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Growing confusion over new CDC guidelines as COVID testing is in high demand

The CDC receiving backlash for not requiring a COVID test at the end of the five-day quarantine period. One local doctor said that could soon change.

SAN ANTONIO — There’s growing confusion today, a week after the CDC changed its guidelines, cutting down isolation or quarantine for people with coronavirus from ten days to five.

The rise in omicron cases prompting the CDC to lower the days after research shows the transmission phase of the variant happens only a few days before someone shows symptoms and a few days after.

“The time from exposure to the time of onset of symptoms is much quicker with omicron, usually people are getting sick within two days,” said Dr. David Gude, Chief Operating Officer and practicing physician with the San-Antonio based Texas MedClinic.

Gude said the omicron strain develops more quickly, and patients are able to clear the infection faster, cutting down the time an infected person could pass along the virus to others.

But, the new changes are causing some confusion with no way of confirming that positive cases are actually the omicron variant.

“We seem to be getting some conflicting information that I haven't seen resolved,” said Gude.  “The state of Texas is publishing data that shows that 90 plus percent of the viruses that they're typing are omicron. So that gives us pretty good confidence that there's a 90 percent chance or greater that yours is omicron, but I've seen other data that says, no, those estimates are way over.”

“We don't know, and I think that's one of the frustrating expectations that patients have,” he added.

Another issue is that the omicron strain tends to show milder symptoms that many people could be mistaking for allergies, especially during the high cedar pollen season right now in San Antonio.

“I personally as a practicing physician, don't think it's really possible in most cases to tell that it is Cedar and not omicron, or we're also seeing starting to see flu cases,” said Gude.  “So, we have three things circulating around out there that all look similar.”

“I think you just have to assume the worst that you have COVID under the circumstances and either isolate or quarantine as per the guidelines,” he added.

On Sunday, Dr. Anthony Fauci said the CDC is facing backlash over the new guidelines.

“There has been some concern about why we don't ask people at that five-day period to get tested,” said Fauci.  “That is something that is now under consideration.”

Gude thinks that concern could soon change.

“I believe the CDC recommendations are going to be that you have a test, a rapid antigen test at five days,” said Gude.  “The issue is that PCRs are still the lab based tests, are still likely to be positive at five days. That doesn't necessarily mean that a person is contagious at five days. It just means they're still have the virus in their system, but presumably it's inactive. With a rapid antigen test, you should be negative at five day.”

“So, I expect that recommendation will be for a negative rapid antigen test, which is the type of test that home-based tests are using as well,” he added.

Gude suggests taking a test to be sure, but finding an available test presents another challenge.

“My answer would be you should test at five days. Unfortunately, I know that to be an impractical recommendation because you would have a hard time, I believe, finding a test in San Antonio today if today was your fifth day,” said Gude.

San Antonio Metro Health is offering pop-up testing sites, but lines and wait times are long.  Other clinics are also overwhelmed and often short-staffed.

“We're seeing our own issue here as every health care organization is,” said Gude. “We have about almost 10 percent of our staff out this week with COVID, and that's going to keep going on, and unfortunately, that's starting to impact the number of tests we can do.”

“If I could double the number of staff that we have, then terrific then we could be happy to do more testing, but we don't have the staff availability to do that,” he added.

Dr. Jan Patterson with UT Health San Antonio said it’s still not too late to get a vaccine or vaccine booster which can only help curb the spread.

“We're seeing that booster does give you significant protection against omicron, even though there are some breakthrough cases in general, there are less cases of people who are boosted, less symptomatic cases and certainly less severe disease,” said Patterson.