Joe Biden has tested positive for Covid-19 again in a rare case of ‘rebound’ following treatment with an anti-viral drug.
The White House said the 79-year-old president, who only emerged from isolation on Wednesday, will now go back into confinement until he tests negative.
It means he has had to cancel planned trips to his home in Wilmington as well as a work trip to Michigan.
White House physician Dr Kevin O’Connor said Mr Biden’s positive test is thought to be the result of a ‘rebound’ experienced by a small number of people who take Paxlovid.
He said in a letter that the president ‘has experienced no reemergence of symptoms, and continues to feel quite well’. The medic added that ‘there is no reason to reinitiate treatment at this time’.
Mr Biden was treated with the anti-viral drug Paxlovid after he first tested positive on July 21.
He tested negative this past Tuesday and Wednesday and was then cleared to leave isolation while wearing a mask indoors.
His positive tests puts him among the minority of those prescribed the drug to experience a rebound case of the virus.
White House Covid-19 coordinator Dr Ashish Jha told reporters on Monday that data ‘suggests that between 5 and 8% of people have rebound’ after Paxlovid treatment.
According to the CDC, those with rebound Covid should isolate for at least five days, ending that if a fever has resolved itself for 24 hours without medication and symptoms have improved.
The patient ‘should wear a mask for a total of 10 days after rebound symptoms started’ it says, adding: ‘Some people continue to test positive after day 10 but are considerably less likely to shed infectious virus.’
Both the Food and Drug Administration and Pfizer point out that 1% to 2% of people in Pfizer’s original study on Paxlovid saw their virus levels rebound after 10 days.
The rate was about the same among people taking the drug or dummy pills, ‘so it is unclear at this point that this is related to drug treatment,’ according to the FDA.
While Biden was testing negative, he returned to holding in-person indoor events and meetings with staff at the White House and was wearing a mask, in accordance with CDC guidelines.
But the president removed his mask indoors when delivering remarks on Thursday and during a meeting with CEOs on the White House complex.
Regulators are still studying the prevalence and virulence of rebound cases, but the CDC in May warned doctors that it has been reported to occur within two days to eight days after initially testing negative for the virus.
‘Limited information currently available from case reports suggests that persons treated with Paxlovid who experience Covid-19 rebound have had mild illness; there are no reports of severe disease,’ the agency said at the time.
Paxlovid has been proven to significantly reduce severe disease and death among those most vulnerable to Covid-19.
US health officials have encouraged those who test positive to consult their doctors or pharmacists to see if they should be prescribed the treatment, despite the rebound risk.
Mr Biden is fully vaccinated, after getting two doses of the Pfizer coronavirus vaccine shortly before taking office, a first booster shot in September and an additional dose March 30.
While patients who have recovered from earlier variants of Covid-19 have tended to have high levels of immunity to future reinfection for 90 days, Dr Jha said that the BA.5 subvariant that infected the president has proven to be more ‘immune-evasive’.
‘We have seen lots of people get reinfected within 90 days,’ he said, adding that officials don’t yet have data on how long those who have recovered from the BA.5 strain have protection from reinfection.
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