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What does 'rebound' case of COVID-19 mean?

President Joe Biden tests positive again after testing negative multiple days
Posted at 5:12 PM, Aug 01, 2022

WEST PALM BEACH, Fla. — President Joe Biden tested positive for COVID-19 on Saturday morning. This comes after his doctor said he tested negative Tuesday and Wednesday.

When the president first tested positive, he was administered the antiviral drug Paxlovid, which was approved by the FDA in December.

But it seems COVID-19 "rebound" cases are not impossible.

In fact, Palm Beach County doctor and infectious disease expert Dr. Larry Bush said it's somewhat common.

"At least 10% of the people I prescribe Paxlovid have called me afterwards saying they had symptoms again after stopping the medication or they tested positive again," Bush said. "Not because they were symptomatic but because they wanted to see if their test was negative."

Dr. Larry Bush speaks about 'rebound' cases of COVID-19
Dr. Larry Bush explains what a 'rebound' case of COVID-19 means for patients.

So, what does it mean to have a "rebound" case?

The CDC issued an advisory in May saying that patients may experience a "rebound" case of COVID-19 after taking Paxlovid.

"A 'rebound' case just means your symptoms haven't totally resolved," Bush said. "But the drug did exactly what it was meant to do, which was to keep you from going on to severe disease."

Paxlovid is prescribed for people with mild to moderate symptoms, specifically those who are considered high risk. The medication must be taken within five days of developing symptoms.

Paxlovid is an antiviral therapy to combat COVID-19.

But Franck Kacou, the manager at Progress Pharmacy in West Palm Beach, said getting people to take four tablets every 12 hours is difficult.

"I've seen that just a couple of weeks ago in two patients that did not complete their treatment," Kacou said. "They are targeting the genetic makeup of COVID and decreasing the viral replication. And that's why it's very important to finish the five days because if you don't it's not going to work as well."

The Centers for Disease Control currently recommends five days of isolation followed by five more days of wearing a mask.

Franck Kacou, manager Progress Pharmacy in West Palm Beach, discusses 'rebound' cases of COVID-19
Franck Kacou explains why patients who take Paxlovid experience "rebound" cases of COVID-19.

But Kacou said this may need to be reanalyzed since people are testing positive seven to 10 days later, and this could mean they are contagious.

"Other countries like France recommend seven days for full vaccinated or 10 days if not vaccinated or partially vaccinated for isolation time," Kacou said.

However, Bush agrees with the CDC's recommendation and said if you don't have symptoms after five days, you don't need to take another test.

Stopping the spread of the virus will come by using the tools we already have.

"Let's get vaccinated, let’s get boosted, let's treat the virus as soon as we can," Bush said.

If you do test positive for COVID-19 after testing negative -- regardless of what may have caused the rebound case -- the CDC recommends isolating again for at least five more days.