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story.lead_photo.caption President Donald Trump heads to Air Force One at Morristown Airport in Morristown, N.J., on Thursday, after a fundraiser at Trump National Golf Club Bedminster. (The New York TImes/Erin Schaff)

WASHINGTON -- President Donald Trump and first lady Melania Trump have tested positive for the coronavirus, the president tweeted early today.

Trump's positive test comes just hours after the White House announced that senior aide Hope Hicks came down with the virus after traveling with the president several times this week.

Trump was last seen by reporters returning to the White House on Thursday evening and looked to be in good health. Trump is 74 years old, putting him at higher risk of serious complications from a virus that has now killed more than 200,000 people nationwide.

"Tonight, FLOTUS and I tested positive for COVID-19. We will begin our quarantine and recovery process immediately. We will get through this TOGETHER!" Trump tweeted.

Trump did not elaborate on what the "quarantine process" will entail. It can take days for an infection to be detectable by a test.

Trump's White House doctor issued a statement just before 1 a.m. today saying the president will continue carrying out his duties "without disruption."

Dr. Sean Conley said the president and first lady "are both well at this time, and they plan to remain at home within the White House during their convalescence."

Trump has canceled plans to attend a fundraiser and to fly to Florida for a rally today, but he did keep on his schedule a previously planned midday telephone call "on COVID-19 support to vulnerable seniors."

The diagnosis marks a setback for the president who has been trying to assure the American public that the worst of the pandemic is behind them. And it stands as the most serious known public health scare encountered by any sitting American president in recent history.

Symptoms of covid-19 can include fever, cough and breathing trouble. Most people develop only mild symptoms. But some people, usually those with other medical complications, develop more severe symptoms, including pneumonia, which can be fatal.

In an interview with Fox News host Sean Hannity on Thursday evening, Trump said he was awaiting results of the covid-19 test.

Hicks traveled with the president multiple times this week, including aboard Marine One, the presidential helicopter, and on Air Force One to a rally in Minnesota on Wednesday, and aboard Air Force One to Tuesday night's first presidential debate in Cleveland.

The White House has access to near-unlimited resources, including a constant supply of quick-result tests, and still failed to keep the president safe, raising questions about how the rest of the country will be able to protect its workers, students and the public as businesses and schools reopen.

Trump, the vice president and other senior staff members have been tested for covid-19 daily since two people who work at the White House complex tested positive in early May, prompting the White House to step up precautions. Everyone who comes into contact with the president also receives a quick-result test.

Yet since the early days of the pandemic, experts have questioned the health and safety protocols at the White House and asked why more wasn't being done to protect the commander in chief. Trump continued to shake hands with visitors long after public health officials were warning against it, and he initially resisted being tested.

He has been reluctant to practice his own administration's social distancing guidelines for fear of looking weak, including often refusing to wear a mask in public.

While there is currently no evidence that Trump is seriously ill, the positive test raises questions about what would happen if he were to become incapacitated because of the illness.

The Constitution's 25th Amendment spells out the procedures under which a president can declare himself "unable to discharge the powers and duties" of the presidency. If he were to make that call, Trump would transmit a written note to the Senate president pro tempore, Republican U.S. Sen. Chuck Grassley of Iowa, and House Speaker Nancy Pelosi, D-Calif.

Vice President Mike Pence would serve as acting president until Trump transmitted "a written declaration to the contrary."

The vice president and a majority of either the Cabinet or another body established by law, can also declare the president unable to discharge the powers and duties of his office, in which case Pence would "immediately assume the powers and duties of the office as Acting President" until Trump could provide a written declaration to the contrary.

VACCINES DELIVERIES

Meanwhile, an ambitious humanitarian project to deliver coronavirus vaccines to the world's poorest people is facing potential shortages of money, cargo planes, refrigeration and vaccines themselves.

In one of the biggest obstacles, rich countries have locked up most of the world's potential vaccine supply through 2021, and the U.S. and others have refused to join the project, called Covax.

"The supply of vaccines is not going to be there in the near term, and the money also isn't there," warned Rohit Malpani, a public-health consultant who previously worked for the Doctors Without Borders charity.

Covax was conceived as a way of giving countries access to coronavirus vaccines regardless of their wealth.

It is being led by the World Health Organization, a U.N. agency; Gavi, a public-private alliance, funded in part by the Bill & Melinda Gates Foundation, that buys immunizations for 60% of the world's children; and the Coalition for Epidemic Preparedness Innovations, another Gates-supported public-private collaboration.

Covax's aim is to buy 2 billion doses by the end of 2021, though it isn't yet clear whether the successful vaccine will require one dose or two for the world's 7.8 billion people. Countries taking part in the project can either buy vaccines from Covax or get them for free, if needed.

One early problem that has emerged: Some of the world's wealthiest nations have negotiated their own deals directly with drug companies, meaning they don't need to participate in the endeavor at all.

China, Russia and the U.S. have said they do not intend to join. Other countries, including France and Germany, will technically join Covax but won't procure vaccines for their citizens through the initiative.

