WASHINGTON (BLOOMBERG) - Frustrated by a lack of federal leadership, governors of both parties are trying to forge a national coronavirus testing program without the White House's help.
The seven-state effort to buy more than 3 million coronavirus antigen tests was born of need and disappointment.
It was midwifed by the Rockefeller Foundation and Maryland Governor Larry Hogan and skirts President Donald Trump's administration, even if many governors would prefer an approach coordinated by the federal government.
The foundation will help marshal funds, and the governors - four Democrats and three Republicans - aim to recruit more states, assuring test-makers of the biggest possible market and filling a vacuum left by federal inaction.
The group includes Louisiana, Maryland, Massachusetts, Michigan, Ohio, North Carolina and Virginia, and the states are already in discussions with test manufacturers Becton, Dickinson & Co and Quidel Corp.
The tests, which search for proteins on the surface of the virus, can deliver results in 15 to 20 minutes.
"The states are leading America's national response to Covid-19," said Virginia Governor Ralph Northam, a Democrat.
"We are bringing together this bipartisan, multistate coalition to combine our purchasing power and get rapid testing supplies to our communities as quickly as possible."
People "want to see action, and we're delivering," he said.
The agreement is a significant reproach to the administration, which has failed to formulate a coherent national plan to fight a disease that has so far killed more than 156,000 Americans and has at times left states competing for supplies.
It brings together politicians of different parties, despite Trump's effort to sow dissent before the November election.
And it comes in partnership with an elite charity that's a bastion of the American establishment.
"This appears to be a joint rebuke based in joint exasperation," said Dan Schnur, who teaches political communications at the University of California at Berkeley and the University of Southern California.
Although many states this spring tried to coordinate their approaches to fighting the pandemic and reopening their economies, those efforts fell short of pooling resources to buy badly needed tests.
"Shared communications and coordination is one thing, but a joint financial commitment in the absence of federal action is something else," Schnur said.
Hogan, the Republican governor of a blue state and the outgoing chairman of the National Governors Association, has openly criticised Trump's handling of the pandemic.
Last month, the Washington Post published an excerpt of his coming book in which he said Trump's lack of leadership had forced governors to confront the deadly virus on their own.
"With severe shortages and delays in testing and the federal administration attempting to cut funding for testing, the states are banding together," Hogan said Tuesday in a press release.
The group's plan is to "leverage all available resources" to create a cooperative agreement for national testing and tracing, according to a letter from the governors to the Rockefeller Foundation.
At an evening news briefing, Trump said his administration has increased the scale and quality of testing.
He said officials have been working with governors and that there have been "no complaints from any of them."
BIGGEST FORCE
But the united states - rather than the United States - are sending a message not only to Trump, but to companies that would be crucial to a recovery.
They're signaling strong market demand for the rapid tests, something more commonly seen on the federal level, said Gigi Gronvall, a senior scholar at the Johns Hopkins Centre for Health Security.
Still, it remains to be seen how these tests will be deployed, what additional orders the states will place, and what screenings may be required to confirm results, she said.
"There's certainly a need for testing of all kinds," Gronvall said.
But when it comes to "how much of a difference it's going to make, we have more questions than we have answers."
The US leads the world in its number of coronavirus cases, with Americans accounting for more than a quarter of infections worldwide and a fifth of total deaths.
The nation's shaky testing infrastructure has frustrated many public-health experts, not to mention test-takers, who complain of waiting a week or longer for results.
The Trump administration has instead left responsibility to states, with the federal government providing some supplies and doling out funds for the purchase of machinery.
The pact announced Tuesday could significantly expand testing in the member states.
Each performed between roughly 330,000 and 844,000 coronavirus tests last month, according to data from the Covid Tracking Project.
The pact calls for each to receive 500,000 tests.
In a sense, the agreement is the revenge of a tweedy establishment that Trump - a product of outer-borough New York - has long derided.
The Rockefeller Foundation, which was founded by oil magnate John D Rockefeller more than a century ago and has more than $4 billion (S$5.5 billion) in assets, has its headquarters a mile south of Trump Tower on Fifth Avenue in Manhattan.
The charity has a mission of improving "the well-being of humanity throughout the world."
It has long worked in public health, with a history in yellow fever and malaria.
Today its head is Rajiv Shah, a physician and former US Agency for International Development administrator during the Obama administration who led responses to crises like the Ebola pandemic in West Africa.
AMBITIOUS PLAN
The foundation became involved in the US testing strategy in late April.
It put out an ambitious plan calling for "launching the largest public health testing program in US history," with the help of thousands of small labs, billions in investments and the use of digital platforms to track the screenings and manage supply needs.
The foundation released a second report in mid-July, saying that although the US has surpassed the amount of testing it called for back in April, long turnaround times made results "practically worthless."
The country performed almost 5.3 million tests last week, according to the Covid Tracking Project, and commercial labs have said that turnaround times are improving, taking a few or several days on average.
The report warned of "impending disaster."
The virus is already taking lives, causing economic damage and exacerbating inequities - and the fall cold and flu system threatens to worsen conditions.
The country must be able to perform 30 million tests a week by the end of October, which would require a "concerted national effort," billions in funding and leveraging fast, cheap testing technology, the report concluded.
HURRYING UP
The interstate agreement represents a bet that faster, cheaper antigen testing can make a dent in long processing times, detecting outbreaks more quickly and making screenings more accessible.
The states will also cooperate to deploy the technology, and will have the Rockefeller Foundation's help to develop financing mechanisms for the arrangement.
They're likely to face constraints nonetheless.
Antigen testing, which is processed in about 15 minutes and doesn't need to be sent to a lab, is currently sold in the US only by Quidel and Becton, Dickinson.
Diagnostics makers are already swamped with demand for antigen and other tests, supply constraints that could limit such orders.
Antigen tests make it possible to screen people before they enter group settings like nursing homes and workplaces, but can also miss infections.
The US Food and Drug Administration has advised that negative results may need to be confirmed with another kind of test.
Despite the tests' limitations, the plan is a significant organisational advance.
"These are very big states" coordinating "to maximise their reach and ability to influence the market and be able to make progress," said Gronvall of Johns Hopkins, adding that similar efforts on other tests could also be forthcoming.
However, she said, a unified approach "would have the power of many more states and the federal government."
