C.D.C. Now Says People Without Covid-19 Symptoms Do Not Need Testing


The newest version, which was posted on Monday, amended the agency’s guidance to say that people who have been in close contact with an infected individual — typically defined as being within six feet of a person with the coronavirus and for at least 15 minutes — “do not necessarily need a test” if they do not have symptoms. Exceptions, the agency noted, might be made for “vulnerable” individuals, or if health care providers or state or local public health officials recommend testing.

“Wow, that is a walk-back,” Dr. Butler-Wu said. “We’re in the middle of a pandemic, and that’s a really big change.”

Dr. Butler-Wu said she was concerned that the guidelines would be misinterpreted as implying that people without symptoms were unable to pass the coronavirus on to others — a falsehood that experts had been trying for months to dispel. “If people are getting exposed, and they’re not getting tested, and they’re not isolating, that’s a huge problem,” Dr. Kuppalli said.

By the C.D.C.’s own estimates, roughly 40 percent of people infected with the coronavirus may never go on to develop symptoms, remaining asymptomatic for the duration of their tenure with the virus. These numbers are tentative — and ironically can’t be confirmed without more testing of people who appear entirely healthy.

Although researchers remain unsure how often asymptomatic people unwittingly transmit the coronavirus, studies have shown that the silently infected can carry the virus in high amounts. The evidence is more clear-cut for pre-symptomatic people, in whom virus levels tend to peak just before illness sets in — a period when these individuals might be mingling with their peers, seeding superspreader events. Notably, experts can’t distinguish asymptomatic people from those who are pre-symptomatic until symptoms do or don’t appear.

“It seems backward to just ignore pre-symptomatic patients,” Dr. Butler-Wu said.

David Piegaro, who lives in Trenton, N.J., had sought out several tests for the coronavirus in recent months, after events like funerals and those that require travel because of his post in the national guard. He never experienced symptoms, and his tests have all been negative, bringing him peace of mind, especially because he lives with his parents and grandfather. “I viewed testing as a good thing to do,” he said. “Asymptomatic people could be spreading the virus, so widespread testing seems valuable.”

Tracking asymptomatic cases is also important from the perspective of the infected, Dr. Kuppalli said. Less than a year into this pandemic, experts still don’t know the full extent of the long-term consequences of contracting the coronavirus, even if the initial encounter seems benign.


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