Los Angeles Times

What Trump’s diagnosis may mean

A look at some questions raised about the president’s COVID- 19 infection

- By Brittny Mejia and Jenny Jarvie

President Trump said early Friday that he had tested positive for the coronaviru­s and that he and First Lady Melania Trump would begin the “quarantine and recovery process immediatel­y.” Trump’s illness could have significan­t repercussi­ons for the 2020 presidenti­al campaign.

Trump’s positive test came just hours after the White House announced that senior aide Hope Hicks, one of the president’s closest advisors, had tested positive Thursday after several days of traveling with the president.

What happens if Trump dies?

Although Trump aides said he was showing only minor symptoms on Friday morning, by the afternoon he had been f lown to Walter Reed National Military Medical Center.

White House Press Secretary Kayleigh McEnany said Trump was going to the hospital only “out of abundance of caution, and at the recommenda­tion of his physician and medical experts.”

If the situation becomes dire, both the Democratic and Republican parties have rules for how to choose a new candidate if their nominee dies or withdraws before the election.

With just 32 days until election day, however, ballots have already been printed and early voting has begun, said UC Irvine law professor and voting expert Rick Hasen.

“What’s most likely [ is] that the election would take place on time with the deceased or incapacita­ted candidate’s name on the ballot,” Hasen wrote in a post on his Election Law Blog, “and then there would be a question if legislatur­es would allow presidenti­al electors of each state to vote for someone other than the deceased candidate.”

Not every state has laws addressing this possibilit­y, leading to more uncertaint­y.

“If we are unfortunat­e enough to have a presidenti­al candidate die or become incapacita­ted this close to the election, what happens next is likely to be uncertain and messy,” Hasen said in an interview. “It could leave room for political gaming as well under the arcane rules of the electoral college.”

If Trump is sick or is hospitaliz­ed for an extended period, can the election be postponed?

No U. S. presidenti­al election has ever been postponed, even during the Civil War, World War II and other times of national crisis. The Constituti­on restricts the president and vice president to four- year terms.

The election would need to be held by Jan. 20, or constituti­onal rules of succession would apply. House Speaker Nancy Pelosi ( DSan Francisco) is next in line.

What symptoms does Trump have?

White House Chief of Staff Mark Meadows said Friday that Trump had “mild symptoms” but did not specify what they were. “He continues to not only be in good spirits, but also very energetic,” Meadows said at a briefing.

In a letter Friday afternoon, White House physician Sean P. Conley said Trump received a single 8- gram dose of Regeneron’s polyclonal antibody cocktail as a precaution­ary measure. He’s also been taking zinc, vitamin D, famotidine, melatonin and a daily aspirin, Conley said.

“As of this afternoon the president remains fatigued but in good spirits,” Conley said. “He’s being evaluated by a team of experts, and together we’ll be making recommenda­tions to the president and first lady in regards to next best steps.”

On Friday evening, Trump was taken to the hospital. Trump would be “working from the presidenti­al offices at Walter Reed for the next few days,” McEnany said.

Melania Trump had a mild cough and headache, the press secretary said.

Is Trump at greater risk of severe COVID- 19?

Trump’s age, sex and weight status increase his risk of developing a severe case of COVID- 19.

According to a report in June from Trump’s physician, the president is 6 feet, 3 inches tall and weighs 244 pounds. That means his body mass index, or BMI, is 30.5, just over the threshold for obesity. Since the early days of the pandemic, researcher­s have observed that COVID- 19 patients who are obese fare worse than those who are not.

Compared with young adults between the ages of 18 and 29, a person between the ages of 65 and 74 is five times more likely to be admitted to a hospital and 90 times more likely to die of the disease.

Other data from the U. S. Centers for Disease Control and Prevention indicate that, among COVID- 19 patients in their 70s, the death rate for those in good health at the time of their infection was 10%. For those already dealing with a medical condition, the death rate was 32%.

A study published in July by the CDC reported that COVID- 19 deaths in men outnumbere­d deaths in women in 41 out of 47 countries assessed.

What has Trump said about COVID- 19?

Trump has downplayed the threat from the disease, which has killed more than 208,000 people in the U. S. As recently as Tuesday night’s debate with former Vice President Joe Biden, Trump defended his campaign rallies, many featuring thousands of his maskless fans crammed together. He falsely stated that his rallies were all outside.

“So far, we have had no problem whatsoever,” Trump said. “It’s outside. That’s a big difference, according to the experts. We do them outside, we have tremendous crowds. … We’ve had no negative effect.”

He held an indoor rally as recently as Sept. 14, in Nevada, and also one in Tulsa, Okla., in June. He also attended an indoor fundraiser on Thursday, after officials had learned of Hicks’ diagnosis.

During the debate, Biden argued that Trump was underplayi­ng safety measures, including the value of wearing a mask. He noted that the head of CDC has said 100,000 lives could be saved by January if Americans increase their mask usage.

“It matters,” Biden insisted.

Trump retorted: “And they’ve also said the opposite.” To which Biden responded: “No serious person said the opposite.”

Trump mocked Biden for holding socially distanced events with smaller groups of voters, and for usually wearing a mask, per public health guidelines.

“Every time you see him he’s got a mask,” the president said. “He could be speaking 200 feet away, and he shows up with the biggest mask I’ve ever seen.”

What safety precaution­s were taken during the presidenti­al debate?

There were several requiremen­ts in place at the debate hall in Ohio, including temperatur­e checks, hand sanitizing, social distancing and masking, according to the Cleveland Clinic, the health advisor to the Commission on Presidenti­al Debates.

The clinic stated it believes there is “low risk of exposure to our guests” but is reaching out to address any questions or concerns. Those allowed inside the debate hall tested negative before entering, according to the clinic.

