Amid increasing daily numbers of COVID-19 cases in the Sunshine State, Florida’s Department of Health has put forth its own set of guidelines for individuals who are considering COVID testing. But there’s a problem.
In a news conference in West Palm Beach on Thursday this week, Florida’s Surgeon General, Joseph Ladapo, spoke about new COVID-19 guidance released by Florida’s Department of Health. But that guidance is contradictory to what the U. S. Centers for Disease Control and Prevention has released.
And Florida’s guidance recommends that only individuals with symptoms and certain risk factors have COVID testing performed. Lapado explained that “sensible public health” is not what’s been taking place at the federal level over the past two years because the focus has been wrong.
“Sensible public health, it’s the very opposite of what we’ve seen over the last two years, where, for example, leadership at the national public health level have sort of convinced people that it’s just as important to run around testing middle schoolers and elementary school students as it is to be testing other members of the population,” Ladapo said during the news conference.
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On Tuesday of this week, Surgeon General Ladapo had said he would give priority to what he called “high value” testing. Lapado defines “high value” as testing that can act as a diagnostic tool for those individuals who would benefit from treatments. He defines “low value” testing as testing administered to an individual without symptoms who will likely not need treatment, even if the individual were to test positive. The Surgeon General is making the distinction in response to the state’s lack of sufficient testing availability.
“People who are unlikely to benefit [from testing], to sort of be in line waiting to get tested, that doesn’t make a lot of sense to me,” Ladapo said in a news conference held on Tuesday. “It doesn’t make a lot of sense to me as a physician. It doesn’t make a lot of sense to me as a clinical researcher.”
According to the Centers for Disease Control, people should take a COVID test if they have been in close contact with someone known to be infected with COVID-19, if they have symptoms of the viral infection, or if they are not fully vaccinated (only the first vaccine or none at all). The CDC has stressed that the virus can be spread by people who have COVID-19, whether they have symptoms or not. That’s part of the reason COVID testing is so important.
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Florida’s new guidelines came in the form of a one-page document on Thursday and have public health experts uneasy about Florida’s COVID future, saying that they could add to Florida’s current surge of new coronavirus cases.
“The upshot, this document, is a recipe for disaster,” said Dr. Aileen Marty, professor of infectious diseases at Florida International University.
Florida’s Department of Health used to adhere to the Center for Disease Control’s recommendations for COVID testing, but now, the department only recommends testing for people who are symptomatic and also have risk factors for severe illness. This particular group of people is referred to as “older adults” by both the Centers for Disease Control and by the Florida Department of Health, as individuals with medical conditions including cancer, diabetes, and chronic lung diseases, as immunocompromised people, and as pregnant women or those who were recently pregnant.
The discrepancies between guidelines for testing set forth by Florida’s Health Department and those set forth by the Centers for Disease Control are striking. According to Florida statutes, individuals who may have been exposed to COVID-19 but have no symptoms are not encouraged to undergo testing, as evidenced by the document released by the state’s Department of Health, which says that for possibly exposed, but asymptomatic individuals, “COVID-19 testing is unlikely to have any clinical benefits.”
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While the new guidelines don’t limit someone from testing, Dr. Marty says they are dangerous. She bases this on the fact that the guidelines set forth by Florida’s Health Department look too much at the testing benefits for individuals and explains that “public health” means protecting the community.
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“This document is written from the perspective of individual health and is not a document about Public Health,” Marty wrote in an email on Thursday. “Public health is about the health of the population, in contrast to clinical activities such as those done by doctors and nurses, who focus primarily on treating individuals after they become sick or injured.”
Dr. Marty says accurate numbers of cases are needed to understand the needs of the community.
“Encouraging individuals NOT to test is the perfect way to mask the truth, hide the risk to the population, underestimate the resource needs, and prolong the problem,” she said.