🔒 Donald Trump and Covid-19: What we know, what happens next – Wall Street Journal

By Natasha Khan, James Hookway and Alex Leary

President Trump and first lady Melania Trump both tested positive for Covid-19. Here’s what we know.

How did President Trump and first lady Melania Trump get infected with the new coronavirus?

That isn’t known. The president announced the coronavirus test results in the early hours of Friday. The news came hours after Mr. Trump confirmed that Hope Hicks, a top adviser who traveled with him earlier this week, had tested positive for the virus. The president and first lady are among at least seven people with positive tests who attended the Sept. 26 Rose Garden ceremony where Mr. Trump introduced Judge Amy Coney Barrett as his Supreme Court nominee.

How old are Donald and Melania Trump? Are they at higher risk?

President Trump is 74 years old; Melania Trump is 50. The risk for severe illness from Covid-19—meaning anything requiring hospitalization or a ventilator—increases with age, with older adults at the highest risk, according to the Centers for Disease Control and Prevention. People in their 60s or 70s are, in general, at higher risk of severe illness than people in their 50s, according to the CDC. However, the greatest risk for severe illness is among those aged 85 or older.

What is Mr. Trump’s condition?

There is a lack of clarity on that question. The president was transported late Friday afternoon to Walter Reed National Military Medical Center in Bethesda, Md., “out of an abundance of caution,” White House Press Secretary Kayleigh McEnany said. On Saturday the White House physician, Dr. Sean Conley, said he was “extremely happy” with the president’s condition, but a person familiar with Mr. Trump’s health said there was more cause for concern.

Dr. Conley said the president’s symptoms of a mild cough, nasal congestion and fatigue were improving and he hadn’t had a fever for 24 hours. But he didn’t give a date for the president’s release.

After Dr. Conley’s briefing on Saturday, another person familiar with the president’s health told reporters that Mr. Trump’s vitals over the last 24 hours were very concerning and that the next 48 hours would be critical. “We’re still not on a clear path to a full recovery,” the person said.

What treatment is he receiving?

Dr. Conley declined to provide a definitive answer on whether Mr. Trump had ever received supplemental oxygen, despite repeated pressing. He said Friday that as a precautionary measure, the president received an eight-gram dose of Regeneron Pharmaceuticals Inc.’s antibody cocktail. He has also been administered the antiviral drug remdesivir, which has been cleared for emergency use by regulators. In addition, he has been taking zinc, vitamin D, famotidine, melatonin and a daily aspirin, according to the White House.

Monoclonal antibodies, administered with a single infusion, have shown promising early results in treating patients earlier in the course of their disease by mimicking the natural antibodies the immune system makes to fight off viruses. The most advanced of these agents, under development by Eli Lilly & Co. and Regeneron, are still in clinical trials and haven’t been cleared by regulators.

Regeneron said Mr. Trump received the experimental drug under a compassionate-use request, which allows unapproved medicines to be used in patients with serious diseases who don’t have other treatment options.

How is Mr. Trump’s general health?

In a June memo, Dr. Conley said Mr. Trump remained healthy. Mr. Trump was reported to be 6 feet, 3 inches tall and weighed 244 pounds. That narrowly put him in the obese category, according to a CDC calculator of body-mass index. Mr. Trump also takes medication used to treat high cholesterol, and the president’s cholesterol numbers are in the range that the CDC considers to be normal.

What happens if the president is incapacitated?

If the president’s condition were to worsen, he could temporarily transfer power to Vice President Mike Pence under Section 3 of the 25th Amendment. White House communications director Alyssa Farah said there would be no transfer of power with the president’s move to Walter Reed. “Absolutely not,” she said.

Has a president handed power to a vice president before?

Yes. In 1985, President Reagan had a colonoscopy. Vice President George H.W. Bush was then acting president for nearly eight hours, until Mr. Reagan signed a letter declaring himself able to resume his duties.

Similarly, President George W. Bush invoked Section 3 to temporarily transfer his powers to Vice President Dick Cheney in 2002 ahead of a colonoscopy. He did the same again in 2007.

What if Mr. Trump is incapacitated without handing power to the vice president?

Article 25 contains a provision in Section 4 empowering the vice president and a majority of Cabinet officials or “such other body as Congress may by law provide” to inform Congress that the president is unable to carry out his duties. This allows the vice president to take over as acting president. The president then resumes his duties after informing Congress that he is able to do so, unless Cabinet officials or another body declares otherwise. Congress would then gather within 48 hours to decide the matter. If two-thirds of the House of Representatives and the Senate each vote that the president is unable to discharge his duties, then the vice president remains acting president until the next scheduled presidential election.

What if Mike Pence gets sick?

If the acting president becomes incapacitated, then under the presidential line of succession the powers and duties of the presidency pass to the speaker of the House of Representatives, Rep. Nancy Pelosi (D., Calif.), then to the president pro tempore of the Senate, Sen. Chuck Grassley (R., Iowa), and then to eligible Cabinet secretaries.

Vice President Pence and the second lady both tested negative, his press secretary wrote Friday on Twitter.

Have other world leaders been infected by the new coronavirus?

U.K. Prime Minister Boris Johnson fell seriously ill with Covid-19 earlier this year, when he was hospitalized in intensive care. He was 55 at the time. Brazilian President Jair Bolsonaro, who had played down the severity of the pandemic and frequently appeared in public without a mask, has recovered after contracting the disease over the summer. Honduran President Juan Orlando Hernández and dozens of high-level officials and politicians around the world have also been infected over the course of the pandemic.

What would happen if President Trump had to drop out of the race?

It isn’t clear how long Mr. Trump will be sidelined and there is no indication he won’t be on the ticket in November. If he did have to withdraw, however, the Republican National Committee has the power to choose a replacement nominee, said Richard Pildes, a constitutional law professor at New York University School of Law. That nominee wouldn’t necessarily have to be Vice President Mike Pence. Similarly, the Democratic National Committee could pick a replacement if the Democratic nominee had to withdraw.

It’s complicated, though, because the election is so near, ballots are printed and people are already voting in some states.

“What would happen is people who want to support the Republican Party would vote for Trump. They might conceivably write in the person the RNC has anointed but more likely they would vote for Trump,” Mr. Pildes said.

If Trump were to win the election, having withdrawn, the members of the Electoral College in states he won would presumably cast their votes for the candidate the RNC chose, even in states where they might be legally bound, technically, to vote for Mr. Trump. Mr. Pildes said one could imagine a scenario in which no one wins a majority in the Electoral College. In that case, the election moves to the House of Representatives.

“We’re getting into more and more possibilities, but who knows,” Mr. Pildes said. “Could 2020 get any more bizarre?”

Write to Natasha Khan at [email protected], James Hookway at [email protected] and Alex Leary at [email protected]