Florida Surgeon General Suggests That Children Should Skip Covid Testing

As the spread of omicron outpaces the enormous demand for COVID-19 tests, Florida Surgeon General Joseph Ladapo has a solution that defies medical professional advice: test fewer individuals.

The surgeon general took aim at mass testing in a Monday news conference, saying the Florida Department of Health will soon advise individuals to avoid testing unless it is “high-value.”

If you have symptoms, have had close contact with someone who has COVID-19, or are not completely vaccinated, the Centers for Disease Control and Prevention recommends that you get tested. Instead of vaccination, certain federal vaccination laws require weekly testing.

People at lower risk of severe outcomes, such as children and people without symptoms, will be tested less frequently under the new guidelines. In contrast, those more likely to need treatment for COVID-19, including the elderly, will be tested more often, he said.

“My department’s goal … doesn’t restrict access to testing, but reduces the use of low-value testing and prioritizes high-value testing. … High-value testing is testing that is likely to change outcomes,” Ladapo said during the news conference at Broward Health Medical Center in Fort Lauderdale. “We need to unwind this … planning and living one’s life around testing.”

According to Florida International University epidemiologist Mary Jo Trepka, Ladapo incorrectly assumes that the highest value gained from testing is determining whether someone needs to be treated for COVID-19, when tests’ ability to tell someone whether they need to isolate, thus reducing community spread, is perhaps even more valuable.

Trepka noted that recent evidence indicates monoclonal antibodies, Florida’s go-to treatments, don’t work as well against omicron as they did against previous variants. One brand, Glaxo Smith Kline’s Sotrovimab, works better than others, but it is hard to get nationwide.

“We don’t really have an effective treatment for COVID-19 with the omicron variant. There’s really only one monoclonal antibody,” she said. “But I would argue that you can really prevent a lot of infections if you test widely because then those people who are asymptomatic or very mildly ill can find out if they have COVID-19 and then they can … avoid spending time with highly vulnerable people.”

Though children are at lower risk of severe outcomes from COVID-19, the CDC reports that they can still spread the virus to others, as can asymptomatic people who may not be aware that they have it.

Infectious disease epidemiologist Elena Cyrus says community testing has guided public health responses for decades and helped control viruses along with other measures, such as vaccination.

“In all epidemics from HIV to previous SARS, screening remains one of the most cost effective ways to help prevent and control the spread of a disease/virus,” she wrote in an email.

Test results can be used to inform decisions, such as whether to reopen schools or implement mandates. For example, Orange County Mayor Jerry Demings ended its state of emergency in October after its COVID-19 test positivity rate remained below 5% for two weeks.

During his news briefing on Monday, Gov. Ron DeSantis backed Ladapo’s decision and suggested that reducing testing would also benefit vulnerable populations such as the elderly.

“What you are seeing is there are people going to the drug stores, buying all these tests. They’ll go multiple times per week to the sites and test, without symptoms. That is just going to contribute to some of the crunch that you are seeing,” DeSantis said.