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With Boris Johnson in Intensive Care, U.K. Faces a Leadership Quandary With Boris Johnson in Intensive Care, U.K. Faces a Leadership Quandary
(3 days later)
LONDON — The British government hurtled into uncharted territory on Tuesday, with its foreign secretary, Dominic Raab, taking up the day-to-day duties of Prime Minister Boris Johnson, who was being treated in an intensive care unit as he battled a worsening case of the coronavirus.LONDON — The British government hurtled into uncharted territory on Tuesday, with its foreign secretary, Dominic Raab, taking up the day-to-day duties of Prime Minister Boris Johnson, who was being treated in an intensive care unit as he battled a worsening case of the coronavirus.
Britain, with no written constitution, does not have a codified order of succession. That legal lacuna has prompted questions during prior episodes where prime ministers fell ill or underwent surgery, and now looms large at a time when Britain faces its greatest crisis since World War II.Britain, with no written constitution, does not have a codified order of succession. That legal lacuna has prompted questions during prior episodes where prime ministers fell ill or underwent surgery, and now looms large at a time when Britain faces its greatest crisis since World War II.
Mr. Raab, 46, as first secretary of state, would become the government’s de facto leader if the prime minister could not carry out his duties. He was “deputized” by Mr. Johnson on Monday, led the government’s daily meetings about the pandemic and will probably take on additional duties, with Mr. Johnson’s prognosis so uncertain.Mr. Raab, 46, as first secretary of state, would become the government’s de facto leader if the prime minister could not carry out his duties. He was “deputized” by Mr. Johnson on Monday, led the government’s daily meetings about the pandemic and will probably take on additional duties, with Mr. Johnson’s prognosis so uncertain.
The government said Mr. Johnson, who has suffered symptoms of the virus for 11 days, was moved into intensive care after his condition deteriorated sharply. He has received “standard oxygen treatment” but is breathing on his own and has not been put on a ventilator. Nor has pneumonia been diagnosed.The government said Mr. Johnson, who has suffered symptoms of the virus for 11 days, was moved into intensive care after his condition deteriorated sharply. He has received “standard oxygen treatment” but is breathing on his own and has not been put on a ventilator. Nor has pneumonia been diagnosed.
“I’m confident he’ll pull through because if there’s one thing I know about this prime minister, he’s a fighter,” Mr. Raab said at a news conference.“I’m confident he’ll pull through because if there’s one thing I know about this prime minister, he’s a fighter,” Mr. Raab said at a news conference.
Still, how the government will function if the prime minister is out for a prolonged period, or dies, is not yet clear.Still, how the government will function if the prime minister is out for a prolonged period, or dies, is not yet clear.
“If he is incapacitated for quite a long time, then you’re in totally different circumstances,” said Jonathan Powell, who was chief of staff to Prime Minister Tony Blair. “In the middle of a crisis like this, in the modern world, it is quite impossible to function without a prime minister.”“If he is incapacitated for quite a long time, then you’re in totally different circumstances,” said Jonathan Powell, who was chief of staff to Prime Minister Tony Blair. “In the middle of a crisis like this, in the modern world, it is quite impossible to function without a prime minister.”
The government will face momentous decisions, including when and how to lift the lockdown on Britain. Mr. Johnson, 55, had been leading that process and communicated the government’s measures to the public in daily briefings, where his familiar shambling style gave way to a graver mien.The government will face momentous decisions, including when and how to lift the lockdown on Britain. Mr. Johnson, 55, had been leading that process and communicated the government’s measures to the public in daily briefings, where his familiar shambling style gave way to a graver mien.
Mr. Raab, by contrast, has been a peripheral figure in the government’s response, mostly focusing on organizing evacuation flights to bring back Britons stranded overseas. He is best known for his hard-line views on Brexit, which helped him get his post in Mr. Johnson’s pro-Brexit cabinet.Mr. Raab, by contrast, has been a peripheral figure in the government’s response, mostly focusing on organizing evacuation flights to bring back Britons stranded overseas. He is best known for his hard-line views on Brexit, which helped him get his post in Mr. Johnson’s pro-Brexit cabinet.
