Anybody else had Paxlovid rebound?

[mrs-b]

My DH and I tested positive for covid - 15 days ago for him, 13 for me. Since we're both immuno-compromised, we were both given paxlovid. Horrible taste, but felt way better after 2 days of taking it. At the end of the 5 day course, no symptoms at all. We'd heard about paxlovid rebound and were aware it can occur in up to 9% of people, but since, compared to the immuno-compromised community in general, we're reasonably healthy, we assumed this wasn't a bullet that would have our names on it.

Wrong, as it turns out. 5 days after we finished the paxlovid, both DH and I started exhibiting symptoms and now we're both coughing, sneezing, wheezing, and generally feeling lousy. We're both testing positive, and the RAT test is coming up faster and stronger than previously, which apparently *is* an indicator of how much of the antigen you have on board. DH is now taking time off work, trying to bounce back by next Saturday...when he's supposed to be heading to Australia to see his elderly parents for the first time in 5 years - a trip which we have all acknowledged will probably be the last time he sees them.

So I just wondered - has anyone else had paxlovid rebound? How did it go? How did YOU go? How long did it take to get over it? We're on a deadline here, and if he doesn't test negative by the time he's meant to leave, we'll have to cancel and it will break his parents' hearts.

So - anyone?

 

[Matata]

This recently happened to a friend of mine with myriad health issues. Paxlovid eased her mild covid symptoms which roared back much worse after she finished the drug. Her symptoms persisted for 2 weeks after Paxlovid and she tested positive for another 2 weeks after that. She wishes she hadn't taken the drug.

I hope your DH quickly returns to good health and can take his trip.

 

[bright&shiny]

Oh @mrs-b, Joe and I are so sorry to hear this! We haven’t had it yet, but many around us have and the experiences with rebound seem quite varied. Hugs and best wishes for a speedy recovery in time for that precious trip!

 

[mrs-b]

This recently happened to a friend of mine with myriad health issues. Paxlovid eased her mild covid symptoms which roared back much worse after she finished the drug. Her symptoms persisted for 2 weeks after Paxlovid and she tested positive for another 2 weeks after that. She wishes she hadn't taken the drug.

I hope your DH quickly returns to good health and can take his trip.

@Matata - that seems to be where we are, too. It's now a week since we finished paxlovid and we both feel worse than we did before we took it. Oddly, tho, not as tired. Everything else, tho - worse, tho only minimally.

We wish we hadn't taken it, either. We'd probably both be well over it if we hadn't.

 

[mrs-b]

Oh @mrs-b, Joe and I are so sorry to hear this! We haven’t had it yet, but many around us have and the experiences with rebound seem quite varied. Hugs and best wishes for a speedy recovery in time for that precious trip!

Hallo! Man, we're doing it tough over here in MA! We can't seem to pull a trick. Just when we think we're turning a corner - wham! - and down we go again. We thought we'd been doing really well avoiding covid up until now - suuuuper careful and up to date on all vaccines - then Tim went to a conference and that was it for us. I'm really hoping Tim is symptom-free by next Saturday - this was his window, and if he doesn't go as planned, he doesn't have the ability to push it back. Plus all his family have booked flights and hotels to converge on the same place to spend time with him, and I've organized someone to come stay with me while he's away - and they've taken annual leave, and on and on and on. It's the whole domino effect.

I'm getting all the same symptoms I originally had - but I've got increased dizziness, which I hate. Probably due to inflamed inner ears and sinuses. I really, really, REALLY just wish this would go away!

Remember when covid didn't exist? I can barely remember a time....

 

[mrs-b]

Here's an interesting thing about paxlovid rebound. Suggests that rebound is due to a healthy immune response to the virus, rather than a weak one.

Interesting and somewhat encouraging stuff. Might also follow that a paxlovid rebound response could be positively correlated with not getting long covid. Nobody is saying that yet, but it definitely would make sense.

COVID rebound after Pfizer treatment likely due to robust immune response, study finds

A rebound of COVID-19 symptoms in some patients after taking Pfizer's antiviral Paxlovid may be related to a robust immune response rather than a weak one, U.S. government researchers reported on Thursday.

www.reuters.com

 

[diamondringlover]

dang I am sorry you all are dealing with this, I havent had covid (knocking on wood) I hope you both feel better soon and I really hope hubby can go see his parents, sending lots of prayers your all's way!

