The dramatic hospitalisation of British Prime Minister Boris Johnson, which has resulted in his spending four nights in isolation at the intensive care unit of one of London's leading hospitals, has highlighted worrying divisions at the heart of the British government over its approach to dealing with the coronavirus pandemic.
On one side, there is the health lobby headed by Health Secretary Matt Hancock, which argues that an ongoing, wide-ranging lockdown that has effectively brought the country to a standstill must remain in place until the overwhelming body of scientific evidence suggests the measures can be lifted.
On the other, there is a more pragmatic approach led by Chancellor Rishi Sunak, which argues that the devastation being caused to the British – and global – economy must not be overlooked. Mr Sunak's camp emphasises the importance of finding a way to ease the lockdown at the earliest possible opportunity.
So long as Mr Johnson was in charge of the government, these divisions were very much under control. At the outset of Britain’s outbreak, which manifested in mid-March, Mr Johnson’s initial instinct was to support his chancellor by allowing Britain to adopt a “business as usual” approach, thereby enabling citizens to carry on with their normal routines. That approach was very much at odds with the stringent measures being taken in most of Europe.
At a time when countries like France and Italy were imposing draconian lockdown measures, forcing their citizens to observe strict rules, British schools remained open, as did pubs, restaurants and cafes. Sports fans, moreover, continued to attend major fixtures, such as the annual Cheltenham horse-racing festival.
Mr Johnson's decision to impose his own nationwide lockdown on March 23 was, therefore, only taken with the utmost reluctance. It came when the Prime Minister found himself faced with alarming evidence from Britain's scientific community that the country could suffer in excess of 250,000 coronavirus-related deaths if the government failed to act in a sweeping manner.
As he changed tack, Mr Johnson made it clear that, in his view, a British lockdown would be very temporary, to be lifted as the earliest possible opportunity to allow citizens a return to their everyday lives and to limit the economic consequences of the pandemic.
And that is the approach that undoubtedly would have formed the cornerstone of British policy had Mr Johnson not himself fallen victim to Covid-19.
The first indication that all was not well with the Prime Minister came on March 27, when he revealed that he had tested positive for the coronavirus after experiencing a high temperature and a cough. Carrie Symonds, his pregnant fiancée, disclosed that she, too, had been suffering symptoms.
In characteristic style, Mr Johnson carried on working and leading the government’s response to the pandemic, even though this required him to work in isolation from other staff at Downing Street, where the British executive is based, and was only able to communicate via video conferencing. To demonstrate that he was still in charge, Mr Johnson posted regular updates to the country on social media. Last week, he even appeared on the steps of Downing Street to join in the nationwide applause for the heroic efforts of staff working for the UK National Health Service.
On Monday afternoon, after Mr Johnson had spent a week in self-isolation, came the shock news that he had been admitted to St Thomas’ Hospital, situated just a half-mile from Downing Street across the River Thames.
It was, the line from the government went, a “purely precautionary step”.
Within 24 hours Mr Johnson was moved to the hospital's intensive care unit, in a move his officials, once again, claimed was a "purely precautionary step". He has remained there ever since.
Mr Johnson may, as many others have, overcome the symptoms of Covid-19. But the very fact that he has been hospitalised and has required intensive care means that he is unlikely to return fully to work for many weeks to come.
Consequently, this has placed the burden of combatting Britain’s coronavirus pandemic fairly and squarely on the shoulders of the Cabinet, with the result that, in the absence of Mr Johnson’s steadying influence, many of the divisions over how best to tackle the crisis have risen to the surface.
Unlike America, where the constitution stipulates that the vice president should take over in the event of a president becoming incapacitated, there is no such provision in Britain. Instead there is an arrangement whereby the prime minister nominates a senior minister – in this case, Foreign Secretary Dominic Raab – to deputise for him “where necessary”.
The vagueness of this arrangement might reassure Mr Johnson that his authority will not be usurped while he is away from his seat, but it has done little to reassure the British public that the government is in a position to provide the strong and effective leadership required in the current crisis.
With Mr Johnson out of the picture for the moment, it has also highlights the relative inexperience of the current UK Cabinet, which is the youngest assembled in more than a century. Even Mr Raab, who was Brexit Secretary prior to his current appointment, has only been an MP since 2010, while Rishi Sunak, the Chancellor, is under 40 and has only been in Parliament for five years.
Consequently, the deterioration of the Prime Minister’s health has – not surprisingly – created a mood of deep unease in British politics, as it raises important questions about whether ministers have the ability to make crucial decisions (such as when to end the lockdown) in the absence of their elected leader.
And if, as seems increasingly likely, Mr Johnson will not be able to return to the political fray anytime soon, then it is vital that ministers set aside their policy differences over how best to combat the coronavirus and work together for the common good.
Con Coughlin is the Telegraph’s defence and foreign affairs editor