How the latest CDC guidance on COVID-19 is creating unnecessary confusion

The latest guidance from the Centers for Disease Control and Prevention on isolation and testing for COVID-19 has received intense pushback. Many health experts are now criticizing what the CDC has said and how its officials have said it. This includes the American Medical Association, which issued a strong rebuke. Dr. Gerald Harmon, president of the AMA, joins Williams Brangham to discuss.

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  • Judy Woodruff:

    The latest guidance from the CDC on isolation and testing for COVID-19 has received intense pushback.

    As William Brangham reports, many health experts are now criticizing what the CDC has said and how CDC officials have said it.

  • William Brangham:

    That's right, Judy.

    The CDC said, if you get COVID, you don't have to isolate for 10 days, like before. You can cut that down to five. But it also said people don't need a negative test to resume regular life.

    Joining a chorus of criticism, the American Medical Association issued a rare, but strong rebuke, saying that the CDC's new recommendations were — quote — "not only confusing, but are risking further spread of the virus."

    The man who wrote those words is Dr. Gerald Harmon. He's the president of the AMA.

    Dr. Harmon, great to have you on the "NewsHour."

    I'd like to have a better sense of what it is that is bothering you about what the CDC did.

    Am I right that you're OK that people might leave COVID isolation after five days, but only if they have a negative test? Is that your issue?

  • Dr. Gerald Harmon, President, American Medical Association:

    William, thanks for having me.

    And that — you have nailed it. That is my issue, as a front-line provider. We have a lot of evidence that shows that viral shedding might stop after five days. We don't know as much about the Omicron variant as we would like. Of course, we are learning on the fly.

    But five days seems a little quick to let someone released back into the wild without at least negative testing before they're going back, even if they're wearing masks, even if they're wearing medical-grade masks.

    Putting someone back into the environment that could spread this — and some of the data shows that as many as 31 percent of those after five days still shed the virus — that's a little inherent risk that I'm not willing to buy into right now.

  • William Brangham:

    I mean, the CDC director, when asked about this, Dr. Rochelle Walensky, said — she implied that that rapid tests were not as reliable as they have been sold, although that's somewhat contrary to what she said at the beginning of the pandemic.

    What do you make of that? Do you think that rapid tests are reliable?

  • Dr. Gerald Harmon:

    Well, I use them. All of us use them. We make a determination whether to put someone in isolation when they come in.

    We use the test that we have available. And that's a rapid test. We tell people all the time, get ahold of a rapid test. If you think you might have been exposed or have symptoms, we tell you, go do a rapid test. That's been a relatively common standard. And if it's good enough to make the diagnosis, I would hope that it's good enough to make the un-diagnosis that you're no longer contagious.

    Now, there are going to be, like any test, some false negatives, some false positives, but it's been the standard. They're generally a good indicator of whether a patient is infectious.

  • William Brangham:

    I mean, anyone who has actually tried to go out and purchase one of those rapid test knows that they are in incredibly short supply right now.

    And your letters seemed to imply that the CDC made this decision because of that shortage. Do you believe that that's really true?

  • Dr. Gerald Harmon:

    Listen, this is not the AMA or other health care agencies against the CDC. We love them. We're supportive of them. They're a public health messenger that we rely on.

    So we're a little bit concerned with the messaging and the confused messaging, because I think testing is good to have. I wish we had more tests available, the rapid tests. I, like others, are struggling to find tests in the community. Almost every day — in fact, every day, people call me: Hey, I need testing, and I can't find one.

    I will tell you a story. I bought a handful of them, four of them, when I could still get four, about a week or two ago. And I have used them when my neighbors come knocking on my door literally to test them, because I need to make a decision about recommending my personal advice to my patients.

  • William Brangham:

    I mean, there's an echo here about what happened with masks at the very beginning of the pandemic.

    I mean, Dr. Fauci himself has now acknowledged that there was the worry that there weren't enough N95 masks and they didn't recommend them for people. You mentioned the somewhat confused and confusing messaging of the CDC. Is this something that has been frustrating to you for a while?

  • Dr. Gerald Harmon:

    Well, again, this is science. This is not mathematics, so that the numbers may change. The data may indicate different transmission variants we have.

    We're learning. All of us, the CDC, all of my scientific colleagues, myself, on the front lines, we're learning. So the messaging may change at times, but it's not in any deliberate format to confuse people or because we don't know what we're doing or the CDC doesn't. Science changes. It is a changing discipline.

    And data tells us what to advise. So, yes, we're now recommending medical-grade masks. I used this. I will use this morning. And I have got a an N95 mask for when I'm in the environment. But I don't use cloth masks anymore, because I think the messaging and the science shows they're not as protective, especially with the transmissibility, of the Omicron variant.

  • William Brangham:

    So, if a patient comes to you and says, look, I tested positive, I have been in isolation for four or five days, CDC says, I can get out without a test, but they're not sure about their symptoms, and they cannot get a test, what would you advise them to do?

  • Dr. Gerald Harmon:

    They do come to me with that very question. You're exactly right. So that's not just a hypothetical thought experiment. That's real time.

    And I'm going to stick with my recommendation, not necessarily the AMA's recommendation, but it's going to be, if you're not sure, you have only been five days since the onset of symptoms or the date of positive testing, then I think, if you don't have an available tests to help support that you are not contagious, you're not infected, why don't you wait a couple more days, and then seven days might be a reasonable, prudent recommendation that you could go back to work?

    If you're — if I did test you positive, I would wait a couple days later and get you tested again. We're not trying to pick a magic number. We're trying to meet someplace in the middle.

    We're trying to do the best we can with the data we have and use common sense. And that is the challenge for all of us right now, is that none of us are deliberately trying to release people into the wild that are infectious or contagious. We're trying to do the best we can to keep our schools open, our hospitals open, our businesses open, and help the economy.

    I understand the motivation, but the science still is catching up with the reality.

  • William Brangham:

    All right, Dr. Gerald Harmon, president of the American Medical Association, thank you so much for being here.

  • Dr. Gerald Harmon:

    William, thanks for having me. Thanks for being part of the solution, and you and the PBS folks being a source of reliable medical information and for being on the side of science.

    Thank you again.

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