Joe Biden is taking Paxlovid, even though doctors know it doesn't really work

• President Joe Biden announced he has COVID on Wednesday.
• The White House says his symptoms are mild, including a runny nose, cough, and malaise.

Another summer outbreak of COVID-19 is here. President Biden announced he is sick with the virus on Wednesday, and he's in good company.

Test positivity rates are up across the country, according to the latest Centers for Disease Control and Prevention data, with rates especially high in California, New Mexico, and Nevada, where President Biden was traveling on Wednesday.

White House Press Secretary Karine Jean-Pierre said in a statement on Wednesday that the president "has received his first dose" of Paxlovid, the antiviral treatment from Pfizer that's meant to ease COVID-19 symptoms and make the virus less dangerous for high-risk patients.

But some experts wonder why you'd even prescribe this drug, which has been shown in study after study to be lackluster, at best.

Evidence suggests that Paxlovid doesn't do a lot

• It doesn't speed up recovery
• There's no evidence it prevents long COVID
• It doesn't seem to make the odds of a rebound, when the virus springs back into action just as a patient is recovering, any less likely — in fact, it may even be a little more common for patients on Paxlovid to rebound than others.

There is maybe one thing Paxlovid can sort of do

The one thing Paxlovid seems to do is prevent a few hospitalizations in very high-risk patients. But even for this, studies suggest it isn't a great drug.

Pfizer's big trial of more than 1200 patients, out in April, suggested that maybe taking Paxlovid can prevent a few hospital admissions among the frailest, most vulnerable patients, but it's tough to say. Five patients on Paxlovid in that study were hospitalized or died. In the control group (not taking Paxlovid) that number was 10. The difference here wasn't even statistically significant.

Paxlovid did seem to make hospital stays shorter in the Pfizer study, and ICU visits less likely. But other research from the UK, out in May, showed absolutely no difference in mortality when comparing hospitalized patients taking Paxlovid to those who weren't on the drug.

ER doctor Jeremy Faust told readers of his Inside Medicine blog in June that "we should brace for the possibility" that upcoming studies will "either show Paxlovid is now completely unable to decrease hospitalizations or deaths, or that at best, it does so modestly for a narrow group of very high-risk patients."

In the early days of the COVID-19 outbreak, Paxlovid looked like a better drug. But it's just not doing that much for us now.

"It isn't that Paxlovid no longer works," Faust said. "Rather, it's that in 2024, there are relatively few people who still seem to really need it to stay alive or out of the hospital."

There is another antiviral drug for COVID that's already available in China, called Simnotrelvir, which seems to help improve the more mild, initial symptoms of this disease. But it's unclear how much it would help the most vulnerable patients, and it's not available in the US anyway.

Pfizer stands by Paxlovid. In a statement, a spokesperson told BI: "We remain very confident in PAXLOVID's clinical effectiveness at preventing severe outcomes from COVID-19 in patients at increased risk."