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

Coronavirus cases increase in 17 states

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Data: The COVID Tracking Project, state health departments; Map: Andrew Witherspoon, Sara Wise/Axios

Coronavirus infections ticked up slightly over the past week, thanks to scattered outbreaks in every region of the country.

Where it stands: The U.S. has been making halting, uneven progress against the virus since August. Overall, we're moving in the right direction, but we're often taking two steps forward and one step back.

Former Pence aide says she plans to vote for Joe Biden

President Trump in the Oval Office on Sept. 17. Photo: Oliver Contreras-Pool/Getty Images

Vice President Pence's former lead staffer on the White House coronavirus pandemic response announced on Thursday that she plans to vote for Joe Biden in the 2020 election, accusing President Trump of taking actions "detrimental to keeping Americans safe."

What she's saying: "It was shocking to see the president saying that the virus was a hoax, saying that everything's okay when we know that it not. The truth is that he doesn't actually care about anyone else but himself," said Olivia Troye, Pence's former homeland security, counterterrorism and coronavirus adviser.

Updated 8 hours ago - Health

World coronavirus updates

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Data: The Center for Systems Science and Engineering at Johns Hopkins; Map: Axios Visuals

Though health workers represent less than 3% of the population in many countries, they account for around 14% of the coronavirus cases reported to the World Health Organization, WHO announced Thursday.

Why it matters: The WHO called on governments and health care leaders to address threats facing the health and safety of these workers, adding that the pandemic has highlighted how protecting them is needed to ensure a functioning health care system.