Biden has gone into isolation at his home in Rehoboth Beach, Delaware, after testing positive on Wednesday with mild symptoms, the most striking example of the virus’s reach. At a July 7 campaign event in Pennsylvania, Biden contrasted himself with Donald Trump by declaring, “I ended the pandemic — he didn’t.”
His administration is no longer treating COVID as a public health emergency, but rather as a routine respiratory virus that must be slowed down with an annual vaccination campaign. This strategy reflects how SARS-CoV-2 has established itself as a common pathogen that no longer overwhelms hospitals or the health care system, a threat that led to drastic measures to contain transmission early in the pandemic.
“Covid is not gone. Covid is here to stay, probably forever, and we will typically see two to three waves a year,” said Ashish Jha, dean of the Brown University School of Public Health who stepped down as White House coronavirus coordinator last year.
“It begs the question of how worried we should be,” Jha added. “It sounds scary, but it’s not, for most people.”
At 81, Biden is in the age group most at risk for serious complications from COVID. Older people are more likely to have milder symptoms if they are up to date on their vaccinations and receive antiviral treatment early in their illness, experts say. Biden began a Paxlovid regimen on Wednesday and received an updated coronavirus vaccine in September. White House officials did not respond to questions about whether Biden received a second dose of the latest vaccine, as recommended for seniors.
The current Republican National Convention in Milwaukee, with an estimated 50,000 attendees, has created opportunities for COVID transmission in an arena full of people without masks. (Masks are also unusual at Biden campaign events.)
Phil Griffin, a congressional delegate from Winchester, Virginia, said he brought two masks in case organizers required them, but he wasn’t worried about COVID, even after Biden tested positive.
“I haven’t heard of anyone in Virginia or any of the delegations around us — Michigan, Ohio, Louisiana — who has had any symptoms,” Griffin said. “So we’re blessed, I think, as is the president,” he added, referring to Trump’s narrow escape from a would-be assassin. “We’re all blessed with good health — as far as we know.”
Meanwhile, medically vulnerable Americans are facing another summer of COVID-19 risk.
Elizabeth Kidd watched with bated breath as emails poured in daily from her mother’s nursing home in Northern Virginia beginning in late June, warning of a growing outbreak, including in the memory care unit where her mother is being treated for dementia.
Kidd, 52, takes medication that suppresses her immune system to manage her Crohn’s disease, which puts her at greater risk for COVID. Her mother is 79 and has trouble remembering what COVID is. So Kidd didn’t visit for two weeks, worried that the prolonged isolation would make it easier for her mother to forget who she is.
“It’s all pretty nerve-wracking,” Kidd said. “I don’t want COVID, and I don’t want to accidentally be the one to bring COVID back to the memory unit.”
Fortunately, her mother did not get sick, and Kidd visited the facility on Tuesday after it had no active cases but was still requiring masks. While Kidd shared updates with her mother about the grandchildren she doesn’t always know are her grandchildren, she also reminded her that COVID is like the flu, which is highly contagious.
Since the pandemic began, the number of Covid cases has increased every summer. Experts blame this on increased travel, large gatherings such as weddings and conferences, the emergence of new variants and even the heat, which keeps people indoors, where the virus spreads more easily.
“When we’re outside, it’s hard for COVID-19 to spread, but it’s been so oppressively warm lately, especially in the Southwest United States, and people are spending a lot more time indoors,” said Andrew Pekosz, a professor of microbiology at the Johns Hopkins Bloomberg School of Public Health who specializes in respiratory viruses like COVID-19.
The continued rise in COVID coincides with the emergence of KP variants called FLiRT and the closely related LB.1, which accounted for 85 percent of new cases as of early July, the CDC estimated. They have mutations that allow the virus to spread more easily than earlier variants and more efficiently infect people with some immunity. But they do not appear to cause more severe disease.
WastewaterSCAN, a private initiative that tracks municipal wastewater data, found a 54 percent increase in viral RNA copies per gram of solids in wastewater between June 30 and July 12. Viral levels were high in most regions and moderate in the Midwest.
“You may have some summer travel plans that you don’t want to be ruined or affected by your illness,” says Alexandria Boehm, a professor of environmental engineering at Stanford University and principal investigator of WastewaterSCAN. “If you are immunocompromised, this might be a good time to think about wearing a mask or just being cautious about going into crowded places.”
According to Demetre Daskalakis, director of the CDC’s National Center for Immunization and Respiratory Diseases, the increases in the virus in wastewater should not be viewed in isolation. Authorities say there have been no significant increases in serious outcomes, such as hospitalizations and deaths.
While COVID-19 is no longer hospitalizing and killing as many people as it once did, even mild cases can still be devastating and cause illness that feels worse than the patient might expect.
Jay Brodbar, who hasn’t flown since the start of the pandemic, regularly wears a mask indoors and received his last coronavirus vaccine shot in April, had hoped to continue avoiding the virus when he embarked on a two-week road trip through the Northeast. But the 74-year-old started developing fever and chills on July 8 while in New York and tested positive the next day.
Brodbar cut his trip short by a week, driving eight hours back home to Toronto. He was reeling from what he described as the worst sore throat of his life and said he felt better after taking Paxlovid and a steroid nasal spray.
The summer surge in COVID comes at an awkward time for public health officials who have made fall vaccination campaigns the cornerstone of their response. The current vaccine targets the defunct XBB variants. Updated vaccines won’t be available for at least a month, leaving patients and their health care providers to debate the tradeoffs of getting an outdated one now shot that still offers some protection or wait for the new version.
Reinfections pose a lasting health risk, particularly for people in high-risk groups. A severe case of COVID increases the chance that someone will end up in the hospital with COVID again, according to a study published earlier this month in Communications Medicine.
Persistent symptoms, known as long COVID, which can follow even mild cases, remain one of the most confusing consequences of the virus. Long-term covid has become less common as hospitalizations decline, but research shows that severe illness is a primary risk factor.
While public health officials say Americans now have the tools to fight COVID, those tools are becoming increasingly difficult to access. The federal government has halted the widespread distribution of free masks and testing kits. The federal Bridge Access Program, which provides free COVID-19 vaccines to the uninsured, ends in August.
Health officials are urging people at higher risk of developing severe COVID-19 to test when symptoms appear and to take Paxlovid early to stop viral replication, as Biden is doing.
But other Americans are having a harder time than the president getting Paxlovid. Many pharmacies are out of stock due to low demand. And those who do manage to get the medication sometimes receive sky-high bills.
Robyn DeChabert, 27, was given a prescription for Paxlovid when The Virginia Beach resident went to the emergency room Sunday with trouble breathing and a painful cough. She credited the antiviral treatment with speeding her recovery the last two times she contracted COVID, when she got the medication for free because the federal government covered the cost.
But when her sister went to pick up the prescription for her this time, The pharmacy charged her $1,700, which she couldn’t afford. Her sister left without the medication. DeChabert will be uninsured until she starts her service job next month.
“It still amazes me that a medication that was accessible to many people two years ago is now too expensive for many Americans,” said DeChabert, who obtained Paxlovid from a friend. “I shouldn’t have to go into medical debt to live.”
Pfizer, the manufacturer of Paxlovid, offers a number of patient assistance programs to help cover the costs that people without health insurance or those with government insurance have to pay. The program also offers up to $1,500 in co-pay assistance for people with private insurance.
Kit Longley, a Pfizer spokesperson, said it takes a few minutes to enroll in both programs to get access to electronic vouchers. But some providers and pharmacies aren’t telling their patients, and DeChabert said she was never told that help was available.
Laura Vozzella contributed to this report.