Health Care

COVID spike casts spotlight on America’s elderly political leaders

A new surge in COVID infections and hospitalizations — and first lady Jill Biden’s positive test — is putting a focus on the lingering risks of the coronavirus, particularly for an elderly political class in America.

The White House on Tuesday said President Biden, 80, will resume wearing a mask when indoors and near infected people. Biden has tested negative to date, and experienced “mild” symptoms when he was infected in 2022.

Biden is one of several elderly politicians in key positions of power. He’s likely to face GOP front-runner former President Trump, who will be 79 by Election Day next November, in what would be the oldest presidential match-up in history.

The average age of senators is 65, the highest on record. Senate Republicans are led by 81-year-old Sen. Mitch McConnell (Ky.), who has twice made headlines this year for freezing while speaking to reporters.

Sen. Dianne Feinstein (D-Calif.) is 90, and has experienced severe health complications after a prolonged absence recovering from shingles. 

Sen. Dick Durbin (D-Ill), who is 78, has suffered three COVID-19 infections in the past year. Still, the No. 2 Senate Democrat told reporters Tuesday that he doesn’t think there will be any additional precautions in the chamber.

Durbin acknowledged he is concerned about attendance issues, as an ill-timed absence could cost Democrats a key vote given the party’s slim majority. But he indicated it’s not a new issue and leadership can devise workarounds.

Public health experts say despite the emergence of new variants, there’s no greater risk today to an 80-year-old getting COVID-19 than there was a year or two years ago, assuming people are up to date on vaccinations.

“There’s always going to be a new variant. Fourty years from now there will be a new variant of COVID. Evolution is not going to stop,” said Amesh Adalja, a senior scholar at the Johns Hopkins University Center for Health Security.

“And the risk is really based on what underlying conditions may be present in people. So that’s the main issue, and this is true not just of COVID but if you look at influenza, the deaths tend to cluster in the elderly. Look at RSV,” Adalja said.

While age isn’t the only risk factor, older people have weaker immune systems, making it harder to fight off an infection. They are also more likely to have underlying conditions.

“The older you are, the less cushion you have to fight diseases. As we get older, that cushion gets thinner and thinner. So a small event can have a big impact as we get older,” said Sharon Brangman, chief of the geriatrics department at SUNY Upstate Medical Center in New York.

Still, a 70-year-old with no underlying conditions, for example, is less at risk than a morbidly obese 35-year-old.

But public health experts say anyone at higher risk for severe disease — including Biden and other aging leaders — should think about taking precautions like masking indoors in large crowds and testing regularly.

“If you want to reduce the transmission, you should test to make sure you’re not carrying it, and you should wear a mask in areas where there are crowds of people,” Brangman said.

“Now whether people want to do this or not starts to get gnarled up with politics.”

There are no mask requirements in the House or Senate, and lawmakers rarely wear them.

Cameron Wolfe, an infectious disease specialist and an associate professor at the Duke University School of Medicine, said older people “absolutely need to be viewing their own situation as different.”

Without speculating about specific politicians and their personal health conditions, Wolfe said “it is a more compelling argument to me that someone who’s 75, for example, not only takes the vaccine when it becomes available in the next month, but also has available rapid tests and sort of a plan to say, ‘Here’s how I’d go about getting an antiviral if I test positive.'”

The antiviral Paxlovid can reduce hospitalization up to 90 percent in unvaccinated patients, but it remains underutilized.

The federal government is on track to approve an updated COVID-19 vaccine as early as next week. Immunity from last year’s bivalent booster shot has waned, and a new shot is needed to target new variants. Health officials are urging everyone to get a new booster when it is available, regardless of age.  

Aside from vaccines and antivirals, the other tool experts and officials stress is testing.

“I think that testing is going to be part of our prevention moving forward, because people have to be able to test to make sure they’re not infected so that they can decide how to move around in crowded areas,” Brangman said.

White House press secretary Karine Jean-Pierre said Biden will be testing “regularly” due to his recent exposure as he heads to India and Vietnam for the Group of 20 summit.

The president has tested daily since Monday night, but Jean-Pierre has not disclosed if that will be the case going forward, or even what Biden’s regular testing cadence is.

COVID-19 testing sites in the Capitol complex closed at the end of May.

Limited COVID-19 tests may still be made available for members who want them as part of their official duties or travel, but otherwise offices rely on tests in the community, which are no longer widely available for free.

Adalja said it makes sense that Congress doesn’t offer tests.

“Offices never had testing for influenza. Offices never had testing for RSV. Offices have never had testing for strep throat,” he said. “COVID-19 is increasingly being handled like other respiratory viruses.”

Al Weaver contributed reporting

Tags Amesh Adalja COVID-19 Dianne Feinstein Dick Durbin Jill Biden Karine Jean-Pierre Mitch McConnell

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