Mercer University quietly changed its COVID-19 protocols in a document posted to its coronavirus page Tuesday. The document is an updated version of one that was released in June.
The updates reduce the amount of time a student who tests positive for COVID-19 must be fever-free before ending their self-isolation and removes a previous suggestion that a student test negative twice before ending self-isolation.
The new document also includes specific guidelines for "immunosuppressed" people who test positive and clarifies the amount of time in which a student can expect to receive test results from Mercer Medicine if they are tested for the coronavirus.
“These changes to Mercer’s COVID-19 protocols are a result of updated guidance from the CDC,” said Kyle Sears, director of media relations for Mercer, in an email to The Cluster.
The Centers for Disease Control and Prevention released updated guidance Aug. 26.
Students no longer encouraged to test negative before ending self-isolation
The initial document recommended that a student who tests positive but does not exhibit symptoms either self-isolate for 10 days or self-isolate until they test negative twice.
The suggestion to test negative twice has been removed in the update.
Symptomatic students are also not advised to receive a negative test before ending their self-isolation. In the first version of the protocols document, students were directed to remain in self-isolation until at least 10 days passed and their symptoms improved. In addition, they must either remain fever-free for 72 hours or test negative twice, 24 hours apart, without a fever. The recommendation to receive two negative tests was removed in the updated protocols document.
Symptomatic students allowed to end self-isolation after 24 hours without fever
Students who have symptoms were initially asked to remain fever-free for 72 hours without fever-reducing medication before emerging from their 10-day self-isolation period. The updated document walks back that requirement to 24 hours without fever-reducing medication.
Symptomatic students are still expected to self-isolate for at least 10 days “with improvement in respiratory symptoms” after testing positive.
The updated protocols specify that immunosuppressed students should self-isolate for 20 days rather than 10, whether or not they develop symptoms.
Test result turnaround time clarified
The university opened a COVID-19 testing facility on the Macon campus in July.
In the original protocols document, the university advised that “specimen collection needs to be completed by noon for return of report within one business day. Specimen can be collected after noon, but report may take up to two business days.”
The revised document no longer specifies how to receive results on the shorter timeline.
The only guidance on turnaround time on the updated document is a statement that “test results are returned in most cases within one to two business days.”
Sears said that “this change reflects the fact that tests aren’t always processed over the weekends.”
New protocols reflect updated CDC recommendations
Mercer’s updated protocols follow guidelines recently put forth by the CDC. The CDC directs symptomatic individuals to self-isolate for at least 10 days and end their quarantine after they have been fever-free for 24 hours without medication and have experienced improvement in their symptoms.
The agency also advises that “most people do not require testing to decide when they can be around others.”
This statement is a reversal of the CDC’s previous position that anyone who had been exposed to someone with COVID-19 should seek testing.
Updated CDC recommendations may reflect pressure from White House to reduce testing
Some experts are concerned that the CDC’s abrupt changes are a result of pressure from the White House to reduce the number of tests performed in the U.S. after President Donald Trump repeatedly implied this summer that the U.S. should conduct fewer tests in order to report smaller case numbers.
“Cases are going up in the U.S. because we are testing far more than any other country, and ever expanding. With smaller testing we would show fewer cases!” Trump tweeted June 23.
He later said that the tweet was “tongue-in-cheek,” according to The Hill, but he said again in July that reducing the number of tests would appear to reduce the number of cases.
“Think of this, if we didn’t do testing, instead of testing over 40 million people, if we did half the testing we would have half the cases,” Trump said, as reported by CNBC. “If we did another, you cut that in half, we would have, yet again, half of that.”
Robert Redfield, director of the CDC, said in August that the recent changes were recommended by the White House.
"These updated guidelines, coordinated in conjunction with the White House Coronavirus Task Force, received appropriate attention, consultation and input from task force experts," Redfield said in a statement released to CNN.
The Department of Health and Human Services, which houses the CDC, denied that the guidelines were recommended by the White House, according to the Washington Post.
"This Guidance has been updated to reflect current evidence and best public health practices, and to further emphasize using CDC-approved prevention strategies to protect yourself, your family, and the most vulnerable of all ages,” said HHS spokesperson and federal testing czar Brett Giroir.
The evidence Giroir referenced is still unclear. The standpoint that asymptomatic people do not need to be tested runs counter to the CDC’s data on asymptomatic transmission.
The CDC reports that up to 40% of all COVID-19 cases are asymptomatic and that asymptomatic carriers are 75% more likely to transmit COVID-19 than symptomatic carriers.
Carlos del Rio, infectious disease specialist and associate dean of Emory University School of Medicine, told Politico that the CDC has not provided any evidence that asymptomatic people do not need to be tested.
“Asymptomatic people transmit, and if you don’t isolate them and you don’t identify them, transmission will continue,” del Rio said. “I’m worried we are not diagnosing the people that we need to diagnose.”
Students encouraged to check Mercer’s website for policy updates
Sears confirmed Tuesday that the updates to Mercer’s protocols were not announced via email or any other mass dissemination method aside from being uploaded to Mercer’s COVID-19 website that day.
“We have been consistently encouraging students, faculty, staff and parents to check Mercer’s COVID-19 site daily. We’ve added a tab at the top of the page that lists the latest updates so they can be easily identified,” Sears said.