Federal health officials are recommending less COVID-19 testing for people not showing symptoms of the disease, but officials in Greene County and at the state level see no scientific reason to follow suit.
A new guideline issued by the Centers for Disease Control and Prevention on Monday said people exposed to a positive individual "do not necessarily need a test" unless they’re showing symptoms or are at high risk for getting very sick from the disease.
The reversal from guidance recommending tests for anyone exposed to COVID-19 surprised public health experts in Missouri and across the country because testing people exposed to the virus who aren’t showing symptoms can be critical to controlling its spread.
People can be infected and contagious for days before they show symptoms, and a significant portion of infections never manifest symptoms at all.
Those traits make the virus difficult to contain without aggressive testing because they mean it can spread widely unnoticed until it makes someone sick, and at that point, it may be too late to track down and quarantine previous infections.
Dr. Randall Williams, Missouri’s state health director, couldn’t see a reason for the change at a news conference Wednesday.
"It’s unclear to me why they’ve made that recommendation," he told reporters. "That’s not the path that I would set out on."
"The governor has worked so hard so we can do 100,000 tests a week that at this point in time, unless I'm presented clear evidence differently, we think that Missourians who want to be tested, who need to be tested, that we would really encourage them to get tested," he added.
Williams repeated those sentiments Friday during a Lunch with a Leader program sponsored by the Columbia Chamber of Commerce.
"We are not going that way," he said. "We will continue to do extensive testing here."
Missouri’s official figure on testing reports the number of people tested, while many states report the total number of tests. Among the 29 states and the District of Columbia that report the number of individuals tested, Missouri is 23rd.
The data on the state COVID-19 dashboard shows 1.26 million total tests, with about 270,000 representing a person being tested a second or more times.
Clay Goddard, the director of Springfield-Greene County’s health department, suggested the CDC could be trying to help areas where testing materials are in short supply.
But Goddard said his department would continue testing people who come into contact with positive cases through its testing program "regardless of symptoms."
The comments from Williams and Goddard came as the Trump administration was coming under sustained fire for the change, including from Democrats who tied it to Trump’s comments at a June rally when he told supporters he'd told his staff to "slow the testing down, please."
Adm. Brett Giroir, the Trump administration’s testing czar, defended the shift in the New York Times that day, saying the new recommendation fit with existing guidance for front-line workers like those in hospitals who encounter infected people.
He also told the Times that testing people exposed to the virus didn’t help much because tests only capture a single moment in time — a person could contract the disease after they got tested but before they received the result — that could offer a false sense of security to those testing negative.
But Dr. Anthony Fauci, the ubiquitous infectious diseases expert on the White House’s coronavirus task force, went on CNN later that day and said he worried the guidelines gave people the wrong idea about the disease.
"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," he said. "In fact it is."
And on that same day, CDC Director Robert Redfield issued a statement rephrasing the guidance that emphasized that testing "may be considered for all close contacts of confirmed or probable COVID-19 patients."
The guidance on the website remains unchanged, though, and on Friday, two organizations representing local public health officials across the country wrote a letter to top Trump administration officials urging them to revert back.
"Changing testing guidelines to suggest that close contacts to confirmed positives without symptoms do not need to be tested is inconsistent with the science and the data," the letter says. "We urge you to pull the revised guidance and revert back to the previous consensus policy where people who may have been exposed to COVID-19 are encouraged to get tested, know their status, and do all they can to physically distance and stop the spread."
Rudi Keller of the Columbia Daily Tribune contributed to this report.