The Atlantic Daily: When You Get COVID Again and Again

Our writers tackle the mysteries of reinfection and the antiviral Paxlovid. Then: Why didn’t the police act faster in the school shooting in Uvalde?

The coronavirus is nothing if not scrappy. In the two and a half years since the microbe hurtled into our midst, it has infected most Americans—probably most of the world’s population—and researchers have cooked up several lifesaving vaccines. And yet, the virus keeps finding new ways to spread quickly among us, sometimes infiltrating the same hosts again and again and again.

Scientists think SARS-CoV-2 will continue to be a recurring visitor. It will reinfect each of us, on average, maybe once every three or so years, Aubree Gordon, an epidemiologist at the University of Michigan, told me. What that means for our health remains unclear. There’s every indication that second infections aren’t as severe as first ones, that third and fourth ones should be more tolerable still. These trends should hold especially true for people who stay up-to-date on their vaccines.

But hospitalization and death aren’t the only coronavirus-related outcomes people are looking to avoid. Infections of all severities can still unfurl into long COVID, or transmit to someone vulnerable, or keep someone away from work or school. And researchers aren’t sure whether a repetitive run of “mild” infections could eventually take a cumulative toll. That means trying to avoid reinfection still seems wise, especially while researchers continue to develop more effective vaccines and treatments.

Which brings us to another COVID mystery: Paxlovid, the antiviral that is shrouded in a cloud of questions that my colleague Rachel Gutman deftly tackled this week. The pills, which were designed to keep newly infected people out of the hospital, do seem to be blocking severe disease. But as of late, the drug’s been linked to a lot of rebounds, in which people dose up for five days, feel better, then experience a symptom relapse—and test positive anew.

Rebounds didn’t seem common in Paxlovid’s clinical trials; experts still haven’t even confirmed that the drug is causing these relapses, which can happen with untreated infections as well. Right now, though, doctors are operating in a vacuum of evidence. Pfizer has published data documenting how the drug works only in high-risk, unvaccinated people in the pre-Omicron era. Now, out in the real world, all sorts of patients are getting prescriptions to fight off a slew of new variants.

So far, Paxlovid doesn’t seem to be causing more severe disease. And health-care providers are still erring on the side of prescribing it—the pills remain one of the best treatment options we have. But as Rachel writes, “If the drug doesn’t really do that much for vaccinated people—if it fails to have meaningful effects on their risk of severe disease, and doesn’t help resolve their symptoms—then giving it out widely could be a waste of the dwindling resources the United States has committed to fight the pandemic.”

More on the school shooting in Uvalde, Texas:

Latest dispatches: Elizabeth Williamson, the author of a book about the Sandy Hook mass shooting, talks with Charlie Warzel about what has, and has not, changed in the United States since that tragedy [Galaxy Brain]. Tom Nichols counters Henry Kissinger and others calling for a cease-fire in Ukraine, arguing that only Ukrainians will decide when the war is over [Peacefield]. Black American artists inherit a literary past that is prickly at best, Imani Perry writes [Unsettled Territory].

Read. Joanne Greenberg’s best-selling but now-obscure 1964 novel, I Never Promised You a Rose Garden, helped the writer Lauren LeBlanc find her voice as a teenager.

Watch. Binge the first seven episodes of Stranger Things’ fourth season, whose new villain embodies the menace of conspiratorial thinking, our critic Shirley Li writes.

Revisit Top Gun, then dive into its long-awaited sequel, which my colleague David Sims described as straight-up “Tom Cruise propaganda.”

Listen. In season two of The Atlantic’s How To podcast series, launching Monday, Olga Khazan will help you overcome the forces of inertia. Listen to the trailer, and subscribe.

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