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President Biden just tested positive for Covid-19. What happens now?

A number of senior US government officials have tested positive in recent months. The president is the latest.

President Biden, wearing a blue mask and a dark suit, gets out of a black vehicle, looking past its door into the camera.
President Joe Biden has tested positive for Covid-19.
Drew Angerer/Getty Images

President Joe Biden tested positive for Covid-19 on Thursday, July 21, according to an announcement from White House press secretary Karine Jean-Pierre.

“He is fully vaccinated and twice boosted and experiencing very mild symptoms,” Jean-Pierre said in a press statement. “He has begun taking Paxlovid. Consistent with CDC guidelines, he will isolate at the White House and will continue to carry out all of his duties fully during that time.”

Biden will use phone and Zoom to continue participating in White House meetings, and has been on calls with administration staff this morning, she said. He last took a Covid-19 test on Tuesday, when he tested negative, and he’ll work in isolation until he tests negative again.

Jean-Pierre noted, too, that the White House is in the process of notifying any direct contacts Biden has interacted with on Wednesday and Thursday, including members of Congress and members of the press, and that it will provide a daily update about Biden’s medical status while he is working in isolation.

Biden himself posted a video on Thursday expressing appreciation for people’s concerns and sharing that he was experiencing mild symptoms. “I’m doing well, getting a lot of work done,” he said in the clip, which showed him standing on a balcony outdoors. “In the meantime, keep the faith. It’s going to be okay.”

Biden counts as one of the most recent of the nearly 90 million infections recorded in the US since the start of the pandemic, and among the prominent US lawmakers who’ve tested positive in the last few months. In April, Vice President Kamala Harris tested positive for Covid-19 and continued to work while isolated at her residence.

Since the president is fully vaccinated and has had two booster shots, his risk of serious symptoms should be significantly reduced. The situation is very different from when President Donald Trump was infected with the coronavirus in October 2020, before vaccines were approved; Trump developed serious complications that sent him to Walter Reed Medical Center, where he was given a suite of medications after his oxygen levels became dangerously low while also receiving oxygen support.

Still, though he is well-protected, Biden’s age — he’s 79 — puts him in a category considered at higher risk for serious complications, so he will be monitored closely by the White House medical team for any signs of worsening symptoms.

Biden’s Covid-19 test comes as US case numbers have been rising; the highly transmissible BA.5 is now the dominant strain in the US. But official guidance, including from the Biden administration, has relaxed since the omicron surge. Outbreaks are going to happen when the country at large decides to live with a virus.

Biden does, however, carry responsibilities most people don’t, and because Covid-19 continues to pose more of a risk to older people, his contracting the virus raises questions about the risks to him specifically and what happens if he becomes unable to perform his official duties.

How much danger is Biden in?

Infectious disease experts don’t expect Biden to develop a serious case of Covid-19. In general, older people face the highest risk of serious complications from a Covid-19 infection, with those over 50 facing significantly higher rates of hospitalization and death than younger age groups.

The risk grows as you move up in years. CDC data from January 2022 revealed that people between the ages of 65-74 had a significantly higher death rate — 45 times higher — than people 18-29 during this past winter’s omicron wave. For people over 75, the death rate was 136 times higher than the 18-29 age group in that same timeframe. Biden’s most recent medical exam reported he was taking medicine for atrial fibrillation and high cholesterol. Those conditions are not named by the CDC as giving a patient a higher risk from Covid-19.

Vaccination significantly lowers the risk of serious illness, especially after booster shots. One recent study out of Israel found that the second booster shot substantially reduced the risk of death in people over 60 during the omicron wave, compared to people who had received one extra dose. But the benefits of that second dose appear to be temporary, starting to wane after a few months, and the study looked at an earlier variant. Biden received his second booster shot on March 30.

“All one can do now is monitor symptoms, oxygen levels, and treat him with Paxlovid,” says Johns Hopkins University infectious disease expert David Celentano.

Arturo Casadevall, also an infectious disease specialist at Johns Hopkins, noted that Covid-19 becomes more concerning if a patient contracts an illness like pneumonia and experiences lung inflammation. “People who are vaccinated, it’s much, much lower risk to progress to that stage of the disease. On top of that, Biden is taking an antiviral,” Casadevall told Vox.

According to current guidelines from the Centers for Disease Control and Prevention, Biden will need to quarantine for at least five days, and he’ll continue to carry out the duties of the presidency in isolation, per the White House.

There are clear routes for Biden to take if he becomes so ill that he can’t serve in his role. As Vox’s Andrew Prokop has explained, if the president is too incapacitated to complete his responsibilities, the 25th Amendment offers a way to temporarily transfer power to the vice president:

If the president submits a written declaration to the speaker of the House and the Senate president pro tem, the VP will take over as acting president and assume all presidential powers. However, if the president later wants to reclaim his powers, he can do so, simply by sending another written declaration.

Were Biden to become this sick, he could temporarily hand powers over to Vice President Kamala Harris, though he could take those powers back at any time. It’s the same protocol that was observed in 2021 when Biden underwent a colonoscopy and Harris served as president for 85 minutes.