The New COVID-19 ‘Test to Treat’ Plan

During the first State of the Union Address of his term, President Biden announced a new national COVID-19 strategy as we begin year three of the pandemic. The ‘Test to Treat’ initiative increases preparedness plans and improves testing and immediate treatment access. In contrast to previous initiatives, Test to Treat allows those who test positive to immediately receive antiviral pills and other COVID-19 treatments at no cost. 

Getting a test for COVID-19 following a known exposure or development symptoms is one of the most critical steps in managing the spread of the virus. With a Mira membership, you get at-home tests and access to low-cost lab tests, discounted prescriptions, and urgent and virtual care services. Sign up today! 

Test to Treat Initiative   

President Biden’s Test to Treat plan is the first step in a national strategy to move the country to a “new normal” stage of the pandemic, in which COVID-19 is no longer a national emergency.

The new program will create a  ‘one-stop test to treat' location at pharmacy-based clinics such as CVS Pharmacy and MinuteClinic medical clinics, community health centers, and long-term care facilities across the country. Over the years, most sites have been equipped to administer rapid and PCR tests for those with presenting symptoms, preparing for travel and as a precautionary measure for group gatherings.  

One-stop locations will allow patients to continue to test at the respective sites; however, under the new plan, patients who test positive can be treated with Pfizer’s Paxlovid antiviral pill, at no cost, immediately after receiving positive results.

The FDA approved Pfizer’s antiviral pills in late 2021. The medication is meant to prevent hospitalization and death for people ages 12 and older who are at risk of developing severe outcomes from infection. The official plan from the White House stated that ‘one-stop’ sites are set to be open and operational within the month. After the initial antiviral approval announcement in November 2021, there was a shortage of antiviral pills in the United States. However, following the announcement of the new strategy, Pfizer has stated 1 million pills would be available this month and 2 million for April. 

Increasing Access to Testing 

The second component of the new initiative is increasing nationwide access to testing. In January 2022, the government launched an effort to provide up to four free rapid antigen tests to any household that requested them through COVIDtests.gov or by calling the website's support line. In the face of the December 2021 Omicron variant surge, the Biden administration made 500 million free tests available, but Americans placed only about 275 million orders.

During the State of the Union Address, President Biden announced that Americans would order an additional set of four tests, starting the week of March 7th. While most public health professionals agree that increasing testing availability is a step in the right direction, there is widespread push to improve the accuracy of at-home tests.  

As of February 2022, most at-home COVID-19 tests detect about 85 percent of positive cases on average. About 15 percent of tests show a false negative. A false negative is when the test comes back negative when you are actually positive for COVID-19. Dr. Micheal Osterholm applauded Biden’s initiative but stressed the importance of more accurate testing. He stated that professionals would hate to turn away those who are a true positive, even if testing deems them negative. 

About Antiviral Medication 

The development of antiviral medication to reduce the severity of COVID-19 infections has been a major goal in the COVID-19 response plan since October 2021. COVID-19 antiviral drugs work by slowing the virus’s replication process, which in turn stops the spread of the virus throughout your body and reduces severity. Although each type of antiviral medication interacts with the body differently, the three main goals are: 

• Lowering the viral load (amount of active virus) in the body
• Block receptors so the virus cannot attach and take over healthy cells
• Boost overall immune system to fight infection

Remdesivir was one of the first antiviral treatments authorized for emergency use and utilized for hospital administration. As of February 2022, Pfizer’s Paxlovid and Merk and Ridgeback Biotherapeutics’ Molnupiravir are the two antivirals that the FDA has authorized to treat mild to moderate COVID-19 cases through over-the-counter prescription. 

Paxlovid  

Paxlovid is the first-choice recommendation for patients presenting mild to moderate infections. Clinical trials showed proper usage reduced the risk of hospitalization and death for people at high risk of severe COVID-19 by 90 percent. Furthermore, studies have also shown that Paxlovid can interact with many common medications, meaning there are no known side effects when taken in addition to your routine prescriptions.  

Paxlovid is authorized for eligible adults and children aged 12 and older who weigh 88 pounds or more. The prescription would require you to take 3 pills by mouth twice a day, for 5 days. The sequence of drugs should start within the first 5 days of feeling COVID-19 symptoms and testing positive. 

