Biden is 79, vaccinated, and twice boosted. Here's his risk of severe COVID.

The White House disclosed Thursday that President Joe Biden had contracted a mild case of COVID-19.
The White House disclosed Thursday that President Joe Biden had contracted a mild case of COVID-19.
  • President Biden tested positive for COVID-19 on July 21 and was "experiencing very mild symptoms," the White House said. 
  • Days later, Biden tested negative but tested positive again on July 30 with a rebound case.
  • Experts say that Biden's fully vaccinated and twice-boosted status bodes well for his chances of avoiding severe illness.

President Joe Biden tested positive for COVID-19 again on Saturday. He had previously tested negative multiple times earlier in the week. 

Upon his first infection on July 21, medical experts at the time told Insider the president's chances of developing severe disease were low. The White House said that Biden was "experiencing very mild symptoms" and had already begun taking Paxlovid, an antiviral drug used to combat COVID-19. In a memo, the president's doctor said he had a runny nose, a dry cough, and fatigue.

Biden's doctor had said his oxygen rates were normal and that he'd taken Tylenol overnight after having a temperature of 99.4 degrees. He also noted that the president developed a "loose" cough and a deeper voice.

Biden tested negative for COVID-19 on July 26 and 27, when he announced he was going "back to the Oval" after isolating. But days later, on Saturday, Biden tested positive for again, tweeting: "I've got no symptoms but I am going to isolate for the safety of everyone around me."

"I'm still at work, and will be back on the road soon," he added.

Biden, who is 79 and has some mild pre-existing conditions, is in an age bracket with high mortality rates but his health and vaccinations offer greatly enhanced protection. Experts characterized the chances of the commander-in-chief's health taking a severe turn as "incredibly low," a situation likely to require invoking the 25th Amendment and transferring control of the US's nuclear forces to the vice president while he would undergo treatment at Walter Reed National Military Medical Center, as happened to his then-unvaccinated predecessor.

Biden will need to stop taking two of his regular medications, one that lowers cholesterol and one that's a blood thinner for a heart condition called atrial fibrillation, for as long as he's on Paxlovid.

"It's a very standard, common thing that we do when we give people Paxlovid," White House COVID-19 coordinator Dr. Ashish Jha said Thursday during a press briefing. "They both get stopped for the five days that he's on Paxlovid, and then they get restarted. And it's totally fine and pretty normal practice."

Biden's doctor, Kevin O'Connor, noted last week that Biden has already received four COVID-19 shots. Given his vaccination status, O'Connor was bullish on Biden's chances for a swift recovery.

"The President is fully vaccinated and twice-boosted, so I anticipate that he will respond favorably, as most maximally protected patients do," O'Connor wrote.

4th shots are key for older adults 

The World Health Organization and the US Centers for Disease Control and Prevention both recommend that older adults should get an additional (fourth) boost, to better protect them against severe disease with COVID-19.

According to a June study of older adults from Israel, having the second boost provides elders much greater protection from bad coronavirus outcomes. 

"Compared with individuals who received 3 doses," the study says, "those who received a fourth dose had a 3.5-fold lower rate of severe disease during a 6-week follow up."

Robust recent data on tens of thousands of Swedes shows, likewise, that a fourth dose can help guard against death from COVID, even "in the oldest and frailest" patients, and "after the emergence of the Omicron variant."

"If you are over the age of 50, and if you've not gotten a vaccine shot in the year 2022, you need to go get one. You need to go get one now," Jha said Thursday.

Biden's 'a healthy and vigorous person with 4 shots'

Dr. Michael Klompas, an infectious disease expert at Harvard Medical School, told Insider that Biden is also generally in good health, which bodes well for his chances of having a mild case. Biden's 2021 health summary presented by O'Connor did not reveal any severe health issues or comorbidities.

"He's old, yes, but he seems to otherwise be pretty vigorous, there's nothing I've heard to say that he's got comorbid illnesses, like bad heart disease, or lung disease, or liver disease, or cancer, or immunocompromised conditions," Klompas said. "I'd say on the basis of that, of being simply old, otherwise a healthy and vigorous person with 4 shots, his risk of a bad outcome's incredibly low."

Dr. Seth Cohen, medical director of infection prevention at the University of Washington Medical Center, echoed Klompas and the booster data. Neither Cohen or Klompas have personally evaluated Biden, or been consulted on his care by White House staff.

Cohen said that Biden's vaccination status decreases his chances of severe illness.

"We also have very, very strong data to show how crucial it is to be fully boosted in terms of preventing severe outcomes from Omicron," Cohen said. "Hopefully, that is giving a lot of people some peace of mind."

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