Biden's age makes COVID risky. Is his health in danger?

President Joe Biden has COVID-19 again, and though he's expected to be fine, at his age, any infection is cause for concern, experts said Wednesday.

The president, 81, is at relatively high risk for severe disease simply because of his age, even though his "fantastic" record of vaccination and quick medical attention improves his odds of having a mild reaction to the virus, experts said.

"You’re always concerned when an older person gets COVID," said Dr. Paul Offit, director of the Vaccine Education Center and an attending physician in the Division of Infectious Diseases at Children's Hospital of Philadelphia. "But he’s certainly in the best possible position. He’s been vaccinated. He’s taking (the antiviral) Paxlovid early. He certainly has good medical care."

According to the Centers for Disease Control and Prevention, people over 65 account for more than 81% of COVID-19 deaths — and the number of deaths among the age group is 97 times higher than for people aged 18 to 29. The odds of getting acutely ill also go up for people with other illnesses.

But Biden's multiple vaccinations and quick receipt of medication will reduce his risk of severe disease down to about 1%, said Dr. Daniel Griffin, an infectious disease specialist and clinical instructor of medicine at Columbia University.

Still, the risk isn’t zero, Griffin said.

"It’s a mixed picture," he said. As a man with some heart disease, his risk is increased somewhat. But he also leads an active life.

"This is not a debilitated person in a nursing home. That’s largely the deaths that we’re still seeing are happening in an immune-compromised, debilitated population," Griffin said.

'Our immune system changes as we get older'

Hospitalizations and emergency room visits are far less frequent than in January when more than 2,000 people a week died from COVID. As of June 15, the CDC estimated fewer than 150 people died of COVID-19. 

Griffin said his real concern is two weeks or a month from now when Biden — or anyone his age — might not fully bounce back from an infection. Each episode of COVID-19 doesn’t predict the next one.

Biden first tested positive on July 21, 2022, and experienced mild symptoms. Nine days later, he tested positive again in a virus "rebound" that patients treated with the antiviral medication Paxlovid sometimes experience, his doctor said. 

Aging has an impact on the body’s ability to fight off infection. "People sometimes forget," Griffin said. "Our immune system changes as we get older. What might be sniffles and something minor for a teenager or someone in their 20s, it’s always different (for an older person)."

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A month or two after a COVID infection, many older people find themselves short of breath after climbing a flight of stairs or a little more forgetful than they were before, Griffin added.

Running for president involves a lot of crowded rooms and hand-shaking and all three leading candidates — Biden, Republican nominee Donald Trump and independent Robert F. Kennedy Jr. — are over 70, Griffin noted.

"How wise is it to put an elderly man up for this role when we live in a world where we people are more vulnerable to things that they didn’t necessarily have to worry about six years ago?" he wondered aloud.