 

[missy]

@mrs-b hope you and Tim start feeling better soon
FYI some info I shared in the Coronavirus update thread

By David Leonhardt

Good morning. The underuse of Covid treatments is leading to many needless deaths.

Alex Merto

The power of Paxlovid​

A worrisome pattern has emerged with Paxlovid and other drugs that reduce the severity of Covid: Many people who would benefit most are not receiving the treatments, likely causing hundreds of unnecessary deaths every day in the U.S.

There seem to be two main explanations for the drugs’ underuse. The first is that the public discussion of them has tended to focus on caveats and concerns, rather than on the overwhelming evidence that they reduce the risk of hospitalization and death. The second explanation is that many Americans, especially Republicans, still do not take Covid seriously.

Today’s newsletter will dig into both issues.

“A large chunk of deaths are preventable right now with Paxlovid alone,” Dr. Ashish Jha, the White House Covid response coordinator, told me. He predicted that if every American 50 and above with Covid received a course of either Paxlovid or a treatment known as monoclonal antibodies, daily deaths might fall to about 50 per day, from about 400 per day in recent months.

Dr. Rebecca Wang, an infectious disease specialist at Dartmouth Hitchcock Medical Center, has said: “Never really in recent history for a respiratory virus can I think of an anti-viral medication being as effective, demonstrated in scientific literature, as what Paxlovid has shown.”

Dr. Robert Wachter, the chair of the medicine department at the University of California, San Francisco, told me that he thought the underuse of Paxlovid was already associated with thousands of preventable deaths in the U.S. “The public doesn’t seem to understand that the evidence around hospitalization and deaths is really powerful,” Wachter said.

Bad-news bias​

By now, you have surely heard about the downsides and shortcomings of Paxlovid.

The drug can produce a metallic taste in the mouth. (One member of my family described it as among the worst tastes she had ever experienced.) Some research has also found that the drug might not cause a statistically significant reduction in hospitalization among younger adults. Most prominently, people who take Paxlovid can endure “rebound” Covid — as both President Biden and Jill Biden did — in which symptoms return after the five-day course of pills has ended.

All of this is true. It also does not change the big picture. Covid is a deadly virus, especially for older people, and Paxlovid reduces Covid’s severity. It does so by inhibiting the virus’s replication inside the human body, the same process that has made H.I.V. treatments so effective.

With Paxlovid, both randomized trials and data from electronic health records have pointed to its effectiveness. Some research finds an effect across all age groups, while other research finds one only among older patients. But that is not surprising. The Covid death rate for people under 50 is already so close to zero that reducing it in a statistically significant way is difficult.

“I think almost everybody benefits from Paxlovid,” Jha said. “For some people, the benefit is tiny. For others, the benefit is massive.” (People who can’t take Paxlovid because it interacts dangerously with another drug they’re taking can usually take monoclonal antibodies.)

A recent analysis of about 568,000 patients by Epic Research found that 0.016 percent of Covid patients over 50 who received Paxlovid died. The death rate for patients who did not get the drug was more than four times higher, or 0.070 percent. And yet the Epic data showed that only about 25 percent of patients eligible to receive Paxlovid actually did, even though the drug is widely available and free for patients.

Perhaps the most shocking statistic about Paxlovid’s underuse — and Jha used the word “shocking” when describing it to me — is that a smaller share of 80-year-olds with Covid in the U.S. is now receiving the drug than 45-year-olds with Covid, according to data he has seen. Many doctors are evidently worried about side effects or rebound cases among their more vulnerable patients.

Even in rebound cases, however, symptoms tend to be milder than they would have been without Paxlovid. After Dr. Anthony Fauci, another White House adviser, who’s 81, contracted Covid in June and then took Paxlovid, he experienced a rebound — and also believed that the drug kept him out of the hospital.

“Medicine is about weighing costs and benefits,” Wachter said. “The recommendation should be clear and unambiguous for people at high risk: The benefits of the drug outweigh the downsides.”

Red Covid​

When I last wrote about “red Covid” — the concentration of Covid deaths in conservative communities because of vaccine skepticism — almost eight months ago, I explained why the partisan gap could eventually shrink: Republican communities might have built up more natural immunity through previous infections, and treatments like Paxlovid were becoming more widely available.

