Explainer

When the Coronavirus Reaches the Top

Trump is far from the first world leader to face the political implications of his own positive COVID-19 test. What happens next?

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Foreign Policy illustration/Getty Images

Foreign Policy illustration/Getty Images

On Friday, in a post-midnight tweet, U.S. President Donald Trump announced that he and his wife, Melania Trump, had tested positive for the coronavirus. The news comes just 32 days before the presidential election and at the end of one of the busiest weeks of Trump’s campaign. Since last Saturday, he has attended two rallies, a fundraiser, and the first of three scheduled presidential debates with Democratic nominee and former Vice President Joe Biden in Cleveland. The president and the first lady are now in quarantine at the White House.

Trump is now one of many world leaders and other top officials to be infected with COVID-19 since the World Health Organization declared the virus a pandemic more than six months ago. From Brazilian President Jair Bolsonaro to British Prime Minister Boris Johnson, the cases have varied in health and political effects—but each infection has intensified questions about the leader’s handling of the pandemic. For Trump’s campaign, much depends on the days ahead and the severity of his symptoms.

Below is a list of the top leaders who tested positive for COVID-19—and what came next.


President Donald Trump, United States

Trump’s announcement came just hours after Bloomberg News reported that Hope Hicks, a senior advisor who traveled with the president this week, had tested positive. The line of transmission remains unclear, and the administration appears to have bungled official communications about potential exposure. The White House did not alert Biden’s campaign before the Friday announcement, even though the two candidates appeared together maskless at the Tuesday debate. Trump held a scheduled fundraiser in Bedminster, New Jersey, on Thursday, despite learning of Hicks’s test results that morning.

With Trump under quarantine, his infection has already jolted the presidential race, but the ultimate political outcome could rest on what happens over the next few days. As a 74-year-old man with obesity, the president is at elevated risk for serious illness, though most people with COVID-19 recover quickly with minimal symptoms, which tend to appear within a few days of infection. The White House has confirmed that both the president and first lady are experiencing mild symptoms of COVID-19.

The COVID-19 Global Response Index: As governments around the world continue to grapple with the pandemic, FP Analytics is tracking national leaders’ responses in critical policy areas across 36 key countries, including public health directives, financial responses, and fact-based public communications. Learn more.

The COVID-19 Global Response Index: As governments around the world continue to grapple with the pandemic, FP Analytics is tracking national leaders’ responses in critical policy areas across 36 key countries, including public health directives, financial responses, and fact-based public communications. Learn more.

Still, Trump’s infection marks perhaps the most serious health threat to a sitting president since the attempted assassination of President Ronald Reagan in 1981, and certainly the most serious so close to an election. If Trump is hospitalized or otherwise incapacitated, he could invoke the 25th Amendment to the U.S. Constitution—temporarily transferring power to Vice President Mike Pence.

For the moment, the news has effectively suspended White House events, Trump’s campaigning, and any future debates. In addition to the Trumps and Hicks, at least two others who attended the White House ceremony announcing Amy Coney Barrett’s nomination to the Supreme Court—Sen. Mike Lee and the president of the University of Notre Dame, John Jenkins—have tested positive. (Barrett, who had COVID-19 earlier this year, tested negative on Friday.) The revelations have also heightened fears among state officials that Trump’s massive rallies across the country in the final stretch of the campaign, including in Pennsylvania and Minnesota this week, could be superspreader events, increasing the number of COVID-19 cases across the country.

Pence, his wife Karen Pence, Secretary of State Mike Pompeo, and Attorney General Bill Barr all tested negative for COVID-19 on Friday morning. Both Biden and his running mate, California Sen. Kamala Harris, have also tested negative, according to their campaign advisors.


A man reads a newspaper story about Boris Johnson outside St Thomas' Hospital in Westminster, where the British prime minister was transferred to the intensive care unit after persistent symptoms of COVID-19, on April 7.

