CDC Broadens Definition of ‘Close Contact’ in Tracing COVID Infections | Health News

By Robin Foster and E.J. Mundell
HealthDay Reporters

(HealthDay)

THURSDAY, Oct. 22, 2020 (HealthDay News) — In a move that widens the pool of people considered at risk for coronavirus infection, U.S. health officials released new guidance on Wednesday that redefines who’s considered a “close contact” of an infected individual.

The change, issued by the U.S. Centers of Disease Control and Prevention, will likely have the biggest impact in group settings where people are in repeated contact with others for brief periods over the course of a day, such as schools and workplaces, the Washington Post reported.

The CDC had previously defined a “close contact” as someone who spent at least 15 consecutive minutes within six feet of a confirmed coronavirus case. Now, a close contact will be defined as someone who was within six feet of an infected individual for a total of 15 minutes or more over a 24-hour period. State and local health departments rely on this definition to conduct contact tracing, the Post reported.

The new guidance arrives just as the country is “unfortunately seeing a distressing trend, with cases increasing in nearly 75 percent of the country,” Jay Butler, the CDC’s deputy director for infectious diseases, said during a rare media briefing Wednesday at CDC headquarters in Atlanta, the Post reported.

CDC scientists had been discussing the new guidance for several weeks, said an agency official who spoke on the condition of anonymity, the Post reported. Then came unsettling evidence in a government report published Wednesday: CDC and Vermont health officials had discovered the virus was contracted by a 20-year-old prison employee who in an eight-hour shift had 22 interactions — for a total of over 17 minutes — with individuals who later tested positive for the virus.

“Available data suggests that at least one of the asymptomatic [infectious detainees] transmitted” the virus during these brief encounters over the course of the employee’s workday, the report said.

Caitlin Rivers, an epidemiologist at the Johns Hopkins Center for Health Security in Baltimore, called the updated guidance an important change.

“It’s easy to accumulate 15 minutes in small increments when you spend all day together — a few minutes at the water cooler, a few minutes in the elevator, and so on,” Rivers told the Post. “I expect this will result in many more people being identified as close contacts.”

At the same time, it’s not clear whether the multiple brief encounters were the only explanation for how the prison employee became infected, Rivers added. Other possibilities might have included airborne or surface transmission of the virus. She also noted that the new guidance “will be difficult for contact tracing programs to implement, and schools and businesses will have a difficult time operating under this guidance.”

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CDC broadens definition of who’s at risk of getting coronavirus

The CDC on Wednesday ramped up its criteria for who’s at risk of contracting the coronavirus, in a move with major implications for school and workplace reopenings.

The updated guidance defines a “close contact” as anyone who spends at least 15 minutes within six feet of an infected individual over a 24-hour period. The agency previously applied that designation to people who spent 15 consecutive minutes within six feet of someone with Covid-19.

“Individuals who had a series of shorter contacts but over time added up to more than 15 minutes became infected,” CDC Director Robert Redfield said at a briefing, citing a study of multiple non-consecutive exposures. Redfield was joined by HHS Secretary Alex Azar and Jay Butler, the CDC’s deputy director for infectious diseases, who warned that the U.S. is showing a “distressing trend” with cases surging over 75 percent of the country.

The details: The guidance is based on a study out today showing brief exposures to infected individuals and resulted in virus spread. The study involved a Vermont correctional facility employee who tested positive after short interactions with multiple inmates who were infected.

The study said the correctional officer was never with the inmates for 15 consecutive minutes. The Vermont Department of Health said the officer wore a cloth mask, gown and goggles and had 22 interactions totaling about 17 minutes with six unmasked inmates who tested positive for the virus.

What’s next: The updated guidance could change how public health departments across the country conduct their contact tracing, by increasing the pool of potentially infected individuals. It also could upend plans to reopen schools and businesses that had been based around the earlier guidance, as President Donald Trump continues to call for a return to pre-pandemic conditions. The CDC in May released guidelines for reopening schools that Trump later disavowed, saying they were too burdensome.

The U.S. is reporting an average 60,000 cases per day with the Midwest seeing the largest increases in cases. Officials warned conditions could get worse as the cold weather sends people indoors, where the virus can spread more rapidly.

So far, there have been 8.3 million reported cases in the U.S. and more than 221,000 deaths.

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