Mr. Raab, officials said, was working from his quarters in the Foreign Office. He would chair meetings on national security, though in the case of an emergency, the cabinet would make decisions on a collective basis.Mr. Raab, officials said, was working from his quarters in the Foreign Office. He would chair meetings on national security, though in the case of an emergency, the cabinet would make decisions on a collective basis.
While he is trusted by the prime minister, Mr. Raab is only one of several ambitious ministers who may assert their right to step up. Michael Gove, a senior cabinet minister and longtime rival of Mr. Johnson, was the face of the government on television Tuesday morning, though he announced that he, too, was now in isolation at home after a family member showed mild coronavirus symptoms.While he is trusted by the prime minister, Mr. Raab is only one of several ambitious ministers who may assert their right to step up. Michael Gove, a senior cabinet minister and longtime rival of Mr. Johnson, was the face of the government on television Tuesday morning, though he announced that he, too, was now in isolation at home after a family member showed mild coronavirus symptoms.
Other ministers — like the chancellor of the Exchequer, Rishi Sunak, and the health secretary, Matt Hancock — have been leading key parts of the response and will have strong voices. Keeping discipline could be difficult, analysts said, with much of the responsibility for that falling to the cabinet secretary, Mark Sedwill.Other ministers — like the chancellor of the Exchequer, Rishi Sunak, and the health secretary, Matt Hancock — have been leading key parts of the response and will have strong voices. Keeping discipline could be difficult, analysts said, with much of the responsibility for that falling to the cabinet secretary, Mark Sedwill.
If Mr. Raab were to become incapacitated, officials said, Mr. Sunak would be next in line as de facto leader. As chancellor, he has gotten good reviews for rolling out gargantuan packages to rescue an economy under lockdown.If Mr. Raab were to become incapacitated, officials said, Mr. Sunak would be next in line as de facto leader. As chancellor, he has gotten good reviews for rolling out gargantuan packages to rescue an economy under lockdown.
In one sense, Mr. Raab’s less direct involvement could be an advantage, allowing him to resolve potential disputes between economic and health officials over the easing of social distancing measures. On Tuesday, Mr. Raab signaled the government was not close to a decision on lifting the lockdown.In one sense, Mr. Raab’s less direct involvement could be an advantage, allowing him to resolve potential disputes between economic and health officials over the easing of social distancing measures. On Tuesday, Mr. Raab signaled the government was not close to a decision on lifting the lockdown.
“The cabinet has to demonstrate unity of purpose, with no squabbling or briefing against each other, and to put the national interest first,” said David Lidington, a former deputy to Mr. Johnson’s predecessor, Theresa May.“The cabinet has to demonstrate unity of purpose, with no squabbling or briefing against each other, and to put the national interest first,” said David Lidington, a former deputy to Mr. Johnson’s predecessor, Theresa May.
The son of a Czech refugee who fled the Nazis in 1938, Mr. Raab is not known for his diplomatic skills. He served as Brexit secretary under Mrs. May, but quit her government after clashes over her negotiations with the European Union.The son of a Czech refugee who fled the Nazis in 1938, Mr. Raab is not known for his diplomatic skills. He served as Brexit secretary under Mrs. May, but quit her government after clashes over her negotiations with the European Union.
In 2012, he was a contributor to “Britannia Unchained,” a book that laid out a vision of a free-market, deregulatory future for a post-Brexit Britain. He mounted an unsuccessful run for party leader last summer.In 2012, he was a contributor to “Britannia Unchained,” a book that laid out a vision of a free-market, deregulatory future for a post-Brexit Britain. He mounted an unsuccessful run for party leader last summer.
If Mr. Johnson died or were permanently sidelined, said Mujtaba Rahman, an analyst at Eurasia Group, the cabinet would probably agree on a caretaker prime minister — probably Mr. Raab — and schedule a vote for the Conservative Party to choose a new leader.If Mr. Johnson died or were permanently sidelined, said Mujtaba Rahman, an analyst at Eurasia Group, the cabinet would probably agree on a caretaker prime minister — probably Mr. Raab — and schedule a vote for the Conservative Party to choose a new leader.
