How will Donald Trump’s covid-19 infection affect the election?

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America’s president said the end of the pandemic was in sight. Now he is the country’s most prominent case

United States

Editor’s note (October 2nd): This piece has been updated since it was first published.

DONALD AND MELANIA TRUMP have both tested positive for covid-19, just four weeks before the presidential election. This must be frightening for them and their family. It will also have an important effect on the presidential campaign. Political journalists have been speculating about an October surprise for months. Now we have one.

One possibility to consider is that the president is just fine. Some infected people suffer no symptoms, or are only mildly ill. Mr Trump quarantines for ten days, receives any care he requires from Walter Reed Military hospital in Bethesda, Maryland. He emerges in mid-October and says: you see, I told you all along it was no big deal.

Even that benign scenario, though, is not good for the president politically. If he receives a sympathy bump in the polls, it is likely to be small. He is still seven points behind Joe Biden in The Economist’s average of polls, which we calculate gives him just a one-in-ten chance of winning the election. Mr Trump wants to change the subject from covid-19, his administration’s mismanagement of the response to the epidemic and the toll it has taken on the economy. His own illness makes that task impossible for the next ten days. By the time he emerges from quarantine there will not be much time left for him to make up the deficit in his poll numbers.

And while he is recuperating, Americans will be reminded that Mr Trump has spent all year playing down the severity of the virus, at one point claiming it would simply disappear. In the first presidential debate on Tuesday night, he said he wore a mask when he needed to—and then mocked Mr Biden for his insistence on wearing one at all times. “I don’t wear masks like him,” Mr Trump said. “Every time you see him, he’s got a mask. He could be speaking 200 feet away from me and he shows up with the biggest mask I’ve ever seen.” He later claimed the end of the pandemic was in sight.

The White House has long insisted that Mr Trump does not need to wear a mask because both he and the people around him are tested constantly. That may be right, but by taking this stance the president has undermined support for wearing masks at a time when his own director of the Centres for Disease Control (CDC) has been insisting that Americans can slow the spread of the virus if they wear one—above all to protect others. It does not take a campaign mastermind to draw a straight line between the president’s ambiguous messaging and the 200,000 Americans who have been killed by covid-19.

There is, of course, a second scenario: Mr Trump gets seriously ill, as Britain’s prime minister, Boris Johnson, did in April. Treatment for those who are hospitalised with covid-19 has improved over the past months. That partly explains why the case fatality rate in America is falling (another reason is that more testing is taking place). On the other hand, Mr Trump ticks three of the known risk factors: being male, elderly (he is 74) and with a body-mass index (BMI) of over 30 (the president’s medical bulletin from April gives him a BMI of 30.5, according to the National Institutes of Health’s calculator). Tom Frieden, a former head of the CDC, tweeted: “A 74-year-old has approximately 3% chance of death, 10-15% chance of severe illness. Higher in males, obesity.” Many people in their 70s also have other medical conditions that increase the risks. However, the president will be able to avail himself of the best medical care in the world.

If Mr Trump were temporarily incapacitated, then Mike Pence, the vice-president, could assume his duties under the 25th amendment to the constitution, which was ratified after John F. Kennedy’s assassination. Mr Pence’s spokesman has tweeted that the vice-president and his wife have both tested negative.

But the uncertainty does not end there. There is a third scenario which would be even more surprising—and which could really turn this election upside down, in the sense of changing the likely result. Any list of possible scenarios between now and November 3rd should also include one where Mr Trump recovers, and Mr Biden gets sick before election day.

That looks implausible. Mr Biden, who spent 90 minutes on Tuesday night a few feet away from the president in a wretchedly ill-tempered televised debate, has also tested negative. But after another astonishing week (which began, remember, with the New York Times’s revelations about the president’s tax affairs), Americans may wonder what on Earth this campaign can throw up next.

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