Zeke Miller and Josh Boak, Associated Press Published Saturday, July 30, 2022 2:57 p.m. EDT Last Updated Saturday, July 30, 2022 5:10 p.m. EDT
WASHINGTON (AP) — President Joe Biden tested positive for COVID-19 again Saturday, a little more than three days after he was cleared to come out of coronavirus isolation, the White House said, in a rare case of a “rebound” after treatment with an anti-viral drug.
White House physician Dr. Kevin O’Connor said in a letter that Biden “has not had a recurrence of symptoms and continues to feel quite well.” O’Connor said there is “no reason to restart treatment at this time.”
In accordance with Centers for Disease Control and Prevention guidelines, Biden will reenter isolation for at least five days. He will self-isolate at the White House until he tests negative. The agency says most recoveries remain mild and that no severe illness has been reported during this period.
Just as with Biden’s first positive test, the White House tried to show that he was still working. The president tweeted a photo of himself wearing a mask and no tie, showing him signing a declaration that added individual aid to Kentucky flood survivors.
The president followed up by tweeting a 12-second video of him on the White House balcony with his dog Commander.
“I feel good, everything is fine,” Biden said, a pair of aviator sunglasses in hand. “But Commander and I have some work to do.”
The announcement of Biden’s positive test — he tested negative Friday morning — came just two hours after the White House announced a presidential visit to Michigan next Tuesday to highlight the passage of a bill to encourage local high-tech manufacturing. Biden was also scheduled to visit his home in Wilmington, Delaware, on Sunday morning, where first lady Jill Biden had been staying while the president tested positive. Both trips were canceled as Biden returned to self-isolation.
Biden, 79, was treated with the antiviral drug Paxlovid after he first tested positive on July 21. He tested negative for the virus last Tuesday and Wednesday. He was then allowed to leave isolation while wearing a mask indoors. His positive tests put him among the minority of those prescribed the drug to experience a repeat case of the virus.
The White House’s COVID-19 coordinator, Dr. Ashish Jha, told reporters Monday that data “shows that between 5 and 8 percent of people have recovered” after treatment with Paxlovid.
“Recognizing the potential for so-called ‘rebound’ COVID positivity seen in a small percentage of patients treated with Paxlovid, the president has increased his testing cadence to protect those around him and ensure early detection of any return of viral replication,” O Connor wrote in his letter.
O’Connor cited negative tests for Biden from Tuesday night, Wednesday morning, Thursday morning and Friday morning, before the positive antigen test result on Saturday morning. “This actually represents ‘bounce’ positivity,” he wrote.
According to the CDC, those with rebound COVID should self-isolate for at least five days, ending if the fever has gone away on its own in 24 hours without medication and symptoms have improved. The patient “should wear a mask for a total of 10 days after the onset of recovery symptoms. Some people continue to test positive after day 10, but are significantly less likely to shed infectious virus.
Both the Food and Drug Administration and Pfizer indicated that 1% to 2% of people in Pfizer’s initial study of Paxlovid saw their viral levels recover after 10 days. The rate was about the same among people taking the drug or dummy pills, “so it’s not clear at this point if this is related to drug treatment,” according to the FDA.
While Biden tested negative, he returned to holding private events indoors and meeting with White House staff and wearing a mask, in accordance with CDC guidelines. But the president removed his mask indoors as he delivered remarks Thursday and during a meeting with executives at the White House compound.
Asked why Biden appeared to be violating CDC protocols, press secretary Karin Jean-Pierre said: “They were socially distancing. They were far enough apart. So we made it safe for them to be together, to be on that stage.
Regulators are still investigating the prevalence and virulence of rebound cases, but the CDC warned doctors in May that it has been reported to occur within two to eight days of an initial negative test for the virus.
“The limited information currently available from case reports suggests that individuals treated with Paxlovid who recovered from COVID-19 had mild illness; there are no reports of serious illness,” the agency said at the time.
When Biden was initially released from isolation on Wednesday, O’Connor said the president would “increase the pace of testing” to catch any potential rebound in the virus.
Paxlovid has been shown to significantly reduce severe illness and mortality among those most vulnerable to COVID-19. US health officials have encouraged those who test positive to check with their doctors or pharmacists to see if they should be prescribed the treatment, despite the risk of rebound.
Biden is fully vaccinated, having received two doses of the Pfizer coronavirus vaccine shortly before taking office, a first booster shot in September and an additional dose on March 30.
While patients who have recovered from earlier variants of COVID-19 tend to have high levels of immunity against future re-infection for 90 days, Jha said the BA.5 sub-variant that infected Biden has proved more ‘immune resistant’.
“We’ve seen a lot of people get re-infected within 90 days,” he said, adding that officials don’t yet have data on how long those who have recovered from the BA.5 strain have protection from re-infection.
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