Not only that, but firm agreements with Covax came in too late to prevent more than half of all potential doses being snapped up by countries representing 13% of the world's population, according to an Oxfam study.

"As a continent of 1.2 billion people, we still have concerns," John Nkengasong, director of the Africa Centers for Disease Control and Prevention, said Thursday.

He praised Covax for the solidarity it represents but said there are serious questions about allocation, saying African nations' envoys are meeting directly with vaccine manufacturers to ask "if we came to the table with money, how would we get enough vaccines to cover the gap?"

The European Union has contributed $469 million to support Covax, but the 27-country bloc won't use Covax to buy vaccines. Instead, the EU has signed its own deals to buy more than 1 billion doses, after some member states raised concerns about what was described as Gavi's "dictatorship" approach to running Covax.

Gavi, WHO and the Coalition for Epidemic Preparedness Innovations announced in September that countries representing two-thirds of the world's population had joined Covax, but they acknowledged they still need about $300 million more from governments or other sources. By the end of next year, Gavi estimates the project will need $5 billion more.

Covax did reach a major agreement this week for 200 million doses from the Indian vaccine maker, Serum Institute, though the company made clear that a large portion of those will go to people in India.

Covax said negotiations to secure vaccines are moving forward despite the lack of funds.

Gavi's Aurelia Nguyen, managing director of Covax, said that nothing similar has ever been attempted in public health.

Covax "is a hugely ambitious project," she said, "but it is the only plan on the table to end the pandemic across the world."

TRANSPARENCY DOUBT

Still, the project is facing doubts and questions from poor countries and activists over how it will operate and how effective it will be.

Dr. Clemens Auer, who sits on WHO's executive board and was the EU's lead negotiator for its vaccine deals, said there is a troubling lack of transparency about how Covax will work.

"We would have no say over the vaccines, the price, the quality, the technical platform or the risks," Auer said. "This is totally unacceptable."

He said WHO never consulted countries about its proposed vaccine strategy and called the health agency's goal of vaccinating the world's most vulnerable people before anyone else a "noble notion" but politically naive.

As part of Covax, WHO and Gavi have asked countries to first prioritize front-line health workers, then the elderly, with the goal of vaccinating 20% of the world's population.

One expensive hurdle is that many of the vaccine candidates need to be kept cold from factory to patient, according to internal documents from Gavi. Industry has signaled that "air freight for covid vaccines will be a major constraint," and a "significant and urgent ramp-up of cold chain capacity" may be needed.

Gavi announced Thursday that it will provide $150 million to help some countries with planning, technical assistance and refrigeration equipment.

Another obstacle: Many of the leading vaccine candidates require two doses. That will mean twice as many syringes, twice as much waste disposal, and the complications involved in ensuring patients in remote corners of the world receive the second dose on time and stay free of side effects.

"Because of the fact that we're looking at trying to get vaccines out as quickly as possible, we're looking at limited follow-up and efficacy data," said Gian Gandhi, who runs logistics from UNICEF's supply division in Copenhagen.

There is also concern that the fear of lawsuits could scuttle deals. According to the internal documents, Gavi told countries that drug companies probably will require assurances that they won't face product-liability claims over deaths or side effects from their vaccines.

Alicia Yamin, an adjunct lecturer on global health at Harvard University, said she fears the "window is closing" for Covax to prove workable. She said it is disappointing that Gavi, WHO and their partners haven't pushed pharmaceutical companies harder on issues like intellectual property or open licenses, which might make more vaccines available.

With little evidence of such fundamental change in the global health world, Yamin said it's likely that developing countries will have to rely on donated vaccines rather than any equitable allocation program.

"I would say that poor countries probably will not get vaccinated until 2022 or 2023," Yamin said.

MODERNA IN SPRING

Meanwhile, Moderna's chief executive said its covid-19 vaccine is not expected to be available for widespread use until the spring.

Stephane Bancel told the Financial Times during a pharmaceutical and biotechnology conference that the company would not be ready to apply for emergency use authorization for its potential vaccine from the Food and Drug Administration until Nov. 25 at the earliest, the newspaper reported Wednesday.

"November 25 is the time we will have enough safety data to be able to put into an EUA ... file that we would send to the FDA -- assuming that the safety data is good, i.e., a vaccine is deemed to be safe," Bancel said, according to the report.

Moderna, he said, would not be prepared to file for approval to distribute the vaccine to the general U.S. population until late January at the earliest. That means the company does not expect to have approval to distribute the vaccine widely until the spring, according to the Financial Times.

"I think a late [first-quarter], early [second-quarter] approval, is a reasonable timeline, based on what we know from our vaccine," Bancel said.

Moderna did not immediately respond to a request from The Washington Post for comment.

The head of Pfizer, another drugmaker racing to develop a vaccine, tried to reassure it U.S. employees that the company won't bend to pressure to move more quickly.

Chief Executive Officer Albert Bourla told the employees Thursday that the company is "moving at the speed of science," rather than under any political timing, according to a staff letter obtained by The Associated Press.

