Boris Johnson tested positive for COVID-19 and is being treated in the ICU. Experts explain the possible fallout of other world leaders catching the coronavirus.

  • The coronavirus, which causes a disease called COVID-19, has killed more than 74,000 and infected over 1.3 million. It has spread to at least 184 countries.
  • On March 27, UK Prime Minister Boris Johnson became the first world leader of a major power to announce that he had tested positive for COVID-19. He is currently undergoing treatment in the ICU.
  • Other world leaders, including US President Donald Trump and Canada's Justin Trudeau, have come into contact with people who tested positive for the illness.
  • Several experts weighed in on the possible social, political, and economic effects of a major world leader contracting COVID-19.
  • Visit Business Insider's homepage for more stories.

As COVID-19 continues to spread around the world, experts have weighed in on the possible social, political, and economic fallout if a head of state were to contract COVID-19.

On March 27, UK Prime Minister Boris Johnson became the first world leader of a major power to announce that he had tested positive for COVID-19, the disease caused by the new coronavirus. On April 5, he entered the hospital for treatment, and as of April 6, he had been moved into an intensive-care unit after his coronavirus symptoms worsened.

"Over the course of this afternoon, the condition of the Prime Minister has worsened and, on the advice of his medical team, he has been moved to the Intensive Care Unit at the hospital," his spokesperson said on April 6. 

Johnson's illness has raised questions of what would happen if other world leaders, like President Donald Trump or Canadian Prime Minister Justin Trudeau, were to be incapacitated by the virus.

Before Johnson's diagnosis, Nadine Dorries, the minister for mental health in Johnson's government, tested positive for COVID-19. Dorries was reported to have met with members of Parliament and Johnson before receiving the diagnosis.

As of April 6, the new coronavirus has killed more than 74,000 and infected over 1.3 million. The virus has spread to at least 184 countries.

On March 11, the World Health Organization declared it a pandemic, a designation not seen since 2009's H1N1 influenza outbreak. Many countries have implemented sweeping lockdown measures in response. 

Other world leaders have had brushes with people who have tested positive for COVID-19.

Trudeau's wife, Sophie Grégoire Trudeau, announced in a statement on March 13 that she had tested positive for COVID-19 and would remain in isolation at home. Before the announcement, Justin Trudeau said he was self-isolating while his wife was being tested. Grégoire Trudeau said that she was "all clear" of the virus on March 29. Trudeau has been working from home and has not reported symptoms.

And Trump might also have come into contact with someone who tested positive for the coronavirus.

An attendee of the Conservative Political Action Conference in February — where thousands of people, including Trump, Vice President Mike Pence, and numerous White House officials, were — later tested positive for the virus. Trump also may have recently had contact with Brazilian President Jair Bolsonaro's communications chief, Fabio Wajngarten, who also tested positive for the virus.

And while Bolsonaro has been tested for the coronavirus, the White House said after the incident that Trump and Pence didn't need tests because they had "almost no interactions" with Wajngarten, though photos show them in close proximity.

The White House said last month that Pence tested negative for the disease, and in early April, the White House said Trump had also tested negative for COVID-19.

Experts say countries likely have contingency plans for when a leader catches a serious illness like COVID-19

Ann Keller, an associate professor of health politics and policy at the University of California at Berkeley, said that in a democracy there is usually a chain of command if a leader becomes incapacitated because of an illness.

"In stable democracies, if a head of state dies in office, there are clear patterns of transition so that there is no vacuum of leadership at the top," she told Business Insider.

In the US, for example, Pence is second in the chain of command after Trump, followed by House Speaker Nancy Pelosi. In Canada, Deputy Prime Minister Chrystia Freeland would temporarily take over Trudeau's responsibilities if he were to become ill. Other pluralist democracies may choose another elected official to lead.

In the UK, foreign secretary Dominic Raab has assumed duties while Johnson remains in hospital. Should Johnson become too ill to serve as prime minister, no immediate election would be called, though the opposition party could eventually pressure parliament into having one. 

Still, some experts said that even if a chain of command were laid out, the unique nature of the new coronavirus might change how responsibilities are carried out.

"Often there's something on paper, but the implementation is up to people around the leader making difficult and sensitive judgments that could easily backfire," Eugene Bardach, a professor emeritus at the Goldman School of Public Policy at Berkeley, told Business Insider. "That is, providing the leader is merely incapacitated and doesn't drop dead, in which case the needed actions get triggered quickly if the death becomes known."

The chain of command is less transparent in nondemocratic societies, making it difficult to predict what would happen if a leader elsewhere in the world were to come down with the disease.

"In autocracies, a death signals a coup or civil war," Bardach said.

hair bolsonaroBrazilian President Jair Bolsonaro has been tested for the coronavirus.Screenshot/Facebook

World leaders have gotten sick in office before

Several world leaders have gotten sick while in power. Four US presidents have also died from illness while in office. 

"It's not that unusual that world leaders get sick (or even die) in office," Sue Horton, a research chair and professor of health economics at the University of Waterloo in Ontario, told Business Insider.

Keller said that "there are a lot of examples of heads of state needing medical care, getting it, sharing that information, and continuing on with their elected roles."

In 1955, US President Dwight Eisenhower suffered a major heart attack while in office and required extensive hospitalization. And French President François Mitterrand had prostate cancer when he left office in 1995.

Several members of Iran's Parliament, including the country's health minister, have been infected with COVID-19.

Keller said that while we have seen leaders battle serious illnesses in the past, the world has not been faced with the prospect of heads of state being affected by a pandemic.

"What I think might be different in this case is that in most cases where a head of state has been sick, they were not also in the middle of trying to lead their country through a crisis," Keller said. "That is an added complicating factor."

Some leaders in the past have also tried to downplay the severity of their sickness to maintain public trust. President John F. Kennedy had an autoimmune condition called Addison's disease that he hid from the American public while in office.

"Leadership benefits from its own credibility and doesn't want to lose it," Bardach said.

The worst fallout from a world leader getting sick would be public opinion and a hit to the global economy

Experts said a world leader falling ill might have serious social and economic effects.

There could be major economic fallout from the coronavirus outbreak as it spreads. Modeling from Australian National University from last month predicted at least a $2.4 trillion hit to global gross domestic product. In the worst case, the global GDP loss could be as high as $9 trillion.

Global stocks have seen a series of erratic raises and dips as the virus continues to impact policy and industries around the world. 

"Markets don't like uncertainty," Keller said. "So if a head of state is sick and not able to perform her or his duties, that could create a lot of uncertainty."

Horton agreed that instability could create uncertainty in the global markets but said she doubted it would have lasting effects.

"There is short-term anxiety about any such [leadership] change, but it has happened often enough that I don't think it would have that lasting of an impact," Horton said.

The experts also said the social response to a world leader's illness could vary.

Bardach said that the fact that the US has an election later this year could affect the White House's transparency about illness among its top ranks.

"The stakes are very high because it's an election season," Bardach said. 

Keller said there would more likely be a mixed response among Americans.

"I tend to think that there is no single public response," Keller said. "If a head of state dies, that can create what political scientists call 'rally around the flag' responses."

She said it was less clear what would happen if a world leader's illness were to be announced via the media.

"That news could undermine morale for the public," Keller said. "Or it could bring home just how serious this pandemic is for members of the public who had been trying to minimize it.

"Along those lines, if a head of state got sick and recovered, that could help the public feel less fear around what might happen," Keller said.

"Of course," she added, "an infected head of state who did not recover could produce the opposite public response."

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