Nearly two years separate the COVID-19 diagnoses of then-President Donald Trump and current President Joe Biden. In a pandemic that has engaged the full powers of the American medical and scientific establishments, that is a lifetime.
And for Biden — a few months shy of turning 80 and joining the age group at highest risk for becoming severely ill or dying from COVID-19 — it could be a lifeline.
The president is said to be working in isolation from the White House and “experiencing very mild symptoms,” including a runny nose and fatigue, as well an “occasional dry cough,” according to his physician, Dr. Kevin O’Connor.
Biden has had two primary doses of Pfizer-BioNTech’s Comirnaty vaccine and been boosted twice, making him “maximally protected,” O’Connor said.
Following protocols that recommend prompt use of an antiviral medication for newly infected people at risk of developing severe disease, the president has begun a course of the antiviral drug Paxlovid. For five days, he’ll take three of the pills twice a day.
That should “provide additional protection against severe disease,” O’Connor said. Among non-hospitalized patients at high risk of progression to severe disease, treatment with Paxlovid reduced the risk of hospitalization or death by 88%.
But if Biden develops worrying symptoms — such as low oxygen levels or abnormalities in the function of his heart or kidneys — his doctors can respond with a small arsenal of medications and procedures refined over the past 21/2 years of a grinding pandemic that has landed close to 5 million patients in U.S. hospitals.
Consider, by contrast, the peril in which Trump found himself when he came down with COVID-19 in October 2020 at the age of 74.
While in generally robust health, Trump was obese, a powerful risk factor for developing a severe case of COVID-19. He was also unvaccinated, as the initial Pfizer and Moderna vaccines were still more than two months away when he tested positive for a coronavirus infection 21 months ago.
In its latest accounting of the vaccines’ effects, the Centers for Disease Control and Prevention has calculated that among people 65 and older, the likelihood of landing in the hospital with COVID-19 is 3.8 times higher for unvaccinated people than it is for their peers who have been fully vaccinated and received a single booster shot.
The protection against dying is even starker. As of May 22, people ages 65 to 79 who were unvaccinated were 6.6 times more likely to die of COVID-19 than were their fully vaccinated counterparts. Getting a booster shot widened that gap: In Biden and Trump’s age group, the unvaccinated were nearly nine times more likely to die of COVID-19 than were their vaccinated-and-boosted peers.
The course of Trump’s illness tells the story.
Within a day of his positive test, the 45th president was rushed to Walter Reed Naval Medical Center after his oxygen levels fell steeply and suddenly.
There, he was quickly treated with the antiviral drug remdesivir, which had been found to benefit COVID-19 patients and was authorized for emergency use by the U.S. Food and Drug Administration. And under a program designed to get still-experimental drugs to patients in extreme circumstances, Trump was given an antibody cocktail developed by Regeneron more than a month before it was authorized by the FDA.
In a sign that physicians were deeply concerned about Trump’s prognosis, doctors also administered the steroid dexamethasone. That workhorse drug has been lifesaving for many patients. But it’s considered safe to use only in those at high risk of developing the kind of overactive inflammatory response to COVID-19 that can lead to organ failure and death.
The particular coronaviruses that infected the two presidents also dealt them very different hands.
In the early fall of 2020, Trump likely faced a version of the virus that closely resembled the one that left Wuhan, China, in the final months of 2019.
Compared with the BA.5 omicron subvariant that now accounts for an estimated 78% of cases in the United States, the “ancestral” strain caused more severe disease. Compounded by physicians’ inexperience in treating those ill with the novel coronavirus, 2020 was a more dangerous time to contract the virus that causes COVID-19.
