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West Virginia health officers say people exposed to covid should still be tested, even without symptoms

Health officers in some of West Virginia’s largest counties aren’t buying the CDC’s controversial new guidance on coronavirus testing.

The Centers for Disease Control and Prevention earlier this week dropped a previous recommendation to test all those who have come in close contact with people with covid-19 — even those not experiencing symptoms.

Sherri Young

“My observation about the change is that it’s not scientifically based,” said Dr. Sherri Young, health officer for the Kanawha-Charleston Health Department.

“We have been working off of the premise that we do contact tracing, we find individuals that need to be tested even if they are asymptomatic — and it is a way for us to stamp out disease.”

Young said that approach won’t change in Kanawha County.

“We are going to continue to do what we’re doing,” she said. “We are going to continue to identify people who need to be tested. If they are asymptomatic we want to test them.”

Forty percent of people tested by the Kanawha-Charleston Health Department are asymptomatic, she said.

“We would miss that many people if we stopped testing the way they recommend,” Young said.

The CDC also has estimated that 40 percent of covid-19 infections are asymptomatic.

“Testing is the best tool we have right now,” Young said today on MetroNews’ “Talkline.”

“If you look at the science of covid, we need to see where it is, where it’s going. It’s an invisible enemy that we have to fight. And part of the time it is in asymptomatic people.”

Dr. Diane Gross, epidemiologist for the northeast region of West Virginia, agreed that continuing to test people who have been exposed to coronavirus even if they are not demonstrating symptoms remains the best strategy.

“The Monongalia County health department approach will not change,” Gross said in a telephone interview.

“I agree that currently people who are identified as close contacts of cases are in a higher risk than the general population of having covid, and we want to concentrate our effort in evaluating them to make sure that if they do become cases that they don’t have the chance to spread it on any further.”

Testing people even if they don’t have symptoms helps local health workers learn more about the spread of the virus, Gross said.

“By testing them we can pick them up earlier if they’re going to be infected and go on to be ill — or if they are never going to show enough signs and symptoms that we can detect coronavirus we can pick that up with testing and make sure they’re under the appropriate isolations,” she said.

Terrance Reidy

Dr. Terrence Reidy, the health officer for the Berkeley-Morgan and Jefferson County Health Departments, agreed.

“I do not presently plan to change our practice of trying to test people with recent risk exposure to a person with active COVID-19,” Reidy said in a written response to a MetroNews question.

“Though there are newspaper articles suggesting a change by the Federal HHS, I have not seen documented rationale that would persuade us to decrease efforts to identify and counsel individuals with COVID-19. Unfortunately not each new idea is an advance and new approaches should be weighed carefully before we change course.”

The quiet change by the CDC stirred a national controversy.

Anthony Fauci

Dr. Anthony Fauci, the nation’s top infectious disease expert, said he was undergoing surgery and under anesthesia when an August 20 coronavirus task force meeting included discussion of the change.

“I am concerned about the interpretation of these recommendations and worried it will give people the incorrect assumption that asymptomatic spread is not of great concern. In fact it is,” said Fauci, director of the National Institute of Allergy and Infectious Diseases.

Robert Redfield

CDC Director Robert Redfield said the guidelines issued on Monday had been coordinated with the White House coronavirus task force.

On Thursday, Redfield issued a new statement saying people who come into contact with confirmed or probable covid-19 patients could be tested themselves, even if they do not show symptoms of the virus.

“Testing is meant to drive actions and achieve specific public health objectives. Everyone who needs a Covid-19 test, can get a test. Everyone who wants a test does not necessarily need a test; the key is to engage the needed public health community in the decision with the appropriate follow-up action,” Redfield said.

Clay Marsh

Speaking about the guidance on Wednesday, West Virginia coronavirus response coordinator Clay Marsh said he was still trying to determine the CDC’s intent.

“This is a guidance that’s a bit different than the guidance that we’ve seen before,” Marsh said during the state’s regular coronavirus briefing.  “We’re certainly waiting for a continuation of this guidance to be delivered.”

Marsh described continued lags in receiving results from testing. He suggested that could be related to the CDC’s revised position.

“After an exposure from somebody with covid-19, the earliest point in time that is really reasonable to test is five days,” Marsh said.

“And I think the CDC guidance is probably recognizing the fact that if we are going to ask people for quarantine for 14 days if you’ve been in close contact with somebody with covid-19 and we wait five to seven days before we test you, unless the lab result can be returned in a really rapid way within 42 to 78 hours — which some of the labs are lagging behind at — then maybe it’s just reasonable in selected cases to let people finish their quarantine as long as they remain asymptomatic for that 14-day period.”

In West Virginia, Marsh said, “We’re still aggressively testing and will remain so. But we certainly do pay attention and also incorporate the guidance from the Centers for Disease Control within the approach that we take.”

Young said she doubts there will be broad acceptance of the CDC’s latest guidelines.

“I believe the scientific community will go against this advice because we’ve learned so much about covid in the short time we’ve had to deal with it. We know testing is the best thing we can do as far as making sure people are safe, even if they are asymptomatic. We want to make sure everyone has the opportunity to test,” Young said.

“If you remember early on in the pandemic, we begged for tests. We needed more testing. We only tested people when they were almost critically ill. And to go back to only testing people who are asymptomatic or only putting people into isolation is not going to be enough going forward.”

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