The idea of Americans being able to quickly, easily and cheaply administer a COVID-19 test at home is a "utopian" concept not workable in the real world of the current pandemic, a top Trump administration official said.

"It's great to talk about this utopian kind of idea where everybody has a test every day and we can do that," Brett Giroir, assistant secretary for health at the U.S. Department of Health and Human Services, told reporters Sept. 1. "I don't live in a utopian world. I live in the real world."

Giroir argued the U.S. could fully return to a normal functioning society without Americans having to undergo frequent COVID-19 testing.

"There may be a time where everybody can wake up in the morning, pass through a tricorder and tell whether they're infected or not," he said, referring to the hypothetical handheld scanning device used on the 1960s science fiction TV show "Star Trek." "We are not there yet," he added.

But Ashish Jha, dean of Brown University School of Public Health, took issue with Giroir's response.

"It's not utopia to want to test teachers and kids to return to school, nursing home residents to stay alive, first responders and other essential workers," Jha tweeted. "That's what White House staff and major league sports get now. Sure, let's call it utopia when it's for the less privileged."

The National Basketball Association has been testing players regularly at the so-called "bubble" at Walt Disney World, a special isolation zone created to protect team members so they could continue their 2020 sports season.

The NBA participated in Yale University School of Public Health's validation program for the institution's COVID-19 saliva-based laboratory diagnostic test, which was granted an emergency use authorization by the U.S. Food and Drug Administration on Aug. 15.

The test, known as SalivaDirect, is intended to be a simpler, cheaper and less invasive test than diagnostics involving nasopharyngeal swabbing.

President Donald Trump and White House staff are tested daily for COVID-19 using a variety of diagnostic tools, including rapid tests.

The U.S. National Institutes of Health launched a $1.5 billion "Shark Tank"-like contest in late April in which innovators have been competing for funds to develop at-home and point-of-care diagnostic tests for COVID-19.

On July 31, the NIH awarded $248.7 million to seven small diagnostic companies to advance their innovations.

"There is no stone unturned, there is no technology that we're not looking at or investing in if it's promising," Giroir told reporters.

But as far as Americans broadly having access to easy COVID-19 tests at home, "I can't tell you when that day is," Giroir said.

"I don't want to answer any more when is that day going to happen because I can't tell you," he said. "It may never happen."

Asymptomatic testing

Giroir insisted the Trump administration's Aug. 24 revisions to the testing recommendations posted on the U.S. Centers for Disease Control and Prevention's website "could not be clearer that we support testing asymptomatic people according to local public health."

Previously, the CDC had recommended testing for all close contacts of people with COVID-19 infection.

Under the revisions, the CDC advises that "If you have been in close contact — within 6 feet — of a person with a COVID-19 infection for at least 15 minutes but do not have symptoms: You do not necessarily need a test unless you are a vulnerable individual or your health care provider or state or local public health officials recommend you take one."

In other words, the CDC had gone from indicating testing for all close contacts of people known to have tested positive for COVID-19, whether they had symptoms or not, to suggesting testing is no longer always necessary in those situations.

As many as 40% of people in the U.S. who have tested positive for COVID-19 have shown no symptoms, or are asymptomatic, and therefore can spread the virus to others unknowingly, according to the CDC.

During an Aug. 26 call with reporters, Giroir acknowledged the revisions were drafted by a number of people outside of the CDC. He wrongly said U.S. National Institute of Allergy and Infectious Diseases Director Anthony Fauci had signed off on the changes. Fauci was having surgery Aug. 20, the day the revisions were finalized and he did not see them until they were posted on the CDC's website Aug. 24.

After the revisions were widely criticized, CDC Director Robert Redfield issued a late-night statement Aug. 26 saying "testing may be considered for all close contacts of confirmed or probable COVID-19 patients," which created more confusion.

Former head of the NIH, Harold Varmus, a professor at Weill Cornell Medicine, and Rajiv Shah, president of the Rockefeller Foundation, condemned the changes to the CDC's testing guidelines and called on healthcare professionals to ignore them.

"These changes by the CDC will undermine efforts to end the pandemic, slow the return to normal economic, educational and social activities, and increase the loss of lives," Varmus and Shah wrote in an Aug. 31 op-ed in The New York Times. "Like other scientists and public health experts, we have argued that more asymptomatic people, not fewer, need to be tested to bring the pandemic under control."

"The CDC, the federal agency that should be crushing the pandemic, is promoting policies that prolong it," they said.