But holding a vote would be difficult until the worst of the pandemic passed, and a full-blown campaign, like the one that ended in Mr. Johnson’s election as party leader last July, seems out of the question for now.But holding a vote would be difficult until the worst of the pandemic passed, and a full-blown campaign, like the one that ended in Mr. Johnson’s election as party leader last July, seems out of the question for now.
Mr. Johnson is only one of several prominent officials to be struck by the virus. Mr. Hancock, the heath secretary, had symptoms and emerged from self-isolation late last week. The chief medical officer, Chris Whitty, made his first public appearance on Monday after a week of self-quarantine.Mr. Johnson is only one of several prominent officials to be struck by the virus. Mr. Hancock, the heath secretary, had symptoms and emerged from self-isolation late last week. The chief medical officer, Chris Whitty, made his first public appearance on Monday after a week of self-quarantine.
Mr. Johnson’s most influential adviser, Dominic Cummings, was filmed hurrying out of Downing Street the day after his boss tested positive for the virus. He has not been seen in public since.Mr. Johnson’s most influential adviser, Dominic Cummings, was filmed hurrying out of Downing Street the day after his boss tested positive for the virus. He has not been seen in public since.
No other Western government has been so ravaged by the virus, and it comes after three and a half years of political upheaval. Even before this crisis, analysts said Mr. Johnson’s cabinet was weak, in part because he purged several senior party members during last fall’s bitter debate over Brexit.No other Western government has been so ravaged by the virus, and it comes after three and a half years of political upheaval. Even before this crisis, analysts said Mr. Johnson’s cabinet was weak, in part because he purged several senior party members during last fall’s bitter debate over Brexit.
Updated June 12, 2020Updated June 12, 2020
Touching contaminated objects and then infecting ourselves with the germs is not typically how the virus spreads. But it can happen. A number of studies of flu, rhinovirus, coronavirus and other microbes have shown that respiratory illnesses, including the new coronavirus, can spread by touching contaminated surfaces, particularly in places like day care centers, offices and hospitals. But a long chain of events has to happen for the disease to spread that way. The best way to protect yourself from coronavirus — whether it’s surface transmission or close human contact — is still social distancing, washing your hands, not touching your face and wearing masks.
So far, the evidence seems to show it does. A widely cited paper published in April suggests that people are most infectious about two days before the onset of coronavirus symptoms and estimated that 44 percent of new infections were a result of transmission from people who were not yet showing symptoms. Recently, a top expert at the World Health Organization stated that transmission of the coronavirus by people who did not have symptoms was “very rare,” but she later walked back that statement.So far, the evidence seems to show it does. A widely cited paper published in April suggests that people are most infectious about two days before the onset of coronavirus symptoms and estimated that 44 percent of new infections were a result of transmission from people who were not yet showing symptoms. Recently, a top expert at the World Health Organization stated that transmission of the coronavirus by people who did not have symptoms was “very rare,” but she later walked back that statement.
Touching contaminated objects and then infecting ourselves with the germs is not typically how the virus spreads. But it can happen. A number of studies of flu, rhinovirus, coronavirus and other microbes have shown that respiratory illnesses, including the new coronavirus, can spread by touching contaminated surfaces, particularly in places like day care centers, offices and hospitals. But a long chain of events has to happen for the disease to spread that way. The best way to protect yourself from coronavirus — whether it’s surface transmission or close human contact — is still social distancing, washing your hands, not touching your face and wearing masks.
A study by European scientists is the first to document a strong statistical link between genetic variations and Covid-19, the illness caused by the coronavirus. Having Type A blood was linked to a 50 percent increase in the likelihood that a patient would need to get oxygen or to go on a ventilator, according to the new study.A study by European scientists is the first to document a strong statistical link between genetic variations and Covid-19, the illness caused by the coronavirus. Having Type A blood was linked to a 50 percent increase in the likelihood that a patient would need to get oxygen or to go on a ventilator, according to the new study.
