COVID-19 drug Paxlovid available at 'Paxmobile' in Nassau 

Health care and government officials in Nassau on Tuesday launched a new effort to bring COVID-19 treatment to underserved communities — a "Paxmobile" that can dispense the anti-viral medication Paxlovid.

The mobile medical service operated by Mount Sinai South Nassau is part of a wider effort to help communities where residents have struggled since the start of the pandemic to get tested for the virus and, later, vaccinated. Expanded access to COVID-19 treatment also comes as the pandemic moves into a new phase of living with the virus — and getting medical aid to reduce symptoms.

Mount Sinai South Nassau and Hempstead Town officials inaugurated the program Tuesday in Oceanside where the van was stationed to give out free Paxlovid to those who tested positive for the virus.

The mobile test to treat program was met with mixed reviews from medical experts Tuesday. Some said it could be a useful tool if done properly, including a thorough check of people’s medication interactions, while others called it impractical and said people may be better off going to their primary care doctor.

Paxlovid, which President Joe Biden is currently using for his COVID-19 infection, reduces the symptoms of the virus if taken within days of getting infected. Its goal is to prevent people from being hospitalized.

The mobile testing and treatment vehicle was stationed Tuesday at the Oceanside library until 3 p.m. Officials plan to park it at the Long Beach farmers market on Wednesday and at the Nassau County Courthouse in Mineola on Thursday.

Anyone who tests positive is eligible for treatment and can be evaluated or tested on site. A doctor or nurse practitioner can prescribe Paxlovid to be filled at a pharmacy or distribute the medication on site, both free of charge, said Mount Sinai South Nassau president, Dr. Adhi Sharma.

"Anyone who wants treatment can come here," Sharma said. "Previously it was reserved for high-risk patients, but right now we can treat anyone if they're feeling sick and have COVID."

The site can test anyone feeling symptomatic or provide a prescription for anyone who tested positive at home, Sharma said.

The five-day pair of medications is designed to reduce the symptoms of COVID-19 and lead to a faster recovery, he said. 

Hempstead Deputy Supervisor Dorothy Goosby said the mobile service is designed to reach all corners of the town including underserved minority communities. It will also reach seniors in her district including in Hempstead, Uniondale and Roosevelt, she said.

"I know it's coming to my area because those are the people who need it most," Goosby said. "A lot of seniors can't get out and I know this is going to be a good thing we're doing."

The mobile program is promising, said Professor Martine Hackett, director of public health programs at Hofstra University.

“Having the Paxlovid available to them immediately can only help by decreasing the barrier of accessing the medication by not having to go to a pharmacist or getting a prescription,” Hackett said.

More such centers exist in New York City, she said, but “to have them in Long Island would be really interesting and useful.”

Stony Brook Medicine is not doing mobile test to treat centers, but is giving PCR tests in emergency rooms and doctors’ offices, said Dr. Sharon Nachman, chief of pediatric infectious diseases for the health system. It's also prescribing Paxlovid to people who test positive and will have no negative interactions with other medications they are taking, Nachman said.

Stony Brook has been able to speed up PCR tests and is now often getting results within two hours, she said.

A mobile site could be feasible if doctors "know what the medications your patient is on when you are prescribing the Paxlovid,” Nachman said.

If the mobile site has that information, and personnel there know about drug interactions, “then it’s great," she said. "But if they don’t, it’s suboptimal.”

In that case, going to your primary care physician — who knows you the best medically — will be a better option, according to Nachman

At the Paxmobile, doctors will evaluate other medications like blood thinners that could interfere with Paxlovid and may require a blood test for prior kidney disease, Sharma said.

The testing sites are using rapid antigen tests and no longer require PCR testing, he said.

Federally Qualified Health Centers on Long Island that serve low-income areas are not using mobile test and treat vehicles, but the permanent centers are testing for COVID-19 and prescribing Paxlovid for those who test positive, said David Nemiroff, president and CEO of Long Island FQHC, Inc.

For now, Paxlovid is the main anti-viral medication being used to fight the virus, said Dr. Bruce Farber, chief of public health and epidemiology for Northwell Health. Other medications, such as Remdesivir, are more complicated because they require IV infusion, Farber said.

He noted that the supply of monoclonal antibodies in the United States may run out as early as late August, so “Paxlovid will become even more important."

Paxlovid is "becoming the only game in town to some extent,” he said, with few good alternatives on the horizon.

At the event Tuesday, Hempstead Town Supervisor Don Clavin said he was prescribed Paxlovid after he tested positive for COVID-19 last month.

"As everyone knows this pandemic and COVID-19 have not gone away," Clavin said. "I was very ill for a number of days and my doctor prescribed Paxlovid. It helped me get the turnaround to feel better."

Sharma said about 50% of the cases Mount Sinai is seeing are the Omicron subvariant BA. 5, in addition to other variants. He said the latest BA. 5 cases are coming with a less frequent fever and doctors are no longer seeing a loss of sense of taste or smell.

“Right now, if you’re feeling sick and have COVID, there’s a treatment available,” Sharma said. 

Catholic Health said it is creating a Virtual Care Unit that will provide quick, easy telehealth access to a primary care provider for calls srelated to COVID-19.

Doctors will be able to assist people who have a positive at-home test and determine if antiviral therapy is needed, or, if necessary, will be able to assist in accessing a nearby Catholic Health Emergency Department, said Jason Golbin, Catholic Health’s chief medical officer. 

Sharma said anyone who is symptomatic or tests positive should take precautions like isolating or wearing a mask before seeking treatment.

Mount Sinai South Nassau can also prescribe Paxlovid through telehealth visits.