This spring and summer, the gap did narrow somewhat. But it has begun growing again in the past two months, according to an analysis by my colleague Ashley Wu.

Data through Oct. 4, 2022, excluding Alaska. | Sources: New York Times database, Edison Research

One possible explanation is that Paxlovid takeup rates appear to be lower in Republican areas, even though they are the very places where the drug could do the most good, because of lower vaccination rates. Government data shows that of the 20 states with the least Paxlovid use between late August and late September (per 100 diagnosed cases of Covid), 18 were won by Donald Trump in 2020.

Paxlovid data is between Aug. 29 and Sept. 25, 2022. | Sources: White House; Edison Research

The shunning of Paxlovid seems to be part of a pattern in which Republican voters have wrongly dismissed Covid as little different from the flu. That mistake has had tragic consequences. A new study by three Yale University researchers found that the wide partisan gap in Covid deaths remained even after controlling for other factors, like age.

Solutions​

Jha told me that the Biden administration was committed to increasing the use of Paxlovid and monoclonal antibodies nationwide. “We are going to go after this problem hard,” he said. “We have got to fix it, and we’ve got to fix it in weeks.”

What might make a difference?

Persuading more doctors of Paxlovid’s benefits would probably have the biggest impact. Wachter thinks that accelerating research about rebound Covid — including whether a longer course of Paxlovid would help — could also increase use, given the fear around the issue. He added that he was surprised that government, academic and private researchers had still not learned more about what causes a rebound and how to prevent it.

Paxlovid update: Effectiveness, rebounding, drug interactions​

Katelyn Jetelina Oct 7

One of our biggest public health challenges is to decrease the rate of severe COVID-19 disease in the face of pandemic fatigue, dried up funding, misinformation, and a changing virus. Paxlovid—an antiviral medication—is a tool we still have left.
However, recent data shows concerning trends of Paxlovid use. For example, less than 30% of 80-85 year-olds with COVID are getting a prescription for Paxlovid. This is a major problem. This group is at the highest risk for severe disease and death, even if vaccinated. Improving knowledge, confidence, and thus prescriptions and use should be a priority.
Here is the latest data on effectiveness, rebounding, and drug interactions with Paxlovid. (To see how Paxlovid works, go here.)

Effectiveness​

As with vaccines, we rely on two types of data: clinical trials data and “real world” data. Both have limitations, so looking at them together gives us the best picture.
Clinical trials

• The original Pfizer clinical trial tested the efficacy of Paxlovid on “high-risk” individuals: unvaccinated with at least one high risk characteristic, such age 65+ or a comorbidity. This trial was during the Delta wave. Paxlovid reduced hospitalization and death by 88%.
• Pfizer had a second clinical trial testing the efficacy on “standard risk” individuals, for example younger people. The drug was not effective. Pfizer stopped the clinical trial early.

Real world data

• A study published in Israel found Paxlovid reduced hospitalization by 70% and death by 80% but only for people aged 65+. There was no benefit for 40-64 year olds.
  • The vast majority of people in this study had some level of immunity (vaccination or prior infection). This means that Paxlovid helps vaccinated older adults.
• A study in Hong Kong found Paxlovid was useful among people >60 years old and <60 years old with a comorbidity. This study also included people who were vaccinated.
• Another study in Hong Kong found that, among hospitalized patients, Paxlovid reduced viral load and helped patients recover faster.
• A non-peer-reviewed report on 560,000 U.S. patients found similar patterns:
  • Among those 65+ years, 73% had a lower chance of hospitalization and 79% a lower chance of death.
  • When separated by vaccination status, the benefit remained. This analysis did not account for other variables that could explain this relationship, but the authors said this analysis is currently underway and, thus far, results have not changed.
    

    ​

    Unadjusted age distribution of COVID-19 hospitalization and death rates by Paxlovid use from March 1, 2022, through August 1, 2022, for patients with a complete primary series of COVID-19 vaccination but no documented booster vaccination.