The unemployment rate fell to 13.3 percent in May, the Labor Department said on June 5, an unexpected improvement in the nation’s job market as hiring rebounded faster than economists expected. Economists had forecast the unemployment rate to increase to as much as 20 percent, after it hit 14.7 percent in April, which was the highest since the government began keeping official statistics after World War II. But the unemployment rate dipped instead, with employers adding 2.5 million jobs, after more than 20 million jobs were lost in April.The unemployment rate fell to 13.3 percent in May, the Labor Department said on June 5, an unexpected improvement in the nation’s job market as hiring rebounded faster than economists expected. Economists had forecast the unemployment rate to increase to as much as 20 percent, after it hit 14.7 percent in April, which was the highest since the government began keeping official statistics after World War II. But the unemployment rate dipped instead, with employers adding 2.5 million jobs, after more than 20 million jobs were lost in April.
Mass protests against police brutality that have brought thousands of people onto the streets in cities across America are raising the specter of new coronavirus outbreaks, prompting political leaders, physicians and public health experts to warn that the crowds could cause a surge in cases. While many political leaders affirmed the right of protesters to express themselves, they urged the demonstrators to wear face masks and maintain social distancing, both to protect themselves and to prevent further community spread of the virus. Some infectious disease experts were reassured by the fact that the protests were held outdoors, saying the open air settings could mitigate the risk of transmission.Mass protests against police brutality that have brought thousands of people onto the streets in cities across America are raising the specter of new coronavirus outbreaks, prompting political leaders, physicians and public health experts to warn that the crowds could cause a surge in cases. While many political leaders affirmed the right of protesters to express themselves, they urged the demonstrators to wear face masks and maintain social distancing, both to protect themselves and to prevent further community spread of the virus. Some infectious disease experts were reassured by the fact that the protests were held outdoors, saying the open air settings could mitigate the risk of transmission.
Exercise researchers and physicians have some blunt advice for those of us aiming to return to regular exercise now: Start slowly and then rev up your workouts, also slowly. American adults tended to be about 12 percent less active after the stay-at-home mandates began in March than they were in January. But there are steps you can take to ease your way back into regular exercise safely. First, “start at no more than 50 percent of the exercise you were doing before Covid,” says Dr. Monica Rho, the chief of musculoskeletal medicine at the Shirley Ryan AbilityLab in Chicago. Thread in some preparatory squats, too, she advises. “When you haven’t been exercising, you lose muscle mass.” Expect some muscle twinges after these preliminary, post-lockdown sessions, especially a day or two later. But sudden or increasing pain during exercise is a clarion call to stop and return home.Exercise researchers and physicians have some blunt advice for those of us aiming to return to regular exercise now: Start slowly and then rev up your workouts, also slowly. American adults tended to be about 12 percent less active after the stay-at-home mandates began in March than they were in January. But there are steps you can take to ease your way back into regular exercise safely. First, “start at no more than 50 percent of the exercise you were doing before Covid,” says Dr. Monica Rho, the chief of musculoskeletal medicine at the Shirley Ryan AbilityLab in Chicago. Thread in some preparatory squats, too, she advises. “When you haven’t been exercising, you lose muscle mass.” Expect some muscle twinges after these preliminary, post-lockdown sessions, especially a day or two later. But sudden or increasing pain during exercise is a clarion call to stop and return home.
States are reopening bit by bit. This means that more public spaces are available for use and more and more businesses are being allowed to open again. The federal government is largely leaving the decision up to states, and some state leaders are leaving the decision up to local authorities. Even if you aren’t being told to stay at home, it’s still a good idea to limit trips outside and your interaction with other people.States are reopening bit by bit. This means that more public spaces are available for use and more and more businesses are being allowed to open again. The federal government is largely leaving the decision up to states, and some state leaders are leaving the decision up to local authorities. Even if you aren’t being told to stay at home, it’s still a good idea to limit trips outside and your interaction with other people.
