Trump’s COVID-19 treatment revives fear over unchecked nuclear authority

PRESIDENT Donald Trump’s long rants and seemingly erratic behavior last week — which some doctors believe might have been fueled by his use of dexamethasone, a steroid, to treat coronavirus disease 2019 (COVID-19) — renewed a long-simmering debate among national security experts about whether it is time to retire one of the early inventions of the Cold War: the unchecked authority of the president to launch nuclear weapons.

Trump has publicly threatened the use of those weapons only once in his presidency, during his first collision with North Korea in 2017. But it was his decision not to invoke the 25th Amendment and turn control over to Vice President Mike Pence last week that has prompted concern inside and outside the government.

Among those who have long argued for the need to rethink presidents’ “sole authority” powers are the former Defense Secretary William J. Perry, considered the dean of American nuclear strategists, who has cited the fragility of a nuclear-weapons control chain and the fear that it can be subject to errors of judgment or failure to ask the right questions under the pressure of a warning of an incoming attack.

Trump’s critics have long questioned whether his unpredictable statements and contradictions pose a nuclear danger. But the concerns raised last week were somewhat different: whether a president taking mood-altering drugs could determine whether a nuclear alert was a false alarm.

That question is a new one. The military’s Strategic Command often conducts drills that simulate actual but inconclusive evidence that the United States may be under nuclear attack. Such simulations drive home the reality that even a president asking all the right questions could make a mistake. But they rarely simulate what would happen if the president’s judgment was impaired.

“A nuclear crisis can happen at any time,” Tom Z. Collina, the policy director at the Ploughshares Fund, a private group that seeks to defuse nuclear threats, noted last week in an opinion piece. “If such a crisis takes place when a president’s thinking is compromised for any reason,” he added, “the results could be catastrophic.”

Traditionally, presidents have temporarily conveyed authority — including nuclear launch authority — to the vice president when they anticipated being under anesthesia. Ronald Reagan took that step in 1985, and George W. Bush did so in 2002 and 2007. There was no indication that Trump was unconscious, but there was reason to be concerned that the cocktail of drugs he was given could impair his judgment to make the most critical decisions entrusted to a president.

Last week in telephone interviews with Fox News and Fox Business Network, Trump said he was no longer taking experimental medications but was still on dexamethasone, which doctors say can produce euphoria, bursts of energy and even a sense of invulnerability. On Friday, he told Fox News he was off the drug, which he appears to have taken for less than a week.

But during that week, his prolific Twitter activity and rambling interviews led many to question whether the drugs had accentuated his erratic tendencies. His doctors’ refusal to describe with any specificity his condition or treatment only played up the concern.

“The history of obfuscating the medical condition of presidents is as old as the Republic,” said Vipin Narang, a professor at the Massachusetts Institute of Technology who has studied the nuclear command-and-control chain. “The issue here is that the dex” — shorthand for dexamethasone — “can make you paranoid and delusional.”