COVID testing and treatment ‘right on the spot at no extra charge’ at Delaware clinic

A married couple in their 50s showing symptoms of COVID-19 headed to the Newark Urgent Care Center within days of each other in the last week to get a rapid test.

Both were positive and had symptoms that had appeared within five days of testing, qualifying them for one of two FDA-authorized medications aimed at preventing hospitalizations or severe symptoms.

But instead of having to go to the pharmacy to get a prescription filled, the man and woman were able to take a five-day packet of medications home to begin treatment instantly.

All for free.

The couple benefited from a new federal Test to Treat initiative that debuted in Delaware last Wednesday at the Newark medical facility. The state also plans to open two more sites by month’s end – one each in Kent and Sussex counties.

“Test to Treat clinics are another tool in our toolbox to help stop the spread of COVID-19 and keep our community safe,” said Dr. Karyl Rattay, director of the Delaware Division of Public Health.

Dr. Jack Horowitz, who runs the Newark clinic, welcomes the opportunity to participate. Since  the pandemic began in Delaware 25 months ago with the first case at the nearby University of Delaware, Newark has become a hub for testing in western New Castle County. Caregivers there have administered more than 45,000 tests.

In an interview Wednesday, Horowitz said that in the first week, 298 tests were given under the program. Of those people, 43 tested positive for the coronavirus, and 19 qualified for take-home medications. Fifteen were provided with Pfizer’s Paxlovid, and four with Merck’s Lagevrio, also called molnupiravir. None of the 43 needed immediate hospitalization, he said.

“The patient has the option to accept treatment or not,” Horowitz said. “But if they accept, we hand them this whole five-day course of antivirals right there on the spot at no extra charge. The government’s paying for it.”

To qualify for the meds, Horowitz said a patient “can’t be too sick or too well, meaning if they barely have any symptoms, we don’t recommend the medicine. If they are very, very ill and need to be hospitalized, then they will get sent to the hospital for a whole different battery of medicine. We’re looking for that type of patient, that kind of the criteria that have the disease  and are at high risk for progression to serious illness.”

That means people with mild-moderate cough, fever, or body aches and are “at high risk of progression, and those are for people with diabetes, heart disease, cancer, immunosuppressive asthma.”

The program is being launched in Delaware as the state, and much of the country, are experiencing increases in COVID-19 infections. Over the last week, an average of 168 new cases were identified every day — compared to 60 a month ago. That’s a 167% increase but pales in comparison to the roughly 3,500 infections a day in mid-January.

The current weekly positivity rate is 7.1%, more than double the number of a month ago.

A total of 37 Delawareans are currently hospitalized, up from 19 on March 27, but less than the 44 a month ago. Rattay and other health officials attribute the relatively low number of hospitalizations — it was 759 in mid-January — to the fact that 95% of adult residents have received at least one vaccination dose and others have some natural immunity from recent infections.

At the Newark facility earlier this week, Dr. Mehdi Jaladi said the first step is to determine whether the patient is infected. He said the rapid tests are 80% effective but if the person has a positive test plus COVID symptoms, it’s appropriate to conclude they are infected and provide the medication.

The next step is to assess whether the patient qualifies for medication and which one to provide, He said Paxlovid “has a higher chance of improvement” but more side effects. Lagevrio isn’t as effective, but has fewer side effects, he said.

“So it’s the thing that we have to discuss with the patient and come up with a better option for them,” Jaladi said. “Of course, for the patients that are at high risk [of a serious case of COVID-19], it’s important that they know that the treatments are available and they shouldn’t wait.

“If they are a candidate, that’s something they can take. The benefit is that their symptoms are going to be shortened and hopefully decreases the risk of hospitalization and death.”

Dr. Donnita Scott, who treated the man in his 50s who tested positive and took home medication, called the program a no-brainer.

“I think it’s a good option for the state of Delaware,’’ Scott said. “Try to keep people out of the hospital to recover at home.”

Danielle Scalia of nearby Landenberg, Pa., who was at the clinic to get evaluated for a cough but did not have COVID-19, praised the program.

“I think that’s really nice because some places take forever for you to get your COVID results back,’’ she said. “And then they also don’t give you the medicine unless you’re like, really bad. And I think with the university here, it allows the kids to get answers quicker and then be able to get back on with their daily life.”