Rebounding​

COVID-19 rebound occurs when a person takes the drug for a few days, tests negative, and then tests positive again several days later. Since my last update, we still don’t know the “true” frequency in which thispens after Paxlovid. But we have discovered other important pieces to the rebounding puzzle:

1. Rebound doesn’t impact immunity. A small but important study found that rebounding after Paxlovid does not interfere with the immune system’s ability to develop protection. In other words, if you take Paxlovid, you will still make antibodies and T cells. In fact, this study found that you make more antibodies.
2. Rebounding is common without Paxlovid. A preprint found 1 out of 8 people rebounded without Paxlovid. Those that rebounded were more likely to be older. Among those that rebounded, only 10% had symptoms.
3. Rebounding may happen more frequently with Paxlovid. Another preprint found rebounding after Paxlovid (3 out of 11) was more common than rebounding without the drug (1 out of 25). Why this is the case is one of our biggest unanswered questions.
   

   ​

4. Rebounding is mild. Another important question is whether rebounding leads to severe disease or milder disease. In other words, does it cause harm? Small studies report the majority of people experience milder symptoms during rebound compared to the initial infection. LA County reports no severe COVID-19 cases after rebounding, too.

Interactions with medications​

One limitation to Paxlovid is that it can interact with other medications. The older the person, the more comorbidities, and the more medications. This may explain suboptimal uptake. The good news is there aren’t too many drug-to-drug interactions. The Infectious Disease Society of Americareleased a report summarizing the the top 200 prescribed drugs and their interactions with Paxlovid. They found only 2 drugs have interactions so severe that Paxlovid should be avoided:

• Rivaroxaban (Xarelto)
• Salmeterol (Serevent)

With the help of a clinician, other medications can be managed so Paxlovid remains an option. Be sure to get advice from a clinician.

Other benefits?​

Severe disease is not COVID-19’s only outcome, so a comprehensive assessment of Paxlovid is beneficial, especially if we are considering populations outside of 65+:

• Transmission: A randomized control trial of more than 3000 people found that Paxlovid does not prevent COVID-19 infection.
• Long COVID: Unfortunately we do not know whether Paxlovid reduces the risk of long COVID.

Bottom line​

Vaccination is the safest and most effective way to stay out of the hospital. Paxlovid acts as a fantastic second line of defense among unvaccinated people and vaccinated older adults. This is the case even if they rebound. We are entering winter with limited tools, so Paxlovid needs to be top of mind. We’re simply missing too many opportunities to use it among high risk people.

 

[mrs-b]

Thanks @missy. I've been reading pretty widely and had actually already come across that article, which I thought was an excellent overview, especially if you're interested in the link between political position and the use of drugs (both vaccines and treatments) for covid. The most convincing study on paxlovid I've read said they were unable to determine the death rate in patients who took paxlovid as it was so small that their study was unable to generate any meaningful statistics. But they guesstimated probably slightly less than 1 in a thousand. I don't know if you read the article I posted, but it suggested that paxlovid rebound could be a result of a strong immune system rather than a weak one. All that to say, there's no need to try to sell me on the efficacy of paxlovid. I'm already there, in general, as evidenced by the fact that I took it.

However - I think (actually, I know) we were prescribed it out of an abundance of caution rather than actual need. Tim got it on Day 4, and his symptoms had already begun to improve, and I think another day or 2 would have seen him largely over it. IF you get paxlovid rebound, it can elongate the situation by weeks, as I think it has/will for him, and that's a problem in his specific situation as he has a departure deadline. So I'm just trying to find out what other people's timeline was like. If he doesn't make it onto the plane, it's going to upset a lot of people, not least of which will be him.

I do think paxlovid is a wonderful tool for many people. But it does have downsides, as all drugs do, and in paxlovid's case it seems to be the extension of the timeline. One needs to trade off the benefits of potentially lighter/shorter symptoms against longer symptoms and isolation. Since so many people seem to be either asymptomatic or to have very light symptoms with the latest covid variant, I'd question Dr Jha's universal comment that everyone benefits from paxlovid. There's a cost to everything, and I know Tim, who, by day 4 of finally getting an appt with his dr, wasn't going to take paxlovid but was largely talked into it, would have preferred in retrospect to have skipped it if he'd known about rebound. We blame nobody for what we didn't know; this information is coming thick and fast, and it's almost impossible to keep up. But we know now and if we'd known then what we know now, he, at least, would have passed.

For myself, I don't know. I took to on day 3, so have less to go on. 2 weeks in, tho, and I can tell you that I'm pretty tired of being back in isolation. I don't care so much for myself, tho, as I'm not trying to travel and I've had colds worse than this many times. But has it made it better? I don't know and never will, I guess.

