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Biden Tests Positive for Covid Again in ‘Rebound’ Case


President Biden tested positive for the coronavirus again on Saturday morning, becoming the most recent example of a rebound case after taking the Paxlovid treatment that has otherwise been credited with broadly impressive leads to fighting the virus and suppressing its worst effects.

“The president has experienced no re-emergence of symptoms, and continues to feel quite well,” Dr. Kevin C. O’Connor, the White House physician, said in a memo released by the press office. “This being the case, there is no such thing as a reason to reinitiate treatment at the moment, but we are going to obviously proceed close remark.”

The “‘rebound’ positivity,” as Dr. O’Connor termed it, meant that Mr. Biden was forced to resume “strict isolation procedures” in line with medical advice. The White House announced that the president would not travel to his home in Wilmington, Del., on Sunday as planned nor make a scheduled visit to Michigan on Tuesday to advertise newly passed laws supporting the domestic semiconductor industry.

Mr. Biden played down the event. “Folks, today I tested positive for COVID again,” he wrote on Twitter. “This happens with a small minority of oldsters. I’ve got no symptoms but I’m going to isolate for the security of everyone around me. I’m still at work, and will likely be back on the road soon.”

The White House later posted a video of the president on the Truman Balcony along with his dog Commander and he appeared well. “I’m feeling high-quality,” he said. “All the things’s good.”

Mr. Biden first tested positive for Covid-19 on July 21 and experienced a sore throat, runny nose, cough, body aches and fatigue. After five days of isolation, he tested negative on Tuesday evening and returned to the Oval Office on Wednesday, declaring that his relatively mild case demonstrated how much progress had been made in fighting the virus that has killed multiple million Americans.

But doctors were anticipating signs of a rebound case and made sure to maintain testing him on daily basis. He tested negative on Wednesday, Thursday and Friday before receiving a positive antigen result on Saturday morning.

Paxlovid rebound has grow to be a source of debate throughout the scientific community and amongst Covid patients. Initial clinical studies of the drug, which is made by Pfizer, suggested that only about 1 percent to 2 percent of those treated with Paxlovid experienced symptoms again. A study published in June that has not yet been peer-reviewed found that of 13,644 adults, about 5 percent tested positive again inside 30 days and 6 percent experienced symptoms again.

However the anecdotal accounts of Paxlovid rebound — including a case involving Dr. Anthony S. Fauci, the president’s chief medical adviser — have echoed widely, causing many to wonder if the reported data was still accurate as the brand new and way more contagious BA.5 subvariant sweeps through communities and reinfects even patients who recently recovered from Covid-19.

“I believe this was predictable,” Dr. Jonathan Reiner, a distinguished cardiologist and professor of drugs and surgery at George Washington University Hospital, wrote on Twitter on Saturday after the president’s positive test was disclosed. He added that “the prior data suggesting ‘rebound’ Paxlovid positivity within the low single digits is outdated” and that the true number was likely significantly higher.

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Either way, experts stressed that Paxlovid had been notably successful in stopping more severe Covid-19 illnesses and hospitalizations. And a Centers for Disease Control and Prevention study published in June reported that symptoms from a rebound tended to be milder than throughout the primary infection and unlikely to guide to hospitalization.

“While we proceed to observe real-world data, we remain very confident within the treatment’s effectiveness at stopping severe outcomes from Covid-19,” Amy Rose, a Pfizer spokeswoman, said in a press release on Saturday.

The C.D.C. issued an emergency health advisory in May that said people experiencing a rebound case “should restart isolation and isolate again” for at the very least five days, reflecting the agency’s general isolation recommendations for people infected with the virus. The advisory also said that rebounding didn’t 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 by taking a look at Twitter, “it appears like everybody has rebound, but it surely turns on the market’s actually clinical data” suggesting otherwise. Furthermore, he said, “Paxlovid is working rather well at stopping 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 clinical director within the infectious diseases division on the Johns Hopkins University School of Medicine, said it was unlikely that Mr. Biden, who has been fully vaccinated and boosted twice, would grow to be seriously sick. He added that scientists were working to clarify why some people experience a rebound of the virus.

Amongst his Covid-19 patients experiencing a rebound case, Dr. Auwaerter said, more of them have had the recent Omicron subvariants. None has been hospitalized while rebounding. Those highly infectious and vaccine-evasive types of the virus, he added, could cause people to check positive for longer.

Taking the drug, Dr. Auwaerter said, could possibly be like “moving the goal posts” in the middle of an infection, suppressing the virus but not clearing it completely. Still, he said, high-risk people should “absolutely” still take the medication.

Dr. John P. Moore, a virologist at Weill Cornell Medicine, said researchers were still lacking correlations between age, risk aspects or vaccination status. “I haven’t heard anyone give you a definitive cause,” he said. “He’s just the unfortunate guy within the one out of 20. It’s only a numbers game.”

Dr. Moore said that if data could support such a move, federal regulators might want to contemplate allowing an extended course of the drug, to definitively rid the body of the virus. “The best thing could be to return on the drug for longer,” he said.

Mr. Biden’s rebound case will complicate his effort to show his illness right into a positive story. Because the oldest president within the nation’s history, Mr. Biden, 79, has been wanting to show that he stays fit, especially as he forecasts plans to run for a second term in 2024. He continued to work from the White House residence during his first isolation, appearing by video before several groups, after which made a triumphal return to work in person on Wednesday.

As an alternative of the narrative of beating the virus, nevertheless, the president’s rebound case reinforces the unpleasant reality that the pandemic refuses to go away. Although the death toll has fallen dramatically, Covid-19 stays a fact of life for Americans, a few of whom have been infected multiple times.

Mr. Biden’s recent positive test may raise questions on his fidelity to precautions against infecting others after returning to the office. Aides said he would wear a mask while with others, but in every public appearance he made since Wednesday, his face remained uncovered.

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

While the president didn’t wear a mask within the video on Saturday, a photograph released by the White House showed him wearing one as he signed a disaster declaration responding to flooding in Kentucky.

Dr. Auwaerter said Mr. Biden may not have put others at great risk in the previous few days even without wearing a mask, since he was being tested for the virus repeatedly and was testing negative. For those not testing as repeatedly, he said, it might be prudent to proceed wearing a tightfitting and high-quality mask, particularly around high-risk people, due to how infectious Omicron subvariants may be.

But the brand new positive test may also set back Mr. Biden’s efforts to get back on the road to advertise his agenda and campaign for Democrats facing an uphill struggle to maintain control of each houses of Congress on this fall’s midterm elections.

The president, whose approval rating stood at only 33 percent in a Recent York Times/Siena College poll in July, has been described as wanting to travel the country after a spate of foreign trips, however the renewed isolation will delay that further.

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