United States President Donald Trump announced on Twitter early on Friday (October 2) morning that he and First Lady Melania Trump had tested positive for the novel coronavirus. “We will begin our quarantine and recovery process immediately. We will get through this TOGETHER!” he wrote.

How serious is this development?

Just a positive test by itself is no cause for panic, or a signal for urgent action of any kind. The President’s physician, Sean P Conley, has said in a statement that “The president and First Lady are both well at this time, and they plan to remain at home within the White House during their convalescence.”

He said that he expected the President to “continue carrying out his duties without disruption while recovering”.

That said, Trump is 74 years old — he belongs to the demographic that has been the worst impacted by the virus across the world. The US Centers for Disease Control and Prevention (CDC) said in an advisory updated on September 11: “As you get older, your risk for severe illness from Covid-19 increases. For example, people in their 50s are at higher risk for severe illness than people in their 40s. Similarly, people in their 60s or 70s are, in general, at higher risk for severe illness than people in their 50s. The greatest risk for severe illness from Covid-19 is among those aged 85 or older.”

More than 2 lakh people have died of Covid-19 in the US so far. Eight out of every 10 of these deaths have been people aged 65 years or older.

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Trump is also overweight, which is one of the classic co-morbidities that make Covid-19 more dangerous. Based on his physical in April, CNN reported in June that he weighed 244 pounds — at 6 feet 3 inches tall, that meant a body mass index of 30.5, which is technically obese. According to the CDC, obese individuals are three times more likely than others to land up in hospital after being infected with the novel coronavirus.

However, Trump does not have any other known medical conditions that would put him at greater risk. CNN reported that his latest physical had detected a slightly high blood pressure, but no evidence of cancer, kidney disease, or diabetes, etc.

First lady Melania Trump is much younger than her husband at 50. She is also a former model and looks in excellent physical shape. But not much is known either about her general health or specific ailments, if any.

Is President Trump showing any symptoms?

It’s not known as yet. Reports from the US say the President’s aides are tightlipped on whether he was showing any symptoms.

However, The New York Times quoted unnamed sources at the White House as saying they had noticed that Trump’s voice sounded “raspy” on Thursday. The report did add the caveat though, that “it was not clear that it was abnormal for him (Trump), especially given the number of campaign rallies he has been holding lately”.

How did Trump catch the novel coronavirus?

It could be from anyone, really — he has been meeting a lot of people of late, and large numbers of those who attend his re-election campaign rallies are proudly without masks. The President is himself seen with a mask only occasionally (though he was seen wearing one last week when he visited the late Justice Ruth Bader Ginsburg lying in state at the United States Capitol), which makes him very vulnerable to the virus.

A couple of hours before he made the announcement about himself and the First Lady, Trump had tweeted that one of his closest advisers had tested positive for Covid-19.

“Hope Hicks, who has been working so hard without even taking a small break, has just tested positive for Covid 19. Terrible! The First Lady and I are waiting for our test results. In the meantime, we will begin our quarantine process!” he had posted on Twitter.

What are the implications of the President getting Covid-19?

Even if the President is able to continue working while in isolation, the diagnosis presents challenges for all those who are physically close to him, including the Secret Service who protect him. However, the use of modern technology will likely enable him to sufficiently distance himself from most aides.

A paper published by the nonprofit public policy thinktank Brookings Institution in July had underlined that should the President test positive, it would be important that those in the line of succession are protected.

“It would be important to keep Vice President (Mike) Pence, Speaker (Nancy) Pelosi, Senator (Chuck) Grassley (President Pro Tempore), and members of the cabinet isolated from the President. It would be especially important to ensure that the Vice President have limited contact with individuals generally to reduce his chances of contracting the virus as well,” the Brookings paper said.

Should Trump fall seriously sick — and there is indeed nothing to suggest as of now that he might — and has to “be administered therapies that will impair his ability to perform the duties of office”, the Brookings paper said, “under Section 3 of the 25th Amendment to the Constitution, the President can transmit to the House and Senate ‘his written declaration that he is unable to discharge the powers and duties of his office’”.

When Section 3 of the 25th Amendment is invoked, the Vice President — in this case Pence — becomes the “Acting President” until such time as the President notifies Congress that he is able to perform his duties once again.

This happened when Ronald Reagan was President in 1985, and then again in 2002 and 2007, when George W Bush was President. In each of this occasions Section 3 was invoked for medical reasons, when the President had to be sedated for some hours for a surgical procedure.

How might the election race be impacted by this situation?

This is where the President and his campaign would be the most concerned.

Election Day — November 3 — is just over a month away now, and Trump’s positive test and quarantine means he can no longer address in-person rallies for a yet-unknown number of days.

This will likely frustrate Trump immensely, because his favourite campaign style is one in which he is able to interact with his supporters, and draw energy from their cheering. Isolation in the White House can be expected to have an impact on both his campaign plans and his mood.

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It is probably too early to speculate on what might happen if he falls more seriously ill, and perhaps has to be hospitalised like Prime Minister Boris Johnson of the United Kingdom was. But should that contingency indeed arise, it is quite likely that questions will be raised over whether he should continue to be on the ballot.

Needless to say, his own illness will deliver a crushing blow to his claims of having handled the crisis well.

Not only has Trump refused to wear a face covering in public, he has repeatedly questioned their effectiveness, mocked his Democratic rival Joe Biden for insisting on wearing one, and claimed that the “China virus” is about to be defeated.

Literally hours before he announced he was infected, the President had told the 75th annual Al Smith Dinner on October 1 that “the end of the pandemic is in sight, and next year will be one of the greatest years in the history of our country”, according to the official White House transcript of his remarks.

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