President appears maskless on Truman balcony. Conspiracy theories rife over circumstances of his illness. Trump demands face-to-face second debate. By Jonathan Pearlman.

‘I’m better,’ says Trump, but health concerns remain

US President Donald Trump removes his mask upon his return to the White House on Monday.
US President Donald Trump removes his mask upon his return to the White House on Monday.
Credit: Win McNamee / Getty Images via AFP

Trump’s treatment

Washington: On Monday night, a coronavirus-infected Donald Trump left hospital, flew by helicopter to the White House, climbed the stairs to the Truman balcony, and turned to face the video cameras before triumphantly peeling off his mask.

“Don’t let it [Covid-19] dominate you,” he said in a video message. “Don’t let it take over your lives … I know there’s a risk, there’s a danger. But that’s okay. And now I’m better. And maybe I’m immune? I don’t know.”

Despite Trump’s carefully staged return from hospital, his doctor, Sean Conley, warned that he “may not be entirely out of the woods yet”.

Since his tweet at 12.54am on October 2, when he announced that he and his wife, Melania, were infected, his medical prognosis has been difficult to follow, partly due to conflicting accounts by his doctors and aides.

Trump, who is 74 years old and clinically obese, has received an experimental drug cocktail, REGN-COV2, which includes copies of Covid-19 antibodies. The drug, produced by the American firm Regeneron, is still in trial but was provided by the firm for “compassionate use”. Trump also received a steroid, dexamethasone, after his oxygen levels dropped twice. Dexamethasone is typically given to patients with Covid-19 who are severely ill, but its usage may have indicated Trump’s doctors were adopting an aggressive treatment. On Tuesday, Trump completed a five-day course of remdesivir, an antiviral drug that can lower the amount of the virus in the body. It is not clear when Trump last had a negative test, or whether his X-rays revealed lung damage.

On Tuesday, Trump tweeted: “Feeling great!” His age, weight and gender increase the risk of severe illness. Typically, severity peaks about 8 to 12 days after infection or the appearance of symptoms, which would most likely be during this weekend.

The conspiracy theories

Since the outbreak of the Covid-19 pandemic, Trump has deliberately downplayed the risks and repeatedly lied or spread misinformation about the virus. He said the virus was mostly harmless, that it would weaken by April, that it was “getting under control”, that the United States has “done as well as any nation”, and claimed as early as March that a vaccine was imminent.

This constant misrepresentation of the dangers of the pandemic has meant official accounts of Trump’s infection have been greeted with public mistrust. But the scepticism has also been fuelled by the conflicting reports about the president’s condition delivered by Trump, his doctors and his aides. Conley, a former US Navy emergency doctor, initially claimed Trump had “mild” symptoms but later admitted he had not revealed the severity because he had not wanted to “steer the course of illness in another direction”.

Aided by this swirl of misinformation, conspiracy theories about Trump’s illness have quickly spread. On social media, some users, particularly critics of Trump, suggested that he had faked his infection to delay the election, or to avoid further debates, or to vindicate his dismissal of the dangers of the virus.

Advocates of the far-right QAnon conspiracy theory tacked on the latest developments to its standard theory and claimed Trump was pretending to be sick as part of his plan to arrest Hillary Clinton over her part in a Satan-worshipping paedophile ring. More than 20 Republican candidates for congress have endorsed or shared QAnon content.

Presidential infirmity

No American election has ever been delayed. If Trump is unable to run, the election will likely proceed as planned on November 3. The Republican Party would be responsible for choosing a new candidate, who would likely be Mike Pence, the vice-president. Most ballots have already been printed and would still list Trump as the candidate.

Voting has already begun, mainly via postal ballots, so a change of candidate would raise questions about how to handle votes for Trump. The president is ultimately elected by a vote of the electoral college, a state-based body of 538 people. Most likely, states would direct their electors to consider any votes for Trump as a vote for the replacement candidate. But the process could become messy. Some “faithless electors” may ignore their instructions, and a Republican state legislature could decide to withhold electoral votes from a winning Democratic candidate (or vice versa, if Joe Biden is unable to run).

Trump, if he becomes incapacitated, can transfer power to his vice-president. Since this constitutional provision was introduced in 1967 after the assassination of John F. Kennedy, only two presidents have handed control to vice-presidents: Ronald Reagan, while he had a colon procedure in 1985, and George W. Bush, who had colonoscopies in 2002 and 2007.

The fallout

Since Trump announced he had Covid-19, Biden’s lead in opinion polls has increased. According to the FiveThirtyEight website, Biden leads Trump by 51.4 per cent to 42.4 per cent. A CNN poll conducted after the first debate last week and mostly after Trump’s Covid-19 announcement found Biden led with 57 per cent support while Trump had 41 per cent, compared with a lead of 51 to 43 when the poll was taken a month previously.

On Wednesday, a CNBC/Change Research poll across six battleground states found Biden’s support had slightly increased in the past two weeks, from 49 to 50 per cent, while Trump’s support remained unchanged at 45 per cent.

Trump’s illness has interrupted his campaign and forced him to cancel plans for further rallies. Staff have been cleared out of the West Wing offices, though by Thursday, Trump, who had been working from the White House residence, was reported to be back in the Oval Office.

Aside from Trump and Melania, some of the president’s top advisers have tested positive, including senior advisers Stephen Miller and Hope Hicks, campaign manager Bill Stepien, and White House press secretary Kayleigh McEnany.

By Friday morning Trump had pulled out of the second presidential debate, scheduled for next Thursday, after organisers announced it would be held virtually “to protect the health and safety of all involved”. The president said the format would be “ridiculous” and raised concerns about being “cut … off whenever they want”. The debate may now be postponed to October 22.

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This article was first published in the print edition of The Saturday Paper on Oct 10, 2020 as "‘I’m better,’ says Trump, but health concerns remain".

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Jonathan Pearlman is The Saturday Paper’s world editor and the editor of Australian Foreign Affairs.

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