President Biden examined constructive for the coronavirus once more on Saturday morning, turning into the most recent instance of a rebound case after taking the Paxlovid remedy that has in any other case been credited with broadly spectacular outcomes in combating the virus and suppressing its worst results.
“The president has experienced no re-emergence of symptoms, and continues to feel quite well,” Dr. Kevin C. O’Connor, the White House doctor, said in a memo launched by the press workplace. “This being the case, there is no reason to reinitiate treatment at this time, but we will obviously continue close observation.”
The “‘rebound’ positivity,” as Dr. O’Connor termed it, meant that Mr. Biden was pressured to renew “strict isolation procedures” in preserving with medical recommendation. The White House introduced that the president would now not journey to his house in Wilmington, Del., on Sunday as deliberate nor make a scheduled go to to Michigan on Tuesday to advertise newly handed laws supporting the home semiconductor trade.
Mr. Biden performed down the event. “Folks, today I tested positive for COVID again,” he wrote on Twitter. “This happens with a small minority of folks. I’ve got no symptoms but I am going to isolate for the safety of everyone around me. I’m still at work, and will be back on the road soon.”
The White House later posted a video of the president on the Truman Balcony together with his canine Commander and he appeared nicely. “I’m feeling fine,” he stated. “Everything’s good.”
Mr. Biden first examined constructive for Covid-19 on July 21 and skilled a sore throat, runny nostril, cough, physique aches and fatigue. After 5 days of isolation, he examined damaging on Tuesday night and returned to the Oval Office on Wednesday, declaring that his comparatively gentle case demonstrated how a lot progress had been made in combating the virus that has killed multiple million Americans.
But docs have been watching for indicators of a rebound case and made certain to maintain testing him day-after-day. He examined damaging on Wednesday, Thursday and Friday earlier than receiving a constructive antigen consequence on Saturday morning.
Paxlovid rebound has grow to be a supply of debate throughout the scientific group and amongst Covid sufferers. Initial scientific research of the drug, which is made by Pfizer, recommended that solely about 1 p.c to 2 p.c of these handled with Paxlovid skilled signs once more. A research published in June that has not but been peer-reviewed discovered that of 13,644 adults, about 5 p.c examined constructive once more inside 30 days and 6 p.c skilled signs once more.
But the anecdotal accounts of Paxlovid rebound — together with a case involving Dr. Anthony S. Fauci, the president’s chief medical adviser — have echoed extensively, inflicting many to wonder if the reported knowledge was nonetheless correct as the brand new and way more contagious BA.5 subvariant sweeps via communities and reinfects even sufferers who just lately recovered from Covid-19.
“I think this was predictable,” Dr. Jonathan Reiner, a outstanding heart specialist and professor of medication and surgical procedure at George Washington University Hospital, wrote on Twitter on Saturday after the president’s constructive take a look at was disclosed. He added that “the prior data suggesting ‘rebound’ Paxlovid positivity in the low single digits is outdated” and that the actual quantity was doubtless considerably increased.
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Either approach, consultants harassed that Paxlovid had been notably profitable in stopping extra extreme Covid-19 sicknesses and hospitalizations. And a Centers for Disease Control and Prevention research published in June reported that signs from a rebound tended to be milder than through the major an infection and unlikely to result in hospitalization.
“While we continue to monitor real-world data, we remain very confident in the treatment’s effectiveness at preventing severe outcomes from Covid-19,” Amy Rose, a Pfizer spokeswoman, stated in a press release on Saturday.
The C.D.C. issued an emergency health advisory in May that stated individuals experiencing a rebound case “should restart isolation and isolate again” for at the very least 5 days, reflecting the company’s basic isolation recommendations for individuals contaminated with the virus. The advisory additionally stated that rebounding didn’t symbolize reinfection with the virus or resistance to Paxlovid.
Dr. Ashish Ok. Jha, the White House’s Covid-19 response coordinator, instructed reporters when Mr. Biden first examined constructive that by taking a look at Twitter, “it feels like everybody has rebound, but it turns out there’s actually clinical data” suggesting in any other case. Moreover, he stated, “Paxlovid is working really well at preventing serious illness, rebound or no rebound, and that’s why he was offered it, and that’s why the president took it.”
Dr. Paul G. Auwaerter, the scientific director in the infectious illnesses division on the Johns Hopkins University School of Medicine, stated it was unlikely that Mr. Biden, who has been absolutely vaccinated and boosted twice, would grow to be critically sick. He added that scientists have been working to clarify why some individuals expertise a rebound of the virus.
Among his Covid-19 sufferers experiencing a rebound case, Dr. Auwaerter stated, lots of them have had the current Omicron subvariants. None has been hospitalized whereas rebounding. Those extremely infectious and vaccine-evasive types of the virus, he added, may cause individuals to check constructive for longer.
Taking the drug, Dr. Auwaerter stated, could possibly be like “moving the goal posts” in the course of an an infection, suppressing the virus however not clearing it fully. Still, he stated, high-risk individuals ought to “absolutely” nonetheless take the treatment.
Dr. John P. Moore, a virologist at Weill Cornell Medicine, stated researchers have been nonetheless missing correlations between age, danger elements or vaccination standing. “I haven’t heard anyone come up with a definitive cause,” he stated. “He’s just the unlucky guy in the one out of 20. It’s just a numbers game.”
Dr. Moore stated that if knowledge might help such a transfer, federal regulators would possibly wish to take into account permitting an extended course of the drug, to definitively rid the physique of the virus. “The simplest thing would be to go back on the drug for longer,” he stated.
Mr. Biden’s rebound case will complicate his effort to show his sickness right into a constructive story. As the oldest president in the nation’s historical past, Mr. Biden, 79, has been keen to indicate that he stays match, particularly as he forecasts plans to run for a second time period in 2024. He continued to work from the White House residence throughout his first isolation, showing by video earlier than a number of teams, after which made a triumphal return to work in particular person on Wednesday.
Instead of the narrative of beating the virus, nevertheless, the president’s rebound case reinforces the disagreeable actuality that the pandemic refuses to go away. Although the demise toll has fallen dramatically, Covid-19 stays a truth of life for Americans, a few of whom have been contaminated a number of occasions.
Mr. Biden’s new constructive take a look at can also elevate questions on his constancy to precautions towards infecting others after returning to the workplace. Aides stated he would put on a masks whereas with others, however in each public look he made since Wednesday, his face remained uncovered.
Aides stated that he was socially distant from others and that he was cautious to keep away from exposing aides, Secret Service brokers and members of the family employees. The White House Medical Unit discovered that 17 individuals had been in shut contact with Mr. Biden earlier than his preliminary constructive take a look at, however as of Wednesday none had examined constructive.
While the president didn’t put on a masks in the video on Saturday, a photograph launched by the White House confirmed him carrying one as he signed a catastrophe declaration responding to flooding in Kentucky.
Dr. Auwaerter stated Mr. Biden won’t have put others at nice danger in the previous couple of days even with out carrying a masks, since he was being examined for the virus usually and was testing damaging. For these not testing as usually, he stated, it might be prudent to proceed carrying a tightfitting and high-quality masks, notably round high-risk individuals, due to how infectious Omicron subvariants could be.
But the brand new constructive take a look at can even set again Mr. Biden’s efforts to get again on the street to advertise his agenda and marketing campaign for Democrats dealing with an uphill wrestle to maintain management of each homes of Congress in this fall’s midterm elections.
The president, whose approval ranking stood at solely 33 p.c in a New York Times/Siena College ballot in July, has been described as desperate to journey the nation after a spate of international journeys, however the renewed isolation will delay that additional.