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No need to test for COVID-19 if asymptomatic, Florida health department says

Experts say the approach comes with downsides.
Gov. Ron DeSantis said during a news conference Thursday that prioritizing tests for people most likely to suffer severe outcomes from COVID-19 is the best way to allocate resources during a spike in cases.
Gov. Ron DeSantis said during a news conference Thursday that prioritizing tests for people most likely to suffer severe outcomes from COVID-19 is the best way to allocate resources during a spike in cases. [ WILFREDO LEE | AP ]
Published Jan. 6|Updated Jan. 6

TALLAHASSEE — The Florida Department of Health issued new guidelines Thursday in an effort to clarify when Floridians should seek a COVID-19 test.

In a one-page document, the department broke test-seekers into three groups: those at significant risk for severe COVID-19 who are showing symptoms, those not at significant risk for severe outcomes who are showing symptoms and the asymptomatic.

According to the guidance, vulnerable populations who are showing symptoms “should” get tested. Those not at significant risk for severe COVID-19 may “consider” getting tested. And for the asymptomatic, “COVID-19 testing is unlikely to have any clinical benefits.”

“When you have an endemic respiratory virus, the default has got to be, you live your life,” Gov. Ron DeSantis said at a news conference in West Palm Beach on Thursday. “Then, if you end up getting sick, test to see what it is.”

The governor noted that the Department of Health guidelines are non-binding. Floridians are still free to get tested as often as they can. But he said prioritizing tests for people most likely to suffer severe outcomes from COVID-19 is the best way to allocate resources during a spike in cases.

That’s why, he said Thursday, his administration would send up to one million rapid tests to long-term care facilities in the state.

Thomas Unnasch, a distinguished professor at the University of South Florida’s College of Public Health, said the state’s approach would make sense but for one key detail: There are not enough effective treatments to go around right now to help vulnerable people infected with COVID-19.

Unnasch noted a study that showed two key types of monoclonal antibodies, manufactured by Regeneron and Eli Lilly, are not effective against the omicron variant of the virus. Other treatments, such as antiviral pills manufactured by Pfizer and Merck, are on the way and appear effective against omicron, he noted. But they won’t appear fast enough to help Florida with the current surge.

That means testing asymptomatic people will remain a key way to protect the vulnerable, he said.

“Once the at-risk population gets it, we don’t have anything to help them,” Unnasch said.

At the news conference, DeSantis contended that the widely used monoclonal antibody treatments have not proven to be ineffective in the real world.

“We think what we’re seeing is probably that the Lilly and the Regeneron may be not quite as effective as it was for delta. But if it’s 50 percent effective and you’re somebody that’s high-risk, that’s something that you would want to see,” DeSantis said. “We don’t have the data to say it definitively doesn’t work.”

Thomas Hladish, a research scientist at the University of Florida’s Emerging Pathogens Institute, said encouraging asymptomatic Floridians not to be tested may also come with broader public health consequences.

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Florida is still in the middle of the omicron wave. Epidemiologists are still tracking the virus’ spread throughout the state. Changing testing guidelines in the middle of the wave could affect public knowledge about the extent of the virus’ spread, Hladish noted.

“There may not be much clinical benefit to testing asymptomatic people because you don’t need to treat those individuals,” Hladish said. “But there is a great deal of public health benefit to knowing if people without symptoms are infected because we know that a lot of transmission happens from asymptomatic or pre-symptomatic people.”

Over the holiday week between Christmas and New Year’s Day, testing sites in Florida were inundated as families reunited and cases soared to record levels.

During that time, Democrats called on the governor to do more to expand testing capacity. Agriculture Commissioner Nikki Fried, the lone statewide elected Democrat, criticized DeSantis for sitting on about one million at-home rapid tests that she says the state could have given out to Floridians hoping to be tested.

At Thursday’s news conference, Kevin Guthrie, DeSantis’ Division of Emergency Management director, said those tests had expired in a state warehouse three months before the end of the year. The state had tried to give them out, but there wasn’t enough demand, Guthrie said. (Department of Health spokesperson Weesam Khoury said the test kits required training to use and weren’t for individual use.)

However, the state was given an extension to use those kits for another three months — until the week of Dec. 26, Guthrie said. With the second deadline set to expire, the state asked the federal government and Abbott for another extension. They did not get a response, Guthrie said.

Requests for comment from the U.S. Department of Health and Human Services and Abbott were not immediately returned Thursday.

• • •

How to get tested

Tampa Bay: The Times can help you find the free, public COVID-19 testing sites in Citrus, Hernando, Hillsborough, Manatee, Pasco, Pinellas, Polk and Sarasota counties.

Florida: The Department of Health has a website that lists testing sites in the state. Some information may be out of date.

The U.S.: The Department of Health and Human Services has a website that can help you find a testing site.

• • •

How to get vaccinated

The COVID-19 vaccine for ages 5 and up and booster shots for eligible recipients are being administered at doctors’ offices, clinics, pharmacies, grocery stores and public vaccination sites. Many allow appointments to be booked online. Here’s how to find a site near you:

Find a site: Visit vaccines.gov to find vaccination sites in your ZIP code.

More help: Call the National COVID-19 Vaccination Assistance Hotline.

Phone: 800-232-0233. Help is available in English, Spanish and other languages.

TTY: 888-720-7489

Disability Information and Access Line: Call 888-677-1199 or email DIAL@n4a.org.

• • •

More coronavirus coverage

KIDS AND VACCINES: Got questions about vaccinating your kid? Here are some answers.

BOOSTER SHOTS: Confused about which COVID booster to get? This guide will help.

BOOSTER QUESTIONS: Are there side effects? Why do I need it? Here’s the answers to your questions.

PROTECTING SENIORS: Here’s how seniors can stay safe from the virus.

NEED TREATMENT: Find a monoclonal antibody site here.

GET THE DAYSTARTER MORNING UPDATE: Sign up to receive the most up-to-date information.

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