I'm not an immunologist, just a data guy. But my reading of the data reaches same conclusion: there is no actual "paxlovid rebound", just COVID rebound, which happens with or without paxlovid. Infection is often biphasic, with 2 distinct symptom periods.
https://www.acsh.org/news/2023/01/11/paxlovid-rebound-isnt-real-it-never-was-16796
@deonandan This makes sense, but what is less clear to me is whether doubling the length of the Paxlovid course would reduce the effect of the viral rebound in a beneficial way. I can't find any evidence that this hypothesis has been tested, though I certainly may have missed it.
If I'm reading this correctly it's a study of health records, so we don't know for certain what testing was done to confirm the rebound? It also could have been different at different locations. Not to say that there's not something to be learned here.
However, if we know that people can test positive via saliva for COVID RNA after they stop testing positive via the nasopharynx, with the potential of propagating virus after a negative nasopharynx test(https://journals.plos.org/plosone/article?id=10.1371/journal.pone.0282708) then I wonder if we're actually getting the whole picture here.
I feel like a whole lot of the assumptions we're making revolve around the idea that you've cleared the virus just because you got a negative nasal swab.
