When Should Asymptomatic Persons Be Tested for COVID-19?

Audrey N Schuetz; Peera Hemarajata; Ninad Mehta; Sheldon Campbell; Stephanie Mitchell; Elizabeth Palavecino; Susan Butler-Wu; Melissa B Miller

doi:10.1128/JCM.02563-20

When Should Asymptomatic Persons Be Tested for COVID-19?

J Clin Microbiol. 2020 Dec 17;59(1):e02563-20. doi: 10.1128/JCM.02563-20. Print 2020 Dec 17.

Authors

Audrey N Schuetz¹, Peera Hemarajata², Ninad Mehta³, Sheldon Campbell^{4

5}, Stephanie Mitchell⁶, Elizabeth Palavecino⁷, Susan Butler-Wu⁸, Melissa B Miller⁹

Affiliations

¹ Department of Laboratory Medicine and Pathology, Mayo Clinic, Rochester, Minnesota, USA.
² Public Health Laboratories, LA County Department of Public Health, Downey, California, USA.
³ Department of Pathology, University of Utah School of Medicine, Salt Lake City, Utah, USA.
⁴ Department of Laboratory Medicine, Yale School of Medicine, West Haven, Connecticut, USA.
⁵ Pathology and Laboratory Medicine, VA Connecticut Health Care, West Haven, Connecticut, USA.
⁶ Department of Pathology, University of Pittsburgh School of Medicine, Pittsburgh, Pennsylvania, USA.
⁷ Department of Pathology, Wake Forest Baptist Medical Center, Winston-Salem, North Carolina, USA.
⁸ Department of Pathology, Keck School of Medicine of USC, Los Angeles, California, USA.
⁹ Department of Pathology and Laboratory Medicine, University of North Carolina School of Medicine, Chapel Hill, North Carolina, USA Melissa.Miller@unchealth.unc.edu.

Abstract

On 24 August 2020, the Centers for Disease Control and Prevention (CDC) updated its website to highlight that asymptomatic individuals, even those with exposure to a COVID-19-positive contact, do not necessarily need to be tested unless they have medical conditions associated with increased risk of severe illness from COVID-19. The CDC subsequently updated its guidance on 19 September 2020 to support testing of asymptomatic persons, including close contacts of persons with documented SARS-CoV-2 infection. In this editorial, the American Society for Microbiology Clinical and Public Health Microbiology Committee's Subcommittee on Laboratory Practices comments on testing of asymptomatic individuals relative to current medical knowledge of the virus and mitigation measures. Specific points are provided concerning such testing when undertaking contact tracing and routine surveillance. Limitations to consider when testing asymptomatic persons are covered, including the need to prioritize testing of contacts of positive COVID-19 cases. We urge the CDC to consult with primary stakeholders of COVID-19 testing when making such impactful changes in testing guidance.

Keywords: COVID-19; SARS-CoV-2; asymptomatic testing; contact tracing; surveillance.

Publication types

Editorial

MeSH terms

Asymptomatic Diseases*
COVID-19 / diagnosis*
COVID-19 Testing / methods*
Carrier State / diagnosis*
Chronic Disease Indicators
Contact Tracing / methods
Female
Humans
Male
SARS-CoV-2 / isolation & purification