The Trump administration plans to release guidance that non-hospitalized patients who test positive for COVID-19 do not need a second test to confirm they are clear of the virus.
The guidance to be released by the Centers for Disease Control and Prevention (CDC) will help to reduce unnecessary testing, Admiral Brett Giroir, M.D., Assistant Secretary for Health at the U.S. Department of Health and Human Services (HHS) told reporters during a briefing Thursday.
"The great majority of people who are diagnosed and who are sick at home don’t need to be re-tested. It’s clogging up the system," Giroir said.
Re-testing also can be a disservice as a second polymerase chain reaction (PCR) diagnostic test could be positive long after the individual is no longer contagious, Giroir said.
Previous recommendations that patients be re-tested to confirm a negative COVID-19 test was a remnant of earlier guidance when cruise ship passengers needed to be quarantined and required two negative tests to be cleared, Giroir said.
"It's no longer needed and it's medically unnecessary," he said.
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Giroir said the average patient with COVID-19 who is not hospitalized and is isolating at home can be generally considered no longer contagious after 10 days from the onset of symptoms or at least three days asymptomatic.
Hospitalized patients should be re-tested as the virus can last longer with an ICU patient who is critically ill, he said.
When asked by a reporter if the guidance was a "preservation tactic" as a result of the bottleneck with testing among commercial labs, Giroir pushed back and said the guidance was not the result of testing shortages.
"It is not a tactic. It is basic medical science. How many people get the flu and go back and get tested twice?" he said.
Testing update
Giroir said 45 million COVID-19 tests had been performed in the U.S. so far, or about 700,000 a day.
"We see early indicators that in the hot areas, the red zones, we’re seeing the positivity rate start to go down or plateau. That's an early sign that we're getting control of this outbreak," he said.
"This is no victory lap, but it does show that our efforts are starting to make an impact," he said. "In Arizona, the positivity rate has dropped dramatically."
Giroir said basic, simple measures will help to curb the pandemic, namely, closing bars and indoor dining at restaurants and individuals adhering to guidance to wear masks in public, practice social distancing and avoid large groups.
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"Our model says [those measures] are what we need to shut the virus down," Giroir said.
Earlier this week, the Trump administration announced it will be ramping up testing at nursing homes in coronavirus hotspots using rapid point-of-care diagnostic test instruments.
The administration will distribute test instruments to all 15,400 nursing homes in the U.S. to test all residents and staff. The distribution will begin next week at nursing homes prioritized by the Centers for Medicare and Medicaid Services.
Health officials want to transition the majority of COVID-19 testing efforts to point-of-care testing, Giroir said.
The Food and Drug Administration granted Emergency Use Authorization for several point-of-care antigen tests, the BD Veritor system along with the Quidel Sofia and Sofia 2 systems, to provide more testing faster.
The Trump administration is aiming to have more than 20 million point-of-care tests performed per month by September, Giroir said.