Common symptoms include fever, a dry cough, fatigue and difficulty breathing or shortness of breath. Some of these symptoms overlap with those of the flu, making detection difficult, but runny noses and stuffy sinuses are less common. The C.D.C. has also added chills, muscle pain, sore throat, headache and a new loss of the sense of taste or smell as symptoms to look out for. Most people fall ill five to seven days after exposure, but symptoms may appear in as few as two days or as many as 14 days.Common symptoms include fever, a dry cough, fatigue and difficulty breathing or shortness of breath. Some of these symptoms overlap with those of the flu, making detection difficult, but runny noses and stuffy sinuses are less common. The C.D.C. has also added chills, muscle pain, sore throat, headache and a new loss of the sense of taste or smell as symptoms to look out for. Most people fall ill five to seven days after exposure, but symptoms may appear in as few as two days or as many as 14 days.
If air travel is unavoidable, there are some steps you can take to protect yourself. Most important: Wash your hands often, and stop touching your face. If possible, choose a window seat. A study from Emory University found that during flu season, the safest place to sit on a plane is by a window, as people sitting in window seats had less contact with potentially sick people. Disinfect hard surfaces. When you get to your seat and your hands are clean, use disinfecting wipes to clean the hard surfaces at your seat like the head and arm rest, the seatbelt buckle, the remote, screen, seat back pocket and the tray table. If the seat is hard and nonporous or leather or pleather, you can wipe that down, too. (Using wipes on upholstered seats could lead to a wet seat and spreading of germs rather than killing them.)If air travel is unavoidable, there are some steps you can take to protect yourself. Most important: Wash your hands often, and stop touching your face. If possible, choose a window seat. A study from Emory University found that during flu season, the safest place to sit on a plane is by a window, as people sitting in window seats had less contact with potentially sick people. Disinfect hard surfaces. When you get to your seat and your hands are clean, use disinfecting wipes to clean the hard surfaces at your seat like the head and arm rest, the seatbelt buckle, the remote, screen, seat back pocket and the tray table. If the seat is hard and nonporous or leather or pleather, you can wipe that down, too. (Using wipes on upholstered seats could lead to a wet seat and spreading of germs rather than killing them.)
Taking one’s temperature to look for signs of fever is not as easy as it sounds, as “normal” temperature numbers can vary, but generally, keep an eye out for a temperature of 100.5 degrees Fahrenheit or higher. If you don’t have a thermometer (they can be pricey these days), there are other ways to figure out if you have a fever, or are at risk of Covid-19 complications.Taking one’s temperature to look for signs of fever is not as easy as it sounds, as “normal” temperature numbers can vary, but generally, keep an eye out for a temperature of 100.5 degrees Fahrenheit or higher. If you don’t have a thermometer (they can be pricey these days), there are other ways to figure out if you have a fever, or are at risk of Covid-19 complications.
The C.D.C. has recommended that all Americans wear cloth masks if they go out in public. This is a shift in federal guidance reflecting new concerns that the coronavirus is being spread by infected people who have no symptoms. Until now, the C.D.C., like the W.H.O., has advised that ordinary people don’t need to wear masks unless they are sick and coughing. Part of the reason was to preserve medical-grade masks for health care workers who desperately need them at a time when they are in continuously short supply. Masks don’t replace hand washing and social distancing.The C.D.C. has recommended that all Americans wear cloth masks if they go out in public. This is a shift in federal guidance reflecting new concerns that the coronavirus is being spread by infected people who have no symptoms. Until now, the C.D.C., like the W.H.O., has advised that ordinary people don’t need to wear masks unless they are sick and coughing. Part of the reason was to preserve medical-grade masks for health care workers who desperately need them at a time when they are in continuously short supply. Masks don’t replace hand washing and social distancing.
If you’ve been exposed to the coronavirus or think you have, and have a fever or symptoms like a cough or difficulty breathing, call a doctor. They should give you advice on whether you should be tested, how to get tested, and how to seek medical treatment without potentially infecting or exposing others.If you’ve been exposed to the coronavirus or think you have, and have a fever or symptoms like a cough or difficulty breathing, call a doctor. They should give you advice on whether you should be tested, how to get tested, and how to seek medical treatment without potentially infecting or exposing others.
