By Dr. Valda Crowder
Coronavirus has infected the most protected person in the world for the second time in a row. First President Trump, now President Biden, have had COVID-19. And we cannot forget about Vice President Harris’s infection.
The news about the 46th President of the United States in quarantine raised a growing number of questions. If Biden, who was so careful – vaccinated and twice boosted – got COVID, should we even bother with a n95 or kn95 mask? Can we do anything to stop coronavirus? Are we likely to get this virus? Is this pandemic going to end?
Let’s move beyond answering a simple “yes” to all of these questions. We need to start with what we all know to stay healthy or recover quickly. After a week of isolation, the President has tested negative; but then tested positive again.
What can we learn from Biden’s experience with COVID?
Knowledge is our best defense during the pandemic. How can you identify risks and address them? In any situation from flying to a busy vacation spot or going to a crowded concert, we can make better decisions armed with more information.
If you are not an emergency medicine doctor facing sick patients on a regular basis, it is hard to keep track of the various flavors of coronavirus. To play an active role in sustaining your own welfare, it is helpful to know about the dominant strain. Read about the White House strategy manage BA.5, released July 12, 2022.
Like mobile phone upgrades with new and better features, the dominant strain of a virus advances, so our thinking must evolve too. We have that in common with the virus, we both want to live as long as possible.
Each version of the Omicron variant of coronavirus from the original version BA.1 to BA.5 represents many genetic changes, known as mutations. In late June, 37 percent of COVID infection cases were the BA.5 subvariant of Omicron, according to the New England Journal of Medicine. This number is expected to grow.
We judge viruses based on their ability to mutate. Does a virus have the ability to adopt? If so, how quickly can a virus adopt? For example, measles lacks the skills to adopt quickly. Influenza, like its distant relative the virus associated with COVID-19, is a master of change and does it quickly.
One well-publicized area of mutations is the spike protein, the surface of the virus. It allows the virus to attach and enter cells or more effectively infect us. The latest versions do a better job of infecting us than the original and other versions. This mutation means that we should wear a well-fitted mask indoors and frequently wash our hands with soap and water.
As coronavirus continues to become more transmissible and better able to elude vaccines and antibodies, this is not the time to relax our guard because it is summertime. Winter may be considered the busy season for COVID-19, but many places are experiencing surges now.
Biden was one of the over 120,000 new cases nationwide a day, according to the CDC Data Tracker. There is so much to learn from the president’s positive test results on July 21. The letter from his physician, Dr. Kevin O’Connor is a gold mine of information.
Testing. First and foremost, Biden routinely tests. Everyone should have a testing ritual. Dr. O’Connor knows that with a regular testing schedule the president most likely was infected within the past two days, the time of his last negative test.
Antigen and PCR tests. When the rapid antigen test came back positive, Biden received a second test, referred to as a PCR or polymerase chain reaction test. The two different tests measure different parts of the coronavirus. The antigen test measures whether or not you are contagious. Check the expiration date before using a test. The federal government mailed tests with one-month expiration dates.
The PCR test, considered more reliable, determines whether you have fragments of the genetic material in the coronavirus. Together the two tests confirm that the President has COVID with a high degree of accuracy.
Therapy. This information from the two tests coupled with mild symptoms allows the doctor to know that Biden was a good candidate for PAXLOVID, an antiviral which produces the best results early in the COVID life cycle. The medication prevents BA.5 from infecting new cells.
PAXLOVID is two pills of NIRMATRELVIR, a new protease inhibitor, and one tablet of RITONAVIR, an older drug known as half an HIV treatment regimen, taken twice a day for five days. Anyone with significant liver or kidney disease should seek medical advice from their physician before taking this medicine. Doctors may prescribe a lowered dose or no medicine depending upon the severity of their liver or kidney disease.
One note of caution is that some cases appear to improve and later rebound with symptoms returning to the patient. This just happened to Biden who tested positive again after the PAXLOVID treatment.
Contact Tracing. The White House announced that staff will notify people who came in close contact with the President and need to test themselves. Anyone who tests positive should tell their colleagues, friends, family and others who were close to them in the past five days to test for COVID.
Treatment Plan. Following the CDC recommendation, Biden was isolated for five days. Under a doctor’s care, Biden monitored his symptoms to make sure that they did not get worse. When he had a fever associated with COVID-19, he took acetaminophen (TYLENOL).
~ Dr. Valda Crowder is an emergency medicine physician; chair, Health Committee, Black Women for Positive Change.