What is US President Biden’s Covid-19 treatment plan?

Here’s a look at the possible treatments US President Joe Biden will receive for Covid-19 and the risks he faces, having most likely been infected with the fast-spreading but less severe BA.5 variant.

Treatments

At 79, the president falls into a high-risk category for Covid but benefits from medical advances that improve his chances of full recovery.

Biden received four doses of highly effective Covid-19 vaccines – a two-course primary series and two booster shots that protect against serious illness and death.

The president also started taking Pfizer Inc’s Paxlovid antiviral drug cocktail, a combination of two pills that in clinical trials have been shown to reduce the risk of serious illness by almost 90% in patients with high risk if taken within the first five days of infection.

Read also | Joe Biden tests positive for Covid-19, has ‘mild symptoms’

Doctors say a lot has changed since President Donald Trump was infected in 2020 at age 74.

“This is a very different situation from Trump’s infection, which occurred before medical countermeasures such as the vaccine and Paxlovid became available,” wrote expert Dr Amesh Adalja. in infectious diseases at the Johns Hopkins Center for Health Security, in an email.

Dr. Jeremy Faust, an emergency medicine specialist at Brigham and Women’s Hospital in Boston, agreed.

“Biden is not remotely in the same risk category as Trump,” Faust tweeted, citing Biden’s four vaccine doses and the drug Paxlovid.

Dr. Bruce Farber, chief of infectious diseases at Northwell Health in New York, which does not treat the president, said Paxlovid is likely the only treatment the president will receive unless his symptoms worsen.

Risks and Complications

A small but significant percentage of people who take Paxlovid will experience a relapse or rebound that occurs a few days after completing the five-day course.

Such was the case with Dr. Anthony Fauci, Biden’s chief medical officer, who last month was infected with Covid, took Paxlovid, started testing negative and then experienced a rebound in the infection.

Fauci was given a second course of Paxlovid by his personal physician, although the Centers for Disease Control and Prevention said there was no evidence such additional treatment was needed.

Even with vaccines and the benefit of strong antiviral medication, a small percentage of older people end up in hospital.

A key indicator to watch will be the president’s oxygen saturation level. If it drops below 94%, or shows signs of difficulty breathing, it would warrant hospitalization, experts said.

Biden’s physique at the end of 2021 showed he was relatively healthy. He is not obese, a risk factor with Covid, and he does not have common health risks for older people, such as heart failure.

The only exception is that he has a common condition known as atrial fibrillation, or AFib, an irregular heartbeat that increases the risk of heart attacks and strokes.

The condition increases the president’s risk of serious illness, Adalja said. “I think that will probably be offset by his vaccination status and Paxlovid.”

The president takes the blood-thinning drug Eliquis, known generically as apixaban, to treat his atrial fibrillation, as well as the cholesterol-lowering statin Crestor.

Because both drugs interact negatively with Paxlovid, the White House said the president had temporarily stopped taking them.

Yale cardiologist Dr Harlan Krumholz said short periods without blood thinners added minimal risk. Atrial fibrillation was also not a major concern due to the current variant.

“This variant is almost impossible to escape and that’s why we’re seeing increased rates of hospitalizations and deaths – but excess deaths are still well below the peaks of previous waves,” he said.

Kevin E. Boling