Skip to main content

Britain's Prime Minister Boris Johnson is in intensive care at St. Thomas' Hospital in central London, on April 7, 2020.ISABEL INFANTES/AFP/Getty Images

British Prime Minister Boris Johnson is expected to remain in intensive care at a London hospital for several days, leaving the country effectively leaderless as the number of COVID-19 cases there has surpassed 55,000.

Mr. Johnson, 55, was moved to the intensive-care unit of St Thomas’ Hospital Monday, almost two weeks after he tested positive for the virus and became ill. Downing Street officials said Tuesday that he was in stable condition and “good spirits.” He has been receiving oxygen treatment but had not been put on a ventilator, they added.

The government’s COVID-19 ICU statistics indicate a sobering 54-per-cent survival rate for those in Mr. Johnson’s age group.

As British PM Boris Johnson lies in intensive care with COVID-19, London’s eerie silence surrounds his hospital room

Mr. Johnson’s absence has left a vacuum at the heart of the government, which has already seen several senior advisers and another cabinet minister, Michael Gove, forced into self-isolation. Mr. Johnson has selected Foreign Secretary Dominic Raab to take over some prime ministerial duties, but Mr. Raab’s power appears to be limited.

He ducked questions Tuesday about whether he was fully in charge or if he would be making major decisions. “Decision making by government is made by collective cabinet responsibility, so that is the same as before,” Mr. Raab said during a news conference. “We’ve got very clear directions, very clear instructions from the Prime Minister, and we’re focused with total unity and total resolve on implementing them.” He added that he was confident Mr. Johnson would return to work “in short order.”

The lack of clear oversight threatens to hobble the government as it faces some major challenges and big decisions about how to handle the pandemic. The number of confirmed cases in Britain reached 55,242 Tuesday, and the death toll hit 6,159. Both figures have been showing signs of levelling off recently, but health officials said they don’t expect the outbreak to peak for another week.

Pressure has been building to increase the amount of testing and to provide more protective gear for hospital staff. Health Minister Matt Hancock has promised to carry out 100,000 tests a day by the end of the month; as of Tuesday, the figure stood at just 14,000. Mr. Raab said the target still stood, but he deflected questions about whether he would take responsibility for ensuring it was met.

He and other ministers will also have to decide whether to extend the near-total lockdown of the country that Mr. Johnson imposed two weeks ago to help stop the spread of the virus. At the time, Mr. Johnson said the measure would be reviewed in three weeks. On Tuesday, Mr. Raab declined to say if the lockdown would be extended or eased. He said it was too early to assess whether the restrictions had sufficiently helped reduce the number of new cases.

The lack of certainty over who is running the country stems from the fact that Britain does not have a deputy prime minister or a clear line of succession. Alex Thomas, a program director at the Institute for Government, said Mr. Johnson could have deputized another minister but he “clearly decided that [Mr. Raab] was the right person to do it to avoid having a row between anybody else.”

Mr. Thomas added that while the Prime Minister doesn’t run day-to-day government operations, he does set the overall strategy and make critical decisions.

It is also unclear what happens if Mr. Johnson dies. Cabinet would have to select a new prime minister, who would have to be approved by the Queen. The Conservative Party would then have to decide whether to hold a leadership race. Whoever won that contest would take over as party leader and prime minister, on approval of the Queen. How long a new prime minister could remain in office without calling an election isn’t clear. The Conservatives won a large majority in December and another election isn’t due until 2024.

“The British way certainly has not been to describe a particular process about how to deal with all these situations,” Mr. Thomas said. “It leaves space for politics to happen.”

If Mr. Johnson is laid up in intensive care for a while it’s because he is seriously ill. The ICU has been reserved for only the most advanced cases of COVID-19, which affects the respiratory system. Patients often require mechanical ventilation to help pump oxygen into the bloodstream. And the survival rate is not encouraging.

A report dated April 3 by Britain’s Intensive Care National Audit and Research Centre found that of the 2,249 patients with COVID-19 admitted to intensive care, 346 died and 344 “were discharged alive from critical care.” The remainder were still in critical care. Those in Mr. Johnson’s age group – 50 to 69 – fared slightly better than the whole group: 142 died and 168 were discharged.

Our Morning Update and Evening Update newsletters are written by Globe editors, giving you a concise summary of the day’s most important headlines. Sign up today.