When it was announced that US President Donald Trump had fallen ill with COVID-19, it was hardly a surprise. His political strategy of playing down COVID-19 required him to be reckless about his own health, and other Republicans were already dropping like flies. Fourteen Republican senators and representatives have now tested positive, compared to six Democrats.
Besides, there really wasn’t much to say about it right away. Journalists who were up against a deadline speculated about how it would affect the election if he died from COVID, but that felt kind of ghoulish, and besides the odds were long against it.
The death rate for people in their 70s who come down with major COVID symptoms is much higher than for younger people, but it’s still only 8.5%. Being male and fat with a heart problem are all additional risk factors for Trump, but they may be counterbalanced by the fact that he was getting excellent medical care 24 hours a day. So wait and see.
Wait how long? Well, a million deaths later (almost a quarter of them in the US), we know a good deal about the pattern of this disease, and it is rarely life-threatening in the first week after symptoms develop. The constant dry cough, the headache, the fatigue, the loss of the sense of smell and taste make it an unpleasant experience, but at worst there’s a certain shortness of breath.
We know that Trump was twice put on oxygen briefly on Friday and Saturday, but that does not mean he was deathly ill. On the other hand, the fact that they let him go home to the White House on Monday doesn’t mean the doctors are hugely confident either.
Trump would have put immense pressure on the doctors to let him go, since that would let him do some macho posturing about having defeated the virus. They would have shrugged their shoulders and given in, because the White House medical facilities are quite adequate for anything short of a major crisis.
And Trump did indeed indulge in some major chest-beating when he got home. “Feeling really good!” he tweeted. “Don’t be afraid of COVID! Don’t let it dominate your life!... I feel better than I did 20 years ago!”
Well, of course he’s feeling better. He’s on a steroid high. His doctors have put him on dexamethasone, a steroid medication that is not normally given to patients who are not critical.
(He’s also taking remdesivir, monoclonal antibodies, zinc, vitamin D, famotidine, melatonin and aspirin, but none of those make you feel like Superman.)
The doctors undoubtedly told Trump that the real make-or-break time with COVID-19 is seven to ten days after symptoms first develop, when some patients who have been feeling reasonably well suddenly go into a steep decline, with severe lung problems. That’s when you get put on the ventilator. But it probably didn’t register.
“Now I’m better, and maybe I’m immune,” he said at the White House. Then he took his mask off on the balcony and, still highly contagious, walked back in among the staff who were standing by inside. (Or at least those who are still standing at all, but almost a dozen have already gone down with the disease.)
If Day 1 for Trump was Thursday, as his doctors say, then Days 7 to 10 are this past Thursday to Sunday. And since he is clearly still at risk, it is now legitimate for us to speculate about how those days might define the future of the presidential election, and perhaps of the US. Tastefully, of course, and with no ghoulishness.
Outcome A: Trump dies. Probability: less than 10% (see above). Consequence: Vice President Mike Pence takes his place, and loses the election.
Outcome B: Trump gets very ill and is re-hospitalized. He survives, but cannot resume the campaign. Probability: around 10%. Consequence: Democratic nominee Joe Biden wins the presidency with a margin big enough that Trump’s people cannot plausibly dispute it. Normal service is resumed, and Trump spends the rest of his life in court.
Outcome C: Trump recovers, and is back out campaigning within a week. Probability: greater than 70%. Consequence: he still loses the election (just look at the numbers), but he is fit enough to build on the foundations he has already laid and lead a campaign from the White House (not necessarily nonviolent) to dispute the postal vote.
He is desperate enough, and ruthless enough, to comprehensively muddy the waters. Perhaps the US becomes a banana republic, perhaps not.
And we must recognize the possibility that Outcome C is already inevitable because Trump contracted COVID days earlier, concealed it, and is already safely past Day 10. In which case this entire drama is pantomime.