Mumbai: Stay careful and alert for rebound Covid-19, warn health experts

In rebound Covid, symptoms of the infection reappear (cold, cough, fever) and the test becomes positive again after a few days of recovery. Representation pic

What do US President Joe Biden, President of INC Sonia Gandhi and politician Priyanka Gandhi have in common? All three, like many others, have suffered from ‘Covid-19 reccurrence' or ‘rebound Covid', which has become a matter of concern for health experts, as symptoms of the infection reappear (cold, cough, fever) and the test becomes positive again, within a short span of recovery.

Covid recurrence or rebound Covid is caused by Omicron sub variant BA 2.75, and is known to spread infection faster than the earlier variants of Covid-19. Dr Wiqar Shaikh, professor of Medicine, Grant Medical College and Sir J.J. Group of Hospitals explained that a treatment being used in the USA since late 2021 for Covid is Paxlovid (a combination of 2 anti-viral drugs viz. Nirmatrelvir and Ritonavir). Dr Shaikh quoted an article from the journal Nature on August 12, which concluded that it is surprisingly common for Covid to return in already infected patients. However, the rebound is fiercer and more common in people treated with Paxlovid. In the USA, 25 per cent to 27 per cent of people infected by Covid reported a rebound in their symptoms. Dr Shaikh said it could be due to an initial high viral load or due to a lingering response to Covid from the body's immune system. "Paxlovid has caused more Covid rebound cases compared to in those who have not taken the drug," Dr Shaikh said.

Dr Subhash Hira, University of Washington

Dr Shaikh quoted another article published in the journal medRxiv on August 2, which concluded that those who had rebound are older patients. However, those who suffer Covid rebound could infect others.

‘Not long Covid'

Dr Shaikh also clarified that rebound Covid is not long Covid. He explained that in long Covid people suffer from symptoms of the infection for at least 4 weeks or more post infection. There is also persistence of symptoms other than usual such as fatigue, which get worse after physical or mental effort, lung issues, including difficulty in breathing or shortness of breath and cough.

Dr Santosh Bansode, Wockhardt hospitals, Mumbai Central

Dr Subhash Hira, professor of Global Health at University of Washington and member of several review panels of WHO-Geneva said BA.2.75 has been detected in over 10 states including Maharashtra and Delhi where positivity rates have crossed past 10-14 per cent. In the past few days, 298 cases of BA.2.76, 216 cases of BA.2.74, and 46 cases of BA.2.75 have been identified in the public database. "It is documented that Joe Biden had completed seven days on Paxlovid but got Covid rebound with symptoms on the tenth day, and required hospitalisation again for treating it. Interestingly, Paxlovid is likely to be approved by the Drug Controller General of India, to treat Omicron," he said.

Don't panic

"The BA.2.75 variant is highly transmissible and causing relapse of infection in people. There is no need to panic as symptoms due to this variant are mostly mild. But we need to remain careful and observe what happens next. Whenever a new variant emerges, we should always remain alert, as we don't know how fast it will transmit and the likely symptoms, either," said Dr Santosh Bansode, head of the department, Emergency Medicine, Wockhardt hospitals, Mumbai Central.

10
No of states where BA.2.75 variant has been detected so far