In Depth

Boris Johnson in intensive care: how bad is it and who is running the country?

The prime minister is breathing without a ventilator and has not been diagnosed with pneumonia

Prime Minister Boris Johnson, who was hopitalised on Sunday due to persistent coronavirus symptoms, spent Monday night in intensive care, Downing Street has said.

“Over the course of [yesterday] 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,” a spokesman said in a statement.

The prime minister had asked the foreign secretary, Dominic Raab, to deputise for him “where necessary”, the statement said.

Why has Johnson been moved?

After being admitted to hospital over the weekend, Johnson was given oxygen late yesterday afternoon, before being taken to intensive care, the BBC says. 

Downing Street has said he is breathing without a ventilator and has not been diagnosed with pneumonia. His spokesman said he was “stable” overnight and is still in “good spirits”.

The move marks a “dizzying turn of events”, The New York Times says, after No. 10’s insistence over the past two days that Johnson remains in charge of the country.

Earlier on Monday, the prime minister posted an update from hospital on Twitter saying that he had undergone “some routine tests” and thanked health workers for taking care of him.

Aged 55, Johnson is not thought to have any pre-existing medical conditions, though he has discussed his struggles with weight in the past. Two years ago he wrote in an article that he had cut out some calorific food because he had reached 16 stone (104kg).

Sources at the hospital have told The Times that Johnson needed four litres of oxygen in intensive care. The normal threshold for intensive care is 15 litres, “suggesting that he was in better health than such patients generally”.

Derek Hill, professor of medical imaging at University College London, told Sky News that “there is no doubt this turn of events means Boris Johnson is extremely sick”.

Who is running the country?

Raab, who last month was nominated as the government’s “designated survivor”, will deputise for the prime minister until he returns to his post.

In its statement yesterday evening, Downing Street put a positive spin on Johnson’s condition but - according to BBC political editor Laura Kuenssberg - “something important has changed, and he has felt it necessary to ask his foreign secretary to deputise for him where needs be.”

Raab, who chaired the daily government coronavirus meeting this morning, admitted that he had not spoken to Johnson since Saturday. In a Twitter post, the BBC’s Andrew Neil asked why there had been no communication between the pair. “Something not right here,” he said.

In an interview shortly after the news of Johnson’s deterioration, Raab said there is an “incredibly strong team spirit” behind the prime minister and vowed that the government would bring the country through the pandemic.

If Raab were to also fall ill, the PM has the power to delegate responsibility to any of his ministers.

What has the reaction been?

Sterling dropped against the US dollar after the news emerged. The pound had been trading higher against the dollar and the euro earlier, but fell sharply after the announcement.

World leaders and former British prime ministers have sent messages of support. France’s President Emmanuel Macron said in a tweet: “All my support to Boris Johnson, to his family and the British people at this difficult time. I hope he overcomes this ordeal quickly.”

Others also sent messages of support to the prime minister.

What happens next?

At yesterday’s press conference, Raab said that it is too soon to discuss a strategy for ending Britain’s lockdown, and insisted that the current focus should remain on physical distancing measures to try to halt the spread of the virus.

According to the latest figures released, 51,000 people across Britain have tested positive for coronavirus and 5,373 people have died, though statistics show the rate of hospital admissions now appears to be slowing.

On the question of how the government is run in Johnson’s absence, the BBC says that Raab has most but not all of the powers of a prime minister, but “in practice any major decisions would probably be taken... in consultation with the cabinet or, where appropriate, the cabinet secretary and other senior officials”.

The Guardian explains that “as the UK is a parliamentary democracy, there is no need, under the UK’s unwritten constitution, for an election in order for Raab to assume prime ministerial powers”.

If the prime minister died, the Queen would ask Raab to form an interim government unless the cabinet put forward someone else. For now, he will chair Cobra and cabinet meetings as the government makes pivotal and difficult decisions on the coronavirus.

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