A man reads a newspaper story about Boris Johnson outside St. Thomas’ Hospital in Westminster, where the British prime minister was transferred to the intensive care unit after persistent symptoms of COVID-19, on April 7. Ollie Millington/Getty Images

Prime Minister Boris Johnson, United Kingdom

British Prime Minister Boris Johnson, 56, is thought to be the first major world leader to test positive for COVID-19. On March 27, Johnson announced in a video on Twitter that he had contracted the virus, just over a week after his government dropped its herd immunity approach to the pandemic.

Despite not being at a high risk for coronavirus complications, Johnson nearly died of COVID-19. After experiencing mild symptoms at first, he was hospitalized for a week and spent three days in intensive care. Johnson later said, it “could have gone either way.”

Johnson’s COVID-19 infection garnered him sympathy as the British death toll rose rapidly in early April. Even those opposed to his politics wished him a speedy recovery, and his brush with death gave him a boost in the polls—his popularity ratings this year peaked the week he was discharged from the hospital.


Prince Charles, United Kingdom

Prince Charles, 71, the heir to the British throne, also contracted COVID-19 in March. After testing positive, he self-isolated with his wife, Camilla, the Duchess of Cornwall—who tested negative—in Scotland.

In June, Charles said that he was lucky he experienced only mild symptoms. He told Sky News that he “got away with it quite lightly” and used COVID-19 as a springboard to address broader environmental issues. “The more we erode the natural world, the more we destroy biodiversity, the more we expose ourselves to this kind of danger,” he said.


French director Claude Lelouch films Monaco’s Prince Albert II as he gets in a Ferrari while filming a short movie in Monaco on May 24.

French director Claude Lelouch films Monaco’s Prince Albert II as he gets in a Ferrari while filming a short movie in Monaco on May 24. VALERY HACHE/AFP via Getty Images

Prince Albert II, Monaco

On March 19, Prince Albert II of Monaco, 62, became the first reigning monarch or head of state to announce that they had tested positive for COVID-19. In the statement, the palace said that Prince Albert’s symptoms weren’t worrying and that he would work from home, and he urged the people of Monaco to follow coronavirus restrictions. Within two weeks, the palace confirmed that Prince Albert had recovered.


Prime Minister Avdullah Hoti, Kosovo

Kosovar Prime Minister Avdullah Hoti announced in an Aug. 2 Facebook post that he had contracted the coronavirus and that he would self-isolate for two weeks. Hoti, 44, said he had “no symptoms, except for a very mild cough.”

The unwelcome shock came only two months into Hoti’s tenure at the country’s helm. Hoti’s Democratic League of Kosovo had actually initially gained power on June 3 after an intra-government rift over Kosovo’s handling of the coronavirus pandemic precipitated a vote of no confidence for his predecessor, Albin Kurti, who refused to declare a state of emergency amid the pandemic.

As the new prime minister wrestled with the virus, Kosovars again expressed frustration with their government’s inaction; the country of 1.8 million people has seen over 12,000 cases of COVID-19. Hoti, for his part, was well enough to make a visit to Washington to meet Trump in early September.


Prime Minister Nikol Pashinyan, Armenia

Armenian Prime Minister Nikol Pashinyan, 45, announced on June 1 that he and his family had contracted the coronavirus. In a Facebook Live video, Pashinyan said that he was not yet experiencing symptoms and assumed he was infected by a gloveless waiter who delivered him a glass of water during a meeting. Armenia, now engulfed in a probable war with Azerbaijan over the disputed region of Nagorno-Karabakh, has suffered over 50,000 cases and nearly 1,000 deaths.


President Aleksandr Lukashenko, Belarus

Belarusian President Aleksandr Lukashenko said in July that he had experienced an asymptomatic case of the coronavirus. “The most surprising thing is that today you are seeing a person who managed to power through coronavirus standing on his feet,” Lukashenko said after he recovered, according to the state-owned news agency Belta. Lukashenko, who has refused to impose a strict lockdown, previously dismissed the threat of COVID-19 as a “psychosis” and suggested that drinking vodka and regular visits to the sauna would keep citizens healthy. Lukashenko’s handling of the coronavirus crisis has contributed to the public discontent driving ongoing protests in Minsk that accelerated after the Aug. 9 presidential election.


