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The final death toll from coronavirus will not be the result of viral disease; it will be the result of mental disease.  The greatest risk factor of disease and death is not being considered, and that is Donald Trump.  If he continues in this presidency, he is on course for having three main effects: First, he will make a deadly pandemic much worse.  Second, he will stoke divisions between “believers” and “unbelievers” in his alternative reality.  And third, he will vastly augment suffering, which he will be tempted to direct into widespread violence.

It is not difficult for scientists to see that the president has already multifold exacerbated the coronavirus pandemic.  The reasons are psychological: he is incapable of doing what is necessary, for that would require him to face reality, which means also his own emptiness and incapacity.  It is unsurprising that he dismantled the infrastructure of one of the top programs for global pandemic preparedness in the world “to save money,” only to pay for it with trillions of dollars, which will still bring back neither the economy nor the millions of lives lost.  However, again, reality will not matter.

A leader who is truly convinced of his false beliefs will be far more effective at spreading those beliefs among his followers than any rational strategy.  Soon, a leader’s pathology becomes a nation’s pathology.

Humanity did not avoid another Plague in the modern era because of the lack of a microbe; we avoided it because of the application of science, public health, and prevention practices.  Severe acute respiratory syndrome (SARS) was a near-pandemic that was stopped because a global network of professionals rapidly detected it—months before the World Health Organization (WHO) even announced the disease.  When H1N1, or swine flu, was detected in Mexico and then the United States in the same month, the U.S. Center for Disease Control and Prevention (CDC) released medical supplies and drugs within a week, and accurate testing in less than two weeks, which it shared with other countries.

A Different Story

Coronavirus has been a very different story.  At any other time, the U.S. would have led efforts and coordinated global fights against epidemics, but the science-averse Trump administration had already axed the CDC expert in China.  Meanwhile, the authoritarian Chinese government reprimanded and silenced the physician who tried to raise alarms about the virus in December 2019; its denial and desire to present orderliness caused the disease to spread freely in the critical early stages.  After five weeks, however, it instituted a vigorous lockdown that broke the spread after two months.

Our government, by comparison, ignored ominous, classified warnings about the global danger through January and February, declined testing that was already available through the WHO, and actively downplayed the threat by falsely stating, “we have it totally under control,” calling it the Democrats’ “new hoax,” and that “like a miracle, it will disappear.”  Despite causing the need for extreme measures, by allowing the disease to spread freely throughout the U.S. in the critical stages, Donald Trump first touted lifting federal recommendations of isolation by Easter to stimulate the economy.  In the absence of a cure or a vaccine, while still exponentially rising, the U.S. has now surpassed every country of the world at over 140,000 cases and over 2,600 deaths), this would have been a recipe for the disease to spiral out of control.  While he finally backed down under great pressure, it reveals what historians might come to call pure madness.

‘Criminal-Mindedness’ and Pathology

As a forensic psychiatrist, I make distinctions between the criminal-mindedness and mental pathology that might combine to produce this kind of “madness”.  These are separate concepts: most criminal minds are not mentally ill, and most mentally ill minds are not criminal.  Yet they are not mutually exclusive: when criminal-mindedness combines with mental pathology or, more, mobilizes it, atrocities such as genocide (or democide) become possible.  We see this when Donald Trump observes the “effectiveness” of his “gut”; he believes it to be good strategy on his part, when he is enabling the power of pathology that will eventually be destructive to all, including himself.

The lack of conscience and detachment from reality make critical situations far worse.  This holds equally true for the economy as for the viral pandemic.  Unable to recognize the underlying cause of the economic downturn, he manages neither the public health crisis nor the devastation of people, and the markets respond accordingly.  Just as with his gutting of our pandemic response capabilities, he had squandered our economic response capabilities earlier by threatening the Federal Reserve to inflate an artificial economy for his reelection purposes.  Now, he has pressured it into depleting the rest of its ammunition when the war has barely begun.

Transmitting Delusions

Another effect of pathology is that delusions will be more infectious: a leader who is truly convinced of his false beliefs will be far more effective at spreading those beliefs among his followers than any rational strategy.  Soon, a leader’s pathology becomes a nation’s pathology.  Delusions, unlike mere misinformation, transmit through emotional bonds, which in turn make their recipients highly resistant to true information and dangerously defensive when facts catch up with them.  Because deaths, suffering, and ruined livelihoods are real, fury will build.

As he creates more crises, these become opportunities for the criminal mind to further its hold on power.  Since the growing fury will never be directed at its true source, it becomes a weapon for the source to redirect against his enemies, critics, or whatever target he wishes.  We have already seen what he can do by calling the novel coronavirus “Chinese virus,” simultaneously deflecting blame and creating new targets for attack.  Meanwhile, vast suffering and deaths will solidify his followers in fearful dependence, defensive idealization, and obedience to cultic programming.  He is already using daily press conferences for hypnosis of himself as protector and giver of false reassurances, even as they recklessly harm and kill.

People have seen how pathology runs deep and is not something a person can “pivot” from to manage a country.  The coronavirus situation is worse than a war, affecting almost every country on earth.  The death toll and hardship he multiplies could lead to actual international conflicts and, thanks to the nuclear arms race he renewed, potential nuclear war.  Those who believe they have seen “the bottom” are unaware that this is actually the tip of the iceberg.  Like all pandemics, the time for prevention is before we see the full effects; for his mental health pandemic, the time for it is now.

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