Former Food and Drug Administration Commissioner Scott Gottlieb warned there will likely be a dramatic acceleration of U.S. coronavirus cases the next two weeks as more testing detects new infections.

Gottlieb said the federal government should have coordinated with both academic and private industry labs to begin testing sooner for the respiratory virus rather than rely solely on the Centers for Disease Control and Prevention’s test kits.

“The mistake we made is we took a very linear approach rather than an all-of-the-above approach,” Gottlieb said during an editorial board meeting Monday with USA TODAY.

As of Monday night, the number of confirmed cases in the U.S. surpassed 750 across more than 30 states and the District of Columbia. The U.S. death toll rose to 26, with 22 in Washington and two each in California and Florida.

CDC developed and shipped testing kits in early February to state and local public health labs to begin testing for coronavirus. But a test kit glitch left state and local public health labs unable to confirm the test results. The flaw delayed rapid testing among state and local labs, just as the deadly respiratory virus gained a foothold among infected travelers returning to the United States.

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Now that testing is ramping up among government, private and academic labs, many share Gottlieb's concern it's too late and also warn further delays are still likely.

Private labs and academic hospitals didn’t get the green light to develop and use their own diagnostics until several weeks later. That delayed testing and left even patients with symptoms of, or exposure to COVID-19 unable to get tested.

The CDC said 78 public health labs in 50 states were testing for the virus as of Monday. The agency also relaxed testing guidelines to allow more people to get tested. Both academic labs and large private lab testing companies such as LabCorp and Quest Diagnostics are rolling out coronavirus tests after receiving FDA authorization.

Ben Pinsky, medical director of the Clinical Virology Laboratory for Stanford Health Care and Stanford Children’s Health, said its lab was up and running in less than a month and "we're working on ramping up capacity as fast as we can." Stanford is now doing the testing for Stanford Medical Center, as well as University of California San Francisco's hospital and Kaiser Permanente until they are able to get their test, Pinsky said.

"We're a little bit ahead of the game," said Pinsky. "Some academic medical centers have labs up and running, but most are still rapidly trying to get tests."

Pinsky said he was concerned about the number of cases in China in late January and started evaluating the test his lab is using in early February. They were developing the test while they were in the process of applying to the FDA for permission to test, but it was still a time consuming process. Components were ordered from different suppliers, assembled and validated before they could be used.

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Given the "amount of effort to bring up a test for our institution," which involved people from the hospital, the medical school and the university, he said he appreciates the challenges "to do it at scale for the CDC for the entire country."

"It's expected there would be potential problems along the way," said Pinsky. "It may well be an excellent test" he said of CDC's.

Still, Gottlieb said the U.S. Department of Health and Human Services should have encouraged academic and private labs to begin developing tests sooner.

“There should have been, I think, a sense of urgency about taking an 'all of the above' approach and trying to get all of the diagnostic players into the game as early as possible,” Gottlieb said. “We ended up doing all those things but we ended up doing them late. And now we’re still behind the curve.“

Because of the time it takes for private lab companies to ramp up and validate their testing, it could be another week or so before testing capacity can keep pace with new infections.

"I was arguing for it six weeks ago," said Gottlieb.

Along with time, it takes money and staff to operate labs operated by public health departments, said Eric Blank, chief program officer at the Association of Public Health Laboratories. Although President Trump signed an $8.3 billion bill to fund efforts to combat coronavirus, it will take months before states are able to hire the people needed after years of massive budget cuts.

By the time all the labs are up, staffed and running, coronavirus' threat could be largely abated, public health experts say. Gottlieb noted the unseasonably warm temperatures in much of the country don't necessarily mean COVID will start to wane like flu does in the summer. It's an unknown virus; March and April are the key time periods to watch, he said.

The capacity of state labs depends on their size, funding and technology, said Blank. That could mean the difference between being able to test batches of nearly 100 samples at a time or doing them one by one, he said.

The new funding could speed things up, said Blank, but it may take up to a month to get the money to the people in states who can spend it on new lab instruments, and another three to four weeks in the procurement process. Hiring people could take six months or more.

The lag time has a serious health effect.

“It’s probably the case we have multiple, large outbreaks in major metropolitan areas that we are unaware of,” Gottlieb said.

Whether the technology and people can be in place while it's still needed to prevent coronavirus' spread remains to be seen, addBlank.

"That’s the one thing we don’t know: When will this virus be over?"