Covid-19 Symptoms Can Rebound Even if You Don’t Take Paxlovid

Oct 27, 2022 · 137 comments
Clare (ct)
I would really like to know if I’m infectious in the rebound phase and not just detecting residual dead virus I get that I need to isolate when I’m initially sick but if the rebound is from my immune system overreaction doesn’t that imply the virus is far less?
Diane (California)
@Clare When you have a rebound Covid case and test positive using the antigen tests, you ARE contagious. We just tested this. We are a completely vaccinated and boosted family who masks whenever going in public (surgical mask) or at work (using N95) and we have been very diligent about precautions due to my autoimmune disorder and my partner’s line of work. My sister and 70 yr old BIL caught Covid on their flight home to the US from Argentina on 11/29/22. They tested positive for Covid with rapid tests on 12/3. My sister was prescribed Paxlovid due to having had chemotherapy during the last two years, my BIL was not prescribed Paxlovid. Both were Covid negative on 12/10. My BIL tested Covid positive again on 12/14. Nine days later, they came to stay with us over Christmas. My partner, who is a surgeon, felt that from the guidelines my BIL should no longer be contagious, even if his rapid tests still showed a very faint positive line. Three days after their arrival, my partner started having symptoms and two days after that he had had a positive rapid rapid test and PCR. He was started on Paxlovid that same evening. Meanwhile, my BIL tested negative again. I was testing negative, but the next day (12/28) tested positive with both rapid test and PCR. I too was given Paxlovid. Symptoms stopped and I tested negative on 1/4. On 1/6, I tested positive again using a rapid test. It’s 1/9, I’m positive and still have full symptoms. It’s discouraging.
Kenneyadams (Brooklyn, NY)
I kept testing negative for Covid in spite of the fact that I had most of the symptoms - chest pains, dizziness, shortness of breath, headaches. The rapid and PCR's always came back negative. Then a cousin told me he had experienced the same symptoms and was also testing negative. Then he took the antibodies test and that determined at some point he in fact had Covid. I did the same and I tested positive as well. My symptoms lingered on for months and I am still dealing with occasional dizziness and chest pains. A family friend - who is a pharmacist - suggested I stop getting boosted - I've had two - but to protect myself by wearing a mask and using a neti pot to clear out my nasal passages. Another friend gave a recipe for a drink that includes citrus fruits, ginger and onion. She and her family - two kids, a husband and a dog - drink this concoction four times a week. They have not been sick in over two years and they opted not to get vaccinated.
Mom (Nj)
My (vaccinated as possible) child just went through this - mild symptoms for a couple of days, improved and tested negative for four days then just when we thought we were in the clear new symptoms came on, the original symptoms came back stronger, and tests reverted to positive through day 10. It’s important that people know this is possible. Had the rebound not fallen on a weekend my child would have been back in school exposing others because we hit all the day five criteria to conclude it was fine. The pediatrician assured us it was impossible.
Paul Dobbs (Massachusetts)
To stop Covid in its tracks, use nasal irrigation with saline. Several peer-reviewed studies, including one at the Medical College of the University of Augusta, GA, have demonstrated this is very effective. Read "Twice-daily nasal irrigation reduces COVID-related illness, death, study finds" posted online by Science Daily , or "Saline Nasal Irrigation After Covid-19 Diagnosis Reduces Hospitalization" posted online by Forbes. I'm no scientist but to me it looks like this treatment as a better success rate than Paxlovid!
Impatient (Boston)
fully vaxxed and boosted. Just got covid for the first time. why? because of work travel. Thoroughly unnecessary. Nearly everyone in airport and on plane, including all of the flight attendants were unmasked. Uber drivers unmasked. Restaurants unmasked. Every single crowded place no masks. At some point I gave up and took off my mask et voila - Covid.
Paul Dobbs (Massachusetts)
@Impatient Are you in the first few days? Try nasal irrigation. See my comment above.
D (Upstate bordertown NY)
@Impatient So, you are saying that the Covid jabs and boosters did not prevent you from getting Covid, only the masks work in preventing Covid?
Rita (Kansas City)
Covid vaccines help prevent disease but most importantly help prevent patients from becoming sick enough to need hospitalization, ICU care, ventilators, death. Masks absolutely mitigate the spread of Covid. I too fail to understand why we can’t at least mask on public transportation. Most important in my mind is we do it to protect those in our midst who are most vulnerable.
twinklefingers (Brooklyn)
There is currently enough Paxlovid being distributed to the states per week (over 600,000 doses) that everyone who tests positive should be able to get 2 courses of it. Why we don't blow it open to everyone is beyond me.
Ryan Bobo (New York)
Ok so nothing to see here. Got it. Who hasn’t had a cold linger? Of course, it could be due to a separate infection, dehydration, dry air, dusty air, or any other number of reasons. But we don’t use critical thinking when it comes to covid. Blind acceptance of the most irrational fear mongering is what we call “following the science” around these parts.
Dave (Mass)
@Ryan Bobo .....Imagine ...over a million deaths in the US alone from fear mongering. What does science know ?? Not to mention those who perished not from Covid itself but from underlying conditions that...they were either unaware of or living with until...they caught Covid ? Follow the Sense !
