Will Biden have a post-Paxlovid Covid rebound?

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resolved Jul 30

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YES

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Biden has tested positive for Covid and is taking Paxlovid. https://www.npr.org/2022/07/21/1112740916/paxlovid-president-biden-covid-antiviral-treatment

Resolves YES if within 20 days after the end of the Paxlovid course, he has a Covid rebound; roughly defined as: symptoms get worse again, or rapid antigen tests go from negative or faint positive to strong positives. I will assess based on reliable media reports.

This question is managed and resolved by Manifold.

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predicted YES

Lol there's definitely no way that the base rate for Paxlovid rebound is like 10%. Way too many high-profile cases of rebounds for that to be true. Honestly given the side effects of the drug and the amount of extra time you have to spend in isolation because of rebounds, Paxlovid is probably not worth it if you're already vaccinated + boosted.

predicted YES

@fortenforge Hmm I'm not convinced, selection bias and availability bias are strong, and unless there's some plausible explanation of why the study could be misleading (not sure if there is, I haven't looked very closely) I still put a lot more weight on it than the anecdotal data. If it was just the original paxlovid study I'd agree but there's this large observational study too.

predicted YES

@jack Ah, I didn't realize that this wasn't just the original Paxlovid study. Well, we'll know more soon enough I guess since I'm sure this is being studied pretty thoroughly.

predicted YES

Yeah see the study link in my previous comment. Personally I thought it was still worth it for me even with the rebound. It reduced my symptoms by like 80 or 90 percent after one day - went from functioning at less than 50% of normal capacity to like 90% of normal. And it increased the length of my symptoms by less than double. So it was a clear win in terms of symptoms, the biggest downside was having to isolate longer, in my case isolating that extra week wasn't a big deal but a different week could have been a lot more annoying.

predicted YES

@jack Curious, did you experience the weird metal taste? If so, how bad was that?

predicted YES

@fortenforge I did, it was noticeable but not a big deal to me. I would have swapped the intermittent cough I had later for the metallic taste if I could. It didn't impact my experience of eating food, it was just a slight background thing that was there for a little while after each set of pills.

predicted YES

Looks like he got it

https://twitter.com/POTUS/status/1553451657748512768

predicted YES

Specifically using the term "rebound": https://twitter.com/WhiteHouse/status/1553448620208316416

predicted YES

He tested negative today: https://twitter.com/jakesherman/status/1552298622468890627?s=21&t=SIjkuW9-SPhYgDeEbsMs_Q

My previous research on base rates was about 5-10%, mostly based on this study on Omicron rebounds https://www.medrxiv.org/content/10.1101/2022.06.21.22276724v1 - it finds about 6% rebound rates after Paxlovid treatment (and about 8% after Molnupiravir). The rate of post-Paxlovid rebounds in symptoms and in positive tests were both about 6%. "The 7-day and 30-day COVID-19 rebound rates after Paxlovid treatment were 3.53% and 5.40% for COVID-19 infection, 2.31% and 5.87% for COVID-19 symptoms, and 0.44% and 0.77% for hospitalizations." The study population includes 11,270 patients who were treated with Paxlovid.

predicted NO

Seems like the White House Covid response coordinator also thinks it's 5-10% citing the same study I found - https://www.nbcnews.com/health/health-news/people-report-paxlovid-rebounds-covid-experts-insist-cases-are-rare-rcna40031

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