This drive-through is one of the first of many sites popping up around the country — from West Barnstable, Massachusetts, to Stanford Health Care in Palo Alto, California — as the United States scrambles to catch up to the demands for COVID-19 testing. The guidelines for who can be tested vary from place to place. An early testing center in San Francisco opened by Kaiser Permanente, a healthcare plan, is for members only and patients must be evaluated by a doctor first, per an article published March 15 in The Mercury News. At Mayo Clinic, the drive-through is open to everyone, according to Mayo Clinic spokesperson Ginger Plumbo. “They don’t need a physician or health department referral, but they do need to start with a phone call to our COVID Nurse Triage Line or their Mayo primary care provider who will then instruct them to the drive-through if appropriate,” said Plumbo in an email response to Everyday Health.
How Drive-Through Testing Can Help Prevent Further Spread of the Coronavirus
In drive-through testing, the patient remains in the car throughout the process while trained staff, outfitted in protective gear and masks, performs the test. As per CDC recommendations, an upper respiratory nasopharyngeal (from the nose) swab is taken for initial diagnostic testing. A swab is inserted into the nostril along the septum floor of the nose extending straight back all the way to the posterior nasopharynx, and then rotated several time while it is in contact with the nasopharyngeal wall, according to LabCorp instructions. Oropharyngeal (from the throat) swabs are a lower priority, according to the CDC, and collection of sputum should only be performed on patients with productive coughs. “Collecting specimens in this way helps us keep possibly infected patients out of the waiting rooms and emergency departments,” explained Plumbo. All the specimens are sent to the lab for testing, and positive cases are reported to public health, she added. “There is no extra cost to use the nurse triage line, and if testing is warranted, there is no extra cost to use the drive-through specimen collection,” she noted. “This is a good way to do testing to minimize the chance of further spread of the disease,” says Joshua Sharfstein, MD, vice dean for public health practice and community engagement for Johns Hopkins Bloomberg School of Public Health in Baltimore, and coauthor of an editorial on the coronavirus testing published on March 9 in the Journal of the American Medical Association. “It’s also an efficient approach,” he adds. RELATED: Scientists Fast-Track Research for Coronavirus Treatment and Vaccine
Drive-Through Healthcare: A New Frontier?
South Korea was the first country to begin testing for COVID-19 in a drive-thru setting, but this method of healthcare delivery isn’t without precedent, says Dr. Sharfstein. “There are examples of drive-through flu vaccination sites and other drive-through programs in public health in the United States. It’s more established than you might think,” he says. “It’s important, of course, to offer testing to people who can’t drive somewhere. This can’t be a way of exacerbating disparities in access to care,” adds Sharfstein. There are a few drawbacks to the system, acknowledges Plumbo. “Traffic flow can be challenging; when people just show up without calling the nurse triage line to be screened first, that greatly delays the process.” Patient privacy is a concern because other people in the parking lot or driving by can see the identity of the patient who is getting a specimen collected, she noted. “The local media basically just shows up and starts filming and taking photos,” said Plumbo. Every effort is made to protect the patients’ privacy — the clinic uses a tent so no one can see the specimen being collected — but it’s still a concern, she added. RELATED: Coronavirus Shopping List: What to Buy and Skip
Drive-Through Testing a Major Part of the Plan to Contain COVID-19
Expect the number of drive-through testing sites to continue to climb. In his state of emergency speech on Friday, President Trump said that the government had been in discussions with pharmacies and retailers to make drive-through tests available in “critical locations identified by public health professionals.” In an address on Sunday, March 15, updating the government’s response to the coronavirus, Vice President Pence said there are more than 2,000 labs coming online to help process the results of the tests, according to Rev.com. “We’re also working with a number of retail partners to add to the work that states are doing around the country, working to set up parking lot testing centers outside of stores,” he said. Pence also reaffirmed President Trump’s pledge that “all coronavirus testing is free for every American, including uninsured Americans.” Deborah Birx, MD, White House coronavirus response coordinator, cautioned people that once the tests are fully rolled out and labs around the country are processing the results, there will be a spike in the number of confirmed cases. People need to be judicious in deciding whether to go get tested, urged Dr. Birx. “I know everybody’s going to want to go to these drive-throughs, but we [should] prioritize…the care of every person with a preexisting condition and immunosuppression, and the elderly with existing conditions,” said Birx. RELATED: 5 Ways the Coronavirus Is Changing Everyday Life
