Thu Jul 18

Joe Biden has COVID. Here’s what someone over 80 can expect

Written by: Hassan Vally, Associate Professor, Epidemiology, Deakin University

If US politics leading up to the 2024 presidential election was a Hollywood thriller, it would be a movie full of plot twists and surprises. The latest twist is President Joe Biden has COVID ^[1] and is isolating at home.

Biden’s doctor says ^[2] his symptoms are mild and include a runny nose, cough and generally feeling unwell. His temperature, oxygen levels and respiratory rate are said to be normal.

Biden, who has been diagnosed ^[3] with COVID twice before, has received ^[4] his COVID vaccine and booster shots, and has taken the first dose of the antiviral drug Paxlovid.

No doubt, Biden will be receiving the best of medical care. Yet, as much recent media coverage ^[5] reminds us, he is 81 years old.

So let’s look at what it means for an 81-year-old man to have COVID in 2024. Of course, Biden is not just any man, but we’ll come to that later.

Luckily, it’s not 2020

If we were back in 2020, a COVID diagnosis at this age would have been a big deal.

This was a time before COVID vaccines, before specific COVID treatments and before we knew as much about COVID as we do today. Back then, being over 80 and being infected with the SARS-CoV-2 virus (the virus that causes COVID) represented a significant threat to your health.

It was very clear early in the pandemic that your chances of getting severe disease and dying increased with age ^[6]. The early data suggested that if you were over 80 and infected, you had about a 15% likelihood of dying from the illness.

Also, if you did develop severe disease, we didn’t have a lot in the toolkit to deal with your infection.

Remember, former UK Prime Minister Boris Johnson ended up in the ICU ^[7] with his COVID infection in April 2020 ^[8], despite being 55 at the time. That’s a much younger age than Biden is now.

Former US President Donald Trump also had what was understood to be a very severe case ^[9] of COVID in October 2020. He was 74 at the time.

How things have changed

So let’s wind the clock forward to 2024. A lot has happened in four years.

COVID is still a disease that needs to be taken seriously ^[10]. And for some people with other health conditions (for instance, people with heart disease or diabetes) it poses more of a threat. And of course we know more about the well-publicised longer term effects ^[11] of COVID.

But the threat COVID poses to an individual is far less now than it has ever been.

More of us have some immunity

First, most people ^[12] have some immunity to COVID now, whether this has come from vaccination or prior infection, and for many both.

The fact that your immune system has had some exposure to the virus is transformative in how you respond to infection. Yes, there’s the ongoing problem of waning immunity over time and the virus mutating meaning you need to have regular booster vaccines. But as your immune system has “seen” the virus before it allows it to respond more effectively. This means the threat posed by infection has fallen drastically.

We know Biden has received his booster shots. Boosters have been shown to offer substantial protection ^[13] against severe illness and death and are particularly important for older age groups.

Now we have antivirals

Second, we also have antiviral medicines, such as Paxlovid, which is effective in reducing the likelihood of severe illness from COVID if taken soon after developing symptoms.

In one study ^[14], if taken soon after infection, Paxlovid reduced the likelihood of severe illness or death by 89%. So it is highly recommended ^[15] for those at higher risk of severe illness. As we know, Biden is taking Paxlovid.

Paxlovid has also been associated with rebound symptoms. This is when a person looks to have recovered from infection only to have symptoms reappear. Biden experienced this in 2022 ^[16].

The good news is that even if this occurs in most instances the symptoms associated with the recurrence tend to be mild.

Biden would have the best care

The other factor of course is that Biden would have access to some of the world’s best medical care.

If his symptoms were to become more severe or any complications were to develop, you can be assured he would get the best treatment.

So is Biden’s diagnosis news? Well of course, given all the speculation about his health. But in terms of COVID being a major threat to Biden’s health, there are no indications it should be.