M. J. (Hunter NY)
@Ryan Bobo Having had a rebound infection myself, the science was clear and present with a positive covid test lasting more than five days into the second infection-relapse. (That followed one day of negative testing after the first infection and 10 days of isolation. Fortunately, I did not infect my 75 year old hiking friend on the day I unknowingly rebounded with "hay fever" symptoms... The risk to her was real... Not coming out of "irrational fear". Those who refuse to recognize the science of their own illness pose a possible risk to those innocent of their friend's, family's, or random stranger's, selfish, arrogant, self-delusions of their own super powers to evade a contagion that has killed millions.... Who are we as a people to behave with such willful disregard for others?
alisonT. (nyc)
Even if Covid also rebounds in people with the virus who are not on Paxlovid, it seems reasonable tio expect that the premiere anti Covid drug would be able to swiftly kill the virus without the added burden of rebound. No one should justify this fault in the drug by saying ok that's what Covid does, too, in some people -- so the drug's rebound is no big deal. We should be developing a drug that overcomes this limitation as well as the possible negative interactions between Paxlovid and the scores of medications that people take regularly for health conditions.
sophia (bangor, maine)
After four shots Covid found me. I started Paxlovid - and stopped it after two doses. I absolutely could not stand the taste in my mouth. I judged that my symptoms are not bad enough to cause hospitalization, so bye bye Paxlovid. Ugh Ugh Ugh. It's been a week and I am on the mend. For anyone taking Paxlovid - be prepared for the worst taste ever!
Jalna Jaeger (Norwalk, CT.)
@sophia I Agree,a terrible taste,but I can deal with anything for 5 days. It shortened my illness, fever,aches considerably. I am also over age 65.
Ernest Mc (Middlebury, VT)
@sophia I took it and it did make me feel better on Day #1 but that taste was definitely NASTY. It made me dislike wine, which takes a lot. I was very glad when the 5 days were up.
Imagine (Scarsdale, NY)
@Ernest Mc Why are you taking alcohol with disease and drugs? Can you go without a drink?
TheBackman (Berlin, Germany)
I find the variations of troubles and the morphing of the virus so quickly makes me think this was a bioweapon that got out before it was "ready." I am not some anti-vaxer. I think polio, smallpox, measles, mumps, and the like are all valuable. But could you imagine if 30-60% of the people who took polio or smallpox vaccines got sick and they told you that you needed a booster every few months? Would you call that a success? I would love the NYT to investigate how many "researchers' are at universities being funded by Chinese grants. We saw universities with chairs funded by the Japanese putting out very pro-Japanese statements. Always follow the money. China had a "vaccine" and they do not seem to be using it. 3 years on, they are still locking down. This is not suspect? The Chinese government doesn't know something? They are still damaging their economy for No Reason? Really? Researchers in the US and Europe saying, "This must be natural and can only come from the Live Market," that never found the virus In that Market, strikes me as odd. The lab that studies coronaviruses is in Wuhan is Just a Coincidence?!? The Chinese scientists are so last century they could not have hidden the manipulation. China's refusal to open that lab and the erasure of data in their database is what exactly. Let's not rock the Chinese boat. Where will we get our iPhones made? People vaccinated twice and boosted twice are getting covid. How do you begin to call this a vaccine?
Marcusnyc (New York)
@TheBackman Vaccine does not mean you will not get sick, it just lessens the severity of the illness. It gives you a one up on the virus. The flu vaccine is a best guess. Who hasn't gotten the flu vaccine but yet later got the flu? No vaccine is perfect, but some are better than others at preventing disease.
Yeoman Jimson (Still inside)
@TheBackman Um, because if you do get Covid, your odds of *dying* are way way down? Ever notice how you can get the flu even after you've had a flu shot?
Karen (Switzerland)
@TheBackman After being fully vaccinated (for my country, i.e. 3x), masking with FPP2 masks in all indoor public spaces for 2.5 years, covid finally got me - the week I was scheduled for major surgery, which has now been postponed. I've been in bed for a week with fever, sore throat, and other aches. This has been no picnic. I have been following the covid origin debate since February 2020, and was struck by the premature, hyperbolically pronounced "consensus" of zoonosis as the origin and the denouncement of any other origin hypothesis as "conspiracy theories". In summer 2021, the taboo on positing that the scientific evidence available to date is consistent with both a natural spillover (zoonosis) and research-related spillover (virus hunting/collection, lab accident) was finally lifted. The circumstantial evidence for research-related spillover is considerable. FOIAed emails revealed that a politics-driven narrative was crafted to push zoonosis and quash the research-related hypothesis. A small subset of virology, gain-of-function of concern (aka research on enhanced potential pandemic pathogens) poses egregious risks that far outweigh any purported benefits. Such research failed to predict the covid pandemic, and possibly even caused it. We may never know. But the global proliferation of biolabs conducting such research underscores the urgent need to subject it to rigorous, transparent, independent regulation and oversight. We ignore this out our grave peril.
Barb (California)
Did I miss it or was there no mention of long Covid?
Steve (Santa Cruz)
They should also have had a control group of people who did not have Covid and ask them to fill out the symptom diary. Fatigue, cough, headaches, muscle aches can be caused by many things, including just day to day activities. I would be curious how they would compare to people's symptoms post-Covid. Rebound or just daily living?
MissFlip (NJ/NS)
@Steve That would be a very good control. But I believe the upshot of the article is that people are testing positive again when their symptoms rebound, after previously getting enough negative tests and symptoms abating to be confident that they could stop isolating and resume their activities. But it's a good point: i have allergy symptoms that wax and wane with changes in barometric pressure, wind, and what not. They're not rebound symptoms, they're just recurring symptoms for the same allergic condition.
Ginger (Lakewood, CO)
I am currently battling my second case of Covid within the last 6 months. Fever, headache, head congestion (lungs OK). I was vaccinated and boosted a year ago but still got it 2x. I thought I'd have antibodies from the case I had in June but... nope. I should have gotten another booster. My advice? Get those boosters!