Molnupiravir  

Similar to Paxlovid, Molnupiravir is an oral medication that should be started within the first 5 days of feeling COVID-19 symptoms and testing positive. The sequencing of pills is different in that you would take 4 pills by mouth every 12 hours for 5 days. 

Unlike Paxlovid, molnupiravir is only authorized for adults ages 18 and older. It has been shown to reduce the risk of hospitalization and death by 30 percent. Furthermore, the interaction of molnupiravir with other common medications is unknown.

It's important to note that molnupiravir is lower on the list of top recommendations and will be limited to situations where other authorized treatments are inaccessible or not clinically appropriate.

The chart below highlights some other key differences between the two medications:

Source: Goodrx.com  

‘Test to Treat’ Initiative FAQ(s)

Questions and answers you may have regarding the ‘Test to Treat’ plan.

How Soon Will the Test to Treat the Program Be Accessible?  

According to the White House, Pfizer has been speeding up the delivery of the pills to make thousands available much earlier than anticipated. In his speech, Biden stated the program would begin this coming week (March 7, 2022). However, experts suggest that late March is a better estimate for seeing availability in pharmacies and clinics nationwide. 

Besides Having a Positive Test, Are There Other Qualifying Guidelines for Getting a Prescription? 

A positive COVID-19 test is the first qualifying factor for getting an antiviral prescription. However, as the plan continues to roll out in the coming month, supply shortages might cause state and local governments to create more restrictive eligibility requirements. Under the National Institutes of Health guidelines, some locations with a limited supply might prioritize unvaccinated patients as the first to receive the medication.

Following the State of the Union Address, some cities have already established prescription criteria on their respective health department websites. Clark County, Nevada has stated that Paxlovid will be given to patients who are: 

• Symptomatic
• Have a positive test
• Over the age of 65.

New York state is prioritizing treatments for those: 

• Moderately to severely immunocompromised, regardless of vaccination status
• Older and not fully vaccinated, with at least one risk factor for severe illness

To find out if you qualify and if your country or state has established additional requirements, you should check your local health department website or ask your primary care physician. Furthermore, it's important to check what your health department classifies as risk factors.  

If I’m Vaccinated and Test Positive, Should I Still Receive an Antiviral Pill?   

If you have been vaccinated, have significant risk factors that put you at high risk for developing a severe COVID-19 infection, and test positive, you may be eligible to receive a prescription for antiviral medication. It's important to note that either antiviral pill is not a substitute for the vaccination.

Even with the vaccine, you can still contract and test positive for COVID-19. It is still critical for those who can get vaccinated to get one of the COVID-19 vaccinations. Talk to your primary care physician before beginning treatment, or even before testing positive to ensure that you are prepared if you do become positive at any point.

How Do I Find Which Clinics and Pharmacies Are Offering Antiviral Medication, Following a Positive Test? 

Similar to the initial rollout of N95 masks and the first round of at-home COVID-19 tests, it's safe to assume some regions and stores will have access to antiviral medications before others. GoodRx has created a tracker system showing where Paxlovid is available. 

In the coming weeks, check with your local clinics and pharmacies to see if they have started the Test to Treat program or have an estimate as to when it will begin in your region. 

Which Antiviral Will Be Available Given At Local Pharmacies and Clinics?  

With Paxlovid being the first-choice recommendation for antiviral treatment, most locations will be administering the Pfizer brand; Furthermore, before FDA authorization in November, the White House already purchased 1.7 million courses of the treatment, anticipating approval. Following Biden’s address, Pfizer stated that 1 million pills would be available this month and 2 million for April.  

Bottom Line

Test to Treat and the production of antiviral prescription medications are initiatives in the right direction to move the country closer to returning to life reminiscent of pre-pandemic. Experts have stated that the facilitation strategy will most likely face implementation roadblocks, but it is unlikely this will derail the entire program. Pairing the steady decline in the case and hospitalizations and increasing vaccination rates, President Biden’s new initiative is a promising strategy to get us past this public health emergency.

As the new initiative begins to roll out around the country, it's crucial to remember that the pandemic is an ever-changing public health concern. In this age of health uncertainty, it's essential to have accessible care at your fingertips. From low-cost virtual and urgent to up to 80 percent off of prescription medications, Mira can offer you peace of mind with every new COVID-19 initiative for as low as $45 a month. Learn More.