 

[missy]

Thanks Missy. I've been reading pretty widely and had actually already come across that article. The most convincing study on paxlovid I've read said they were unable to determine the death rate in patients who took paxlovid as it was so small that their study was unable to generate any meaningful statistics. But they guesstimated probably slightly less than 1 in a thousand. I don't know if you read the article I posted, but it suggested that paxlovid rebound could be a result of a strong immune system rather than a weak one. All that to say, there's no need to try to sell me on the efficacy of paxlovid. I'm already there, in general, as evidenced by the fact that I took it.

However - I think (actually, I know) we were prescribed it out of an abundance of caution rather than actual need. Tim got it on Day 4, and his symptoms had already begun to improve, and I think another day or 2 would have seen him largely over it. IF you get paxlovid rebound, it can elongate the situation by weeks, as I think it has/will for him, and that's a problem in his specific situation as he has a departure deadline. So I'm just trying to find out what other people's timeline was like. If He doesn't make it onto the plane, it's going to upset a lot of people.

Yes. My sister’s best friend is an infectious disease specialist and when my sister got Covid her friend told her hold off til day five. My sister has severe asthma and had to take a round of steroids but ultimately she also had to take paxlovid. On day five. Fortunately she did well with it and experienced no rebound. I just shared the above articles with you so you could take comfort in that you did the best thing under the circumstances. Unfortunately there’s still much we need to learn. We are in the infancy of Covid. Wishing you a speedy recovery dear girl.

 

[mrs-b]

Unfortunately there’s still much we need to learn. We are in the infancy of Covid.

Thanks @missy. I have a habit of posting a bit of a response, then editing and elongating once it's posted. I just added a lot to what I originally posted, and it explains a bit better our situation.

More than anything, I agree with your highlighted comment above and had added something similar to my post as well. I was reading studies that used as few as 6 people (a non-statistically relevant number as you can't generate a normal curve with the results, so all results fall into the category of being idiosyncratic) - but it's all researchers have to deal with at the moment re studying rebound. I feel like everyone is doing their best with the information they have, but it's such a moving target.

To be clear, based on our experiences, I support the use of paxlovid in general, but people just need to be aware that there's a statistically relevant rebound, and certain people might consider that a downside.

The good news is, tho, both Tim and I feel better today, so we're hoping for a continually upward trajectory.

 

[missy]

To be clear, based on our experiences, I support the use of paxlovid in general, but people just need to be aware that there's a statistically relevant rebound, and certain people might consider that a downside.

Agreed. I am thankful that our friend knows this field upside and down which is why she advised my sister to wait to see how she was doing before starting Paxlovid. Some doctors prescribe it immediately as a knee jerk response without fully evaluating the individual.

The good news is, tho, both Tim and I feel better today, so we're hoping for a continually upward trajectory.

Grateful for this happy update. Hoping Tim can visit his parents in Australia next weekend. Fingers crossed for continued improvement.

Thanks @missy. I have a habit of posting a bit of a response, then editing and elongating once it's posted. I just added a lot to what I originally posted, and it explains a bit better our situation.

Ha I think many people do that here. I just write another post with more thoughts as they come to me.

I think it is important each individual is evaluated on their specific circumstances before taking any medication and that includes but is not limited to Paxlovid. It can be a miracle med for some but it must be used judiciously.

It should be interesting to see where we are five years from now. Sometimes it feels as if this pandemic is never ending but I am hopeful eventually we will be (please) in an endemic situation with a yearly vaccine that proves effective.

 

[tyty333]

I'm sorry @Mrs B ...I'm hoping that you test negative very soon and that your DH is able to go on his long awaited trip. Please keep us
posted. Sending your family healthy, healing vibes.

 

[wildcat03]

I've done a lot of reading on Paxlovid in the last 9 months. I think two things contribute to the idea of Paxlovid rebound that are not, in actuality, related to Paxlovid. First, COVID has always been a biphasic illness. People often got sick with the original symptoms (cough, loss of smell/taste, fatigue, etc.) and partially recovered. Then, around day 7+, started feeling much worse with shortness of breath. In the early phases of COVID, this was often the start of what we called "cytokine storm" and the cascade of hospitalization, ICU stay, etc. Obviously, with vaccination, fewer people had that severe second phase. Anecdotally, I heard from many of my colleagues/friends that their course of COVID still mimicked that, though. In addition, once home antigen tests became more popular and were covered by health insurance (or the government) people started taking them much more frequently. The concept of "testing out of isolation" really came about in January 2022 when the CDC shortened the isolation requirement and someone made a throwaway statement about how people could do a rapid test at day 5/6 if they had one. Before that, everyone just isolated 10+ days (well, reasonable people) and figured they were done once their symptoms had improved and their 10+ days was up. Now, with rapid tests a lot of people are testing out of isolation (which is great) but it's providing this data that didn't exist as much before and given the context (Paxlovid becoming available the same time this trend started) I'm not sure whether Paxlovid rebound is as prevalent as it is said to be.

