Mike Pence, Nancy Pelosi and Chuck Grassley are in the line of succession. What if they get sick with COVID-19?

WASHINGTON – When President Donald Trump was hospitalized last week with COVID-19, the administration sought to assure Americans he was still fit to carry out his duties as president.

While he appears to be on the way to recovery, the outbreak that has engulfed the White House and infected more than a dozen staffers has sparked questions about whether other officials in the line of succession should be self-quarantining in case the president becomes incapacitated.

The people in line to take over the president's duties if Trump were to become gravely ill are "not taking seriously their responsibilities as best we can tell under succession" regarding their health and safety, said political scientist Norman Ornstein with the American Enterprise Institute think tank.

Take these examples: The vice president is still traveling, and so is the secretary of state. A senior Republican senator in the line of succession won’t even get a COVID test, even though he was at a committee hearing with another senator who has tested positive.

Trump and other Republicans have come under fire for disregarding Centers for Disease Control and Prevention guidelines to slow the spread of the coronavirus, including social distancing and mask-wearing.

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The White House and the Trump campaign hosted events that drew thousands of people in close proximity, including a Rose Garden event now thought to be a "superspreader" for the virus. And after Trump's positive test and quarantine, the campaign didn't quit in-person events.

And Republican officials in the line of succession have, for the most part, kept up their usual schedules and practices.

On Oct. 4, with Trump still hospitalized for COVID-19, Secretary of State Mike Pompeo left for a trip to Asia. Although he trimmed his itinerary, he still met with a parade of dignitaries, including Japan's prime minister.

In an interview Friday morning with the Hugh Hewitt Show, Pompeo said he has never had any concerns about Trump's fitness for duty. "None," he said when Hewitt asked if he'd ever had a moment of doubt about whether Trump was fully in charge.

Trump is "not the least bit tired," Pompeo said, adding he has had "long conversations" with Trump to keep him updated on world affairs.

On Saturday Trump held a campaign-style rally on the South Lawn, saying he'd been cleared by his doctor to resume public events. But the question lingers: If he were to experience a relapse in symptoms and become seriously ill, who would take charge?

"In a responsible administration, you would at least have in reserve a letter signed by the president turning authority temporarily over to the vice president, so that there's a clear chain of command in case you become incapacitated before you can do that," Ornstein said.

Under the 25th Amendment, the president could notify House Speaker Nancy Pelosi, D-Calif., and the Senate GOP's senior member, Sen. Charles Grassley, R-Iowa, that he is unable to function, transferring power to Vice President Mike Pence until the president indicates he is able to return.

The amendment both set up the process for the president to voluntarily relinquish duties and created a method – which has never been used – for powers to be taken away when others believe the president is “unable to discharge the powers and duties of his office."

If Trump believes he can still do his job but Pence and a majority of the Cabinet disagree, a transfer of power to Pence would require the backing of two-thirds of both the House and Senate. Lawmakers could also designate through legislation an alternative group – other than the Cabinet – that the vice president could work with to declare Trump unable to serve.

In an extreme circumstance, if the president were to die from the virus, Pence is first in line to succeed him, as established by the Presidential Succession Act of 1947. Pelosi is second, followed by the president pro tempore of the Senate, a title held by Sen. Charles Grassley, R-Iowa.

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On Friday, Pelosi and Rep. Jamie Raskin, D-Md., introduced legislation they said would create a commission on the presidential capacity to discharge his or her powers and give Congress a role in ensuring "effective and uninterrupted leadership" in the nation's highest office.

Pelosi said the move was not about Trump, but rather the need for clear procedure, while Raskin noted that COVID-19 has affected several government officials. In addition to Trump and First Lady Melania Trump, an array of White House advisers and Republican senators have also contracted the virus.

There is no mechanism, however, that establishes a procedure should both Trump and Pence become incapacitated and unable to serve but do not die, Ornstein said. The chance of that happening is not very high, but the pandemic has resurfaced concerns over gaps in the continuity of the U.S. government in the midst of the health crisis.

"There are nightmare scenarios that we're talking about here, all of which, let's say have been triggered by the utter irresponsibility of the president, holding these events, without masks, without any precautions, which has created the super spreader problem," Ornstein said.

Those in the president's orbit have been regularly tested throughout the pandemic, but the recent White House outbreak showed that even repeated negative tests don't mean a person was not exposed and won't test negative later.

Following are the list of people in the line of succession and details about how they are dealing with the risks of COVID-19:

Vice President Mike Pence

Pence, 61, says he has tested negative for COVID-19. He continued to travel and hold campaign events after Trump tested positive and said he had not been considered in close contact with the president to be at risk of being exposed. He participated in the vice presidential debate with Sen. Kamala Harris, D-Calif., on Wednesday in Salt Lake City.

Speaker Nancy Pelosi

Pelosi, 80, has said she is confident in the protocols established for the House. She has also maintained she wears a face mask when she is around others and that she has tested negative for the virus since Trump's diagnosis.

Sen. Chuck Grassley

Grassley, 87, "has been tested multiple times when the situation warrants and upon the recommendation of his doctors," his spokesperson, Michael Zona, said. Grassley was criticized for saying he would not seek a test after attending a meeting with Sen. Mike Lee, R-Utah, who later tested positive for the virus.

"Sen. Grassley continues to take precautions to defend against contracting the virus," Zona added. "Regarding recent COVID-19 cases in the Senate, Sen. Grassley’s doctors have not recommended he be tested as he has not come into close contact with anyone suspected of having or confirmed to have coronavirus."

Secretary of State Pompeo

Pompeo, 56, is fourth in the line of succession if Trump should be unable to carry out his presidential duties. Although he truncated his trip to Asia, he has not cancelled other events. The State Department's press office did not answer questions about whether Pompeo has cancelled other in-person meetings or taken additional precautions to keep himself extra safe given Trump's diagnosis.

Treasury Secretary Steve Mnuchin

Mnuchin, 57, fifth in the line of succession after Pompeo, has been tested daily for COVID-19 for months, according to his spokesperson Monica Crowley.

"He has consistently tested negative for COVID-19 and will continue to be tested daily," she said.

Defense Secretary Mark Esper

Esper, 56, who is sixth in line, has not released any COVID testing results. He continues to make public appearances, with a visit to West Point on Friday.

Attorney General William Barr

Barr, 70, is seventh in line, and was in attendance without a mask at the Rose Garden event celebrating Trump's Supreme Court pick the weekend before Trump's positive test. His spokesperson said he would quarantine as a precaution for several days on Sunday after receiving multiple negative tests, AP reported. On Tuesday, DOJ spokesperson Kerri Kupec said he again tested negative.

Interior Secretary David Bernhardt

Bernhardt, 51, eighth in line, "follows CDC guidance, has been tested numerous times and has not tested positive for COVID-19," his spokesperson Conner Swanson said.

Secretary of Agriculture Sonny Perdue

Perdue, 63, ninth in line and a member of the White House coronavirus task force, "recently tested negative this week," the Department of Agriculture said on Tuesday.

"I haven’t been around [Trump] in more than a week so I don’t feel it’s necessary to get a test. I feel comfortable where I am, I’m very aware of my body and symptoms. I feel good, I have a lot of energy and we’re out here across the country advocating for American agriculture," Perdue said last week after Trump's diagnosis.

Commerce Secretary Wilbur Ross

Ross, 82, who is 10th in line, told Bloomberg TV he had tested negative on Monday and that his department was doing a lot of remote work during the pandemic.

This article originally appeared on USA TODAY: COVID-19: What if officials in the line of succession get sick?