By Cody Mello-Klein | cmelloklein@alextimes.com

Inova Alexandria Hospital’s drive-through testing site for COVID-19 in Old Town is up and running.

In Alexandria, private doctors, Inova and community health organizations like Neighborhood Health have provided Alexandrians with a number of options for receiving a COVID-19 test. However, with 700 positive cases of COVID-19 in Alexandria as of April 29, patients, doctors and public health officials have been unified in calling for more testing.

The city announced on April 17 that it was supporting Inova in bringing vehicle-side testing to the Inova Primary Care Old Town clinic located at 325 S. Washington St. The Old Town site has been functioning as a respiratory illness clinic with limited hours since April 20, and it joins three other Inova facilities in offering vehicle-side testing, an option that has become increasingly common across the country and in the region.

In mid-March, cities in California, Colorado, Connecticut, Indiana, Minnesota, New York, Texas and Washington began offering vehicle-side, or “drive-through,” testing options. As of April 10, the joint Arlington County-Virginia Hospital Center drive-through testing site, which opened on March 18, had tested more than 1,000 people, according to ARL Now.

Drive-through testing has been a subject of interest for residents, but the city’s latest testing option isn’t the McDonald’s of testing that some might think it is. Like any COVID-19 testing or screening option, it comes with criteria and restrictions for who can get tested and when.

“Those individuals who are getting vehicle-side tests have already consulted with a physician and have a prescription/order for a test,” an Inova spokesperson said in an email. “The prescribing physician coordinates the vehicle-side testing with Inova. This is done because some physicians do not have testing capabilities within their practice.”

“There’s really nowhere around here where you can get screening and testing without symptoms and without an appointment,” Craig Fifer, director of communications for the city, said. “I think when people think of the phrase ‘drive-through testing,’ that’s often what they’re thinking of.”

Patients are screened by their own doctors and, in the case of Inova, by an Inova doctor before they can get an appointment for a vehicle-side test. Testing criteria are based on the Virginia Department of Health and Centers for Disease Control and Prevention guidelines, one of which requires that the patient display symptoms in order to get tested.

Vehicle-side testing at the Old Town clinic is, like most testing, by appointment-only. In the case of the facility’s drive-through testing option, it requires that the patient’s doctor, not the patient, makes the appointment, due to limited capacity. 

“Last week we tested almost 100 people through our appointment only vehicle-side testing.  We are able to perform up to 60 [tests] each day at the Old Town Respiratory Illness Clinic if needed,” the Inova spokesperson said.

(Read more: The Times’ daily COVID-19 update)

Unlike Inova’s other three vehicle-side testing sites, which are urgent care clinics, Inova’s Old Town site is a primary care clinic. As a result, the site only functions as a respiratory illness clinic for limited hours, from 1 to 4:30 p.m. Monday through Friday. Between 2 and 4 p.m. on those days, patients who have had an appointment set by their doctor can receive a vehicle-side COVID-19 test.

“The limited hours were determined in order to ensure current patients can see their doctors in the morning and meet the demand for vehicle-side testing services,” the Inova spokesperson said.

Vehicle-side testing provides the same quality of testing as that offered inside a hospital or clinic.

“The type of test that’s done for car-side testing, the fact that it’s being done in a car, does not diminish the efficacy or anything like that,” Dr. Vivek Sinha, founder and chief medical officer at Belleview Medical Partners, said. “As long as you have a qualified person doing the swab, if they do it in the office, if they do it in the home or if they do it in the car, it’s the same thing.”

Drive-through testing does present logistical challenges for healthcare organizations attempting to expand their testing capabilities.

“Most [health care providers] have not gone out of their way to do vehicle-side testing because it means having to come out of your facility, it means having to set up new logistics, it means having to not be able to do the inside functions that you were doing,” Fifer said.

Yet the appeal of drive-through testing, for patients and health care workers, is clear.

“The reason people are doing vehicle-side testing is to reduce the risk of transmission to health care workers. They’re in an outdoor environment, less risk of transmission,” Dr. Basim Khan, executive director at Neighborhood Health, said “… I think that’s why a lot of practices are doing it, as opposed to doing it in the office.”

In addition to reducing the risk of transmission for both potential patients and healthcare workers, vehicle-side testing can also help decrease the amount of personal protective equipment, most of which is one-time use, that needs to be used, Sinha said. 

“If I go to one house, I have to wear all the PPE and theoretically PPE is not supposed to be reused … so it really helps conserve PPE, but, most importantly, it limits exposure both ways,” Sinha said.

In that way, vehicle-side testing can help organizations like Neighborhood Health conserve their vital, but limited, supply of PPE.

Inova’s expansion of its testing services and ability to now offer drive-through testing in Old Town came with some logistical challenges for the city, given the clinic’s location.

“When Inova reached the point where they could do another clinic, a fourth clinic, because their clinic is located on the corner of Washington Street in Old Town, it introduced some traffic questions,” Fifer said. “And so, we, the city, provided support in the form of closing an HOV lane and putting up temporary signage and using cones to create a dedicated lane and making sure the police department was aware of the potential traffic patterns.”

Inova isn’t the only healthcare provider that’s offering vehicle-side testing in the city.

Neighborhood Health, a federally qualified health center that provides primary care services primarily to northern Virginia’s low income, underinsured and uninsured residents, has been providing vehicle-side testing to its patients since April 2. Testing is still by appointment only, but for patients that are low income and uninsured, testing at Neighborhood Health is free.

Since most of Neighborhood Health’s patients have had to continue work through the pandemic – since they literally can’t afford not to – they are less likely to social distance and more susceptible to the virus.

Of the 500 people Neighborhood Health has tested, more than 50 percent have come back positive for COVID-19. That’s significantly higher than the positive response rate for Northern Virginia – about 24 percent – and Virginia as a whole – about 16 percent, Khan said.

Neighborhood Health has been increasing its vehicle-side testing services at four clinics since April 2. The organization hopes to hit 200 drive-through tests per week, Khan said. It is also offering walk up testing for patients that don’t have cars.

“A lot of people don’t own cars, so obviously we’re not going to turn them away. At least two of our sites we have it set up where they can walk up. They still have to make an appointment, so that’s all the same,” Khan said.

Between in-clinic and vehicle-side testing at private doctors, Inova Alexandria and healthcare organizations for the uninsured like Neighborhood Health, Alexandrians have a variety of options for where and how they can get tested for COVID-19. 

“I think in order to really hit all the masses, you have to use different modalities, and I think drive-through testing cuts into that quite a bit,” Sinha said.

That will become more important as the city continues its fight to contain COVID-19 and as Gov. Ralph Northam begins to consider reopening the state.

“There’s all this talk about potentially reopening, and the reality is unless we ramp up testing significantly, unless we ramp up contact tracing, it’s going to be really difficult to do that in a way that’s safe,” Khan said.

(Read more: Residents organize homemade mask-making efforts)