Brill (NYC)
I got Covid last spring during a 2 hour outdoor lunch with a dear friend who tested positive the following day. Paxlovid was being given out like candy in NYC at the time, so when I got sick and feverish and tested positive, my doctor put me on it. While I was on it, I read about the possibility of the so-called rebound. And then a week later, I rebounded and got sick all over again. The month of May was disrupted in every way. I exposed my partner (twice because of the rebound), my parents, and had to cancel a series of incredibly important meetings and even some plain old fun long-in-the-works plans and events. I celebrated my anniversary feeling sick and in isolation. Months later I still am experiencing residual symptoms. Breathing issues, swollen glands. It comes and goes. I'm very active and have had to curb my exercise routine. I've consulted doctors to get recommendations but they're all flying blind. Covid also complicated my friendship with someone who is very dear to me and who has just avoided the subject almost entirely, including the erasure of the circumstances that clearly brought Covid into my life and body. That has hurt and upset me as much as my lingering symptoms. Covid stinks. And I know there are millions who are way unluckier than me. I have endless empathy for each and every person that it has touched and affected in myriad ways.
alisonT. (nyc)
Sorry you are experiencing these unpleasant effects of Covid. i am 65 and three weeks ago got Covid for the first time. I had pretty moderate symptoms, my lungs were clear, so I chose not to go on Paxlovid bc I was concerned that the rebound might cause more or worse symptoms. I also have had extreme sensitivities to medications. I got through the Covid alright and tested negative after two weeks. i have been taking many supplements and herbs for decades, eat garlic and onions regularly and had confidence that I would do fine without the Paxlovid.
twinklefingers (Brooklyn)
As someone with a decent job with union benefits, my sick leave accumulates up to 1200 hours. The unused extra hours count as service credit, which will sweeten my pension when I retire. Plus it will offset my health insurance. That's lovely, but it sort of defeats the public health rationale if employees have a strong incentive to bank their sick time.
Frau Greta (Somewhere In NJ)
I got the virus mid-August of this year. My only lingering issue was no taste or smell, but after about a month or so it started to slowly come back and had fully returned just a couple of weeks ago. This weekend I started to realize that I couldn’t smell or taste anything again. Rebound? Long COVID? Does it really matter? Does anyone even care? None of my doctors even cared that I had COVID (they don’t even check to see if I’m up to date on my vaccines), so I suspect if I tried to report the anomaly through them I’d just get a shrug.
marmccu (Buxton)
@Frau Greta same happened to me, Dr not concerned at all.
alisonT. (nyc)
There are many articles online about the use pf essential oils to bring back smell and taste. Good luck to you.
Luis Andrei (Jersey City)
@Frau Greta consider getting a new doctor. No one should be made to feel like their ailments are uninteresting or unworthy of attention. Doctors are people too that come with their own opinions about the state of the world. Perhaps find one that aligns with yours and makes you feel like they got your back.
A (Seattle)
This doesn't seem like a very well-organized study. It reminds me of the study where HPV shot pain was judged by parents watching their daughters get the shot. It's incredibly sloppy to just ask people whether they had symptoms come back a little or not. When people get pax rebound, it's A LOT more dramatic than a regular viral course of infection with a few natural highs and lows. It seems like this study was intentionally designed to be sloppy in order to confirm the, "Well, rebound always happens!" idea just to get more people to take paxlovid.
Annie (PNW)
@A I don't know that many people who've taken Paxlovid but every one of them has rebounded. My own rebound case is considerably worse than the initial day of symptoms. I'm wondering if I started it too soon, before my immune system ramped up, or was the course not long enough? Maybe both.
Wolf Kirchmeir (Blind River, Ontario)
Tangential thought: Rebound and long covid both have economic consequences. A sick worker will work inefficiently or not at all. Sick workers that must come to work are health risks to their colleagues. Seems to me that paid sick leave is a no-brainer. Footnote: In most G20 countries, annual sick leave of two weeks is the norm, and in many of them unused sick-leave accumulates to some maximum.
Lisa Owens (Denver)
I have Long Covid. My first Covid experience was in May 2020, very early on in Pandemic time. I was not hospitalized. I had a temp for 17 days. As was the case “way back then”, as soon as I didn’t it was expected my life would go back to normal, like any other virus. I went back to my routine, bike riding, yoga, running. But it would take me days to recover. We now know this as Long Covid. When the vaccines came out, I got mine ASAP. I was very sick from it, but it seemed to help my LC symptoms moving forward. One step forward 2 steps back. Exercise recovery was slow. I had a heart murmur. My heart rate was higher than it had ever been, and my blood pressure was scary high, for me. My legs hurt all the time. A short hike would exhaust me for days. 2 years. In September this year, both my husband and I tested positive for Covid again. We were both prescribed Pavloxid, and were negative within 5 days. The drug had some side effects, nasty Covid taste in my mouth, fatigue (or was that Covid?). My husband recovered quickly. It took me a bout 10 days to not feel fatigued and “Covidy. But guess what? Long Covid symptoms practically gone! I’m able to exercise regularly again for the first time in 2 years. I can go to yoga and do other things in the same day. I don’t forget things 2 seconds after I hear it. Someone needs to do a study on the effects of having Covid a second time and/or taking Pavloxid. Was it having the virus again that finally “cured” me? Or was it Pavloxid?
marmccu (Buxton)
@Lisa Owens I'm so glad you're doing so much better !
GeeDee (Portland, ME)
Here it is! Announcement of a new study: 15 days of Paxlovid for long covid. That will be enough for some, but I predict it won’t be enough for others. But maybe it will lend credence to the theory that viral persistence is driving long covid some cases. Very hopeful!
Dr B (Nyc)
I’m 71. Five vaccinations. Tested positive for Covid 9/25. Started Paxlovid on 9/26. Felt sick for three days. Tested negative on 9/30. On 10/15 spiked 102.8 fever. Started coughing. Much congestion and fatigue. Dr wouldn’t see me in office at Nyu because they have a rule about no in person visits if you have a fever. So scrounged around for a dr who would listen to my lungs. Was worried about pneumonia. Got a chest X-ray. Thankfully it was negative. It’s been more than two weeks. Coughing subsiding. No more fever. So do I have Covid rebound? Or did I catch RSV from my grandson three weeks ago? I thought I had superlative medical care. Ha, those days are gone. We are all on our own.
