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Illustration: Eniola Odetunde/Axios

The U.S. has never really managed to get coronavirus testing right for any extended period of time, and now we're entering a new phase of potential dysfunction.

Driving the news: Democrats and some health care experts are livid over the Centers for Disease Control and Prevention's latest change to its testing guidelines, which now recommend against testing for asymptomatic people.

  • It's a flashback to the spring, when the U.S. could only perform a tiny number of tests and reserved them for the sickest patients.
  • It was true then, and remains true now, that an ideal testing strategy would not exclude asymptomatic people. Some 40% of all cases are asymptomatic, meaning a whole lot of people are likely spreading the virus without knowing it.

Between the lines: The U.S. is now conducting some 690,000 tests per week, but it still hasn't been enough to keep up with demand, causing delays of up to two weeks for test results — which renders them all but useless.

  • Cutting back on testing is a way to ease those backlogs, but at the cost of missing some infections.
  • Testing was declining even before the CDC revised its guidelines. It fell by about 5% over the past week.

The intrigue: Sources told multiple news outlets that the White House pressured the CDC to revise its guidelines. Brett Giroir, the Trump administration's "testing czar," said that wasn't true, and that the revisions came from the CDC and the White House's coronavirus task force.

  • But Anthony Fauci, a prominent member of that task force, told CNN, "I was under general anesthesia in the operating room and was not part of any discussion or deliberation regarding the new testing recommendations."
  • "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," he said.

What they're saying: The response to the change has been overwhelmingly negative.

  • California Gov. Gavin Newsom said his state wouldn't follow the guidelines.
  • The Association of American Medical Colleges called them "irresponsible" and "a step backward."
  • "This is potentially dangerous ... I feel like this is going to make things worse," infectious disease physician Krutika Kuppalli told NYT.

Go deeper

Updated 4 hours ago - Politics & Policy

Omicron dashboard

Illustration: Shoshana Gordon/Axios

  1. Health: CDC director says number of U.S. Omicron cases "likely to rise" — Two years of COVID-19 — Prior coronavirus infections may not protect well against Omicron.
  2. Vaccines: Data demonstrates most-vaccinated counties less vulnerable to worst of COVID — Omicron adds urgency to vaccinating world — Omicron fuels the case for COVID boosters.
  3. Politics: Nevada to impose insurance surcharge on unvaccinated state workers — New Jersey GOP lawmakers defy statehouse COVID policy — Oklahoma sues Biden administration over Pentagon vaccine mandate.
  4. World: Vaccine mandates lose steam in the U.S. while Europe doubles downWHO: Delta health measures help fight Omicron — COVID cases surge in South Africa in sign Omicron wave is coming.
  5. Variant tracker: Where different strains are spreading.
Dec 4, 2020 - World

UN: "2021 is literally going to be catastrophic"

David Beasley, executive director of the World Food Programme. Photo: Souleymane Ag Anara/AFP via Getty Images

Next year is "going to be catastrophic" in terms of worldwide humanitarian crises, World Food Program executive director David Beasley warned on Friday, per Reuters.

Driving the news: The stark outlook comes as many countries contend with not only the coronavirus pandemic, but also possible famine, economic instability, conflict and other humanitarian crises. A record 235 million people will need humanitarian assistance and protection next year, a nearly 40% increase from 2020, the UN projected earlier this week

Dec 4, 2020 - Health

Bay Area counties to enact stay-at-home order ahead of state mandate

Golden Gate Park. Photo: Justin Sullivan via Getty

Counties around the San Francisco Bay Area will adopt California’s new regional stay-at-home order amid surges in cases and ICU hospitalizations, health officials said Friday.

The big picture: California Gov. Gavin Newsom announced a three-week stay-at-home order on Thursday that would go into effect in regions with less than 15% ICU capacity. Despite the Bay Area’s current 25.3% ICU capacity, health officials from Alameda, Contra Costa, Marin, Santa Clara, San Francisco and the city of Berkeley are moving ahead with a shelter-in-place mandate in the hopes of reducing risk.