White House adviser joins DeSantis to tout COVID strategy: Test only those with symptoms

Gov. Ron DeSantis brought the White House’s new coronavirus adviser, Scott Atlas, to Tallahassee on Monday to embrace a controversial testing policy that suggests people with no symptoms should be discouraged from testing because it leads to shutdowns, a position opposed by other members of the president’s task force.

“The CDC is not saying you cannot get a test. They’re just saying there’s a rationale for getting a test, and if you are concerned, you can contact your doctor or your local health official,’’ said Atlas, an adviser to the White House Coronavirus Task Force, at the media event held at the state Capitol. “But there must be a prioritization because we need to use the testing — not to lock down society — you need to have the testing result in something very positive and that is decreasing deaths.”

DeSantis invited Atlas, a neuroradiologist from Stanford’s conservative Hoover Institution, to speak on the day the last of Florida’s school districts resumed classes, some online and some in person. Also with them was Education Commissioner Richard Corcoran, Surgeon General Scott Rivkees and two parents of children in Tallahassee schools. None of the panelists wore masks.

Atlas said that while “asymptomatics [people who have no symptoms] can spread” the coronavirus that causes COVID-19, it is less important to prevent the spread of the virus among the general population than it is to prevent the spread among the vulnerable.

“You don’t have to be a genius to figure out that if someone’s coughing up virus, they are going to be spreading so there’s no doubt that the symptomatic super spreaders are the symptomatic people,’’ Atlas said.

Atlas supports policies of herd immunity and has urged that the United States adopt the model Sweden has used to respond to the virus outbreak, which advocates for lifting restrictions to allow more exposure and allow people to build up immunity to the disease rather than limiting social and business interactions to prevent the virus from spreading, according to recent reporting in The Washington Post.

“If everybody in the world was asymptomatic and they test positive, that’s not the goal here — that’s not the way to look at it,’’ he said. “The way we look at it is who is sick and how do we prevent the people who are highly vulnerable from getting sick.”

DeSantis said he has been in frequent contact with Atlas and agreed with his strategy to discourage testing of those who have no symptoms.

“We also have to always remember when you lock down the quarantine people who are healthy but happen to be testing positive, you are creating enormous harms to them and to their family,” Atlas said. “We’re the only country among the nations in the Western world hysterical about opening schools.”

Left unsaid is what schools should do if children with no symptoms spread the virus to parents, teachers and others who are more at risk for serious illness.

Debating asymptomatic testing

The idea that asymptomatic people do not need to be tested for COVID-19, even if they’ve been in close contact with an infected person, is not universally accepted among public health officials, including those on the White House task force.

“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,” Dr. Anthony Fauci, director of the National Institute of Allergy and Infectious Diseases, told CNN after the U.S. Centers for Disease Control and Prevention modified its proposal on Aug. 20 to discourage testing among asymptomatic people.

A day before, the White House task force leader, Dr. Deborah Birx, told state and local leaders that universities should test all students returning for fall classes as well as set up “surge” testing.

“Each university not only has to do entrance testing,” Birx said, according to a recording of the call obtained by the Center for Public Integrity. “What we talked to every university about is being able to do surge testing. How are you going to do 5,000 samples in one day or 10,000 samples in one day?”

Atlas contradicted that position, suggesting that colleges should refrain from mass testing.

He argued: “If you close colleges, you’re sending low-risk asymptomatic people into a high-risk environment by sending them home with their older parents out into the community.”

Atlas said testing is designed primarily “to protect the vulnerable” but he opposes using testing to detect “low-risk schools. The goal of testing is not to close the schools. The goal of testing is to open schools.”

According to CDC data, he said, “in terms of low-risk groups in children, it’s very well documented,’’ Atlas said. “It is incontrovertible that there is extremely low risk to children from the virus.”

The reaction to the comments drew a rebuke from incoming Florida Senate Democratic Leader Gary Farmer, a Broward County lawyer.

“This is infuriating!!’’ Farmer wrote on Twitter. “Already we are seeing more kids testing positive than any state...we know asymptomatic people (kids & adults) can spread...& many will suffer lingering effects, maybe for life. We need a reality-based policy that protects our kids & teachers!!”

CDC’s flip-flops on guidance

Atlas’ visit comes one week after the CDC revised its guidance for who should be tested for SARS-CoV-2, the virus that causes COVID-19.

Before Aug. 24, the CDC website recommended testing “for all close contacts of persons with SARS-CoV-2 infection.” But after Aug. 24, the agency changed its guidance to say that those who had “close contact” — defined as being within six feet for at least 15 minutes — but did not show symptoms did not “necessarily need a test.”

After public health experts criticized the change, saying the pandemic requires more testing, not less, CDC Director Robert Redfield revised the agency’s guidance again on Thursday, saying that those who come in contact with a confirmed or probable COVID-19 infected person can be tested even if they don’t show symptoms.

Central to the debate on testing guidance is the testing technology being used, which is primarily the molecular or PCR test, a clinical diagnostic test that is very accurate but can take days or longer to produce results when used in a pandemic.

A new generation of rapid tests are in development, however, that are cheaper, easier to use, produce results in less than one hour and do not require a laboratory to process — making it possible to test tens of millions of Americans a day on a regular basis.

Without such technology, testing asymptomatic persons randomly may not be effective, said Michael Mina, a pathologist and infectious disease expert with Harvard T.H. Chan School of Public Health.

“If you’re not exhibiting symptoms, random surveillance of individuals is usually not particularly effective for a virus like this unless you’re doing it very frequently and at scale,” Mina said during a press conference with reporters on Friday.

Mina said the country needs to test 50 million to 100 million people a day on a regular basis in order for COVID-19 surveillance to be most effective.

PCR tests are best suited for clinical diagnosis, Mina said, and using them on asymptomatic persons at drive-thru sites can lead to backlogs at clinical laboratories and a reduction in testing for other infectious diseases, such as HIV or chlamydia.

“There is a role to rethink what type of asymptomatic testing we’re doing,” Mina said, “and we need to get it out of the clinical diagnostic world and probably really scale it up if we want it to be useful.”

DeSantis touted the schools opening across the state as a success.

In Miami-Dade County, students returned virtually but faced portal crashes, confusion and questions from students, parents and teachers trying to log on for their first day of school.

Mary Ellen Klas can be reached at meklas@miamiherald.com and @MaryEllenKlas