Wolf Kirchmeir (Blind River, Ontario)
Tangential thought: Both rebound and long covid have economic implications. Sick people can't work, or can't work well. Those who can work and show up at the workplace are risks to their colleagues. IMO, paid sick leave is a no-brainer.
Carol (minneapolis)
Had COVID and took Paxlovid (yes pax mouth is a real thing and it is horrible). Immediately felt better and symptoms disappeared. A few days later, I had a horrible cough that stayed with me for weeks... at some points I thought I would crack a rib from all the coughing. I tested for COVID consecutive days after the cough settled in and was always neg, but this article has me wondering.
Mary (Connecticut)
@Carol It sounds like you are past the cough, but for others to remember; a bacterial infection can move in in the wake of a viral thing in the lungs. I would ask a doctor for an antibiotic for a persistent post Covid cough. Doing so helped a friend of mine with Covid-
Bonnie (Pennsylvania)
Please continue to publish the latest scientific findings about covid. We need to continue to be informed about how this virus is acting and changing.We need to know how best to protect ourselves if we become sick. It appears the articles are fading into the sunset even though this virus is still out here and hundreds die every day. I, for one, would like to stay current on any new findings regarding this virus.
R (Phoenix)
Good information! Thanks.
Imagine (Scarsdale, NY)
We shouldn't be guessing at this point.
akamai (New York)
But, sure, Covid is over. Ask the 95%+ of people who are crowding together without masks, or boosters. Why care when it's only a mild cold? Except When It Becomes a Life-Changing Horror Show for possibly the rest of your life. We need to publicize rebounds and "permanent"? Covid because an awful lot of people are going to be very sorry. You're "tired" of masking? You "can't" breathe? Good luck with Long Covid. The sane ones among us are going to be masking until this is gone.
Janet (California)
This story doesn't address whether people test positive again for Covid. We know a certain number of people taking Paxlovid will seem to feel better and test negative, only to test positive again several days later and would be infectious. Testing positive again is an indicator of a rebound case. Unless this study also looked at testing results for people who didn't take Paxlovid but symptoms reappeared, it's not a true comparison.
Dawn Hannay (New York)
This was exactly my experience. I tested positive, took Paxlovid, tested negative for a few days, and then symptoms returned and I’m testing positive again. All my varied symptoms have been mild. Classic rebound. My dilemma, and that of many, I suspect, is how do you know when you’re not infectious any more, in a rebound situation? Tests will no doubt continue to be positive for some time. I don’t want to expose others, so I guess I’ll just wait until all of my symptoms are gone. It seems it’s all on the honor system.
Elle SH (Cali)
Interesting. I definitely experienced rebound symptoms after my bout with COVID 19 (although no active COVID infection, verified by testing). I was unsure whether it was Covid rebounding symptoms, or whether I had been re-exposed to Covid again but immune system handled it due to antibodies.
Jafawa (San Diego)
I got COVID a month ago. I tested positive on my second day of symptoms and called for an e-appointment with my medical group. I’m 70 with a few risk factors. After a lengthy questionnaire and look at my medical record the doc prescribed Paxlovid. My COVID symptoms were minimal. I did continue to test positive and have some residual effects, but I’m better now. Paxlovid appears to have worked well for me. The medication does have some side effects, and I would not encourage a young, healthy vaxed person to take it, but for us oldies and others with reduced immune response, I say go for it.
twinklefingers (Brooklyn)
I too hope not to get Covid until I'm 70. I'm 48 and I've had 7 shots. So far so good. Once Paxlovid becomes readily available to everyone, I might let my guard down.
Marion Eagen (Clarks Green, PA)
Fully vaccinated and triple boosted, I got COVID anyway. Took Paxlovid and tested negative before I even finished the five day dose protocol. Cold symptoms and fatigue never left and remain with me three weeks in. Every time I have gotten a cold in the past, symptoms have lingered on and on so I am not surprised to have the same thing happen here. As a 78 year old person, what I am is eternally grateful for readily available vaccines and ant-viral medication. When this virus first appeared and before these remedies were created, people in my age group regularly became very Ill and died.
Virginia Plain (NoVa)
This article shed some light on my experience with Covid this year. I am fully vaxed and boosted yet still was positive three times, in February, August, and September. Fortunately symptoms were mild. The first two were hallmarked by lost taste and smell, but the third developed into something like a bad head cold with congestion (I thought it was a cold but took the test just in case and it was positive). The second and third infections were four weeks apart and the third took longer to recover, though the symptoms didn’t become any more severe and steadily improved. No Paxlovid for that reason. Doctor said it was probably one of the new variants, but reading about the high incidents of rebound Covid helped understand what happened.
Harcourt (Florida)
I am 82 came down with Covid at the beginning of October. It was confirmed by two different quick tests. Within a day and a half, I got Paxlovid. By the time I had completed the five days of my prescription, my symptoms had disappeared. I returned to power biking and other normal activities for two days. At this point, my symptoms recurred in milder form, and I was still testing positive. It took me a week to overcome the milder symptoms and to finally test negative for Covid. This stuff was a nasty experience for me, and I am thankful for Paxlovid and my apparent full recovery.
Giulia (NYC)
I agree that virus can be around somewhat long after the first negative test following Covid diagnosis, so ok. But having immune system flares and symptoms here and there (occurs with many viral infections) or having a renewed viral replication that goes above the test threshold (happens with paxlovid) is not the same thing, IMO. So not sure what the point of this article is.
Jafawa (San Diego)
The point is that Paxlovid doesn’t necessarily cause a rebound and you may as well take it if you are among the population it’s currently being prescribed for.
David In Ohio (Columbus OH)
I believe the point is that the rebound is not due to Paxlovid.