Prime Minister Mikhail Mishustin, Russia

Russian Prime Minister Mikhail Mishustin, 54, self-isolated in the hospital after testing positive for COVID-19 in late April. The prime minister, who took office in January, temporarily stepped back from his duties until he recovered. Several other ministers, including Kremlin spokesperson Dmitry Peskov, tested positive around the same time.

Russia, which soon plans to share the initial results of its vaccine trial, has recorded over 1 million cases of COVID-19 but lifted its strict lockdown restrictions in June. Despite life largely returning to normal in Russia, President Vladimir Putin reportedly rarely leaves home and conducts most senior-level meetings over video.


Brazilian President Jair Bolsonaro takes off his protective mask to speak to journalists during a news conference about the coronavirus outbreak at the Planalto Palace in Brasilia on March 20.

Brazilian President Jair Bolsonaro takes off his protective mask to speak to journalists during a news conference about the coronavirus outbreak at the Planalto Palace in Brasília on March 20. Andressa Anholete/Getty Images

President Jair Bolsonaro, Brazil

After spending months dismissing the seriousness of the coronavirus pandemic, Brazilian President Jair Bolsonaro, 65, tested positive for COVID-19 in early July. The president, who had compared the virus to a “little flu” and had carried out large political demonstrations that went against public health guidelines, announced he was taking hydroxychloroquine, which health experts have warned is not an appropriate COVID-19 treatment, after showing mild symptoms.

“For those who root against hydroxychloroquine, but don’t present alternatives, I regret to inform you that I’m very well with its use and, with God’s grace, I will live for a long time still,” Bolsonaro said.

When announcing his test results to the press, Bolsonaro took off his mask to show that he was doing “perfectly well,” which prompted a group of journalists to sue the far-right president. At least 11 Brazilian governors, as well as top government officials and first lady Michelle Bolsonaro, tested positive for the virus.

Brazil, which has confirmed nearly 35 million COVID-19 cases and at least a million deaths, has been the epicenter of the disease in Latin America since at least June. Globally criticized for his handling of the pandemic, Bolsonaro has fired two health ministers since March out of the belief that their approach was too extreme, more recently appointing an army general for the position. “We have a military occupation with no expertise whatsoever in the management of the public health system,” Luiz Henrique Mandetta, one of the fired ministers, said.


President Juan Orlando Hernández, Honduras

Honduran President Juan Orlando Hernández, 51, and his wife tested positive for COVID-19 back in June. Despite being hospitalized and treated for pneumonia, the president announced that he would continue to carry out his duties remotely. “I feel enough strength and energy to continue forward and beat this pandemic,” Hernández said in a televised statement.


Jeanine Añez, Bolivia’s interim president, signs a law further delaying the 2020 general elections at Government's Palace in La Pas on Aug. 13.

Jeanine Añez, Bolivia’s interim president, signs a law further delaying the 2020 general elections at Government’s Palace in La Paz on Aug. 13. Gaston Brito/Getty Images

Interim President Jeanine Áñez, Bolivia

Interim Bolivian President Jeanine Áñez, 53, tested positive for the coronavirus in July, a moment when her country was experiencing turmoil due to the postponement of the presidential elections. Many of her government officials, including Health Minister María Eidy Roca, who was appointed in late May after her predecessor was arrested for corruption, also contracted the virus.

With protests growing increasingly violent in the country after that, Áñez opted to drop out from the upcoming presidential election scheduled for Oct. 18. The decision came one day after a highly regarded poll ranked her fourth in the race. “I’m doing this because of a risk that the vote gets divided between various candidates,” Áñez, who is trying to garner support for the conservative bloc, said. “If we don’t get together, democracy loses.”


