I’ve known Boris Johnson for 30 years. He is the most fiercely competitive of men. He plays tennis like a gorilla. Using a warped wooden racket, he leaps in the air with a fearsome grunt and smashes the ball past you. His alpha-male image helped him become British prime minister, a job he has sought all his life. He is something of a fitness fanatic and saw himself as invulnerable, even when he first contracted the coronavirus, three weeks ago.

The news on April 5, that Johnson had been taken into intensive care with severe symptoms of Covid-19 convulsed Britain and made headlines across the world. The shock was all the greater because for the previous 10 days, both Johnson and his Downing Street spin doctors had systematically downplayed his symptoms.

This pattern has been seen all over the world, from U.S. President Franklin D Roosevelt, who hid his partial paralysis from the American public, to President François Mitterrand of France, who went to great lengths to conceal his terminal cancer from the nation. It is also one I recognize well. In 2003, I made a BBC TV documentary titled “The Downing Street Patient,” which looked at the gulf between the image of robust fitness for office that U.K. prime ministers seek to project and their true state of health. 

Lord David Owen, a former cabinet minister and medical doctor who has written a book on this subject, told me, “Political leaders are usually, by nature of the office they hold and the greasy pole they have climbed to get there, exceptional people. They want to appear super-fit supermen or superwomen. So, when they get unhealthy, they want to give the impression that they're still healthy.”