Medical Examiner

What’s So Different About Biden’s COVID Case vs. Trump’s

The president announced that he was positive Thursday morning.

Donald Trump and Joe Biden during the final presidential debate
Donald Trump and Joe Biden during the final presidential debate on Oct. 22, 2020. Brendan Smialowski/Getty Images

So, Joe Biden has COVID. The thought of a 79-year-old infected, especially one in such a position of power, might make your mind jump to the worst possible scenario (I’ll admit, the news inspired me to look up the order of presidential succession).

But things are a lot different than in October 2020, when the previous president, who was 74 at the time, had COVID-19 (and survived). It seems like Biden will most likely be OK.

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“I would not have said this a year ago or two years ago, but my level of concern is quite low,” Megan Ranney, a practicing emergency physician and dean of public health at Brown University said. “We have a week or so before we know with certainty that he’s out of the woods. But the likelihood of him getting really sick is way lower than it was for former President Trump.”

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For one, Biden is vaccinated and double boosted. The vaccine “decreases your chance of getting infected, period, and decreases the chance of ending up with severe outcomes should you get infected,” said Ranney. According to a Scientific American article that mapped out death rates by age group in March 2022, the rate of COVID deaths per 100,000 people was 9.29 for individuals who were 65 and older and unvaccinated, and 1.18 for those who were vaccinated. Biden also has a booster—the death rate for folks over 65 who are vaccinated and boosted was just 0.55 per 100,000 people or 0.00055 percent. Experts have said that while BA.5 is better at getting around our immune defenses, it doesn’t look like it causes more severe illness. Vaccines and boosters truly make a difference for this age bracket. Plus, according to Biden’s health summary from 2021, his physician describes him as “healthy, vigorous.”

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Biden is also currently taking Paxlovid, an antiviral pill that will hopefully lessen symptoms and potential for long COVID. “Paxlovid is lovely because it works for both vaccinated and unvaccinated folks, but is gonna make the risk of severe disease, hospitalization, or death for vaccinated people close to 0,” Ranney said.

Estimates on the prevalence of long COVID vary. According to the CDC, 1 in 13 adults have symptoms that last more than three months. Biden’s vaccination status should reduce his risk a little bit. Weirdly, so may his gender and age: Women are twice as likely as men to have long COVID, and “nearly three times as many adults ages 50-59 currently have long COVID than those age 80 and older,” according to the CDC, though of course, these might just be correlations.

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When Trump had COVID, he had special access to treatments. But now treatments are available to the public, too. “What Biden has done up until this point and what he is receiving right now is actually not VIP care,” says Ranney. “This is, or should be, standard care in the United States right now. It is certainly what I recommend to all of my patients, to my family members, and to my friends who are in those older age groups or have multiple comorbidities.”

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As for the only other thing that she recommends Biden—or really anyone else with COVID— do?

“The most important things are to rest, stay hydrated, and to have an adequate supply of ibuprofen or acetaminophen to help with body aches,” she says. “Certainly folks work through COVID but what I hope what the president is doing is recognizing and respecting his body’s signals when he’s feeling fatigued.”

Although he does seem to be staying hydrated (a plastic water bottle in this economy?), it doesn’t seem like he’s truly resting. Thursday morning he declared that he is “keeping busy!” Maybe he should just take a few sick days?

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