My guess is that this is occurring more frequently than in 1% of 2% of people. Nou dadelik, we only have a series of anecdotes and friends’ worried phone calls. Plus, some of the main symptoms, like sniffles and headache, can be ascribed to allergies or angst or whatever.
I should know… for I, ook, am a rebounder. After the first dose or two of antiviral, I welcomed a glorious easing of my symptoms. Maar dan, three or four days after stopping my meds, my nose began to run once more, my morning throat discomfort returned, as did the grinding headache, the low-grade fever and the sudden, even dramatic fatigue that resolved only after a brief, or not so brief, nap.
I wasn’t certain that it was a rebound, so I reached out to doctor friends who also were caught in the latest Omicron wave to exchange stories. To my surprise, many told me that they too had rebounded a little or a lot after finishing their Paxlovid course. Toegegee, doctors are particularly predisposed to describing even a sniffle or the passing throat twinge in excruciating detail. The challenge of applying hyper-technical medical-ese to our own mortal selves somehow is irresistible.
The complaints I heard from friends though were not simply verbal acrobatics: Some felt lousy enough to miss a day or two of work. Others felt worse than ever. Personally, I dragged for several days, never quite sure if I was ill or milking it a bit — until the sudden fatigue descended at an odd moment and lying down right there on the floor for 40 winks seemed like a great idea.
, the rebound is not a huge surprise
, nor does it offset the usefulness of the new drug
. Other viruses
, when suppressed by antivirals
, also can bounce back
, sometimes with a vengeance
, if antiviral treatment is stopped
. Byvoorbeeld, people with HIV may experience a new “acute infection” syndrome similar to mononucleosis
, while those who stop treatment for hepatitis B may induce a flare of liver inflammation that can be fatal
. But these are infections known for their long duration and high level of virus in the blood
; neither property applies to the coronavirus
So once again we are in uncharted Covid-19 waters, trying to use sort-of-similar situations as a guide for what’s ahead even as countless new questions arise.
Eerste, does the rise in the amount of detectable virus during rebound mean a person is again contagious and, Indien wel, does the rule of five days of isolation, five more days of masking no longer apply? (My guess is that a longer stay away from the crowd is necessary.) Tweede, is there a connection, favorable or not, between rebounding and development of long Covid-19? (I doubt it.)
Will this bounce back predispose to a faster emergence of drug resistance? (Sover, geen, but data is still being collected.) What about the impact of a rebound on protection against the next variant? It might be wishful thinking, but one could argue that the rebound and re-exposure to virus so soon after the first challenge could lead to a more durable immune response.
These questions lead us to the tiresome but correct bromide that more studies are needed to figure out the implications of this bump in the road.
What is clear is that the hope for a game changer from this particular drug is overly optimistic
. Add viral rebound to the list of concerns already raised about the drug
: die many drug-drug interactions
, frequent appearance of a metallic taste in the mouth and its failure to prevent infection among uninfected close contacts
(usually the easiest task for an antiviral
). Plus, its efficacy has been shown only in the unvaccinated
. Now comes an unexpected and still poorly understood new phenomenon that may create additional public health confusion regarding contagiousness
Weereens, our pandemic fatigue and longing for unrestricted daily life have gotten the better of our judgment
. The drug by itself will not stop the pandemic or be a
.” But its availability is an important incremental step
: We now have a medication that reduces the risk of hospitalization and death among the unvaccinated by a staggering amount
As with other substantial steps forward, including effective vaccination, treatment with the steroid dexamethasone, immunity from infection and monoclonal antibody treatment, we have been reminded again that no shortcuts exist in the battle to control the pandemic. Like all real-life struggles, this particular game is very, very difficult to change. But all can agree that, more than two years into the pandemic, the likely fate of a person, aka die “spel,” who was infected in March 2020 versus now has been fundamentally changed.