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President Biden tested positive for Covid-19 Thursday — a coronavirus case that reflects both the high ongoing levels of transmission of the virus and its ability to cause infections even in people who have layers of protection.

Biden, 79, has “very mild symptoms” and has started taking the antiviral Paxlovid, the White House said. He is isolating.

In a memo, Kevin O’Connor, Biden’s physician, wrote that the president has a runny nose and is fatigued. He also has a cough, which started Wednesday evening.

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Biden last tested negative Tuesday, according to the White House.

As a nearly octogenarian, Biden is at higher risk of more serious outcomes from Covid-19 — age is the single biggest risk factor for severe complications. But his case also underscores how far the country has come in its fight against the SARS-CoV-2 virus.

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Biden has been vaccinated and received two boosters (people 50 and older are eligible for second boosters). The shots’ power to block infections has been dampened by newer variants, but they continue to provide robust protection against more severe illness. Oral antivirals like Paxlovid have also been shown to keep people from getting so sick they need to be hospitalized.

When former President Trump got Covid-19 in October 2020 and had to be hospitalized, vaccines had yet to be authorized, and the only available treatments were given intravenously.

In some ways, Biden’s infection is not a surprise. Most Americans have had Covid-19 infections, and many other White House officials and top politicians have contracted the virus. His health advisers have acknowledged that Biden could very well get Covid one day.

Biden received his second booster on March 30. Studies have shown that antibody levels — which are correlated to how well someone can prevent an infection entirely — fall off in a matter of months.

In April, in a discussion about the then-possibility of Biden getting Covid, William Hanage, an epidemiologist at Harvard’s T.H. Chan School of Public Health, noted that Biden was vaccinated and boosted and would receive top medical care. “He’s also relatively healthy,” Hanage told STAT then. “Under the circumstances, it’s about as good as you can get.”

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