President Alejandro Giammattei, Guatemala

On Sept. 18, Guatemalan President Alejandro Giammattei, 64, became the latest Latin American leader to test positive for COVID-19. The president, who has multiple sclerosis and uses crutches to walk, had previously said that he was a high-risk patient. Despite presenting mild symptoms, Giammattei said that he would keep himself “busy working from home.” The announcement came on the same day Guatemala reopened its borders and reinstated international flights after a six-month lockdown.


President Pierre Nkurunziza, Burundi

On June 8, the government of Burundi announced that President Pierre Nkurunziza, 55, had died of a heart attack after a brief illness. But according to accounts from local news outlets and diplomats, he was the first head of state killed by COVID-19. Senior officials have denied the reports as rumors, and at the time Burundi had limited testing and only 83 reported cases. In the weeks before his death, Nkurunziza downplayed the pandemic and allowed campaigning for the May 20 election to replace him to go ahead with limited social distancing at rallies.

Elected successor Évariste Ndayishimiye took office two months ahead of schedule on June 18, inheriting a public health crisis, an ailing economy, and a country in need of wide-ranging reforms after Nkurunziza’s 15-year rule.


Michel Barnier, European Union chief Brexit negotiator

Michel Barnier, the EU’s chief Brexit negotiator, tested positive for the coronavirus on March 19, just as the virus was making its first sweep across Europe. In a tweet, Barnier, 69, said he was “doing well and in good spirits,” offering a message of solidarity to all impacted by the virus and lockdown. Barnier returned to his Brussels office on April 14.

In September, Barnier’s name again began trending with “coronavirus” as he suggested that the latest twists in the Brexit saga—Westminster’s efforts to veto certain aspects of the withdrawal agreement it signed in 2019—may have been motivated by the British government’s efforts to detract from its domestic failings in dealing with the coronavirus.


Former Italian Prime Minister Silvio Berlusconi is discharged from the San Raffaele hospital in Milan on Sept. 14 after being treated for COVID-19.

Former Italian Prime Minister Silvio Berlusconi is discharged from the San Raffaele hospital in Milan on Sept. 14 after being treated for COVID-19. Pier Marco Tacca/Getty Images

Silvio Berlusconi, former Italian prime minister

Italy’s notorious media mogul and former Prime Minister Silvio Berlusconi, beset by sex and corruption scandals as he headed four different governments, tested positive for the coronavirus on Sept. 2. Berlusconi, 83, was hospitalized two days later and remained in treatment until his release on Sept. 14.

Berlusconi called his infection “the most dangerous test of [his] life,” and said he “dodged a bullet once again” by not succumbing to COVID-19. While hospitalized—and then from his villa in Arcore—Berlusconi campaigned for his party, Forza Italia, in regional elections that took place on Sept. 20 and 21. Its candidates did not perform well.


Sophie Grégoire Trudeau, wife of Canadian Prime Minister Justin Trudeau

Sophie Grégoire Trudeau, 45, the wife of Canadian Prime Minister Justin Trudeau, tested positive for COVID-19 following a trip to the United Kingdom in March. “Being in quarantine at home is nothing compared to other Canadian families who might be going through this and for those facing more serious health concerns,” she said. Neither the prime minister nor their three children contracted the virus.


Nursultan Nazarbayev, former Kazakh president

Former Kazakh President Nursultan Nazarbayev, 80, self-isolated in June after testing positive for the coronavirus and had recovered within three weeks, according to his spokesperson. Central Asia experienced a surge in cases over the summer after some countries eased restrictions, and Kazakhstan imposed a second lockdown in July.

Nazarbayev resigned as president in 2019 after nearly three decades in power but has retained political influence in Kazakhstan as the chairman of the Security Council.

Audrey Wilson and Robbie Gramer contributed to this report.

Augusta Saraiva is an intern at Foreign Policy. Twitter: @gutavsaraiva

Allison Meakem is an editorial fellow at Foreign Policy. Twitter: @allisonmeakem

Chloe Hadavas is an editorial fellow at Foreign Policy. Twitter: @Hadavas