White House press secretary Jen Psaki said today the president will likely mask and will not attend the “eating portion” of the dinner on Saturday, which is currently clocking in at more than 2,600 attendees. He’ll just show up for his speech and subsequent roasting. Even so, he’s 79. So Nightly asked our go-to public health experts to assess the president’s risk if he were to test positive, given what we know about his age, health, vaccination status and medical care. “Anytime a 79-year-old individual with dyslipidemia and atrial fibrillation contracts an acute infectious disease, it is always concerning. However, since the president is vaccinated and up to date with his boosters, he’s unlikely to have a severe bout of Covid although it could be uncomfortable and disruptive in a person like him. He also has prompt access to monoclonal antibodies and antiviral therapies, which would limit severity.” —Amesh Adalja , senior scholar at the Johns Hopkins Center for Health Security “I think it’s important to continue a full court press and do everything reasonably possible to prevent the POTUS from acquiring Covid. His age places him in a high-risk category even after his immunizations and boosts, and we’re seeing a fair number of breakthrough hospitalizations in his age group. Once transmission goes down in Washington, D.C. — and it won’t be much longer before that happens — then I believe it’s safe for President Biden to attend public events. However, until then, it’s best he avoid big gatherings in my opinion. “In the end, it’s all about community transmission.” —Peter Hotez , dean of the National School of Tropical Medicine at Baylor College of Medicine and co-director of the Texas Children’s Hospital Center for Vaccine Development “After reviewing President Biden’s medical records and knowing that he has had four shots of the vaccine, I would estimate his risk of getting ill from Covid if he is exposed as very low. “After two vaccines, the risk factors for a severe breakthrough infection, per the CDC, are if someone is immunocompromised and/or 65 and older with comorbidities, specifically diabetes, chronic kidney, cardiac, pulmonary, neurologic, and liver disease, which predispose to severe Covid infection. The president is generally healthy and does not have any of those risk factors for severe breakthrough infections after vaccination. “If he tests positive for Covid-19, he will be evaluated closely and likely offered Paxlovid (an oral antiviral) within the first five days after contracting Covid if he develops low oxygen levels or any other symptoms (e.g. shortness of breath) that are concerning for proceeding to severe disease (his cholesterol medication will have to be temporarily stopped due to drug-drug interactions with Paxlovid). “However, he does not actually fit the clinical criteria of being treated with Paxlovid, as he is neither unvaccinated at risk of a severe infection nor immunocompromised. Therefore, like many of his fellow political figures (such as Nancy Pelosi who is of similar age and health and did not have any symptoms when she tested positive), it is very unlikely he will become sick.” — Monica Gandhi , infectious diseases expert at the University of California at San Francisco “Biden would have a reassuringly low risk of severe disease or death — largely due to the benefits of being vaccinated and boosted. “Given his advanced age he would be at high enough risk of progression that he should receive Paxlovid as long as he doesn’t have any contraindications or prohibitive factors, which it doesn’t seem like he has from what we know. And while he has been reported to have atrial fibrillation and a remote surgery for brain aneurysms, his list of other comorbidities seems relatively short. His doctors should ensure that any medications he is on should not have any significant drug-drug interactions with Paxlovid & that he receives the correct dosing based on his kidney function. “That the president would get all the care he needs without delay is not a surprise — but is a reminder that this isn’t the case just yet for all Americans. With serious issues related to the roll out and distribution of Paxlovid, high-risk Americans who are not the president are the people I’m more worried about that cannot easily access the antiviral within the small window where it has the most benefit. Some of these people are not vaccinated; and a much bigger portion are still not boosted.” —Abraar Karan , infectious disease doctor at Stanford University Welcome to POLITICO Nightly. Reach out with news, tips and ideas at nightly@politico.com. Or contact tonight’s author at mward@politico.com or on Twitter at @MyahWard.
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