Anecdotally, my colleague who did NOT take Paxlovid was antigen negative for 5 days at the start of her illness, stopped testing day 5 and then proceeded to test positive until day 14 on antigen tests.

 

[mrs-b]

I'm sorry @Mrs B ...I'm hoping that you test negative very soon and that your DH is able to go on his long awaited trip. Please keep us
posted. Sending your family healthy, healing vibes.

Thank you, @tyty333. Tim's parents are in their late 80's and he hasn't seen them for 5 years. I have some significant health issues of my own, so getting him home to Australia is not easy for us, as I can't really be left. I'm hoping for some surgery next year that will resolve the problem, but the surgery of itself has a recovery time of anything from 6 months to 2 years, so our ability to be spontaneous is basically zero and traveling takes a lot of organization.

Fingers crossed that, come next Saturday, he's on that plane!

 

[Karl_K]

So sorry your both dealing with this, prayers outgoing!

 

[Daisys and Diamonds]

My DH and I tested positive for covid - 15 days ago for him, 13 for me. Since we're both immuno-compromised, we were both given paxlovid. Horrible taste, but felt way better after 2 days of taking it. At the end of the 5 day course, no symptoms at all. We'd heard about paxlovid rebound and were aware it can occur in up to 9% of people, but since, compared to the immuno-compromised community in general, we're reasonably healthy, we assumed this wasn't a bullet that would have our names on it.

Wrong, as it turns out. 5 days after we finished the paxlovid, both DH and I started exhibiting symptoms and now we're both coughing, sneezing, wheezing, and generally feeling lousy. We're both testing positive, and the RAT test is coming up faster and stronger than previously, which apparently *is* an indicator of how much of the antigen you have on board. DH is now taking time off work, trying to bounce back by next Saturday...when he's supposed to be heading to Australia to see his elderly parents for the first time in 5 years - a trip which we have all acknowledged will probably be the last time he sees them.

So I just wondered - has anyone else had paxlovid rebound? How did it go? How did YOU go? How long did it take to get over it? We're on a deadline here, and if he doesn't test negative by the time he's meant to leave, we'll have to cancel and it will break his parents' hearts.

So - anyone?

what bad timing
mind you i dont think any time with covid is good timing
i hope hubbie is still able to go see his mum and dad
they must be so looking forward to seeing him

are you actually getting better or feeling worse ?
is this the treatment Mr Biden had when he had it ?

 

[mellowyellowgirl]

Does he need a negative PCR @mrs-b or a RAT will do?

Fingers crossed for you!!! Laws have totally chilled in Australia now (seriously you can catch Covid and roam). Do you need a negative test to board the plane? Because from what I've been reading we will happily let him in no questions asked!

 

[AprilBaby]

I got paxlovid on day 2 and in 24 hrs felt much better. It made my mouth taste like sewer. As I said before, after I missed a dose because I finished the meds I got crazy sick vomiting for 12 hrs till I got zofran. On the zofran I was still sick. No rebound Covid but I wish I had never taken the paxlovid because I think my recovery would have been faster without. I am high risk for death from Covid being immunocompromised. Its been two weeks no isolation, I’ve been crazy tired, things taste funny but most of all I have trouble remembering words. I see what I want to say but I can’t remember the word or maybe a good friends name. Hoping it all goes away.

 

[KaeKae]

Not me, but my husband
We both came down with covid within a day if each other
He chose to take paxlovid I did not.
He felt better in a few days and was able to return to work within 4 or five days.
I had a fairly mild case but tested positive for 10 days
However a couple days after I came out of it his symptoms returned and gave him another 5 or so days as positive as well as lingering effects for weeks
This was back in July so my timing may be off a bit but it's close to what happened

 

[rainydaze]

I wanted to give others who could address your question a chance to respond before saying that I'm sorry the Paxlovid may spoil some very important, special plans, and that I hope both you and Tim recover completely - sooner rather than later!

