Paxlovid: Playing the Odds With COVID-19 Rebound

Let’s recap my medical history here, just for, you know, fun.
 
1999: To treat my ITP, my hematologist wants to use a cure that would avoid a splenectomy. They need to make sure I’m Rh positive, because if I’m Rh negative, it won’t work. “Don’t worry,” she tells me. Neither parent is RH negative, which means I have a less than 7% chance of being RH negative. I test RH negative and have to have the splenectomy rather than the noninvasive treatment.
2016: My doctor sends me to a hematologist because my iron levels are dreadfully low and aren’t improving with medicine. He tells me my iron levels “are the lowest I’ve ever seen” (and he’s a hematologist oncologist!) and sends me to a gastroenterologist to deal with what we assume are bleeding ulcers. He tells me I probably have celiac. I tell him it’s a bullshit disease (literally, that’s what I said). He insists on a scope and a blood test. 1% of people around the world have celiac. I have celiac.

2020: I sign up for a clinical trial for a drug to treat celiac that would allow me to eat gluten. They run bloodwork, which I’m assured is routine. The day before I’m supposed to head down to South Florida to get the first infusion, the doctor calls me and says I don’t qualify because I have an incredibly rare celiac mutation. 5% of celiacs have an antigen called HLA-DQ8. That’s 5% of 1% of the population. I’m a writer, so my math skills are shaky, but in a world of eight billion people, I’m one of four million with this particular antigen. That’s about the size of Oklahoma.

 

2022: My doctor tells me I have a low thyroid, which explains a lot, and puts me on medicine. It doesn’t work. He runs tests and tells me my iodine is “the lowest he’s ever seen” and the human body needs iodine to make T3 and T4, so get on som iodine. Apparently this is an unusual problem. I roll with it, because hell, I’m getting used to being the medical anomaly.

Three pills scattered
Rebound is rare, the doctor said. I should have known right then and there it would happen to me.
Intellec7, CC BY-SA 4.0, via Wikimedia Commons

Also 2022: I get COVID-19 and, because of my Rh- blood, I have no spleen, so the doctor prescribes Paxlovid. She tells me there’s an incredibly small chance I’ll relapse but, she assures me, it’s only 1% of the people who take Paxlovid. (It’s actually 3.53% for rebounding within seven days, and I was right at the edge of that window.) I woke up Saturday with a scratchy throat, but tested negative Saturday night and again Monday morning. I called the doctor, who said, “Well, you don’t have fever, and you do have sinus issues, so it’s probably a sinus infection. Test one more time inside the five day window of feeling bad, just to be sure, but it’s highly unlikely you have COVID again.”  
On the last day of the window where I could have relapsed, I tested positive. For COVID-19. Again. That’s twice in one month that I’ve had COVID-19. I’m twice vaxxed and twice boosted and apparently two is my lucky number.
I don’t know why I’m even shocked. 
I’m gonna go buy some scratchers now. I mean, it’s a 1 in 300 million chance. I figure I’m due.