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West Virginia Gov. Jim Justice, pictured here during a COVID-19 press briefing Sept. 10, 2021, was diagnosed with the virus earlier this week.

CHARLESTON — Gov. Jim Justice battled congestion Wednesday while being treated for COVID-19 at his Greenbrier County home on the day he was to deliver his State of the State address to the West Virginia Legislature.

“He’s getting the care, and I think he’s trying to put up a strong front in front of us. When you talk to him, you know he’s not doing well,” Chief of Staff Brian Abraham said. “You can hear the congestion, hear the distress in his voice. He’s being brave, but you can tell it’s affecting him.”

The Justice administration announced late Tuesday the governor tested positive for the virus after reporting he felt “extremely unwell.” Officials postponed the State of the State address. The governor has said he is fully vaccinated and boosted.

Justice was continuing to experience “moderate symptoms” Wednesday evening, according to a news release from the Governor’s Office.

Abraham said Wednesday that Justice is “still in charge of things” and has been on the phone “constantly” with the chief of staff and other leaders as they discussed and organized announcements scheduled to coincide with the beginning of the 2022 legislative session.

First lady Cathy Justice and Justice’s office staff all have tested negative, according to the news release.

Abraham said Justice has “medical people that are assisting him” at his home. The governor’s daughter Jillean, a physician, and state coronavirus czar Dr. Clay Marsh are advising on treatment, Abraham said. It was unclear which virus variant Justice contracted.

On Dec. 14, 2020, Justice, 70, received his first dose of the Pfizer COVID-19 vaccine during one of his live pandemic briefings. Since then, he has pleaded with his constituents to follow his lead and get fully vaccinated — and now boosted — to protect themselves from the virus.

Administration officials said the governor is receiving monoclonal antibody treatments. The treatment was received well, according to a news release.

Dr. Myron Cohen, director of the University of North Carolina’s Institute for Global Health and Infectious Diseases, who helped develop the use of antibody treatments for COVID-19 and other illnesses, said such treatments are a useful intervention for people at risk of seeing progressed illness of COVID-19.

The largest risk factors for seeing progressing diseases are age — the older someone is, the more at risk they are, even if they are fully vaccinated — and body mass index, which is a measure of body fat based on height and weight.

Justice, who stands 6 feet, 7 inches tall, is a man of imposing physical stature and has referred to his size during news briefings and other events.

“Typically, we see the most progression of illness in people who are older, over 65. What we see in those groups is that, if you are older, you also are more likely to have other (health conditions) that could make you more vulnerable,” Cohen said. “BMI — that’s a big risk factor, too. If BMI is over 40, well, that’s a huge risk factor. It’s certainly a concern that the (COVID-19 infection) could progress, and these factors make that more likely.”

Cohen said 80% of people who are administered monoclonal antibody treatments see an improvement in their COVID-19 infections. The more underlying conditions someone has — including if they’re older or overweight — can potentially lessen those odds.

Antibody treatments work by stunting the virus’s ability to reproduce in an infected person’s body. The sooner that replication is stopped — meaning when the treatment is administered — the more likely it is to have positive results, Cohen said.

“In the first five days, you want to interrupt the reproduction of the virus. The sooner you’re able to do that, the more effective it could be,” he said. “That’s the key to any of the interventions available — the quicker they’re given, the better they can take effect.”

Breakthrough infections like Justice’s — where a fully vaccinated person contracts the virus — are not evidence that the vaccines are ineffective, Cohen said. With such high transmission of COVID-19, especially with the omicron variant, it’s inevitable that vaccinated people will contract it and some will get sick, he added. The vaccines still work in preventing severe infection, hospitalization or death in most people, he said.

Abraham said any plans for future care — whether through a hospital or other means — would be up to the governor.

He said Justice has “tried to set the example” in following COVID-19 protocols. The governor initially mandated shutdowns and other steps to guard against the virus, but he halted those when the outbreak eased last summer and declined to reinstitute them when the pandemic roared back last year.

The governor has used his COVID-19 news briefings and other efforts, such as a sweepstakes for people who get the shots, to advocate for vaccinations.

“(Justice) was the very first person to get the vaccine when they came out. He’s had the booster. He wears a mask when he can,” Abraham said. “He’s followed his own lead and done everything he has asked everyone else to do. He’s anywhere and everywhere and, unfortunately, that meant he was exposed. I hope all West Virginians are praying for his swift recovery.”

It’s unclear when or where Justice was exposed to the virus. The administration’s news release said he began displaying symptoms Tuesday. Symptoms can occur two to 14 days after exposure.

Abraham declined to detail Justice’s schedule over recent days or say how many people might have been exposed to the virus through the governor. Photos posted on the governor’s website show Justice without a mask speaking to a crowd at a West Virginia Business and Industry Council event Monday at the Capitol Complex.

“He’s always running wide open — he’s everywhere. As he says, he’s anywhere and everywhere all the time,” Abraham said. “He’s been here late hours, into the evenings, preparing for the State of the State, for the big economic development announcements that are taking place. There’s not a person that comes up to him that he turns away, and (that) comes, I guess, with the risk of exposure.”

Abraham said he didn’t know what constitutional provisions are in place if Justice has to temporarily hand power over to Senate President Craig Blair, R-Berkeley.

The West Virginia Constitution says the Senate president “shall act as governor” if there’s a vacancy or “other disability” of the governor. If the Senate president is unable to act, the speaker of the House would act as governor.

Abraham said it is his and Justice’s interpretation that “disability” in the constitution refers to a condition or circumstance that make someone incapable of performing the role of governor. He said the constitutional provision, in his opinion, does not apply to temporary circumstances.

“Disability would infer something permanent that would impair one’s ability to complete the duties of office,” Abraham said. “The governor is still working. He’s still involved in all we’re doing, I’ll tell you that.”

People who’ve contracted COVID-19 typically are infectious two days before their onset of symptoms, the U.S. Centers for Disease Control and Prevention says. The peak viral load — meaning when the virus is most infectious — tends to occur with the onset of symptoms and usually decreases after the first week the symptoms began.

This can differ depending on the severity of the illness.

Justice’s health frequently has been a topic of speculation around the Capitol. In 2017, he was treated for a viral infection at Johns Hopkins Hospital. The governor has declined to release his medical records.

HD Media staff writer Lacie Pierson contributed to this report.

Caity Coyne covers health for HD Media. She can be reached at 304-348-7939 or Follow @CaityCoyne on Twitter.

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