 

[tyty333]

Not me, but my husband
We both came down with covid within a day if each other
He chose to take paxlovid I did not.
He felt better in a few days and was able to return to work within 4 or five days.
I had a fairly mild case but tested positive for 10 days
However a couple days after I came out of it his symptoms returned and gave him another 5 or so days as positive as well as lingering effects for weeks
This was back in July so my timing may be off a bit but it's close to what happened

@KaeKae Do you know on what day of his symptoms he took paxlovid?

 

[mrs-b]

I've done a lot of reading on Paxlovid in the last 9 months. I think two things contribute to the idea of Paxlovid rebound that are not, in actuality, related to Paxlovid. First, COVID has always been a biphasic illness. People often got sick with the original symptoms (cough, loss of smell/taste, fatigue, etc.) and partially recovered. Then, around day 7+, started feeling much worse with shortness of breath. In the early phases of COVID, this was often the start of what we called "cytokine storm" and the cascade of hospitalization, ICU stay, etc. Obviously, with vaccination, fewer people had that severe second phase. Anecdotally, I heard from many of my colleagues/friends that their course of COVID still mimicked that, though. In addition, once home antigen tests became more popular and were covered by health insurance (or the government) people started taking them much more frequently. The concept of "testing out of isolation" really came about in January 2022 when the CDC shortened the isolation requirement and someone made a throwaway statement about how people could do a rapid test at day 5/6 if they had one. Before that, everyone just isolated 10+ days (well, reasonable people) and figured they were done once their symptoms had improved and their 10+ days was up. Now, with rapid tests a lot of people are testing out of isolation (which is great) but it's providing this data that didn't exist as much before and given the context (Paxlovid becoming available the same time this trend started) I'm not sure whether Paxlovid rebound is as prevalent as it is said to be.

Anecdotally, my colleague who did NOT take Paxlovid was antigen negative for 5 days at the start of her illness, stopped testing day 5 and then proceeded to test positive until day 14 on antigen tests.

Hi @wildcat03 -

An interesting theory - and entirely possible. Tho - how to know? I know the original covid was a pretty clear 2-step process, but is that true of the latest covid strains? I haven't heard that so much recently, with most people describing the latest strains as 'just a cold'. We're now at days 15 and 17 respectively and DH is aaaalmost negative on his test - faintest possible line that only appears after a few minutes. I, being 2 days behind him in my initial positive test, am still a strong, fast red line, despite having no symptoms now for a couple of days, and a period of no symptoms for 5 days in the middle of the 15 days, after taking the paxlovid. We're still isolating and will continue to do so - tho I do wonder if it's necessary. I'm pretty sure DH will test negative by the weekend - we thought today's test was going to come back negative, then this tiiiiny almost invisible pink line finally emerged - but we're not prepared to risk anyone by him flying too soon. DH's taste was effected - everything tasted just..."wrong", apparently. But even that has been back to normal for some days now.

And @missy - I am SO with you re the "where will we be in 5 years" question. I feel like this has been going on forever. I can't remember a time when I was in a crowd and didn't feel nervous.

 

[mrs-b]

So sorry your both dealing with this, prayers outgoing!

@Karl_K -

Thank you so much for your kind wishes. I've been following the thread about your neck/arm. I have that same trapped nerve issue with my sciatic nerve, and it was interesting to hear you use the exact same terms I've used to try to explain how this feels. I've seen 3 surgeons so far and have had 3 different suggestions on how to treat it, tho all end in surgery. But the pain clinic, my physical therapist and my primary care physician have all said I'm a bad candidate for the surgery, as spinal fusion doesn't necessarily fix a trapped nerve, so I'm very confused as to how I should proceed. I feel as tho, where these surgeons are concerned, when all you have is a hammer, everything looks like a nail - ie surgery is all they have to offer me, so they all keep suggesting the same end approach, despite the fact that each one of the three has suggested a different level of surgery, one said I have a 10% chance of the sciatic nerve being severed during the surgery, and one saying I *should* have the surgery, after initially telling me emphatically that I *shouldn't*. The first one wrote the whole report about the wrong leg, which didn't do a lot to instill confidence.... I'm seeing a new surgeon in 2 weeks, so we'll see what he says; at that point I might just take a vote.

