On Thursday, President Joe Biden tested positive for Covid-19, but his infection, while potentially serious, does not put him at the same risk as former President Donald Trump, who was infected just before the 2020 election.
Biden, who has received two boosts and has already started Paxlovid, is experiencing mild symptoms, according to the White House.
Here are four reasons Biden’s case is not like Trump’s.
The key difference between Trump’s infection, which landed him in Walter Reed Military Medical Center for three nights, and Biden’s is vaccinations, experts said.
Biden has received four doses so far, developing a high level of protection against hospitalization and death. When Trump contracted the virus, there were no vaccines available.
The Centers for Disease Control and Prevention discovered that in Januaryduring the height of the Omicron wave, an unvaccinated person was 12 times more likely to be hospitalized than a vaccinated person.
“However, it is a completely different scenario to talk about a Covid infection and someone who has been vaccinated four times versus someone who has not been vaccinated,” said Céline Gounder, a physician at Bellevue Hospital and an epidemiologist at the Grossman School of Medicine in NYU, he said in a May interview. “And I think that message still doesn’t seem to get through to people: that vaccines are really highly effective in preventing hospitalization and death.”
Without access to vaccines, Trump faced a much higher risk of infection.
“[Trump] he would have been quite ill; at his age, he was predicted to be quite sick,” said Eric Topol, MD, professor of molecular medicine and founder of the Scripps Research Translational Institute. “And indeed, he was.”
Biden also has new treatment options to help fight the infection, including Pfizer’s antiviral pill Paxlovid.
“We know that Paxlovid is also very effective at keeping people out of the hospital,” Gounder said.
Pfizer’s Covid-19 antiviral pill reduced the risk of hospitalization or death from 89 percent in high-risk patients that he had been experiencing symptoms for three days or less, according to trial results the company released in December.
While relapses with the antiviral are possible, an issue still under investigation, it remains a highly effective solution and another level of protection.
When Trump had Covid-19, he was given a monoclonal antibody treatment made by Regeneron, as well as remdesivir, an antiviral.
Monoclonal antibody treatment is also an option for Biden, if needed, experts said, but it doesn’t work as well, and there are fewer treatment options, compared to when Trump was infected.
“We are running out of possibilities for monoclonal antibodies to help. There is a lot of immune escape for this variant,” Topol said of the Omicron variant, including subvariants such as BA.2 and BA.5.
The new strains of the virus, now much more transmissible than the original version, are another difference.
Trump contracted a less infectious but more virulent strain, public health experts say.
The virus is still evolving, with several sub-variants recently emerging around the world.
“There is a small risk of [Biden] have severe covid, severe illness, and require hospitalization,” Topol said. “Fortunately, that risk is small, but it has increased as the virus has evolved into these much more difficult variants.”
While treatments may be less effective due to new strains of the virus, the dominant variants circulating today are not known to be significantly more deadly than earlier versions.
Another difference between the Biden and Trump infections is their comorbidities.
“The main risk factor for Trump was his obesity, and we know that carries a significant risk for Covid,” Topol said. “Obviously that’s not a problem with Biden. I am not aware of any other comorbidities that Biden has outside of his age.”
While full medical records are not available, both administrations have released some details about the health of Trump and Biden. In 2020, just before Trump got infected, the White House released his physical. Trump weighed 244 pounds and was 6 feet 3 inches tall. That meets the clinical definition of obesity and puts you at higher risk of hospitalization for Covid-19, According to the Centers for Disease Control and Prevention. Biden is less than 6 feet tall and weighs 184 pounds, according to her physical.
Biden is 79 years old. Trump was 74 years old when he contracted covid. The risk increases for people in their 50s and increases further for those in their 60s, 70s and 80s, according to the CDC. People age 85 and older are the most likely to get seriously ill.
Biden could still be susceptible to prolonged covid. The post-viral condition, which sometimes includes severe fatigue, ongoing breathing problems, or cognitive decline, is still poorly understood.
Now, experts say, the extensive list of symptoms has disabled some, even those who have been vaccinated. Although a minority of infected people experience Covid for a long time, according to the first dataover a million people in the UK have reported persistent symptoms of Covid-19.