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I got COVID (again). I'm staying home (again). Why are so few following the rules?

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I feel like a schmuck.

After I tested positive for COVID-19 two weeks ago, my doctor prescribed the anti-viral Paxlovid, which would lessen the severity of the disease. The only hitch, she explained, was that a small percentage of those taking this drug experience "rebound," also called "rapid relapse," meaning they develop symptoms anew after apparent recovery. Even worse, they test positive again shortly after a negative test. She pointed out that even more people might be rebounding than early data showed.

I didn't care. I just wanted to get well fast and get on with my life. I took the Paxlovid.

I used the Centers for Disease Control and Prevention calculator to determine when I could exit my quarantine. Five days at home, followed by up to 10 days of wearing a mask in public from the onset of symptoms. Ugh. I had no problem staying home those first several days since I felt crappy anyway: body aches, a temperature, a sore throat and a cough.

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I spent five days in prison – I mean my house – then on Day 6, I got my "get out of jail free" card, which meant I could leave home but should wear a mask in public. Although I was never a Boy Scout, I followed the rules and kept interactions to a bare minimum.

Finally, the calculator handed me the news I had been waiting for: no more masking. I was like a racehorse busting out of the gate. Within three days, I had dinner with two sets of friends and went on a date – all unmasked.

This again? Well, now I feel foolish.

Four days later, my cough returned, along with the lethargy. I took another COVID test and saw that second bar – positive! – appear right away. I was now officially a rebound case. (I alerted the friends I had seen to my new status; fortunately, none of them tested positive.)

I hoped the CDC calculator would be more lenient the second time around. Nope. The guidelines for rebound are exactly the same as for a first case. My upcoming calendar showed drinks with my friend Doug (who has an unvaccinated baby), dinner with a married couple in their 80s and four weekend guests. Did I really have to cancel all those plans?

According to the CDC, yes.

But here’s why I feel like a schmuck: I initially tested positive within days of two friends of mine. Apparently, we had all been infected while together at a workshop in Mexico. One of them, also a rebound case who had new symptoms, mentioned he was flying to a business meeting one day after retesting positive. (He should have been isolating.) A week later – when he still should have been masked in public – he sent me a photo of himself, unmasked, dancing at a crowded festival. "Not fair!" I shouted to myself.

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The other friend had actually tested positive while still in Mexico but decided after three days that she had enough of isolating. Even though she should have remained in lockdown, she flew to Tijuana and walked across a bridge to San Diego – likely still infectious. A mutual friend noted, in quite an understatement, "That didn’t seem right." Uh huh. (This was when we still had to take a COVID test before returning home.)

Transmission risks don't just evaporate

I was stunned by how bold my friends were about breaking the rules.

One of them chastised me for following the CDC guidance, wrongly telling me there was no way my rebound case could infect someone else. According to the CDC, it may still be possible to transmit the virus to other people during COVID-19 rebound. A recent study documented 10 rebound patients, including two who appear to have infected others. The researchers' recommendation: "The presence of high viral load and the occurrence of two transmission events suggest that patients with relapse should isolate until antigen testing is negative."

Arthur Caplan, a medical ethicist at New York University's Grossman School of Medicine, worries about the numbers of us going rogue.

"No one seems to be tracking compliance for those found positive for COVID," he told me. "My impression is that isolating is not well understood, with a large number of people making up their own rules. Sadly, indifference to others is the governing ethic for exposure."

This indifference makes it harder for everyone. It's one thing to stay home. It's another to see others with the same COVID status out and about, unmasked. Without community norms, doing the right thing can make you feel, well, like a schmuck.

I'm reminded of the 1980s

I remember another time when lax community norms allowed for a different virus to spread like wildfire. Back in the 1980s, at the outset of the HIV/AIDS epidemic, behavioral psychologists urged the widespread adoption of condoms to reduce the toll from what was then a uniformly fatal disease.

As an HIV educator with the San Francisco AIDS Foundation, I edited a book, "Ending the HIV Epidemic," which focused on changing "group norms to change individual behaviors." We enlisted hunky bartenders to share safer sex information. ("If he’s using a condom, I will," friends often noted.)

Similarly, a billboard featuring two attractive men went up in the Castro District that said: "You won’t believe what we like to wear in bed. More and more smart men are slipping into condoms tonight. Protecting themselves and their partners."

Condom use surged, according to a report in the American Journal of Public Health. If you didn’t want to use a condom, you became the outlier, rather than the other way around. That’s how we began to take care of each other.

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How do we take care of each other now? Like so many others, I have COVID-19 fatigue, which is to say I'm tired of the whole pandemic. Although numbers are way down from the peak, we’re still averaging more than 100,000 new cases each day and nearly 300 daily deaths. Like it or not, we’re all in this together. If you don’t play by the rules, you put others at risk. It’s that simple.

Steven Petrow
Steven Petrow

When I canceled drinks with my friend who has the baby, he texted me, "Thanks for being a good human, and friend and retesting." I don’t repeat that to praise myself. After all, I was only doing what I'm supposed to do.

Steven Petrow, a writer on civility and manners and a member of USA TODAY's Board of Contributors, is the author of five etiquette books, including "Stupid Things I Won't Do When I Get Old." Follow him on Twitter: @stevenpetrow

You can read diverse opinions from our Board of Contributors and other writers on the Opinion front page, on Twitter @usatodayopinion and in our daily Opinion newsletter. To respond to a column, submit a comment to letters@usatoday.com.

This article originally appeared on USA TODAY: Biden tests positive for COVID-19 again. What is rebound COVID?