The Centers for Disease Control and Disease Prevention updated its testing guidance COVID-19 schools Wednesday.

The new guide includes detailed information on how to prioritize fresh testing of students, teachers and members of staff case of an outbreak. But it disappointed some experts who think the CDC Guidance on testing of asymptomatic individuals for purposes of disease monitoring and surveillance falls short of what is needed.

While an earlier version of the guidelines recommend against testing all students, faculty and staff upon returning to school - the so-called input test - the states version updated to

targeting "an entry strategy screening tests combined with periodic series could prevent or reduce the transmission of SARS-CoV-2". It does not reach, however, to recommend entry combined events with serial testing regularly as a strategy, recommending instead that universities consult with public health officials to determine strategies for optimal assay based on their individual contexts .

Some experts have criticized guidance preflight CDC, which focused mainly on the evidence of symptomatic individuals and close contacts of people with known infections. It said the previous guidance given schools an excuse to be lax in their testing regimes. Study In August led by researchers at the California Institute of Technology and published as a preliminary test found that 27 percent of colleges provided for testing students returning to school, while 20 percent plan "put regularly test their communities to some extent. "

The new guidance sets out five different strategies to test asymptomatic individuals with no known exposure to COVID - ranging from the entrance, one universal time screening for retesting to chance or no screening test to all - and considerations relevant to each of these strategies.

"While the new orientation is less harmful than the guide June CDC is still wrong, in my opinion, not really a recommendation in support of testing entry followed by high testing frequency monitoring all students, "said Gavin Yamey, professor of global health and public policy at Duke University.

"in the new guidance, CDC simply notes that a variety of approaches are being used yda these equal weight, what's wrong," said Yamey. "But here's the kicker Along with this list of options, there is a note at the foot of the CDC says." This is an emerging area, and no scientific evidence is currently limited to guide decisions to use or not use one of these strategies, but public currently is conducting health research to examine the effectiveness of these strategies in the IHE environment. This note is inaccurate. Tests modeling, for example by David Paltiel and his colleagues have shown that in assuming typical student behavior, testing all students two to three times a week is the optimal strategy to prevent outbreaks. "

Paltiel, professor of public health at Yale University who led the study modeling, was equally impressed by the orientation with respect to the systematic investigation of patients with no known exposure to COVID-19.

"are suggesting that there is limited evidence to support a choice between doing nothing at all and testing on a regular basis. That is false and dangerous," he said.

"You could nit-pick and say it's true and say that there is no direct empirical evidence of the effectiveness of testing high frequency for SARS-CoV-2 on college campuses in the middle of a COVID pandemic, "continued Paltiel. "But many are evidence that young individuals, asymptomatic and presymptomatic are fueling the pandemic, and need not be a big inferential leap from there to see that this is evidence for asymptomatic detection common control on campus."

The CDC published an article earlier this week finding that the number of young adults aged 18 to 22 with COVID-19 increased by 55 percent from early August to early September as many universities began to bring students back for the fall. The number of cases increased at a rate faster than did the rate of testing, ie, the increase is likely that it was not solely attributable to an increase in testing.

The new CDC guidance document provides a hierarchy of five parts for selection with individuals, with individuals who have symptoms COVID-19 and those who have had close contact with infected people get priority.

The guide also includes much advice that has been available to date in testing during an outbreak situation. three-tier approach is presented for how faculty, students and staff should be prioritized for testing in the event of an outbreak, according to their level of exposure to an individual with COVID-19.

For example, the guide says that students, faculty and staff who shared a classroom with an infected person that were not spaced six feet also starting two days before the onset of symptoms or, case of asymptomatic tests, collecting a test sample would be among the most highly prioritized for testing (level one). Those who shared a class that was held at the least six feet away from people at all times there would be a lower priority for evaluation (Level Two).

Other individuals identified as the highest priority level one, for testing in the event of an outbreak include:

  • students share a room or bathroom in a residence, living at home brotherhood / sisterhood or living in housing outside the campus with an individual who is COVID-19 positive
  • students, faculty and staff who have used the same dining room more or less at the same time (s) as an individual with COVID-19
  • students, faculty and staff who are on / involved with the same sports team as an individual with COVID-19
  • students, faculty and staff who have attended events on campus or social gatherings unauthorized (as parties outside the campus), which was social distancing not strictly adhered to by one or more individuals with COVID-19
  • students, faculty and staf f identified as one o'clock ET Recho contact through case investigation and contact tracing.

    The new guide also refers to a recent paper guide to the CDC for K-12 schools that identifies the specific metrics for the number of cases of the local community and the types of positive tests that can be used to inform managers about the risks of providing learning in person. The CDC says these indicators, designed for K-12 schools, "could have relevance to higher education institutions that attract students most immediate local community and not on campus residential facilities for students or limited. For IES residential facilities and students drawn from a much wider and diverse geographic region and communities with different levels of current transmission of SARS-CoV-2, these indicators may have less direct applicability. "

    the CDC guidance emphasizes the importance of combining the tests with strong contact location and quarantine measures and measures to mitigate the spread of disease, including social distancing, using the mask, hand hygiene practices and improved cleaning and disinfection.

    "This is a long-awaited first step that needs constant updates based on analysis of emerging data and best practices," Professor Harvey Fineberg said Howard K. Koh V., the practice Leadership in Public health at Harvard University and former Assistant Secretary for health for the Department of health and Human Services.

    US "We now have data," Koh said. "My main expectation now is that the state by state and community by community, there must be some integration of all test data coming out of these universities to see the effectiveness, profitability and many other indicators."

    A wide range of testing strategies being employed at this time, he added.

    "We need to have a better understanding of what are feasible and effective and ultimately recommended," Koh said.

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