Ask A Genius 1469: Eleven-Day COVID Experience: Paxlovid, Vaccination, Long-Term Risks, and Endemic Trends
Author(s): Scott Douglas Jacobsen
Publication (Outlet/Website): Ask A Genius
Publication Date (yyyy/mm/dd): 2025/08/05
Rick Rosner, fully vaccinated and on Paxlovid, describes his eleven-day COVID bout: negative Tuesday, positive again Sunday, mild symptoms, and fear of long-term effects, ongoing spread. He’s cut exercise 20%, avoided severe disease risk through vaccination, and highlights endemic COVID patterns, immunity levels, variant naming shifts, and data access challenges.
Scott Douglas Jacobsen: You have had COVID for eleven days? What is going on, ma’am?
Rick Rosner: I took Paxlovid and metformin. Paxlovid is an antiviral meant to reduce viral replication and severity, and metformin has been studied for potentially improving COVID outcomes. However, it is not an officially recommended treatment.
I tested negative on Tuesday, but now it is Sunday, and I tested positive again yesterday. I will test again tomorrow. Honestly, it has not been terrible. My worst symptom was probably a sore throat, and even that was not as bad as strep throat.
I am fully vaccinated and boosted, which significantly reduces the risk of severe disease, hospitalization, and death. However, I still worry about the potential long-term effects of COVID. With a common cold, people generally don’t worry about lasting organ or neurological damage. Still, COVID has documented evidence of causing “Long COVID” in some people—lingering symptoms that affect multiple organ systems for weeks or months.
I haven’t stopped lifting weights, but I’ve reduced the amount I lift by about 20%, just to be safe. Medical guidance generally advises against intense exercise during active infection because the body needs energy to recover, and pushing too hard might increase the risk of complications like myocarditis, though evidence is still evolving.
I managed to avoid COVID for over three years.
Have you had it before?
Scott Douglas Jacobsen: No. Never.
Rosner: And you’ve been travelling all over?
Jacobsen: Yes.
Rosner: Do you still mask?
Jacobsen: No.
Rosner: Yeah, many people have stopped. The fatality rate from COVID has dropped dramatically compared to early 2020, mainly due to widespread vaccination, prior infections building immunity, and better treatments like antivirals and monoclonal antibodies. Early on, limited testing and new treatment protocols made the case fatality rate appear higher than it was.
Now, over 95% of people in the U.S. have some level of immunity from vaccination, prior infection, or both. This immunity doesn’t entirely prevent infection—especially with highly transmissible variants like Omicron—but it does substantially reduce the risk of severe illness and death. The virus itself hasn’t necessarily become weaker; instead, our immune systems are better equipped to handle it.
But COVID hasn’t disappeared. It has become an endemic virus with seasonal patterns. In the U.S., we generally see waves of increased cases in late fall and winter, with smaller peaks at other times. While peak case numbers have decreased compared to the pandemic’s height, baseline transmission remains steady.
This means there’s always a pool of people infected and capable of spreading the virus. With public health agencies like the CDC shifting focus from broad surveillance to targeted monitoring, and with less media coverage, many people don’t track COVID statistics closely anymore.
The CDC has made it harder to find some of the COVID data. For example, it’s no longer as straightforward to access long-term historical data—like five years’ worth—on their site. I’m hoping I’ll test negative again in the next day or two.
Jacobsen: You sound pretty negative to me. So rank the symptoms, best to worst—although they’re all bad.
Rosner: The worst part isn’t even the physical symptoms—it’s the fear of potential long-term damage. There are studies suggesting COVID can have neurological effects, but findings vary widely depending on infection severity. Even mild cases have been linked in some research to measurable, though small, cognitive changes. In contrast, severe cases can have a larger impact.
For physical symptoms, the most common was a sore throat. That was the most uncomfortable. Number two was the coughing, which made it hard to sleep, and the phlegm. Number three, sneezing—but that’s pretty minor unless you’re sneezing seven times in a row, which just reminds you you’re not done with it yet.
Jacobsen: To Americans, the ones that’ll matter are hairlines and sex. Does COVID affect that?
Rosner: There’s a term some people jokingly use—“COVID dick.” It’s harder to get or maintain an erection while you’re sick. That’s not unique to COVID—it happens with many illnesses, especially as you get older.
Jacobsen: So this isn’t permanent?
Rosner: No. There’s no solid evidence that COVID generally causes permanent sexual dysfunction. But it does make sense that if blood flow or clotting were affected in rare cases, it could theoretically impact erectile function.
Jacobsen: Has that ever been reported?
Rosner: I’ve never heard of priapism linked to COVID. What I have heard of, though, is something less pleasant—digestive changes. JD, whom you’ve interviewed before, said COVID changed the colour of his stool. I think it may have done the same for me, but it’s hard to tell because Carole put that blue toilet cleaner in the bathrooms, so everything looks tinted.
Jacobsen: What’s in that blue stuff?
Rosner: Just dye and some kind of detergent. I think it’s mostly there to make things look cleaner.
Jacobsen: Anything else?
Rosner: Yeah. Paxlovid. It leaves you with a terrible taste in your mouth—people call it “Paxlovid mouth.” Most of the side effects are minor nuisances, but it’s still annoying. Also, I’m sleeping in the attic to avoid giving it to Carole.
Jacobsen: Has she managed to stay negative?
Rosner: So far, yes. I wear a mask around her, and we’ve been eating at different times just to be cautious.
Jacobsen: Oh, that’s very smart. I guess it’s a straightforward change that makes a big difference. Yeah. Do you clean off counters or spray things down as you pass them, or whatever?
Rosner: A little bit. A little bit. I try to keep my hands pretty clean. I try not to touch my face. But, you know, most evidence suggests it’s much harder to get it from surfaces than from airborne transmission.
Jacobsen: So anyway, have you noticed any change in your sense of smell?
Rosner: No. Smell and taste are intact, which fits what’s been reported with this variant. I think it’s called NB.1.8.1.K—or maybe “Nimbus,” though the official naming system has shifted chiefly away from memorable names. People aren’t paying attention to variant names much anymore.
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