“Individual­s traveling with both candidates, including the candidates themselves, had been tested and tested negative by their respective campaigns,” the clinic said in a statement.

Although attendees entering the hall were masked, the clinic stated, some removed their masks once they were seated.

“A Cleveland Clinic physician did offer audience members masks, but some did not adhere to the requiremen­t,” a spokeswoma­n said. Trump’s family members were among them.

“The first family came in wearing masks, but they took them off,” moderator Chris Wallace said on Fox News. “Members of the Cleveland Clinic came up to them and said, ‘ If you need a mask...,’ and they waved them away.”

What about the upcoming debates?

The vice presidenti­al debate on Wednesday will continue as scheduled, according to Frank Fahrenkopf, co- chairman of the Commission on Presidenti­al Debates.

“As far as we know, we’re going forward,” he said. “Both campaigns have said they’re proceeding.”

Both Vice President Mike Pence, who met with Trump on Tuesday, and California Sen. Kamala Harris, the Democratic nominee, tested negative for the coronaviru­s on Friday.

In a memo, Pence’s physician said that the vice president “is not considered a close contact with any individual­s who have tested positive for COVID,” including the president, and did not have to quarantine.

Pence “remains in good health and is free to go about his normal activities,” Navy Lt. Cmdr. Dr. Jesse Schonau said in a statement.

During a rally Tuesday, Pence told the crowd he had met with the president in the Oval Office that day. People who have been in “close contact” with someone who has COVID- 19 should be quarantine­d, which means staying away from others until they know if they’ve been infected, according to public health officials.

The CDC defines close contact as being within six feet of someone who has COVID- 19 for 15 or more minutes; providing care to someone with the disease; having direct physical contact with an infected person, such as through a hug or a kiss; sharing eating or drinking utensils; or being sneezed or coughed on by the infected person.

Even if you test negative for COVID- 19 or feel healthy, you should stay home ( quarantine) since symptoms may appear two to 14 days after exposure to the virus, according to the CDC.

A little less clear is the status of the second presidenti­al debate, scheduled for Oct. 15.

The University of Utah remains ready to host the debate, said university spokesman Chris Nelson. No one will enter the media filing center or debate venue “without having had a negative COVID19 [ test] within a day of entering the area.” There is a mask mandate inside any building or tent, as well as a requiremen­t for physical distancing, Nelson said.

“It is our campus expectatio­n and guideline that anyone in one of our buildings wear a mask [ except the two candidates and moderator on stage who will be physically distanced],” he said. He said the university would be in communicat­ion with the commission on enforcemen­t of that requiremen­t.

“In terms of campaign staff, CPD staff, or family members of the candidates we would work in partnershi­p with the CPD to determine next steps,” he said.

Fahrenkopf said a decision on the second debate will probably come down to whether the president is still sick at that time. “It’s too early to say,” he said.

How will this affect campaignin­g?

The immediate effect of the illness will be to keep Trump off the campaign trail, possibly preventing him from participat­ing in the Oct. 15 debate. The former vice president tested negative twice on Friday.

Trump is unlikely to be able to stage the kind of rallies that have energized him and his most loyal supporters. On Friday, his campaign announced that scheduled events involving the president and his family were “being moved to virtual events or are being temporaril­y postponed.” Fundraiser­s set for next week in Orange County and Beverly Hills were canceled.

The president’s illness adds new uncertaint­y to the campaign and the election itself.

How could Trump’s diagnosis alter the 2020 race?

Political experts say Trump’s diagnosis will pose a political challenge, refocusing the nation and the 2020 campaign on his response to the pandemic, an issue on which the president has received low marks from voters. The president has already consistent­ly trailed Biden in polling.

“The consequenc­es of this will be disastrous for Trump’s already f lagging reelection campaign,” Alan Abramowitz, Emory University’s national polling and election forecastin­g expert, said in a statement. “Even if he avoids a serious illness, he will be forced off the campaign trail for a considerab­le length of time and the questions about his handling of the pandemic and his personal behavior in relation to it will intensify.”

What happens if Trump’s condition deteriorat­es? What is the transition of power?

Pence’s negative test for the coronaviru­s Friday alleviated some immediate concerns about the presidenti­al line of succession if Trump becomes badly ill and is unable to perform his duties.

According to the 25th Amendment to the Constituti­on, when a president determines that he can’t carry out his duties, he informs the speaker of the House and the president pro tempore of the Senate, in writing, of his incapacity. While he’s incapacita­ted, the vice president serves as acting president. Pelosi is the speaker; Iowa Republican Charles E. Grassley is the Senate president pro tempore.

If a president can’t certify his own incapacity, the amendment allows the vice president and a majority of Cabinet secretarie­s to inform the speaker and the president pro tempore. In that case, the vice president would immediatel­y take over as acting president.

If the president disputes the matter, the vice president and a majority of Cabinet secretarie­s must again declare the president incapable, in writing, within four days. Congress must then convene to decide the issue, and a two- thirds vote of both chambers is required to declare the president unable to exercise his authority.

 ?? PRESIDENT TRUMP’S Ji m Watson AFP/ Getty I mages ?? wife and adult children, from top, Eric Trump, Ivanka Trump, First Lady Melania Trump, Tiffany Trump and Donald Trump Jr., are maskless at Tuesday’s debate, except for the f irst lady.
PRESIDENT TRUMP’S Ji m Watson AFP/ Getty I mages wife and adult children, from top, Eric Trump, Ivanka Trump, First Lady Melania Trump, Tiffany Trump and Donald Trump Jr., are maskless at Tuesday’s debate, except for the f irst lady.

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