Presidential COVID-19 diagnosis to negatively impact US political stability over next month

• The diagnosis does not immediately destabilise the US government or implicate presidential succession; the extent of any impacts depends on the progress of the president’s illness and any spread within the White House.
  
  
• However, at a minimum, an outbreak at the highest echelon of the US government is likely to disrupt policy implementation and coordination over the coming weeks, negatively impacting political stability.
  
  
• The impacts on the presidential election campaign range from moderate to severe, depending on how Trump’s illness develops and the potential exposure of rival candidate Joe Biden.
  
  
• However, as a baseline, Trump’s diagnosis further reduces the likelihood that he is re-elected.

Political stability

How severely the diagnosis impacts political stability will depend on the progression of Trump’s illness and on who else may have been infected, including those in the line of succession. Trump plans to quarantine from the White House, forcing key administrative functions to go substantially virtual over the coming weeks. There is no indication that Trump plans to temporarily transfer any presidential powers to Vice-President Mike Pence, who on 2 October was reported to have tested negative for COVID-19, as has Secretary of State Mike Pompeo, who is fourth in line for succession.

In addition, Trump’s diagnosis means that others within the White House – including within the national security apparatus – are likely to test positive for COVID-19 in the coming days. Even absent severe complications, a cluster would be likely to limit the administration’s ability to conduct sensitive communications related to domestic policy and national security. That said, National Security Advisor Robert O’Brien in late July contracted COVID-19, returning to his duties in about a week following negative test results, with no apparent impact on the national security function.

Unlike the UK, the US has a well-articulated (if rarely used) framework for presidential succession, which also allows for the temporary transference of executive authorities in the event of incapacitation (last used in 2007 by former president George W Bush (2001-09)).

Election dynamic

Trump’s diagnosis is likely to have at least moderate negative impacts on his campaign for re-election.

• Even with mild or no symptoms, Trump’s quarantine and convalescence will preclude campaign rallies in the coming weeks (including those immediately planned for Florida, Wisconsin and Arizona), blunting his efforts to appeal directly to voters in key swing states. (The diagnosis is also likely to reinforce popular concern about attending mass political rallies.) Quarantine will also consume scarce campaign time remaining before the 3 November election, further limiting opportunities to reverse the trajectory of a race that polls indicate Trump is losing. Trump will be forced to leverage his significant online presence and increase his reliance on campaign surrogates, including Pence, state governors and Congressional candidates. The underlying trajectory of the race would be least impacted under this scenario.
  
  
• More significant illness could force a protracted absence for Trump from the campaign trail, potentially up to the election itself, more negatively impacting Trump’s re-election chances by both disrupting his campaign and calling into question his fitness for office. However, Trump would be unlikely to withdraw from the race or be removed from the ticket over health challenges that he could overcome.
  
  
• Trump’s incapacitation as a result of COVID-19 could severely disrupt the campaign and election dynamic, and increase the likelihood that Trump resigns, withdraws, or is forced from the race before the election. With early voting under way nationwide, it would be too late to replace Trump on printed ballots with a different candidate in many states. Nonetheless, in the event of his withdrawal, the national Republican Party could select a different presidential candidate according to party rules. A last-minute change in the ticket would be likely to severely compromise the party’s presidential chances and potentially confuse Electoral College balloting post-election. Incapacitation or withdrawal after the election is a more politically and constitutionally ambiguous situation.


Presidential health

Presidential health concerns are typically handled behind closed doors and Trump has been particularly secretive about his health history. It is not clear what planning or contingencies the administration may have put into place in anticipation of a COVID-19 outbreak in the White House. COVID-19 remains a highly infectious and lethal disease, with more than 40,000 cases and 700 deaths daily in the US. Trump is in a high-risk age group but will also benefit from excellent healthcare.

The sequence of events is emerging, but close presidential advisor Hope Hicks reportedly tested positive and displayed symptoms on the night of 30 September, one day after the presidential debate in Cleveland (Ohio state). Following media reporting of Hicks’ diagnosis, Trump stated in a media interview on the evening of 1 October that he had undergone a diagnostic test and several hours later reported the positive result.

Democratic candidate and former vice president Joe Biden reportedly will be tested on 2 October and presumably publicise the results as soon as possible. Biden was in relatively close proximity to Trump during the Cleveland debate.