So all that to say - I feel for you. I know *exactly* what you're going through, and it hurts like all get out. I've had regular periods of screaming and sobbing and times when I've been stuck in the hall, for example, because the nerve suddenly grips, the muscles spasm, and I can't walk. My right leg and foot will cramp and twist to the left, while my big toe will point at the ceiling. I get the shakes and my BP plummets and sometimes even my hands will spasm into claws and I have to take diazepam for it to all let go and I end up exhausted and like a damp dishcloth, panting, dizzy and ill. Combine that with my Crohn's and all the gut issues and...well, you get the general picture. Have you tried Lyrica? I'm on that now, and I find it works better than oxycodone, which is what I was on before, tho a very, very low dose (I don't like drugs at the best of times, and taking a narcotic doesn't sit well with me). Anyway, Lyrica has been useful and things have been better than normal for the last 2 weeks. I'm always better in the afternoon and evening, when the piriformis is more relaxed and the nerve slides more back into alignment. That's when I am more myself and can do housework, exercise, write, and - most of all - laugh. 2 years ago I didn't have any of this, and I wish more than I can say that I could turn back the clock. Anyway, I'm right there with you, brother, and I know the level of pain this causes that just can't be conveyed by saying "I have a trapped nerve and it hurts." if you haven't walked that path, you really don't know. But I'm on the path with you and I've been praying for both of us regularly. Hugs to you!

 

[mrs-b]

what bad timing
mind you i dont think any time with covid is good timing
i hope hubbie is still able to go see his mum and dad
they must be so looking forward to seeing him

are you actually getting better or feeling worse ?
is this the treatment Mr Biden had when he had it ?

Hi @Daisys and Diamonds - yes, we're both feeling better now, after the initial rebound. And yes, this is the same treatment President Biden had.

We definitely have our fingers crossed that he'll make it, but to be honest, we're not feeling 100%, since this thing seems so come-and-go, so stop-and-start. But we're hopeful!

 

[mrs-b]

Does he need a negative PCR @mrs-b or a RAT will do?

Fingers crossed for you!!! Laws have totally chilled in Australia now (seriously you can catch Covid and roam). Do you need a negative test to board the plane? Because from what I've been reading we will happily let him in no questions asked!

Neither Qantas nor the Australian govt requires a negative covid test to board the plane or enter Australia, from what we can understand. our reservations are more to do with his elderly parents than whether we'll fail prerequisites to enter the country. We're pretty responsible citizens, tho, so if he doesn't test negative before he flies, he won't be going. I really don't think that will happen, tho. Just by living with him, I can tell he's way better than he was and basically symptom free. So fingers crossed!

 

[mrs-b]

@AprilBaby - you sound like us, minus the vomiting. We're both immuno-compromised, and were both incredibly tired, tho both seem to be over it now. And my husband's sense of taste was really wonky for a week after he finished the paxlovid - - not sure if that was due to tpaxlovid or the covid - but either way - coffee tasted like salt, jam tasted like salt, meat tasted like...you guessed it, salt - and so on. He's over it now, and his sense of smell wasn't effected, but he wasn't a happy camper while it was going on.

I'm really sorry you went through what you went through. This thing is a pain in the neck and I hope *everything* settles down for you and you're back to normal (or better!) very, very soon.

 

[mrs-b]

@KaeKae - how are you feeling now? Is it all gone? And how is your husband? DH and I feel fine - we're just testing positive, me more than him, tho really, I'd say my symptoms were more mild than his from day 1 till now.

We both felt great while we were *on* the paxlovid, and also for a week afterward. But then it just all came back, tho it was never terrible, either before or after the paxlovid. I do believe the science on this, tho - I think paxlovid keeps people out of hospital, and death if you've been on it is almost non-existent. So it's hard to argue against.

Hoping you and your husband are feeling 100%!

 

[mellowyellowgirl]

Fingers and toes crossed for you @mrs-b !!!!!

Great to hear that he's better! Pity you're not coming over as well!

 

[mrs-b]

Fingers and toes crossed for you @mrs-b !!!!!

Great to hear that he's better! Pity you're not coming over as well!

I really wish I was, @mellowyellowgirl. I hope to be over for a couple of months either next year or the year after, Perhaps we could organize a PS get-together?