head of the U.S. Food and Drug Administration; and Dr. Scott Atlas, a new adviser to the president.
"I worked on them. Dr. Fauci worked on them. Dr. Birx worked on them. Dr. Hahn worked on them. Dr. Atlas provided input. So, it's kind of hard to know how much was written by one person at this time, but it was a CDC product with lots of editing. Lots of input probably over about a month period of time," Giroir said.
At one point, Giroir noted "we all signed off on it, the docs" before political leaders saw it.
Fauci, though, said he did not personally sign off on the new guidance. The revisions were approved during a task force meeting on Aug. 20 -- the same day Fauci was under general anesthesia for surgery to remove a polyp from his vocal cords.
New York Governor Andrew Cuomo said Wednesday on a conference call with reporters that the reversal from the CDC "strains credulity."
"The only plausible rationale is they want fewer people taking tests," said Cuomo.
A nurse with the Washington, D.C. Dept. of Health, administers a COVID-19 test on F Street, Aug. 14, 2020, in Washington.
The White House and CDC did not answer questions about the change, which was made quietly on the CDC website this week. Questions were referred to Giroir and CDC's parent agency, the Department of Health and Human Services, which is run by Azar, who as a Cabinet secretary reports directly to Trump.
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Trump has said he thinks the U.S. conducts too many tests and falsely claimed that testing is what has caused a surge in cases in the U.S. Last June, Trump told supporters in Tulsa, Oklahoma: "When you do testing to that extent, you're going to find more people, you're going to find more cases. So I said to my people, 'Slow the testing down, please.'"
(FILES) In this file photo Robert Redfield, director of the Centers for Disease Control and Prevention (CDC), speaks during a House Subcommittee on the Coronavirus Crisis hearing on a national plan to contain the COVID-19 pandemic, on Capitol Hill in Washington, DC on July 31, 2020. - A rare neurological condition that mostly affects children and mysteriously returns every two years is likely to flare up in the coming weeks and months, US health authorities warned on August 4, 2020.
A spokeswoman for the New York City Health Department told ABC News the city would make no change to its testing policies: "We've fought like hell to expand testing without any federal support and we're not slowing down any time soon!"
It's possible that the relaxed guidance will lend cover to other states seeing widespread transmission. While CDC guidelines are voluntary, many local officials use them to insist on people removing themselves from classrooms or work to await testing results. The new rules could be used to allow people, such as teachers, to remain in classrooms even after a known exposure.
Innew guidancedated Aug. 24, CDC says that so long as a person doesn't show symptoms testing not necessary.
"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 CDC now states.
Fauci and Giroir told Congress last June that Trump had never asked them to slow down testing efforts. Giroir at the time said he was proceeding in the opposite direction.
"My purpose in leading is to increase the number of testing," Giroir told a House committee on June 23. "The only way we will be able to understand who has the disease, who is infected and can pass it, and to contact tracing, is to test appropriately, smartly, and as many as we can."
The quiet change comes amid questions on whether politics has leaked into public health guidance.
President Donald Trump speaks as Stephen Hahn, FDA commissioner, listens during a media briefing in the James Brady Briefing Room of the White House, Aug. 23, 2020, in Washington.
This week, the head of the U.S. Food and Drug Administration, Stephen Hahn, acknowledged that he overstated the benefits of convalescent plasma. With President Donald Trump at his side, he announced he was authorizing the treatment -- frustrating some researchers who say they wanted to continue to conduct placebo-controlled clinical trials to see if it worked.
Trump later bragged that he got the FDA to act, despite the agency's insistence that politics hadn't influenced its decision.
On Wednesday, Hahn said he wanted to work on building trust with the public ahead of the vaccine trial.
"We at FDA recognize that we must build public trust so there is confidence in future decisions about vaccines for #COVID19," he tweeted Wednesday. "I am concerned when I see public surveys that many people will decline taking a vaccine."
