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Puerto Rico health officials: Softening CDC guidelines could leave airport vulnerable

By on August 27, 2020

Rebuke changes, say protocol for prior contact with coronavirus-infected person remains the same

SAN JUAN — The Centers for Disease Control’s (CDC) decision to change its Covid-19 testing guidelines to not recommend testing for people who have been in contact with a Covid-positive patient but are not showing symptoms was met with strong condemnation from the healthcare community, including in Puerto Rico.

Experts say the recommendation creates a blind spot when it comes to asymptomatic carriers, and in the case of Puerto Rico this blind spot could affect travelers.

Dr. José Rodréguez Orengo, executive director of the Puerto Rico Public Health Trust. (Courtesy)

“In some municipalities where we, the Puerto Rico Public Health Trust [PHT] are collaborating with contact tracing, we have seen that close to 50 percent of the people who have tested positive are asymptomatic. Therefore, tests should also be done to those who have been in contact with people that have tested positive so that we can have the virus a little more under control,” PHT Executive Director José Rodríguez Orengo said.

The PHT director suggested that the move from the CDC could result in a softening of the testing requirements for travelers, which could have an effect in Puerto Rico because the island doesn’t currently have the capacity to test all incoming travelers. Rodríguez went on to express satisfaction with the decision from Puerto Rico Health Secretary Lorenzo González to not make any changes to existing protocol.

The Telenoticias TV news program reported that Secretary González would not be changing the testing guidelines and that the official found the CDC’s changing of guidelines problematic.

After days of backlash, CDC Director Robert Redfield softened his interpretation of the guidelines, with the New York Times quoting him assaying: “Everyone who needs a Covid-19 test, can get a test,” and later adding that the CDC is “placing an emphasis on testing individuals with symptomatic illness, individuals with a significant exposure, vulnerable populations […].”

As of Thursday afternoon, the CDC website still included the Aug. 24 guideline change, which 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.”

As for testing capacity, Rodríguez explained that in the first week of August, Puerto Rico lowered the amount of testing done. One of the issues is that the four largest laboratories on the island use Roche Covid-19 testing kits, but Roche Diagnostics has experienced delays in shipping more kits to the island.

However, the PHT director did point to a possible option that could address insufficient testing at the airport: Abbott’s announcement of a $5 antigen test. Contrary to the antibody test, “what the antigen does is that it takes part of the virus molecule and tells you if you have the virus with you,” Rodríguez explained.

However, to administer the number of tests needed, Rodríguez argued that the Puerto Rico government depends on the assistance of the federal government to ensure access to antigen test kits.

“[Abbott] says that in a month they will be doing over 50 million of these types of tests. I understand that the United States government has already bought the first tests from them to then distribute them to the different relevant areas and I hope [the federal government] will not leave us again until the end. Rather, [Abbott] would produce enough tests for us to use in these types of places such as the airport to be able to control those people who come to visit us infected,” Rodríguez concluded.

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