While the White House announced plans to make the antiviral medicine Paxlovid more accessible across the US, scientists and federal agencies said they are investigating reports of Americans who say they experienced a rebound of COVID-19 soon after finishing the course.
The nation's first federally backed test-to-treat site opened Thursday in Rhode Island, providing patients with immediate access to the Pfizer drug once they test positive.
The US has ordered 20 million courses of Paxlovid from the drugmaker Pfizer, and the country risks running out this winter if the drug continues to be used widely.
The White House has been pressing Congress for additional funds for months to support purchasing more Paxlovid and other treatments, as well as additional boosters.
While the US government is purchasing more Paxlovid, patients, scientists and even federal agencies are uncertain about its effectiveness as in several cases people have complained of experiencing a second round of symptoms in what is being called as “rebound illness” or “Paxlovid rebound”.
What is Paxlovid?
An oral antiviral, developed by Pfizer, Paxlovid has proved to cut the risk of hospitalisation and death by 89 per cent, according to The Atlantic. It was termed “a real game changer” by US President Joe Biden in January this year.
As per Patrick Jackson, assistant professor of Infectious Diseases, University of Virginia, Paxlovid is made up of two protease inhibitors, including one used in treating HIV as a booster medicine.
Protease inhibitors are synthetic drugs that block enzymes that viruses need to replicate. The combination in Paxlovid basically prevents the coronavirus from completing its life cycle, he said in a report for The Conversation.
What is the problem with Paxlovid?
Over the last few months,the US government has urged medical practitoners to prescribe the Pfizer drug. However, patients in increasing numbers complained of a bitter, metallic taste, or one like grapefruit juice mixed with soap, as reported by The Atlantic.
Some had more serious side-effects as they reported experiencing a second round of symptoms. And when the pills were over they went back to testing positive, a phenomenon that’s become known as “Paxlovid rebound”.
Some vaccine scientists too complained of the alleged Paxlovid rebound.
Well thought Covid was over, finished a 5 d Paxlovid, felt well, X2 neg antigen tests. 5 d later up this AM lots of rinorrhea, sore throat, antigen test screaming +. So either this post-Paxlovid relapse is real, something unique to BA.2.12 (although can’t confirm)…or something
— Prof Peter Hotez MD PhD (@PeterHotez) May 18, 2022
According to a report by Time, Pfizer reported that one to two per cent of people taking the medication experienced rebound.
The company says the rates of rebound in the treated group in its study and among those receiving placebo were similar, indicating that “elevated nasal viral RNA is uncommon and not uniquely associated with treatment.”
What is the US federal agency saying?
The US Centers for Disease Control and Prevention (CDC) has advised people who experience recurrence of COVID-19 symptoms after completing treatment with Paxlovid to isolate again for five days.
The CDC said in its advisory that case reports suggest that recurrence results in mild symptoms, and there have been no reports of severe disease so far.
The agency still continues to recommend the oral antiviral drug as a treatment, despite the possibility of recurrences.
“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,” it said.
CDC has recommended that patients with COVID rebound can end their re-isolation period after five full days if there is no fever for 24 hours and symptoms improve, but such patients should wear a mask for a total of 10 days after rebound symptoms begin.
With inputs from agencies
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