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British Prime Minister Boris Johnson was transferred to intensive care in London as he deals with his case of coronavirus COVID-19. He's receiving "standard oxygen treatment" and breathing without assistance, said his spokesperson on Tuesday.
The spokesperson said his condition is stable and he "remains in good spirits." He has not required invasive or non-invasive ventilation and does not have pneumonia.
Johnson was initially taken to the St. Thomas' Hospital on Sunday evening, with Downing Street saying at the time it was a precautionary measure because he continued to have a cough and fever 10 days after he tested positive for COVID-19. On Monday his condition deteriorated, and he was moved to the ICU.
Senior Cabinet minister Michael Gove said Johnson was "receiving the very best care" at the London hospital after being taken to the ICU at 7 pm. Gove is self-isolating because a family member was displaying COVID-19 symptoms. He is continuing to work and does not have any symptoms.
The prime minister's deteriorating condition at a time of national emergency called attention to the lack of a formal procedure for U.K. heads of government. It raised questions about who is leading the country.
Johnson nominated Foreign Secretary Dominic Raab, to deputize for him "as necessary," but there is no recent precedent for a sitting prime minister who becomes incapacitated for a considerable amount of time.
Downing Street stressed in its daily update to reporters that Raab was running the country from the Foreign and Commonwealth Office and has the support of government officials.
He would chair meetings of the National Security Council if needed while he was deputizing, said a spokesperson. Raab and the U.K.'s Cabinet have the authority and ability to respond in Johnson's absence on military action.
Decisions that relate to the coronavirus pandemic will be made in the usual way through the daily morning meeting and other ministerial groupings. While he chairs the morning meetings, he does not have the authority to hire and fire ministers or officials, according to the spokesperson.
The lockdown in the U.K. will continue with the government "focused on stopping the spread of the infection." If there is evidence that more needs to be done to slow the rate of COVID-19 transmission, the spokesperson said, "We would be prepared to do that."
There are few formal powers given to the prime minister, and key decisions are made collectively by the Cabinet or sub-committees. Individual secretaries of state hold many statutory powers. In modern history, the U.K. prime ministers have adopted a style that was more presidential.
"The prime minister has a team around him who ensure the work of government goes on," said Gove. He did not answer questions about who would make decisions in the event of a nuclear attack, stating he would not discuss national security issues.
Despite the lack of a formal succession procedure in the U.K., Johnson's spokesperson said there was an established order of ministerial precedence with the top finance minister, Rishi Sunak following Raab. Still standing are the "letters of last resort." These are sealed documents written by the prime minister to ballistic missile submarine commanders in the case of a nuclear attack.
"The prime minister remains the prime minister," insisted the spokesperson.
Gove said on Tuesday that Cabinet members were not told about Johnson's deteriorating condition until nearly an hour after he'd been taken to the ICU. Asked whether he'd been upfront with the public regarding the situation and whether the Cabinet had been taken by surprise, he said, "Yes, we were. The [daily coronavirus] briefing that was given at 5 o'clock was given at a time when we didn't know about the deterioration in the prime minister's condition."
"We were informed subsequently. The prime minister was admitted to intensive care at 7 o'clock, and that information wasn't given to us in government."
Buckingham Palace and the Queen have been kept updated on Johnson's condition, according to Downing Street. His two most senior officials, the cabinet secretary and his principal private secretary will maintain contact with the palace, but there will be no weekly audiences with the Queen for the time being.
The Queen sent a message to Carrie Symonds, Johnson's pregnant fiancée, and the prime minister's family. "Her Majesty said they were in her thoughts and that "she wished the prime minister a full and speedy recovery," said Buckingham Palace.
Prince William added, "Our thoughts are with the prime minister and his family, who like so many in the U.K. and around the world are affected by coronavirus."
Donald Trump said at Monday's press briefing that his administration had been in contact with Johnson's doctors. "We're very saddened to hear that he was taken into intensive care, this a little while ago. He's been a really good friend. He's been really something very special. Strong. Resolute," he said.
The prime minister's spokesperson said the government was "grateful for all the warm wishes the PM has received overnight" and "confident he is receiving the best care from the NHS. Any treatment he receives is a matter for his doctors."
There have been others in the British government affected by COVID-19. Health Secretary Matt Hancock said he had the virus on March 27, the same day chief medical officer Chris Whitty announced he was self-isolating after showing symptoms. Neil Ferguson, a top UK government adviser on coronavirus, said nine days earlier he believed he was infected.
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