Toxicologist (if it matters) (Maryland)
The reason both treated and untreated COVID-19 patients get rebound symptoms of fatigue, cough and headache has nothing to do with drugs These symptoms are caused by the carbon monoxide our bodies make 24/7, which comes from the breakdown of heme proteins by heme oxygenase, the Universal Stress Enzyme We make a lot more CO naturally in response to viral infections (it is antiviral). But this CO does not stay in our lungs. It diffuses through our blood into all our organs, where it causes multi organ hypoxia going in and rebound symtpms when coming out. Just as with alcohol, both abnormally rising and falling levels of CO cause symptoms. Maybe someday NYT will report on the role of CO in COVID-19...
Ray Wulfe (Colorado)
About a month ago, I got a cough, congestion, aches, fatigue, and a mild headache. Of course I did a home covid test, and it was negative. The worst of it was over in a few days, but the fatigue and cough persisted. And persisted. Again with two more negative test. Finally now, a month later I'm feeling better. I've read that covid sometimes doesn't register on the tests. So did I have covid? I'll never know for sure without further testing. It mutates so rapidly and readily that science is always one step behind and it seems to present differently in each individual. It is a strange and unsettling thing...
Dwayne (USofA)
Be sure to check the expiration dates on those tests. The ones we got from the government already expired. My cousin used them anyway and tested negative twice, then went to the doctor and tested positive.
Caesius (LINY)
@Ray Wulfe Yes, check the expiration dates - both on the box and on the contents. I had a box that said it was expired, but the contents had a much later expiration date. The expired tests gave me negative results, while the other box, with the later dated contents...I tested positive. And so did my PRC. As a result, I went three plus days out spreading it, before going home to isolate. Unsettling yes, unexpected, no.
@Ray Wulfe The home testing for CV is often inaccurate. A public health guru told us that these home tests for CV often do not 'catch' that the patient has CV (often being between 40 and 50% of the time) However, if they do register a positive result that is always deemed as accurate. is probably more likely that you did have CV. If it looks like a duck, quacks like a duck....walks like a is probably a duck.
stillskeptical (Bellevue, WA)
Thanks to everyone who gave comments here. It has been very informative. I hope to not get covid, but if I do, I’ll take Paxlovid.
Imagine (Scarsdale, NY)
Two of the newly hired people at my workplace got the virus recently. It laid them low for a week. Another one got symptoms but never tested, lost appetite but appeared to have recovered, then died of a massive heart attack during a phone call three weeks after it unfolded. Caveat emptor.
stillskeptical (Bellevue, WA)
@Imagine Wow
Sierra Morgan (Mi)
@Imagine We had something sim at my old job. They demanded that 25 people come back to the office in April 2022 two days a week. By Friday 12 people were confirmed SARS-COV-2 positive. Two weeks later 4 of them were in ICU. Three didn't make it. Everyone had all the shots possible. One was a mom with 3 young kids. Common thread, all had autoimmune diseases and taking immunosuppressive medications.
Regina L (Boston)
@Sierra Morgan That is so unbelievably sad. Thank you for reminding so many that what we do or do not do has consequences for others. Like insisting that nonessential people come into the office, not masking, not staying home when sick and not testing. I continue to be worried that nobody cares about immune-compromised folks, babies and the elderly, and with winter's arrival in the northeast I wish folks would simply mask up for them. Sad situation when everyone insists that we all "go back to normal." Whenever I hear someone say that I remind them that its synonymous with "survival of the fittest."
JTE (Cape Cod)
I am recovering from a recent bout with covid. I had all my vaccinations and boosters, thank goodness, so it wasn't as bad as it might have been. After feeling better this last week I have suddenly lost my energy again, still hack and cough in the morning, and have muscle aches. I did not call a doctor when I tested positive and I know many people that have not reported their recent cases as well. I imagine that the reason for this lack of reporting is that with mild to moderate cases there is no need for medical intervention and thus an accurate statistical reference cannot be formed for better understanding of current or future outbreaks. How can we make government take account of these flaws in our system? We need the best information to make the safest decisions for the health of both individuals and our larger social groups. At this time, it is not available and politically unpopular. As Kurt Vonnegut said, "So it goes".
Ken (New York)
@JTE When I tested positive recently, using an iHealth kit that was sent free of charge by the Biden adminstration via USPS, the instructions were to install a mobile app. Through that app, my test result was sent to the CDC. While nobody is forcing anyone to report their result, if they follow the directions on the test kit, the result should get reported and rolled into the statistics.
"Covid-19 Symptoms Can Rebound Even if You Don’t Take Paxlovid" And when the day is sunny, the sky is often blue.
Lynn in DC (Here, there, everywhere)
Why would vaccinated people need to take Paxlovid? We have been told over and over that the vaccines prevent serious illness and death. Are the vaccines not doing this?
Paul (NY and SF)
@Lynn in DC Vaccines are indeed excellent at preventing hospitalization and death, but nothing is 100%. Paxlovid provides another layer of protection for the more vulnerable population. Why wouldn't you maximize your resources against this disease?
roseberry (WA)
@Lynn in DC Very old people, people on chemotherapy or immune suppressing drugs, and people with immunodeficiencies, all will generate only moderate resistance to Covid from vaccination.
Ernest Mc (Middlebury, VT)
@Lynn in DC COVID vaccines and boosters are effective at preventing serious illness and death. The statistics have made that clear: the unvaccinated fare much worse with COVID. Paxlovid, like many medications, is another layer of protection for the more vulnerable. It also helps people feel better faster. As my doctor said recently when I came down with a relatively mild case: It’s great that you’re boosted but you don’t get a prize for refusing Paxlovid. So I took it and didn’t have symptoms impact my life in any significant way.
Kathy Kreeger (Boise)
Breaking news: we know more today than we knew yesterday. Vaccinate. Mask. Being smart means using common sense and not waiting for a poorly designed study to tell us what we suspected.
