ExpressCare Offers "Test-to-Treat" Program for the Community


Following COVID-19's peak and variant surges earlier this year, state and federal regulations have relaxed. The vaccination rate in Maryland is high, and morbidity has lessened compared to early in the pandemic. People have become less vigilant as a result, and unfortunately, COVID positivity rates are rising.

"Transmission has risen because the strains are more transmissible and less virulent," says Jonathan Thierman, M.D., Ph.D., chief medical officer for LifeBridge Health Partners, which operates ExpressCare, an urgent care center chain in Maryland. "Viruses mutate over time and as they evolve, they become more contagious and less dangerous. We've moved in a predictable manner, which is that it's a highly transmissible, less lethal strain, and we're not masking up as much as we used to. For those two reasons, it's, we're seeing huge jumps and volumes."

At ExpressCare, volumes are up five-fold since early April, with more children testing positive.

In an effort to equip the community in the fight against COVID-19, ExpressCare became the first urgent care chain in the state of Maryland to participate in the Test-to-Treat (T2T) Program. The federally funded, state driven program enables the dispensing of an FDA emergency use authorized oral antiviral agent to patients who test positive, are within the first five days of symptoms and meet certain criteria. LifeBridge Health's ExpressCare is working with the Maryland Department of Health to dispense Paxlovid, an oral antiviral agent prescribed when someone tests positive for COVID, and meets age, weight and certain risk factor requirements. ExpressCare provided the best opportunity for distribution locally, as the urgent care chain meets the requirements for participation, being able to test and then treat patients.

Candidates for Paxlovid:
"* Have mild to moderate COVID-19 
"* Are over 12 years of age
"* Weigh at least 88 pounds
"* Have a high risk for severe COVID, based on a medical condition that causes moderate to severe immunocompromise 
"* Are age 75 years or older regardless of vaccination status
"* Are age 65-74 and not up to date with vaccination or with priority risk factors (see below)
"* Are pregnant and not up to date with vaccination

Priority Risk Factors:
"* Obesity (BMI over 35)
"* Have a chronic respiratory disease (COPD, moderate or severe asthma requiring daily inhaled medications)
"* Pregnancy
"* Chronic Kidney Disease

"The antiviral medications are very effective at keeping people out of the hospital and alive," Dr. Thierman explains. "They prevent severe COVID."

Paxlovid, according to Dr. Thierman, has an 89% efficacy rate for keeping high risk individuals out of the hospital and alive. All 27 ExpressCare locations are stocked with Paxlovid. The medication is provided at no cost for qualifying patients, based on T2T federal funding, and LifeBridge Health has waived the dispensing fee to ensure patients are able to receive the medication.

 "Most drugs don't have a 90% efficacy," Dr. Thierman notes. "It's really the next wave of defense against COVID. It will make the biggest impact after the vaccine."

ExpressCare clinicians are seeing many COVID-positive patients with coexistent diseases like the flu and strep throat. Patients gain an advantage by being treated at ExpressCare as they not only receive Paxlovid, but they also are tested and treated for other conditions as well.

Patients experiencing symptoms should test at home, but also ought to rely on testing at a facility for official records, air travel and better accuracy. 

"It's done in a regulated way, following a protocol and procedures," Dr. Thierman notes. "At home, sometimes people don't adequately swab their nasal passage, sometimes they don't adequately mix the cotton swab in the solution for long enough to transfer the virus to the solution, and sometimes they don't get the right number of drops. If you're in a medical facility that has protocols and procedures, it's done exactly the same way every time."

In addition, test reliability is an important consideration. ExpressCare's rapid test was vetted for reliability. With home tests ordered online or purchased in a drug store, there is not a guarantee of reliability. ExpressCare also provides the option for PCR testing, which is sent to a lab for evaluation. 

"There are a lot of advantages to getting tested in a facility," Dr Thierman says. "But, there's nothing like the vigilance of being able to test frequently at home. There's a place for both home testing and testing in the facility."

When testing at home, Dr. Thierman recommends keeping the following in mind:
"* Follow the instructions exactly as recommended by the manufacturer
"* Make sure to get a good sample, using both nostrils
"* Wait the specified amount of time to determine results

"While home testing is good if you follow the directions, if you think you're positive, and you want reassurance that you don't have anything else going on, and if you want to get Paxlovid for being positive, you should come to ExpressCare to get evaluated and treated, if it's appropriate for you."

For a listing of ExpressCare locations or to make an appointment, visit