The curious case of the Covid-19 rebound – CNN

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If weve learned anything over the past two and a half years, its that Covid-19 is one strange disease. The latest case in point: the coronavirus rebound.

The condition grabbed international attention last week when US President Joe Biden tested positive for the virus six days after testing negative following his first bout of the illness.

The White House said Biden, who is back in isolation, was experiencing a bit of a loose cough but did not have a fever and his lungs were clear.

The President tested positive again after being treated with the antiviral Paxlovid. White House officials had previously suggested a rebound case of Covid was unlikely, based on reports of cases around the country, but Bidens doctors continued to monitor his health and test him.

Dr. Ashish Jha, the White House Covid response coordinator, said clinical data shows the rate of rebound infections is low and noted that even those who suffer them are still generally protected from serious illness.

Biden is not the only high-profile patient to develop the condition. National Institute of Allergy and Infectious Diseases Director Dr. Anthony Fauci also experienced rebound Covid-19. Unlike Bidens, his symptoms got worse when they returned after treatment with Paxlovid, and his doctors prescribed another course of the drug.

Experts have been calling for more systematic research into the instances of rebound to understand who is most at risk and whether the standard five-day course of Paxlovid should be lengthened to prevent it.

Studies have shown that people can pass the infection to others during a rebound, which is another reason to try to understand it better.

The United States Centers for Disease Control and Prevention (CDC) issued a health alert to doctors in May about the potential for Covid-19 rebound, saying symptoms sometimes come back, and that may just be how the infection plays out in some people, regardless of whether theyre vaccinated or treated with medications like Paxlovid.

The CDC said most cases of rebound involve mild disease and that Paxlovid continues to be recommended for early-stage treatment of mild to moderate COVID-19 among persons at high risk for progression to severe disease.

Pfizer, the company that makes Paxlovid, has said its studies showed rebounds were rare, and that they happened in both people who took the drug and those who took a placebo pill. Because investigators noted the phenomenon in both groups, the company doesnt believe it is tied to the medication.

Q: How does Paxlovid work?

A: Considered a game-changer when it was authorized in December because of its strong performance in lowering the risk of severe Covid-19, Paxlovid in combination with vaccines and boosters is thought to be one of the best ways to protect people at high risk for severe illness.

The drug suppresses the coronavirus, blocking an enzyme that helps it reproduce inside the body.

As with all antivirals, the treatment is thought to work best if started within five days of the first symptoms appearing.

Clinical trials of Paxlovid showed that it reduced the risk of hospitalization and death by 88% when given within five days of the start of symptoms.

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Most US public schools plan to keep masks optional for start of classes

Students are heading to another school year amid the Covid-19 pandemic, but this time, there seem to be fewer discussions and less fretting about masks and other mitigation measures despite a rise in infections across the country.

Most of the largest public school districts in the US are not requiring masks for the new school year, making masking optional as students return to classes and the highly transmissible BA.5 subvariant spreads.

Dr. Sanjay Gupta: Are we making the same mistakes?

The pandemic, which has held the US and almost every other country in its grip, should have taught us valuable lessons about how to manage a public health emergency. But it seems we are making some of the same mistakes with the monkeypox virus that we made not even three years ago when the SARS-CoV-2 virus started to spread.

Testing for monkeypox, once very limited, is now more available, but underused. The demand for vaccines is outpacing the supply. There are nearly 2 million courses of the highly effective TPOXX antiviral sitting in the Strategic National Stockpile, but many health care providers are still having a hard time getting the medication for their patients.

At this time, only 336,710 doses have been shipped to states. Ordering only just began for about 800,000 more doses. This scarcity has created long lines in monkeypox hotspots like New York City, which has the highest number of cases in the country.

Updated Covid-19 booster shots could be available in September

Moderna and Pfizer booster shots updated to target Omicron coronavirus subvariants could be available in the US in the early fall, pending signoff by federal health agencies, the US Department of Health and Human Services said Friday.

The US Food and Drug Administration advised vaccine makers in June to update the boosters to add an Omicron BA.4/5 component and create a bivalent booster that would work for two different strains.

Pfizer and Moderna have indicated that they anticipate the modified vaccines being available as early as September, an FDA spokesperson said.

Many children will soon be returning to schools while coronavirus cases are still high.

Parents and caregivers have a lot of questions about what precautions they should take. Do kids need to wear masks again? How often should families test kids? What happens if their kids contract Covid-19? How long should they stay out of school? CNN Medical Analyst Dr. Leana Wen answers the most pressing questions.

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The curious case of the Covid-19 rebound - CNN