» White House is at risk of an outbreak within.
WASHINGTON — President Donald Trump’s advanced age and his immune system’s response will most strongly influence the course of his battle with COVID-19, a disease whose impact ranges unpredictably from no symptoms at all to rapid death, according to experts and research.
The president’s path over the next 10days— or possibly longer, if he develops an extended version of the disease—also maybe dictated by whether he inhaled a large amount of virus deep into his lungs.
Trump, famously opposed to the medical guidance that Americans wear masks inmost circumstances, may have left himself vulnerable with that behavior to receiving a heavy dose of the corona virus. COVID-19, the disease caused by the virus, has killed at least 207,000 people and infected more than 7.2 million in the United States, according to a Washington Post analysis.
“The odds are far and away that he’ll have a mild illness” as most people with the virus do, said Dr. Gregory Poland, an infectious disease specialist at the Mayo Clinic who has no role in Trump’s care.
People with underlying health problems also tend to have poorer outcomes. The 74-year-old president weighs 244 pounds, a total thatmakes him slightly obese at 6 feet 3 inches tall, according to information released by the White House after Trump’s physical exam in June. He takes a statin for high cholesterol and his blood pressure is somewhat elevated.
“This is a reminder that COVID-19 is an ongoing threat to our country and can happen to anyone,” said Tom Frieden, director of the Centers for Disease Control and Prevention during the Obama administration. “Learning more about when President Trump and others with whom he had contact last tested negative and first tested positive will help understand this outbreak and limit the risk of further spread.”
As of now, the most important factor is the president’s age. Human immune systems, which battle the virus, become less effective as we grow older. Even as the overall COVID-19 death rate in the United States has declined during the eight months of the pandemic, nearly 80 percent of fatalities occur among people 65 and older. Older men die more frequently than older women.
Someone in Trump’s age group faces five times the risk of hospitalization as does an18- to29-yearold and an even greater risk of death, said Graham Snyder, medical director of infection prevention and hospital epidemiology at the University of PittsburghMedical Center. The likelihood of Trump developing symptoms, and the severity of those symptoms, also increases with age.
“Age is very clearly the strongest predictor of not doing well with the virus,” Snyder said. “The likelihood of him developing symptoms, including death, is most strongly predicated on his age.”
According to the CDC’s best estimates, 5.4 percent of people 70 years or older who contract COVID-19 die. For people between 20 and 49, it is just two-hundredths of 1 percent.
Frieden said Friday on Twitter that a 74-year-old “has approximately 3 percent chance of death (and a) 10-15 percent chance of severe illness.”
It is not clear whether Trump has other underlying health problems.
Now that the virus has taken hold, doctors will closely monitor the response of Trump’s immune system. Many people who suffer the worst outcomes experience a “cytokine storm,” an overreaction of the body’s immune system that can ravage delicate blood vessels and lead to fluid buildup and pneumonia. Many of those patients require ventilators, typically in a medically induced coma, that essentially breathe for them.
The first five to seven days after Trump was infected — a date that may be difficult to determine — are critical. That is when he could develop the pneumonias, blood clots and bacterial infections that have made COVID-19 so deadly, though some complications also can come later.
The severity of Trump’s illness also may depend, in part, on how he contracted the virus. Many researchers believe the virus is airborne — that it can float distances on tiny exhaled particles smaller than respiratory droplets, which are heavy enough to drop out of the air.
That could lead to infection deep in the lung sand a more severe outcome, said Columbia University epidemiologist Jeffrey Shaman. Wearing am ask can help prevent that, research has shown.
The amount of virus transmitted to a patient— the viral load— is another important factor in disease progression, said Albert Ko, an infectious-disease epidemiologist at the Yale School of Public Health.
“For many infectious diseases, the higher your infecting inoculum dose is, the more risk you have of getting infected, the more risk you have of getting a disease and severe complications and dying,” Ko said.
“That’s something that’s hard to predict. It’s not like we’re measuring the number of viruses that someone was exposed to at the time they were infected.”
‘Odds are far and away that he’ll have a mild illness’ as most people do, doctor says