Dwayne (USofA)
@Kathy. A common sense comment like yours is so welcome these days. This virus is not gone or going away at this time. We get vaccinated and wear masks in public much to the dismay of so many who prefer to think the pandemic is over.
marmccu (Buxton)
@Kathy Kreeger yes, MASKs work! I wonder how many of us that have covid have let our mask wearing defenses down. That's how I got it, I am guessing, because I didn't get it when I was vigilant in wearing a mask. When I became less so, that's when I caught it.
sophie tucker (sliver springs)
The trifecta of viruses is already here. Covid, RSV and the flu. Wear a mask. practice great hygiene and social distance. These precautions could have protected you in the first place. As usual, nobody wants to hear it. There are consequences for not following the science. Hope all Covid sufferers get well soon and realize the pandemic is not matter what they try to tell you...
dennis piper (ohio)
@sophie tucker Thank you for stating the obvious, but you forgot something. A person can all the preventative measures you mentioned AND GET VACCINATED AND BOOSTED. Now here is the thing: you can do all that and still get Covid.
Carla (Brooklyn)
Yes but your chances of dying are less.
John Malcolm (Asheville, NC)
My theory (I'm an MD but not an infectious disease specialist) is that Paxlovid buys time for our immune system to ramp up a maximal response. It does that by killing or inactivating the virus that's in us. When we take away the Paxlovid, the virus starts multiplying like mad and the immune system jumps all over it, causing the common symptoms of viral infections like fever, headache, fatigue, etc. The point is that COVID is a very sneaky bug that's new to humanity, so it can get a BIG head start on our immune system. By the time we get ready to fight, the virus has spread so widely that our immune system goes ape trying to save us from utter destruction. That much immune activity is pretty toxic, especially to older, sicker folks with less in reserve. That's why Paxlovid makes sense as a stop-gap measure, and the data show that it greatly reduces our risks from COVID. That's not to say that vaccination and mask wearing are unimportant. One gives our immune system a head-start on the virus, and the other really slows the virus's spread within communities. There's no good reason to buck the experts on these matters; they usually know more than the politicians. Problem is, so many people get their information from poisoned sources: foreign powers wanting a weak America join with opportunistic media idols to push lies and distortions to those who don't have the scientific background to sift out the chaff for themselves. Future generations will read this history and cry.
Sierra Morgan (Mi)
@John Malcolm Very good points, but I but I will add that SARS-COV-2 is not new to humans. The 2 at the end is the clue. Sure there are a few new features, like it is not as deadly as SARS-COV-1 that appeared in 2003. But most of the important things are the same, like transmission vectors. Had the truth been told from the start, that this is an airborne virus, people might be more compliant with masking, distancing, and complying with quarantines.
marmccu (Buxton)
@John Malcolm thanks for your insight!
Nancy Passow (Englewood, NJ)
What is not mentioned in the article is whether people test positive again when they experience a rebound. My husband (over 65 with underlying health issues) started Paxlovid the first day he tested positive. Within a day or so his fever was gone and in a week he tested negative. However, a week later he was feeling very tired for several days and then tested positive. Because we didn't realize he was once again contagious until he was retested, he was not isolating and we were not wearing masks around the house. And so I was infected with Covid. I did not take Paxlovid. It took a week for my fever to be gone and 12 days until I tested negative, but I did not have a rebound.
Famdoc (New York)
@Nancy Passow Most do test positive again, although usually weakly so.
teresa (Eugene, Oregon)
@Nancy Passow It's mentioned in the article, that you can even test negative then get a rebound.
dennis piper (ohio)
@Famdoc MOST???? where did you get your data?? this is contrary to what i have read thus far, that rebound cases are NOT the norm but in a minority of cases
Paul B (San Jose, Calif.)
"If you do experience a rebound after treatment, there is no evidence that you need to start another course of Paxlovid." Oh? How do we "know" this? Ever since this "Paxlovid rebound" issue surfaced, I've always thought it's probably just that people need 10 days rather than 5 days of Paxlovid. For shingles, you take antivirals for 5-10 days. I suspect the medical/insurance community is just unwilling to approve Paxlovid for a longer period due to cost. And they've figuring "Well, we've given the immune system a 5-day head start, and patients can just deal with the "illness" problems for another another week." This is like the issue of how soon to get a 2nd shot. The medical community realized only later that a longer time period actually was better than the original four weeks recommended by the CDC.
Famdoc (New York)
@Paul B Before paxlovid, uncomplicated COVID produced a positive antigen test for 8-13 days in 90% of patients. With 5 days of paxlovid, that is shortened to 5-7 days. Five days is enough. With "paxlovid mouth", few patients relish the idea of taking it for five more days. Relapse occurs in 8-12% of patients (data anecdotal, but from a series of 300+ patients).
@Paul B I agree. People should just be given a longer course of treatment. Think about antibiotics. If you don't take the full course of antibiotics that you are prescribed, then you can have a rebound infection. It seems the same to me with Covid. There need to be studies comparing a longer course of Paxlovid with the five-day course to see if the longer course prevents the rebound. Perhaps you are right that cost concerns are the reason this is not done, but if there were a willing funder for such a study and our hypothesis was proven, then it would be harder for payers to deny payment for a longer course.
A (Virginia)
There was no “original four weeks recommended by the CDC.” For its clinical trials, Pfizer chose 3 weeks between its first two shots. Moderna chose 4 weeks between its first two shots. The FDA initially granted EUA to the companies on the basis of the companies’ findings.
Carmen (Philadelphia)
Yeah, I'm not anti-science by any means, but the constant rationalizations around weird Paxlovid effects strike me as a case of "Who do you believe, me or your own eyes?" Literally everyone I know who took Paxlovid had a rebound. Including every famous person – I completely expected both Bidens, Fauci et al to report rebound, and they all did. Literally nobody I know who didn't take Paxlovid had a rebound. Mostly they got sick, and then they got better. I'm not saying it doesn't happen – there are always outliers – but I just don't buy this. This study reminds me one I read about in college "proving" that birth control pills absolutely cannot cause weight gain. Yeah, right.
