Over the course of the pandemic, the official guidance on coronavirus testing in New York City has shifted dramatically. At the onset of the crisis in March, a shortage of tests and protective gear worn by those administering tests forced city officials to advise young and healthy New Yorkers who felt sick not to get tested, but to simply stay at home and let the illness run its course. Even during the height of the outbreak in April, city and state testing sites were still prioritizing testing for certain vulnerable communities and groups.

It was not until early June, on the heels of expanded testing capacity, that the city began encouraging all New Yorkers to get tested regardless of whether they felt sick or suspected they may have been exposed to the virus. As the de Blasio administration rolled out its Test and Trace Corps, the imperative for widespread testing has become that much greater: testing is the first step to tracing and containing any potential outbreak.

Now, one of the city's top health officials has controversially pushed the city's public campaign to get New Yorkers tested even further.

On Monday, Dr. Jay Varma, the mayor's senior adviser for public health, said city residents should consider getting tested at least once every month.

"That's kind of a good rule of thumb," he said, during a press conference with Mayor Bill de Blasio. "In an ideal world, we would have, you know, readily available tests that people could even just give them in their homes, but we're not in that world right now. So about once a month is practical and then to consider getting tested immediately if you are exposed to anyone."

Varma explained that more testing of asymptomatic individuals gives the city a better measure of how much the virus is spreading.

But Manhattan Councilmember Mark Levine, who chairs the health committee, said getting New Yorkers tested once a month is not feasible.

"We simply don't have the capacity to do that. That would mean 200,000 tests a day," he said.

He has tweeted about the disconnect in offering tests to those who don't appear to need them.

The city says it can currently test 50,000 people a day, although the highest number it has reached has been around 36,000 people.

On social media, many people reacted with incredulity to Varma's advice, pointing to testing delays that have persisted for more than month, even after the city said it would introduce new strategies to reduce turnaround time.

Stu Loeser, the former press secretary for Mayor Michael Bloomberg, who now works as a Democratic strategist, tweeted: "Serious question - if hundreds of thousands of us come out and do that, will we by and large get the results from one month's test back before the next test?"

Levine said that outpatient clinics in the city have continued to warn people of wait times between 7 to 14 days, a problem resulting from surge in demand for testing that has put a strain on commercial testing labs used by urgent care clinics like CityMD.

Although the Department of Health has access to faster machines, its lab can only produce a few thousand tests a day, according to Levine.

Denis Nash, a professor at the CUNY School of Public Health who formerly worked as a director of HIV/AIDS surveillance in the Department of Health, said that in light of the national testing delays, the city's "blanket strategy" on testing was misguided.

"It would seem like a waste of resources and time and effort," he said, before adding, "And it could have negative consequences for people who need to get tested."

Asked about Varma's advice, Avery Cohen, a City Hall spokesperson, on Tuesday underscored his comment that city had not yet developed "formal" guidance on how frequently New Yorkers should get tested.

According to Nash, the problem stems from the fact that the city has yet to articulate a clear public health strategy on testing.

"The city just doesn't have a clear direction," he said. "They are just sort of rudderless on what the testing program is all about."

Given the delays, he said, the city’s testing recommendations need to “be very considered.”

This will only grow more important as schools, colleges and more workplaces look to reopen, and the demand for testing rises.

While there is only so much the city can do to alleviate the testing delays, Levine said the city could publicize the number of tests that are taking longer than 72 hours, the period which he said was critical for tracers to locate and alert the potential contacts of infected individuals.

He also said that it would be useful to differentiate the turnaround time for patients tested at hospitals, which have access to faster results, and the wider public, who use walk-in clinics.

Ultimately, the councilmember said the struggle with widespread testing is a "double whammy" of the federal failure to nationalize testing as well as the private lab industry's inability to scale up quickly amid a public health crisis.

"Mass testing is the goal," he said. "That’s the aspiration but we have real capacity challenges right now."