President Biden's COVID case raises many questions for the nation

President Joe Biden has COVID-19. His spokespeople say he has a mild case and that his symptoms are, as his physician wrote Monday, "almost completely resolved." Let’s hope his progress continues. 

While the focus of coverage is on his day-to-day health, there are broader implications for how America and the world battle this pandemic. These include whether Biden did enough to lesson his risk of contracting the disease, the kind of care he will receive versus what other Americans can access, and what having the disease might mean for his presidency and political future.

Biden is 79. That in itself puts him in a high-risk category for catching and suffering from new COVID variants. Despite that, and despite the fact that his own Centers for Disease Control and Prevention and other public health officials urge masking, he did not. He was seen prior to his diagnosis all around the world unmasked. He also did not socially distance, nor did he avoid indoor settings likely to have poor ventilation. Americans already not masking very much or insisting on ventilation upgrades are highly unlikely to do so if the message from the White House is that catching COVID at this point is both inevitable and not a big deal.

Biden has access to very good health care. He has boutique medicine — his own doctor and a team of others ready to step in, including specialists at Walter Reed Hospital in nearby Bethesda, Maryland. He has had four shots, is already on the antiviral Paxlovid and is isolating comfortably while continuing to work. That is fine but too many Americans can’t receive anything close to adequate COVID-19 care.

Many have no access to primary care which is often crucial for the success of testing. Others cannot find vaccines to boost themselves, or due to poor messaging, think they are fully vaccinated if they received two shots. Some still can’t find vaccines for their kids. Others don’t have any or the right insurance to cover antiviral drugs. And many are working two jobs or a job with little sick time or family leave so they can’t and aren’t isolating even when they know they are sick. Presidents are going to get optimal care but the rest of America should at least expect decent care during a pandemic.

What if the president were to take a turn for the worse? The nation still has not figured out how to transparently invoke the 25th Amendment. Donald Trump’s doctors did not tell the truth when he wound up with serious respiratory disease at Walter Reed and insisted on taking a spin around the hospital parking lot, trying to fool us about his health while putting the Secret Service at risk.

And if Biden’s COVID should become chronic, in the admittedly unlikely chance that he becomes debilitated by long COVID, will we know, given that our adversaries will want to know? With there being lots of talk already of him being too old to run again, would longterm COVID end his political career?

Biden is likely to pull through COVID-19 as do most others catching the new variants who have been fully vaccinated with four shots. But even if he does, his recovery may signal the end of the ability of the nation to mount any vigorous future effort to minimize the impact of COVID on the rest of us.

This guest essay reflects the views of Arthur Caplan, director of the Division of Medical Ethics at New York University's Grossman School of Medicine.