“We figured this out ourselves,” said Dr. Aaron E. Carroll, an associate dean at the university’s medical school, who helped devise the program. Federal guidelines were of little use, he said.
Trump administration officials like Adm. Brett P. Giroir, the testing czar and an assistant secretary of health, say they want states and localities to create their own testing plans that fit their specific needs rather than to be forced to follow federal dictates. But many experts complain that the lack of federal decision-making — including how many tests a day the United States should aim for — is an impediment in the nation’s battle against the virus, which so far has killed more than 184,000 people and infected more than six million.
“Let’s not just say we are ramping up and hope we get there. Let’s have a goal in mind,” said Dr. Mark McClellan, the director of the Duke-Margolis Center for Health Policy and the commissioner of the Food and Drug Administration under former President George W. Bush. “It’s not just a matter of getting the tests to market.”
In a recent interview, Dr. Bruce J. Tromberg, who directs the N.I.H.’s test development program, estimated that the United States needed to test about six million people a day, citing reports by experts at the Rockefeller Foundation and other organizations. Without federal assistance, he said, companies would at best produce only half that number by the end of the year.
The government’s purchases of hundreds of millions of tests for nursing homes and other hot spots have helped spur development and manufacturing. The N.I.H. is trying to encourage even more production, Dr. Tromberg said, with grants that have allowed companies to build laboratories and open new manufacturing lines.
Six million daily tests “is what we are on the trajectory for,” he said.
But in a briefing last month with reporters, Admiral Giroir appeared to contradict that. “I am really tired of hearing from people who are not involved in the system that we need millions of tests every day,” he said. “We are doing the appropriate amount of testing now.”