President Biden’s covid diagnosis is a case study in what it means to be vaccinated, boosted and have access to Paxlovid

President Joe Biden’s positive test for covid, announced on Thursday, comes as both a reminder of the continued severity of the pandemic and a marker of how far treatments for the virus have come, public health experts said.

“He is fully vaccinated and twice boosted and experiencing very mild symptoms,” said a statement from White House press secretary Karine Jean-Pierre. Biden later tweeted that he is “doing great.”

The 79-year-old president’s mild condition is in sharp contrast to what is seen among the unvaccinated and un-boosted elderly who catch covid, who are roughly 18 times more likely to die from an infection, according to data from the Centers for Disease Control and Prevention. About 4.5 million Americans 65 and older remain unvaccinated more than two years after the shots became available. Boosters are even less popular in that age group, with only about a third of older Americans eligible to receive second boosters receiving them.

It’s a vastly different landscape than in October 2020, when then-President Donald Trump fell ill. Vaccines were still in the final stages of testing, not yet available to the public, and treatments were scarce. Then, serious complications led to the unvaccinated president being rushed to Walter Reed National Military Medical Center for treatment with then-experimental monoclonal antibodies. Their use required a signoff from the FDA chief, Stephen Hahn. That treatment is no longer effective against the BA.5 variant.

“Any time an elderly person contracts COVID is concerning and this is not surprising giving the ubiquity of the virus in the country,” Amesh Adalja, a senior scholar with the Johns Hopkins Center for Health Security, told Grid in an email. “By being vaccinated, boosted, and receiving Paxlovid he will likely fare well.”

The challenge now is in convincing people to take advantage of these tools as the third year of the pandemic unspools.

About 350 people a day are dying of covid, with the highest death rate among the unvaccinated over age 65. The ongoing surge of the BA.5 omicron variant continues to put many U.S. counties in the “high risk” category for virus transmission.

Biden is mostly suffering from a runny nose, fatigue and a dry cough that began on Wednesday evening, according to a letter from the White House physician. He had a full physical exam and is healthy, symptoms aside, said White House covid czar Ashish Jha in a Thursday afternoon briefing. Biden will continue working in isolation for the next five days and until he tests negative for the coronavirus, according to the statement. (The White House said he last tested negative on Tuesday.)

Biden is being treated with the antiviral drug Paxlovid, which is normal for someone in a high-risk group. “I anticipate he will respond favorably, as most maximally protected patients do,” said his physician, Kevin O’Connor, in a letter released by the White House. No further cases have been reported among White House staff.

Contact tracing of recent close contacts of the president has started to warn people of possible exposure to the virus. Jean-Pierre said “it doesn’t matter” where Biden was infected and noted his busy travel schedule. “He engages with a lot of people,” she said. The president travelled to Somerset, Massachusetts, to give a speech on climate change on Wednesday. Although the White House pledged to report if its staff find out where Biden was infected, testing for covid has largely collapsed in the U.S. in the last year, making such an investigation unlikely to come to a definite conclusion.

The White House’s 81-year-old chief pandemic scientist, Anthony Fauci, in June had a mild covid case that rebounded after treatment with the antiviral, requiring a second course of the drug.

Thanks to Lillian Barkley for copy editing this article.