President Biden, doubly boosted, is in a good position to fight against covid

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The second US president infected with the coronavirus is in a much better position to fight covid-19 than the first.

When President Donald Trump fell ill in October 2020 – before vaccines were rolled out – he experienced covid symptoms severe enough to send him to hospital as doctors rushed to administer a range of drugs to a patient whose oxygen level had dropped to dangerous levels.

But President Biden, who tested positive for coronavirus on Thursday, has been fully vaccinated and double-boosted, as recommended for people his age, and has an excellent chance of avoiding the worst consequences of covid, according to sources. doctors interviewed on Thursday.

The president’s doctor, Kevin C. O’Connor, said in a statement released by the White House that Biden suffered from fatigue, a runny nose and an “occasional dry cough,” which the doctor called a “mild” symptoms.

O’Connor recommended Biden take the antiviral drug Paxlovid – a powerful drug that was unavailable when Trump fell ill.

The drug is considered most effective when administered at the onset of the disease. Biden has been regularly tested for covid. On Thursday, a rapid test showed a positive result, which was quickly confirmed by a PCR test.

“The president is fully vaccinated and has had two boosters, so I anticipate he will respond favorably, as most maximally protected patients do,” O’Connor said.

Other medical experts echoed this rosy prognosis.

“The chances are very good that he will be fine,” said Jeanne Marrazzo, director of infectious diseases at the University of Alabama at Birmingham School of Medicine. “He is a healthy old man. He’s fully boosted, he’s fully vaccinated, and he received prompt treatment. I think all indications are positive.

The White House released a brief video in which Biden assured him he was fine.

“The symptoms are mild,” Biden said. “I’m fine, I’m doing a lot of work. I will continue to do so. And in the meantime, thank you for your concern. And keep the faith. It’ll be fine.”

When Trump fell ill nearly two years ago, it was the mainstream news for days, a month before the presidential election. Biden’s illness, though a thunderclap of news amid the stifling summer in Washington, seems less likely to rattle the political world for the simple reason that the virus has become less deadly.

Biden received his first two vaccines in December 2020 and January 2021. He received his first booster last September and his second on March 30 of this year.

“We’re in a very different place right now in the pandemic because we have the tools like rapid tests, vaccines, antivirals,” said Andrew Pekosz, a virologist at the Johns Hopkins Bloomberg School of Public Health. But we have to stick with what works, he said: “We have to keep using [the tools] effectively to minimize the severe impacts of covid-19.

Covid is much more likely to cause serious illness in older people, and for the 79-year-old president, age is a risk factor.

But it also has three things going for it, said Albert Ko, an infectious disease physician and epidemiologist at the Yale School of Public Health. He has has had all of his shots, he’s getting help from Paxlovid, and the now-dominant omicron strain of the coronavirus in the US is generally less virulent, meaning less likely to cause serious illness, compared to strains that have spread in 2020 and most of 2021, says Ko.

“The strain we knew about at the time had a higher infection fatality rate,” Ko said. “Hopefully the prognosis is good. that mitigate a severe outcome.

Some covid patients find out they have the disease only after they become extremely ill and realize they may have something more than a case of sniffles and need to be tested for coronavirus. By contrast, Biden’s infection was discovered through what the White House said was a regularly scheduled rapid test.

Although doctors interviewed Thursday said they did not expect Biden to have a severe case, covid has always been an unpredictable disease, and continues to be so even among people who have been vaccinated.

“What they describe sounds like a cold. Certainly, these symptoms could get worse. Every case of covid or any other disease has to start somewhere,” said David Dowdy, an epidemiologist at the Johns Hopkins Bloomberg School of Public Health.

But, like other experts, Dowdy thinks Biden will likely start feeling better within days, even if he has persistent symptoms, like a cough, for longer. “If things are going to get worse, we’ll probably see this happen in the next 48 hours,” he said.

Coronavirus vaccines — in Biden’s case, the Pfizer-BioNTech product — have helped reduce the rate of death and serious illness from the virus since they were first rolled out in December 2020, months after Trump fell ill.

But vaccines, while preparing multiple layers of the immune system to recognize and respond to the pathogen, do not form an impermeable barrier to the virus – as countless people who are fully vaccinated and boosted and who end up get sick from covid. Virus-neutralizing antibodies produced by vaccines (or previous infection) decline within months. The deeper layers of the immune system need to kick into high gear and eliminate the virus once it has a foothold.

Infectious disease specialists said they approve of the publicly announced treatment regimen for Biden, noting that although he appears to be healthy and fit, he is considered at high risk for serious illness solely because of his age. . Immediately putting him on Paxlovid, the five-day antiviral treatment, is the right course of action, they said.

Marrazzo said there was no downside to taking Paxlovid if a patient was symptomatic and potentially at increased risk, for example due to age.

“Most people start feeling really better within 24 to 48 hours,” Marrazzo said.

Pekosz said of the president, “He is doing everything the way you are supposed to in order to minimize serious illness. He has a very good chance of recovering without too much difficulty.

Research shows that Paxlovid significantly reduces hospitalizations and deaths in unvaccinated patients, said Erin K. McCreary, director of infectious disease improvement and clinical research innovation at UPMC Pittsburgh Medical Center. The impact of the drug is less clear in vaccinated patients — Biden received four shots — but it will have some effect for him, she said.

The pill was widely studied when the delta variant of the coronavirus was widely available, she said, so its effect during the current surge in omicron subvariants is less well known. While this helps reduce disease severity and disease progression, it does not reduce the duration of symptoms, she said.

A common sense approach to the viral illness should also be part of the president’s treatment, said Richard A. Martinello, an infectious disease specialist at the Yale School of Medicine.

“I think relaxing, listening to our body, not overdoing it is probably good advice for everyone,” Martinello said. “As part of that, getting plenty of sleep, staying hydrated, eating well but not too much.” Biden could even do some light exercise if he’s feeling well enough, Martinello said.

He urged unvaccinated people to consider Biden’s disease a reason to get vaccinated – even if he was infected – because the benefits have proven to be so substantial.

“It’s probably the most studied vaccine we’ve used” for any disease, Martinello said. It’s the “best thing” we have for covid, he added.

The virus evolved in response to greater population immunity. The mutations changed the structure and chemistry of the spike protein on the surface of the virus, making it less easily recognized by the frontline antibody defense.

The most transmissible form of the coronavirus to date, the omicron BA.5 subvariant now accounts for nearly 80 percent new infections in the United States, according to the Centers for Disease Control and Prevention. An almost identical sub-variant named BA.4 accounts for 13%. None of the subvariants are known to cause more severe disease than previous versions of omicron.

It’s basically the same virus that has traveled the country in a succession of mutated strains since omicron emerged late last year, according to Anthony S. Fauci, Biden’s chief medical adviser on the pandemic.

On the omicron family tree, BA.5 “is just a wee bit of a sub-twig,” Fauci said Thursday just before the news of the president’s infection was announced.

“What we’ve been through is a gradual evolution of viruses that have a transmission advantage over the previous variant that they knocked off the table,” he said.

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