How Risky Is COVID for an 81-Year-Old?

Today, for the third time in two years, President Joe Biden tested positive for COVID-19, the White House said. The president was in Las Vegas—attempting to convince voters, donors, and his fellow lawmakers that he is still the candidate best poised to defeat former President Donald Trump in November—when he fell ill with a runny nose and cough, according to a White House statement. He’s already taking the antiviral Paxlovid and will isolate at his home in Delaware.

Since Biden’s first two COVID bouts—an initial case and a rebound shortly thereafter in 2022—much has changed for the president, and for the trajectory of the pandemic. Biden’s cognitive abilities have come under more intense scrutiny, especially following a debate with Trump last month in which the president demonstrated difficulty completing sentences and holding on to a train of thought. Reported rates of COVID infections, hospitalizations, and deaths have declined—thanks in large part to vaccination—and precautions have become ever more rare. Biden is vaccinated and has superb access to medical care. Chances are, he will be fine. Yet one basic fact remains unchanged: COVID is still capable of inflicting great damage, especially upon the elderly.

In June, according to provisional CDC data, about four out of every 100,000 Americans over the age of 75 (or 0.004 percent) died with COVID-19. That’s a far cry from the staggering fatality rates of 2020 (roughly 0.17 percent for the same age group in April of that year), but still sizable in comparison with younger Americans’ risk. The June 2024 COVID death rate among 30-to-39-year-olds, for example, is two out of every 10 million. Hospitalizations tell a similar story for the elderly: Last month, more than 60 out of every 100,000 Americans over 75 were hospitalized with COVID. And according to the CDC, this is likely an undercount.

Still, the risks of COVID seem to increase over even just a few years of life for the elderly. People 75 or older are currently 3.5 times as likely to be hospitalized and seven times as likely to die with COVID as people ages 65 to 74. And people in their 80s can accumulate health problems with startling speed. Heart disease, diabetes, kidney disease, cancer, and stroke—all maladies more likely to affect older people—increase a person’s chances of serious complications from COVID.

Biden is as likely as any American of his age to come away from this infection with minimal long-term effects. So far, according to the White House’s statement, his symptoms are mild, he has no fever, and his blood-oxygen level is normal. He was first vaccinated against COVID in 2020 and has received several shots since, most recently in September. Vaccines are proven to mitigate the most serious risks of the disease, especially among the elderly. And should things take a turn, Biden, as president, has care teams and resources at his instant disposal.

That said, as far as COVID is concerned, good for an 81-year-old is not reliably good. And COVID does not have to kill someone to have troubling, lasting effects. Even mild bouts of COVID can lead to symptoms that linger for weeks or years and range from inconvenient to debilitating. In a study published today, about 7.8 percent of patients infected since Omicron became the dominant variant in the United States developed long-term symptoms. Given current concerns about the president’s health and brainpower, any further deterioration is a sobering prospect. A report published by the National Academies of Science last month found that older Americans are especially at risk of cognitive impairment following a COVID infection. What would that mean for a man who has already shown signs of substantial decline—a man subjected to the rigors of one of the most demanding jobs on the planet during the most crucial political campaign of our lifetimes, who refuses to lift the burden of American democracy from his aging shoulders?

Ten days ago—after Biden’s feeble debate performance, but before a gunman attempted to assassinate his opponent at a rally—the president made a perplexing statement. Addressing the crowd at a Pennsylvania campaign event, he declared, “I ended the pandemic.” The reality is that COVID continues to upend lives every day. Americans should be mindful that it could still upend elections, too.

Lila Shroff contributed reporting.