"The only pressure we feel -- and it weighs heavy -- are the billions of people, millions of businesses and hundreds of government officials that are depending on us," Bourla wrote.

Pfizer has said that by late October it expects to have data from its ongoing late-stage test that could show whether the vaccine is safe and effective. In his letter to employees, Bourla wrote that the company hopes to have "a hundred million doses delivered by the end of the year."

'ROLLING REVIEW'

In London, the European Medicines Agency has started a "rolling review" process for the covid-19 vaccine being developed by Oxford University and AstraZeneca, a move it hopes will speed any eventual approval.

In a statement Thursday, the EU regulator said instead of waiting for all of the required vaccine data to be submitted before beginning its assessment, the European Medicines Agency has begun analyzing the preliminary information from scientists on the Oxford vaccine.

That data suggests the vaccine "triggers the production of antibodies and T-Cells," referring to immune system cells that target the virus. The agency said it was waiting for data from ongoing late-stage tests of the vaccine involving thousands of people, which it hopes will be available in the coming weeks and months.

"The rolling review will continue until enough evidence is available to support a formal marketing authorization," the agency said.

The agency said it could not estimate how long this process might take, but that it would be quicker than the normal evaluation procedure. A similar process was used to issue an approval for remdesivir, one of the only licensed drugs to treat covid-19. That approval was issued in just over one month while the standard process can take nearly seven months.

Oxford's vaccine is designed to reduce disease and transmission.

Information for this article was contributed by Zeke Miller, Jill Colvin, Kevin Freking, Maria Cheng, Lori Hinnant, Linda A. Johnson, Jonathan Lemire, Scott Bauer, Todd Richmond and Cara Anna of The Associated Press; and by Paulina Firozi of The Washington Post.

Counselor to the President Hope Hicks walks unmasked from Marine One on Wednesday at Andrews Air Force Base, Md., to accompany President Donald Trump on Air Force One for a campaign trip to Minnesota after also flying with him to the presidential debate on Tuesday.
(AP/Alex Brandon)
Counselor to the President Hope Hicks walks unmasked from Marine One on Wednesday at Andrews Air Force Base, Md., to accompany President Donald Trump on Air Force One for a campaign trip to Minnesota after also flying with him to the presidential debate on Tuesday. (AP/Alex Brandon)
FILE - In this Wednesday, June 24, 2020 file photo, a medical worker addresses some of the first vaccine volunteers, at the Chris Hani Baragwanath hospital in Soweto, Johannesburg. An ambitious humanitarian project to deliver coronavirus vaccines to the world’s poorest people is facing potential shortages of money, cargo planes, refrigeration and vaccines themselves — and is running into skepticism even from some of those it’s intended to help most. (AP Photo/Siphiwe Sibeko, File)
FILE - In this Wednesday, June 24, 2020 file photo, a medical worker addresses some of the first vaccine volunteers, at the Chris Hani Baragwanath hospital in Soweto, Johannesburg. An ambitious humanitarian project to deliver coronavirus vaccines to the world’s poorest people is facing potential shortages of money, cargo planes, refrigeration and vaccines themselves — and is running into skepticism even from some of those it’s intended to help most. (AP Photo/Siphiwe Sibeko, File)
FILE - In this July 30, 2020 file photo, Kai Hu, a research associate transfers medium to cells, in the laboratory at Imperial College in London. Imperial College is working on the development of a COVID-19 vaccine. An ambitious humanitarian project to deliver coronavirus vaccines to the world’s poorest people is facing potential shortages of money, cargo planes, refrigeration and vaccines themselves — and is running into skepticism even from some of those it’s intended to help most. (AP Photo/Kirsty Wigglesworth, File)
FILE - In this July 30, 2020 file photo, Kai Hu, a research associate transfers medium to cells, in the laboratory at Imperial College in London. Imperial College is working on the development of a COVID-19 vaccine. An ambitious humanitarian project to deliver coronavirus vaccines to the world’s poorest people is facing potential shortages of money, cargo planes, refrigeration and vaccines themselves — and is running into skepticism even from some of those it’s intended to help most. (AP Photo/Kirsty Wigglesworth, File)
FILE - In this Wednesday, June 24, 2020 file photo, a volunteer receives an injection at the Chris Hani Baragwanath hospital in Soweto, Johannesburg. An ambitious humanitarian project to deliver coronavirus vaccines to the world’s poorest people is facing potential shortages of money, cargo planes, refrigeration and vaccines themselves — and is running into skepticism even from some of those it’s intended to help most. (Siphiwe Sibeko/Pool via AP, File)
FILE - In this Wednesday, June 24, 2020 file photo, a volunteer receives an injection at the Chris Hani Baragwanath hospital in Soweto, Johannesburg. An ambitious humanitarian project to deliver coronavirus vaccines to the world’s poorest people is facing potential shortages of money, cargo planes, refrigeration and vaccines themselves — and is running into skepticism even from some of those it’s intended to help most. (Siphiwe Sibeko/Pool via AP, File)

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