Biden tests positive for Covid again in ‘rebound’ case

President Biden tested positive for the coronavirus again on Saturday morning, becoming the latest example of a rebound case after taking the Paxlovid treatment which has otherwise been credited with largely impressive results in battling the virus and suppressing its worst effects.

“The president has not experienced any recurrence of symptoms and continues to feel reasonably well,” White House physician Dr. Kevin C. O’Connor said in a note released by the press office. “This being the case, there is no reason to resume treatment at this time, but we will obviously continue close observation.”

The “‘rebound’ positivity”, as Dr O’Connor called it, meant that Mr Biden was forced to resume “strict isolation procedures” in accordance with medical advice. The White House announced that the president will no longer travel to his home in Wilmington, Del., on Sunday as planned, nor will he travel to Michigan on Tuesday to promote the passage of legislation supporting the national semiconductor industry. .

Mr. Biden played down the development. “Friends, today I tested positive for COVID again,” he said. wrote on Twitter. “It happens with a small minority of people. I have no symptoms but will self-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 with his dog Commander and he appeared fine. “I feel good,” he said. “All is well.”

Mr Biden first tested positive for Covid-19 on July 21 and suffered from a sore throat, runny nose, cough, body aches and fatigue. After five days in isolation, he tested negative on Tuesday evening and returned to the Oval Office on Wednesday, saying his relatively mild case demonstrated progress in battling the virus that has killed more than a million Americans.

But doctors were watching for signs of a rebounding case and making sure to keep testing him every day. He tested negative on Wednesday, Thursday and Friday before receiving a positive antigen result on Saturday morning.

Paxlovid’s rebound has become a source of debate within the scientific community and among Covid patients. Early clinical studies of the drug, which is carried out by Pfizer, suggested that only around 1-2% of people treated with Paxlovid experienced symptoms again. A study published in June that has yet to be peer-reviewed found that out of 13,644 adults, around 5% tested positive again within 30 days and 6% experienced symptoms again.

But anecdotal accounts of Paxlovid’s rebound – including a case involving Dr. Anthony S. Fauci, the president’s chief medical adviser – have been widely echoed, leading many to question whether the reported data was still accurate as that new and far more contagious BA.5 sub-variant is sweeping communities and even re-infecting patients who have recently recovered from Covid-19.

“I think it was to be expected,” said Dr. Jonathan Reiner, an eminent cardiologist and professor of medicine and surgery at George Washington University Hospital. wrote on Twitter on Saturday after the disclosure of the president’s positive test. He added that “earlier data suggesting Paxlovid ‘rebound’ positivity in the low single digits is outdated” and that the true number was likely much higher.

Either way, experts pointed out that Paxlovid was notably successful in preventing more serious illnesses and hospitalizations from Covid-19. And a Centers for Disease Control and Prevention study published in June reported that symptoms of a rebound tended to be milder than during the primary infection and were unlikely to lead to hospitalization.

“As we continue to monitor real-world data, we remain very confident in the efficacy of the treatment to prevent serious consequences from Covid-19,” Amy Rose, a Pfizer spokeswoman, said in a statement on Saturday. .

The CDC issued an emergency health notice in May saying people facing a rebound case “should restart isolation and self-isolate again” for at least five days, reflecting general isolation recommendations from the agency for people infected with the virus. The notice also said the rebound did not represent reinfection with the virus or resistance to Paxlovid.

Dr. Ashish K. Jha, the White House’s Covid-19 response coordinator, told reporters when Mr. Biden first tested positive that looking at Twitter, “it feels like everyone world has bounced back, but it turns out there’s actually clinical data” suggesting otherwise. . Plus, he said, “Paxlovid works really well to prevent serious disease, rebound or no rebound, and that’s why he was offered it, and that’s why the president took it. .”

Dr. Paul G. Auwaerter, clinical director of the division of infectious diseases at Johns Hopkins University School of Medicine, said it was unlikely that Mr. Biden, who was fully vaccinated and twice boosted, falls seriously ill. He added that scientists were working to explain why some people experience a rebound from the virus.

Of his Covid-19 patients experiencing a rebound case, Dr. Auwaerter said, more of them have had the recent Omicron subvariants. None were hospitalized as they rebounded. These highly infectious and vaccine-evasive forms of the virus, he added, can cause people to test positive for longer.

Taking the drug, Dr Auwaerter said, could be like “moving the goal posts” during an infection, suppressing the virus but not eliminating it completely. Still, he said, those at high risk should “absolutely” continue taking the drug.

Dr. John P. Moore, a virologist at Weill Cornell Medicine, said researchers still lack correlations between age, risk factors or vaccination status. “I haven’t heard anyone come up with a definitive cause,” he said. “He’s just the unlucky guy in 20. It’s just a numbers game.”

Dr Moore said if the data could support such a decision, federal regulators could consider allowing longer treatment of the drug, to permanently rid the body of the virus. “The easiest thing would be to take the drug again for longer,” he said.

Mr. Biden’s rebound case will complicate his efforts to turn his illness into a positive story. As the oldest president in the nation’s history, Mr Biden, 79, has been keen to show he remains fit, especially as he plans to seek a second term in 2024. He has continued to work from the White House residence during his first isolation, appearing via video in front of several groups, then made a triumphant return to work in person on Wednesday.

Instead of the narrative of defeating the virus, however, the president’s rebound case reinforces the unpleasant reality that the pandemic refuses to go away. Although the death toll has dropped dramatically, Covid-19 remains a reality for Americans, some of whom have been infected multiple times.

Mr. Biden’s new positive test may also raise questions about his loyalty to precautions against infecting others after returning to office. Aides said he would wear a mask with others, but in every public appearance he has made since Wednesday his face has remained uncovered.

Aides said he was socially distant from others and careful to avoid exposing aides, Secret Service agents and household staff. The White House medical unit found 17 people had been in close contact with Mr Biden before his first positive test, but as of Wednesday none had tested positive.

While the president was not wearing a mask in Saturday’s video, a photographer released by the White House showed him wearing one as he signed a disaster declaration in response to flooding in Kentucky.

Dr Auwaerter said Mr Biden might not have put others at great risk in the past few days, even without wearing a mask, because he was regularly tested for the virus and tested negative. For those not testing as regularly, he said, it would be prudent to continue wearing a well-fitting, high-quality mask, especially around high-risk people, because of how under- Omicron variants can be infectious.

But the new positive test will also set back Mr Biden’s efforts to get back on the road to promote his agenda and campaign for Democrats facing an uphill struggle to retain control of both houses of Congress in this midterm elections. fall.

The president, whose approval rating was just 33% in a New York Times/Siena College poll in July, was described as keen to travel domestically after a string of overseas trips, but the new isolation will further delay this.

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