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 that has otherwise been widely credited with impressive results in the fight against the virus and the suppression of its worst effects.

“The president has not experienced any recurrence of symptoms and remains quite well,” Dr. Kevin C. O’Connor, White House physician, said in a statement released by the press office. “In this case, there is no reason to restart treatment at this time, but obviously we will continue to watch closely.”

The “rebound” positivity, as Dr O’Connor called it, meant Mr Biden was forced to resume “strict isolation procedures” in accordance with medical advice. The White House announced that the president would no longer travel to his home in Wilmington, Del., on Sunday as planned, or make a scheduled visit to Michigan on Tuesday to promote newly passed legislation supporting the nation’s semiconductor industry.

Mr. Biden downplayed the development. “Friends, I tested positive for COVID again today,” he wrote on Twitter. “This happens to a small minority of people. I have no symptoms, but I will be isolating for the safety of everyone around me. I am still at work and will be back on the road soon.”

The White House later released a video of the president on Truman’s balcony with his dog Commander, and it looked good. “I feel good,” he said. “Everything is fine.”

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 in isolation, he tested negative on Tuesday evening and returned to the Oval Office on Wednesday, declaring that his relatively mild case showed how much progress had been made in the fight against the virus that has killed more than ‘one million Americans.

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

The Paxlovid rebound has become a source of debate within the scientific community and among Covid patients. Initial clinical studies of the drug, made by Pfizer, suggested that only 1 to 2 percent of patients 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 A study published in June that has not yet been peer-reviewed found that of 13,644 adults, about 5 percent tested positive again within 30 days and 6 percent experienced symptoms again.

But anecdotal accounts of Paxlovid rebounding, including a case involving Dr. Anthony S. Fauci, the president’s chief medical adviser, have drawn widespread attention, leading many to question whether the reported data were still as accurate as the new and the much more contagious BA.5 subvariant ravages communities and reinfects even patients who have recently recovered from Covid-19.

“I think this was predictable,” Dr. Jonathan Reiner, a leading cardiologist and professor of medicine and surgery at George Washington University Hospital, wrote on Twitter on Saturday after the president’s positive test was disclosed. He added that “prior data suggesting low-digit ‘bounce’ Paxlovid positivity is outdated” and that the true number was likely significantly higher.

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Either way, experts stressed that Paxlovid had been remarkably successful in preventing more serious Covid-19 illnesses and hospitalizations. And a Centers for Disease Control and Prevention study published in June reported that symptoms of a rebound tend to be milder than during the primary infection and are unlikely to lead to hospitalization.

“While we continue to monitor real-world data, we are very confident in the treatment’s effectiveness in preventing serious outcomes from Covid-19,” Amy Rose, a Pfizer spokeswoman, said in a statement Saturday.

The CDC issued an emergency health advisory in May that said people with a rebound case “should restart isolation and self-isolate again” for at least five days, mirroring general isolation recommendations of the agency for people infected with the virus. The advisory also said the rebound did not represent re-infection with the virus or resistance to Paxlovid.

Dr. Ashish K. Jha, the White House’s co-ordinator of the Covid-19 response, told reporters when Mr. Biden first tested positive that looking at Twitter, “everybody seems to have recovered, but it turns out there is actually clinical data” that suggests otherwise. . He also said, “Paxlovid is working very well to prevent serious disease, rebound or no rebound, and that’s why it was offered to him, and that’s why the president accepted it.”

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

Among his Covid-19 patients who experienced a rebound case, Dr. Auwaerter said, more of them have had the recent Omicron subvariants. None were hospitalized while recovering. 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 goalposts” in the course of an infection, suppressing the virus but not eliminating it completely. Even so, he said, high-risk people should “absolutely” still take the drug.

Dr. John P. Moore, a virologist at Weill Cornell Medicine, said the researchers still had no 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 lucky one out of 20. It’s just a numbers game.”

Dr. Moore said that if the data could support such a move, federal regulators might want to consider allowing a longer course of the drug to permanently rid the body of the virus. “The simplest thing would be to take the drug again for a longer time,” he said.

Mr. Biden’s rebound case will complicate his effort to turn his illness into a positive story. As the nation’s longest-serving president, Mr. Biden, 79, has been eager to show he’s staying fit, especially as he plans to run for a second term in 2024. He continued to work since the White House residence during his first self-isolation, appearing by video before various 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 fact of life for Americans, some of whom have been infected multiple times.

Mr. Biden’s new positive test may also raise questions about his adherence to precautions to avoid infecting others after returning to office. Aides said he would wear a mask while 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 was careful to avoid exposing aides, Secret Service agents and domestic staff members. The White House Medical Unit found that 17 people had been in close contact with Mr. Biden before his initial positive test, but none have tested positive as of Wednesday.

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

Dr. Auwaerter said that Mr. Biden may not have put others at risk in recent days, even without wearing a mask, because he was being tested for the virus regularly and was testing negative. For those who don’t test as regularly, he said, it would be prudent to continue wearing a tight-fitting, high-quality mask, especially around high-risk people, because of how infectious the Omicron subvariants can be. .

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

The president, whose approval rating stood at just 33 percent in a New York Times/Siena College poll in July, has been described as eager to travel the country after a series of trips to the foreigner, but the renewed isolation will further delay it.

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