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I tested positive on 8/2. Started Paxlovid on 8/3-had one bad day (fever, chills, congestion) and then felt fine...until Day 11 (8/12) when congestion returned along with a cough (no fever), much worse than first round. Tested positive twice after that until today(8/19) when I was negative though still have mild symptoms (mostly cough). Husband tested positive on 8/6; started low dose Paxlovid and had more severe symptoms (fever, congestion, cough) for several days. Still (today is day 14 for him) sneezing, congestion; some cough but better. May have had some rebound but not as distinct as mine. Still positive today. Can we be reinfecting each other? Can I get it AGAIN from him now that I'm negative? I didn't think you could get a viral infection twice in the span of 12 days. Or is this just a rebound case? Our dilemma is everything I read is you're good to go after 5 days and it has been 18! How can you not be contagious when you test positive on a home test?

Your comment brought up 3 things that I’d like to respond to and highlight:

 

1. It appears that the likelihood of experiencing Covid rebound with Paxlovid treatment may be as high as one-third of people…not so rare as initially believed. However, the Covid rebound has not been observed to be of severe consequence (i.e., significant enough that it sends people to the hospital’s ICU or causes death).  So, Paxlovid is still a very valuable tool for the treatment of Covid, despite the commonality of the rebound potential.

 

2. We know that some people can get a repeated Covid infection as early as 21 days from their last infection, but I have not yet seen that a person could get over an infection and get the “new” infection sooner than 21 days. So, I think that you need not be overly anxious about this fact. 

 

3. However, the last comment about only being infectious for 5 days…is completely wrong (i.e., you are not “good to go” after 5 days).  The CDC’s guidance (which might be misleading) states that you must remain in isolation for a MINIMUM of 5 days then you are ALLOWED to leave isolation but MUST wear a mask (because you could still be infectious but they’re letting you be able to get back on to your job so that there is less impact on your ability to raise an income; remember that poorer populations have carried the large burden of infections and have borne major costs to their quality of life and livelihoods).  The guidelines are not clear to most people and commonly misinterpreted as “5 days and you’re good”. Here is what I think is clearer as a guideline: you should remain in isolation from the instant that you know you have Covid and remain in isolation until you have resolution of symptoms and are able to test negative twice (with sequential tests separated by 12-24 hours apart) by an at-home rapid antigen test; the problem is that for persons who live on the razor’s edge of making ends meet from week to week or month to month, this approach would not work as they could lose out on 2-weeks of income.  This may be catastrophic for many families, sending them on a clear road to homelessness and life-long debt. So, I cannot endorse that this approach would work for all persons and we must societally try to find ways to protect the most vulnerable in our populations.  Also, I will mention that sometimes symptoms do not completely resolve even when a person is no longer infectious, so symptoms may have largely gotten better but it is acceptable to have some mild remaining symptoms which may take many days or weeks to resolve; also many people experience long-term symptoms (“long Covid”). Basically, there should be assurance that you are not shedding large amounts of infectious viruses and the testing negative twice will be a method to prove that you are able to come out from isolation. But having this as a hard or strict rule may cause more harm to certain people.