If you’re sick and you think you’ve been exposed to the new coronavirus, the C.D.C. recommends that you call your healthcare provider and explain your symptoms and fears. They will decide if you need to be tested. Keep in mind that there’s a chance — because of a lack of testing kits or because you’re asymptomatic, for instance — you won’t be able to get tested.If you’re sick and you think you’ve been exposed to the new coronavirus, the C.D.C. recommends that you call your healthcare provider and explain your symptoms and fears. They will decide if you need to be tested. Keep in mind that there’s a chance — because of a lack of testing kits or because you’re asymptomatic, for instance — you won’t be able to get tested.
Downing Street has released few details about Mr. Johnson’s condition. On Monday, Mr. Raab told reporters that the prime minister had spent a comfortable night and was in good spirits. But he said he had not spoken to Mr. Johnson since Saturday. Two hours after that soothing prognosis, Mr. Johnson was being moved into intensive care.Downing Street has released few details about Mr. Johnson’s condition. On Monday, Mr. Raab told reporters that the prime minister had spent a comfortable night and was in good spirits. But he said he had not spoken to Mr. Johnson since Saturday. Two hours after that soothing prognosis, Mr. Johnson was being moved into intensive care.
[Analysis: Peaks, testing and lockdowns: How coronavirus vocabulary causes confusion.][Analysis: Peaks, testing and lockdowns: How coronavirus vocabulary causes confusion.]
On Tuesday, Mr. Gove acknowledged that he had not spoken to Mr. Johnson either. No doctor has briefed the press about the prime minister’s condition.On Tuesday, Mr. Gove acknowledged that he had not spoken to Mr. Johnson either. No doctor has briefed the press about the prime minister’s condition.
British governments have typically tried to hush up cases where prime ministers had health problems. In 1953, Winston Churchill suffered a serious stroke and was spirited to his country house, Chartwell, where he recuperated in secrecy with a nurse and his private secretary bringing him government papers.British governments have typically tried to hush up cases where prime ministers had health problems. In 1953, Winston Churchill suffered a serious stroke and was spirited to his country house, Chartwell, where he recuperated in secrecy with a nurse and his private secretary bringing him government papers.
For weeks, his secretary, Jock Colville, later wrote, “My colleagues and I had to handle requests for decisions from ministers and government departments who were entirely ignorant of the prime minister’s incapacity.”For weeks, his secretary, Jock Colville, later wrote, “My colleagues and I had to handle requests for decisions from ministers and government departments who were entirely ignorant of the prime minister’s incapacity.”
In 1983, Margaret Thatcher had an eye operation for a detached retina at a private clinic in Windsor. The government did not disclose her location, but the press discovered it and the surgeon later spoke to reporters.In 1983, Margaret Thatcher had an eye operation for a detached retina at a private clinic in Windsor. The government did not disclose her location, but the press discovered it and the surgeon later spoke to reporters.
In 2003 and 2004, Mr. Blair underwent two heart procedures for cardiac arrhythmia, at least one of which required sedation. In both cases, Mr. Powell recalled, “We kept it hush-hush and didn’t brief it beforehand.” But Mr. Blair was back on the job within 24 hours and suffered no lingering effects.In 2003 and 2004, Mr. Blair underwent two heart procedures for cardiac arrhythmia, at least one of which required sedation. In both cases, Mr. Powell recalled, “We kept it hush-hush and didn’t brief it beforehand.” But Mr. Blair was back on the job within 24 hours and suffered no lingering effects.
Part of the problem, Mr. Powell said, is that the role of prime minister has evolved from being first among equals in an empowered cabinet to more of a singular national leader, in the mold of an American or French president.Part of the problem, Mr. Powell said, is that the role of prime minister has evolved from being first among equals in an empowered cabinet to more of a singular national leader, in the mold of an American or French president.
“We don’t have a cabinet system in the old way,” Mr. Powell said. “Since Thatcher, the prime minister has been more of a president. We need a prime minister in place to make the key decisions.”“We don’t have a cabinet system in the old way,” Mr. Powell said. “Since Thatcher, the prime minister has been more of a president. We need a prime minister in place to make the key decisions.”