Famdoc (New York)
@Carmen Only 8-12% of patients who take paxlovid experience a rebound. 8-12% of those who DON'T take paxlovid experience a rebound.
Alisa Keesey (Santa Cruz, California)
@Carmen I did not get a rebound case. Started Paxlovid on day 3.
Dylan (Honolulu, HI)
@Carmen How dare you question the science? Whatever science says is the truth, even if your eyes see differently.
Tom (US)
In other words this virus behaves very much like other respiratory viruses in that things can drag for a few weeks once someone is back on their feet. So not really news, except that COVID-19 stories get clicks. Right?
Philosophias (Midwest)
@Tom The story was apparently written in response to the widespread experience that the symptoms of the viral infection drag on after dosage with the drug meant to cure the viral infection. The real takeaway is whether one needs to bother with the drug, which is being pushed into a significant segment of the infected population.
Kathy Kreeger (Boise)
@Philosophias Paxlovid was not formulated to “cure” the viral infection. The study endpoints were length and severity of illness in a vulnerable population with the intent of reducing hospitalizations. Same moa as Tamiflu and influenza.
teresa (Eugene, Oregon)
@Tom Yes, and you clicked on it. Personally, I am still interested in covid. I have managed to avoid this pesky and sometimes deadly virus so far, and see no reason to stop paying some attention to it.
Seth (Westport, CT)
This is me right now. It is the same as when I last had Covid in October 2019 before it was even a known thing. I felt sick then I felt better for a week and then I was sick again. I did not get vaccinated nor did I get sick after 2019 until last week. Last week I felt horrible this week I feel good next week I'll probably feel horrible again
BBB (Ny,ny)
@Seth how do you know you had Covid in October of 2019 before it was even a known thing? Oh right, you don’t. You have no idea what you had in October of 2019. I had a weird set of non-specific viral/flu-like symptoms in March of 2020, before testing became available for Covid and everyone I tell says “oh you definitely had Covid.” Guess what? I have no idea what virus I had in March 2020.
Mouse (Maine)
I am now taking paxlovid and dreading the possible rebound. But I was told also that it reduces the viral load so that my partner might have less chance of being infected. If so, worth it.
Bryan (NY)
Bless you for basing your decision on care for others. So many folks decide only based on their own health. “I’m young and healthy, so…”. We affect everyone we encounter. Masks, for instance, protect not ourselves, but the most vulnerable among us. Bless you.
Ampleforth (Airstrip One)
Almost three years in, and basic information and abatement measures are lousy worldwide. Is any nation mailing N95s to all its seniors once a week? Do we know if exposure to Covid without getting infected ramps up the immune system for any period of time? Why no scare health information campaign to battle obesity? And how about some sorrys for bad information and judgments of the past? Gawd, we need a Covid-19 nonpartisan commission, and fast. Another pandemic will come sooner or later.
inquiring minds (Durham, NC)
They say not to take a second course of Paxlovid with rebound. Then why did Dr. Fauci take it again?
BlarryG (Silicon Valley)
I've never had a cold or flu rebound, but after Paxlovid, Covid did. This happened to several friends so I warned some newly infected friends to fake it to get 2 Paxlovid courses. The two who listened had Covid, Paxlovid took them to away rapidly, both rebounded within 2 days and both started a second course of Paxlovid which immediately ended symptoms and Covid did not return.
Kathy Kreeger (Boise)
@BlarryG Did you say that you told friends to fake it? I’m confused.
marmccu (Buxton)
@Kathy Kreeger typo? f & t are close on the keyboard, but I wondered that also.
jeanne K (New Mexico)
Meanwhile, we are not gathering data, as we used to. Johns Hopkins tried, valiantly. States are hardly reporting data. Out of sight. Out of mind. And the public health experts are more interested in being on TV rather than gathering, assembling and interpreting data. As a scientist, I find this sad. We are doomed to repeat the same mistakes - in the next pandemic.
Alisa Keesey (Santa Cruz, California)
I tested positive yesterday after feeling mildly symptomatic for a week. I had a full blown case of Covid in August and took Paxlovid with no rebound. My daughter was exposed at school last week and stayed home sick for about 8 days. My second case is very mild but I definitely had symptoms that appeared to go away and come back a few days later with a low fever. I knew when I got the chills and that rundown brain fog feeling that I should test again — and the 5th test was positive with a dark red line. Not sure when to start the clock on this one... 8 days ago or two days ago. Covid testing is exhausting in itself.
Russell F (Montpelier VT)
Since the world went back to normal I had Covid, got better, then had the rebound. Then a few weeks ago I had the flu or a severe reaction to my flu shot. All told I have been sick a month out of 10 so far this year. It is a quality of life issue, and mine has gone down dramatically. I consider my self lucky as I don't seem to have long Covid. It is hard to believe that anyone is really paying attention to this.
Miriam (NY)
The government has essentially dropped the ball on research, funding and implementing interventions to combat this horrible disease. A significant number of people end up with Long Covid, their lives imploded by chronic health problems. Maybe this rebound phenomena is just part and parcel of that from the plague that is wreaking havoc all over the globe. The trick to survival these days is to avoid catching Covid to begin with but unfortunately that solution has its own host of problems.
Harry Paget (Southern Nevada)
We have vaccines and treatments that virtually eliminate serious risks from this virus, funded by the government, but what you see is we dropped the ball? Did we lose WWII too?
Miriam (NY)
@Harry Paget Government won't be giving out free vaccines or treatments anymore. Phizer says vaccines will cost well North of $100. By next year there should be a complete transition to insured or out of pocket costs for those who don't have insurance.
