By Lissandra Villa
October 9, 2019

Vermont Sen. Bernie Sanders, one of the leading 2020 candidates, has been off the trail for a week since he suffered a heart attack on Oct. 1. In his absence, his campaign has been on autopilot.

They’ve dispatched surrogates to early states on his behalf. They’ve rescheduled an ad buy in Iowa that was postponed in the wake of the medical emergency. They’ve announced a new policy plan to get money out of politics. They’ve sent supporters to a climate strike with Greta Thunberg. They pushed out the news that Sanders plans to participate in the upcoming Democratic primary debate was out.

“[The strategy] is to show that this campaign continues to have momentum and energy and enthusiasm,” says Rep. Ro Khanna, a national co-chair to the Sanders campaign. Sen. Sanders built the campaign, Khanna says, “Explicitly on a premise that this is not about him, that it’s about all of us.” The plan now is for him to rest while the “movement” carries it forward.

But that plan is also a test. Sanders’ aides are declining to say when he will be back on the trail full time, and with his return date uncertain, and his poll numbers sagging, a question hangs over the campaign: how long can the 78-year-old’s movement maintain momentum without him.

Sanders told reporters Tuesday outside his home in Burlington that whenever he does return, he will have to change the “nature” of his campaign. “Probably not doing four rallies a day,” Sanders answered when a reporter asked him what he meant.

His allies are trying to put the best face on the situation. Khanna, who was a surrogate for Sanders in Iowa over the weekend, says that the events he attended there had high turnout. “Partly I think people were coming out to show their support in light of what happened with Sen. Sanders.”

Political watchers are turning their attention to next week’s primary debate, where the expectations for Sanders are high.

“If he doesn’t show up at the debate next week and perform very well, there’s going to be a rising crescendo of people telling him to step down if only for health reasons,” said a longtime Democratic strategist. “This is going to be nagging him.”

Sanders, who is resting at home in Burlington, VT, on Tuesday morning told reporters outside of his home that in the past couple of months, he’d started feeling fatigued more than usual.

“I must confess that I was dumb,” Sanders said in a video by CNN. “I should have listened to those symptoms. I should have listened to those symptoms. So if there’s any message that I hope we can get out there, it’s that I want people to pay attention to their symptoms.”

It remains unclear when Sanders will return to the trail outside of the campaign’s commitment that he’ll participate in the Oct. 15 debate. Asked if any decisions had been made on timing of his return or what other events Sanders would participate in, a campaign aide did not answer the question.

But Sanders has some leeway. By all measures, he has established himself as a top-tier candidate who is in the race for the long haul. Not only was he himself campaigning at a relentless pace prior to the heart attack, but he consistently comes in the top three in polls, raised the most money in the third fundraising quarter, and has qualified for both the October and November primary debates.

Despite being the oldest Democratic candidate running, Sanders is often spotted playing sports while out on the trail, or walking briskly around Capitol Hill. People close to him have noted his personality does not mesh well with being sidelined.

“This is everything he hates all at the same time,” a former aide to Sanders’ 2016 campaign said, noting that Sanders’ personality likely has him wishing more attention would be paid to the policy rollout his campaign made Monday morning rather than to his health and age.

Of how this will affect voters’ perceptions of Sanders, the former aide, who requested anonymity to speak candidly, said, “My sense is most people don’t really care, because even if you’re drawn to Bernie, you’re not drawn to him because he gets on a skateboard. … My sense is it won’t really bother his supporters.”

The initial instinct in the campaign was to relay little information after they announced Sanders had experienced chest discomfort and needed two stents inserted to address a blocked artery. The campaign would not confirm details about the Senator’s well being while he was still in the hospital, and did not say whether he’d had a heart attack until after he’d been dispatched days later.

But since his release, Sanders has been spotted multiple times out in public. Sanders tweeted a video of himself standing alongside his wife and close adviser, Jane Sanders, in Las Vegas after he’d been released from the hospital on Friday, thanking well wishers. Reporters saw the couple taking a walk around their Burlington neighborhood on Monday. In a video by CNN of the exchange he had with reporters, Sanders said he’d be back on the trail “soon.”

“I think over the next week or two, people are going to be a little skittish about his health,” says Patrick Bourgeacq Pinzón, a staff member at Drake University who endorsed Sanders in August. “But as soon as they realize that he’s just as or more energetic than he was before, I’m sure people will realize that this was nothing.”

Write to Lissandra Villa at lissandra.villa@time.com.

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