Oregon’s Coronavirus Testing Guidance Now Weaker Than Trump Administration's
The Oregon Health Authority on Friday would not commit to recommending that anyone exposed through close contact to COVID-19 should be tested, regardless of symptoms, leaving the state with weaker testing guidance than issued by the Trump administration.
The state’s reluctance to encourage testing for exposed but asymptomatic people came as the Centers for Disease Control and Prevention adopted that guidance after facing weeks of pressure.
Federal and Oregon officials have long said people exposed and who have symptoms should be tested. But the CDC last month indicated testing for exposed people without symptoms could be optional, setting off a political firestorm.
Federal officials changed course Friday and made clear that anyone who is within close contact of COVID-19 should be screened, even if they lack symptoms.
“You need a test,” the CDC wrote on its website, under a section about what someone without symptoms should do if they had spent at least 15 minutes within six feet of a person with a confirmed case of COVID-19.
Oregon public health officials said Friday they aren’t ready to match that recommendation. It matters because medical professionals often rely on the state’s testing guidance when deciding who should be tested – and studies have found half of people with infections may not have, or may not yet have developed, symptoms. Oregon’s murky testing guidelines have previously caused confusion about testing for people without symptoms.
Dr. Tom Jeanne, the deputy state epidemiologist and deputy state health officer, said in a statement that officials will evaluate what impact CDC’s guidance has for testing in Oregon.
But Jeanne defended the state’s approach, which allows for – but does not explicitly recommend – testing people without symptoms following COVID-19 exposure.
“We believe that within the parameters of our current guidance there is ample room for health care providers to make individual choices about testing asymptomatic people based on exposure as well as other risk factors,” Jeanne said.
Oregon’s desire to maintain ambiguous testing guidance is apparently tied to concerns over testing availability. If the state explicitly recommended testing for everyone who has been exposed through close contact, regardless of symptoms, officials seemingly are concerned about a run on tests.
Oregon has one of the lowest per capita testing rates in the country and has never surpassed 41,500 tests in a given week. Tests had topped 30,000 each week since mid-June but officials are expecting a dramatic drop off because of recent wildfires.
“We continue to need to weigh expanding testing guidance to include more people against the current limitations on supplies and the need to test in particular communities or demographic groups at greater risk for COVID-19 and adverse health outcomes,” Jeanne said.
Oregon’s screening guidance now recommends “viral testing for all people with new symptoms consistent with COVID-19, regardless of severity.”
But for people without symptoms, the state “recommends that testing … be limited” to only certain groups. Among those groups are close contacts of confirmed or presumptive cases, people exposed in congregate living settings and people of color.
But while that guidance may seem clear, it does not explicitly say that testing is recommended and the ambiguity has created confusion before.
As an example, a Latino couple in June attempted to seek testing but was repeatedly turned away by health care providers, prompting calls for clearer state guidance. In response to that incident, state officials provided contradictory statements about whether testing for people without symptoms should be available.
Nationally, when the CDC changed its testing recommendations in August, doctors and public health officials expressed concern. The agency’s online guidance morphed from “testing is recommended for all close contacts” to close contacts “do not necessarily need a test” if they lack symptoms.
The Oregon Health Authority didn’t balk at the revision.
“We don’t expect much of an impact because the CDC’s new guidance about asymptomatic testing is consistent with our current guidance,” a spokeswoman said at the time.
But the CDC change has been heavily scrutinized by the national media. This week The New York Times reported that the CDC’s less aggressive testing language was not written by scientists and was posted to the agency’s website despite their objections.
Given the weeks-long consternation over the federal advice, how do Oregon health officials feel to now have less aggressive guidance?
“We are evaluating this new change and will adjust our guidance as appropriate, given the broader context of capacity and the situation in Oregon,” Jeanne said. “We always review CDC guidance to determine how to adopt or adapt it to ensure it meets the unique health needs of Oregonians.”
-- Brad Schmidt; [email protected]; 503-294-7628; @_brad_schmidt
This story was originally published by The Oregonian/OregonLive and is posted here through an agreement among a dozen Oregon media outlets to share coronavirus content.
Sep 21 2020