Health Care

Overnight Health Care: CDC testing guidance change was approved by White House task force | CDC says asymptomatic people don’t need testing, draws criticism from experts | No coronavirus response deal until late September? Meadows not optimistic

Welcome to Wednesday’s Overnight Health Care. 

The CDC changed its testing guidelines about asymptomatic people, and faced swift backlash. The Trump administration’s testing “czar” said it was a CDC decision, while reports indicate it was forced on the agency. Meanwhile, White House chief of staff Mark Meadows says he’s not optimistic about a quick end to the stalemate with the House on a coronavirus package deal. 

Let’s start with the CDC: 

CDC testing guidance change was approved by White House task force

The Trump administration’s coronavirus testing coordinator on Wednesday denied that officials at the Centers for Disease Control and Prevention were pressured into narrowing its guidelines about who should be tested.

Adm. Brett Giroir told reporters the updated guidelines were a collaborative product and were approved by the entire task force, but they ultimately belong to the CDC and the agency’s director, Robert Redfield.

“Let me tell you right up front that the new guidelines are a CDC action,” Giroir said. “As always, guidelines received appropriate attention, consultation and input from [White House coronavirus] task force experts, and I mean the medical and scientific experts including CDC Director Redfield.”

Giroir added there was high level input from multiple people, including Anthony Fauci, director of the National Institutes of Health’s National Institute of Allergy and Infectious Diseases, as well as task force coordinator Deborah Birx, and Scott Atlas.

Atlas is a recent addition to the task force. A physician and fellow at Stanford University’s conservative Hoover Institution, he believes concern over COID-19 spikes is “fearmongering,” and has publicly called for fewer COVID-19 tests. He is not an epidemiologist. 

Timing: The guidelines were posted on Monday. Giroir said the task force approved them last Thursday. Something else that happened last Thursday: Fauci was undergoing surgery to remove a polyp on his vocal chords, and was under general anesthesia at the time. 

Pressure: According to multiple reports, top political officials forced the CDC to make the change. The New York Times reported that the CDC did not write the guidance, but it was forced on the agency. President Trump has long said he thinks the U.S. conducts too many tests, and the high numbers of positive COVID-19 cases those tests discover make him look bad.

Read more here.

So what did CDC change?

CDC says asymptomatic people don’t need testing, draws criticism from experts

CDC guidance now says that asymptomatic people do not need to be tested for coronavirus, even if they have been in close contact with an infected person.

The agency made the move by updating its website but did not make any public announcement or explain the reasoning behind the major revision. 

The guidance now states: “If you have been in close contact (within 6 feet) of a person with a COVID-19 infection for at least 15 minutes but do not have symptoms: 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.”

That is a stark change from the previous CDC guidance, which emphasized the importance of testing people who were in close contact with infected people.

Asymptomatic people are the ones most likely to spread COVID-19, so testing to identify asymptomatic people with the virus is important. The change drew criticism and confusion from public health experts.

Carl Bergstrom, a professor of biology at the University of Washington: “The most recent guidelines seem to give up any pretense of using contact tracing to control COVID. The whole point of contact tracing is to find asymptomatic contacts of known cases and isolate them. If you aren’t even going to test them? Certainly no point in tracing.”

Angela Rasmussen, a virologist at Columbia University: “Now what the hell kind of CDC recommendation is this? We need to be doing MORE testing, not less.”

Read more here.

No coronavirus response deal until late September? Meadows not optimistic

White House chief of staff Mark Meadows on Wednesday warned he did not expect a quick breakthrough on stalled coronavirus relief talks, floating the possibility that they could drag into an end-of-September government funding fight.

Meadows, during a live interview with Politico, said he hadn’t had any recent conversations with Speaker Nancy Pelosi (D-Calif.), beyond his staff reaching out to her staff on Tuesday.

“I don’t anticipate that we’ll actually get a phone call,” he said.

Meadows added that he’s had “very productive conversations” with House and Senate Democrats, who he argued wanted a deal, but that he didn’t expect an agreement in the immediate future.

“I’m not optimistic. I think the Speaker is going to hold out until the end of September and try to get what she wants in the funding for the government during the [continuing resolution],” Meadows said.

Read more here.  

COVID-19 vaccine candidate shows promising results in older patients

A coronavirus vaccine candidate has shown signs of promise in older adults during an early stage clinical trial. 

Using participants aged 56 and older, Moderna’s experimental vaccine produced neutralizing antibodies which are believed to build immunity against the virus, the biotech company announced Wednesday.

Older adults, particularly those 60 and older, are at highest risk for serious illness or death if infected with COVID-19. 

While the vaccine produced side effects in some participants, including fatigue, fever and chills, it was well-tolerated across all age groups, and symptoms were resolved within two days.

Results for the phase three trial — which will determine whether the vaccine is safe and effective in 30,000 healthy people — are expected in the fall. The vaccine will have to protect at least 50 percent of the people to be deemed effective.

Read more here.

DOJ asks governors about coronavirus orders that may have resulted in nursing home deaths

The Justice Department (DOJ) on Wednesday requested data from four governors on their orders requiring nursing homes to admit coronavirus patients.

“Protecting the rights of some of society’s most vulnerable members, including elderly nursing home residents, is one of our country’s most important obligations,” Assistant Attorney General for Civil Rights Division Eric Dreiband said in a statement.

“We must ensure they are adequately cared for with dignity and respect and not unnecessarily put at risk,” he added. 

The department requested data from Govs. Andrew Cuomo (D) of New York, Phil Murphy (D) of New Jersey, Tom Wolf (D) of Pennsylvania and Gretchen Whitmer (D) of Michigan.

Political concerns: Nursing homes continue to be devastated by COVID-19 outbreaks, and the decisions made by some governors early in the pandemic have been scrutinized by nursing home advocates. But the focus on Democratic-led states is raising concerns that the DOJ is not interested in investigating and finding solutions, and only wants to score political points for President Trump and Republicans.

Cuomo and Whitmer both pushed back on the DOJ’s request, calling it a “nakedly partisan deflection” announced during the Republican National Convention.

Republicans and advocates have frequently blasted Cuomo’s response to the virus in particular, but in their criticisms, Republicans have glossed over the Trump administration’s role in the nearly 180,000 deaths. 

Read more here.

What we’re reading: 

How Obamacare helped millions who lost their jobs during COVID-19, in 3 charts (Vox.com

Why does the coronavirus hit men harder? A new clue (The New York Times)

Veteran’s appendectomy launches excruciating months-long battle over bill (Kaiser Health News)

State by state

Coronavirus outbreak at Maine nursing home and jail linked back to wedding reception (CNN

Cuomo rips into CDC as Trump’s political tool, says New York won’t follow new virus guidance (CNBC

How L.A. doctors plan to include more people of color in COVID-19 vaccine trial (Los Angeles Times

Op-eds in The Hill

Transforming our food culture — a matter of life and death