Miriam (NY)
@Harry Paget Also, have you noticed a lot of public testing facilities available lately? Many scientists and doctors are truly concerned that we are in a bad place to handle any kind of surge this fall and winter.
lgkinney (Seattle, WA)
Note that study of 107 with some rebounding didn't include a study of those taking Paxlovid or at least didn't include it. I'm one of those over 65 who rebounded six days after finishing the five day Paxlovid protocol. I had been vaxed to the max prior to Covid. My rebound Covid was far worse. If I get Covid again, I would not consider taking Paxlovid.
Harry Paget (Southern Nevada)
Did you require hospitalization? Because that’s what Paxlovid is for.
BlarryG (Silicon Valley)
@lgkinney I had Covid 3 days headache/fatigue took Paxlovid (better in 2 days, testing zero by day 5) rebounded 2 days later to mild symptoms that went on for 2 additional weeks (basically a running faucet in my left nostril and some fatigue). I warned 2 friends who then took 2 courses of Paxlovid (both took one course, rebounded, then took another course). In both cases, the second course of Paxlovid completely cleared the Covid. I thus suspect that Paxlovid should be more like an 8 day rather than a five day course.
AjaBlue (Beaufort)
@lgkinney I’m 66, got Covid for the 1st time September 2022 after being vaccinated and boosted to the max. Started Paxlovid immediately. Symptoms were minor. No rebound. I’d do the same again and would urge my 85 year old husband to do the same if he ever gets Covid.
Richard Wilson (Boston,MA)
"One of the limitations of the study, however, is that it looked at older strains of coronavirus in people, before vaccines became available. " That's one giant limitation. Congress has cut funding for COVID research so we are woefully falling behind on research and treatments.
Jen (NC)
@Richard Wilson One giant limitation among many others, unfortunately.
Lynn (New York)
@Richard Wilson "Congress has cut funding for COVID research so we are woefully falling behind on research and treatments." To be accurate: Republicans in Congress have blocked funding for COVID that has been requested by the Biden administration and supported by the vast majority of Democrats
Cynthia (South Orange, New Jersey)
@Lynn—Excellent point. It’s not Congress, it’s the Republicans that have denied the funding we so desperately need.
Leroy (Michigan)
My personal analysis from my recent experience with COVID (w recent bivalent booster) is that it takes a long time to actually get rid of the virus. I tested positive 16 days deep. But I’ve been asymptomatic for the past 7 days. The line on the tests have gradually gotten softer until just barely visible. My (highly uneducated) understanding is that the at home antigen tests require a certain viral load to register a positive result. Point being, whatever the physiological half life of this thing is, you’re going to have it in your system for a while after testing negative and/or becoming asymptomatic. If it’s still swirling around in there, any lapse in immune response may give it an edge for a moment to climb back up.
Harry Paget (Southern Nevada)
Many of us have had colds or even flu a few times in our lives. During these illnesses, we did not test ourselves daily for the next two weeks and marvel that the virus was still there and worry we were still contagious.
Longislander (NYC)
@Harry Paget Tell yourself whatever you need to tell yourself to feel ok about it all. Covid is different and more life threatening than a cold or almost all flus (even the flus that kill 1,000s every year). Note also that current science supports that 1/3 of the people who get Covid develop some form of long Covid - and that includes known numbers of mild or asymptomatic Covid. Neither a cold or the flu does that.
CC (Chicago)
@Longislander Do you happen to know how that 1/3 looks from an obesity/chronic illness standpoint? I’m genuinely curious.
Sue Sullivan (Colorado)
Would be so profoundly useful to get beyond self-reported, subjective symptom reporting at this stage of the pandemic. What does it mean to rebound, for viral shedding and transmissability to others? How does rebounding correlate with frequency of LC/post-acute sequelae? Why haven't we yet identified (or consistently reference, if we have) biomarkers (blood work, imaging tests, lung-functioning, cognitive performance, etc) for the lingering impacts of this disease? Why can't we turn well-designed studies around faster than 2 years on a virus that is evolving massively month-to-month? I assume this another artifact of our fragmented, underfunded public health and research systems in this country. Our failure to cohere as a nation around the common good, or even a shared definition of what the common good should be, continues to create needless suffering and loss.
Seth (Westport, CT)
@Sue Sullivan I am a contact tracer and our contract is ending in three weeks. No more funding
Cathy Seregny (Indiana)
Perhaps our profit oriented health 'care' system has set us up for failure?
Steven Mccain (New York)
I caught Covid in September of this year. I had been Vaccinated and boosted prior to catching Covid. Went to a cookout tested my self and tested positive. No real symptoms just a little fever. Got Paxlovid took it for five days. On the fourth day i no longer tested positive. Tested negative for three days but on the fourth day tested positive again. Took four days to test negative again. All I know is bless the people who produced these treatments. I remember almost a thousand people were dying daily in New York when this pandemic started. Bless all those involved in this.
Famdoc (New York)
We knew this. This study confirmed our anecdotal experience.
Dr. J (WH)
The article states that anti-viral drugs “successfully reduce the risk of hospitalization and death by 88 percent in unvaccinated people.” But what is the benefit in vaccinated and boosted people?
Famdoc (New York)
@Dr. J The studies have not been completed yet, but many of us are offering paxlovid to low-risk individuals, finding that it is associated with a reduction in symptoms intensity and the time to a negative antigen test, indicating end of infectivity.
JoeA (Cali)
@Dr. J - But what never gets mentioned in these articles is that the percentage of people who go to hospital from Covid is less than 1% of those who get infected. This number was based on an article discussing original type A Covid. Omicron hospitalization risk exposure was significantly less. But let's run with the 1% exposure risk and let's reduce that by 88%. 88% of 1% = a real exposure of less than 0.13%, which is not anything to worry much about. Stop the scare flogging!
AB (Brooklyn)
Most likely this wasn’t studied as your chances of hospitalization as a vaccinated and boosted individual is slim to negligible anyway. Every single COVID patient I’ve come across in my ICU is either unvaccinated or incomplete first series.
See also