It didn’t have to be this way. As the United States gets slammed by yet another wave of Covid-19—the country now has more than 12 million cases, and over a quarter-million people have died—it is important to remember that what we are experiencing now is almost entirely by choice. We’ve known for months how to limit the spread of the disease, but a vocal minority of Americans have chosen not to do it. And they have chosen this path of most resistance thanks largely to one obnoxious person who has used his bully pulpit to frustrate public health: Donald Trump.

From the very first wave of the virus, Trump and his entourage of quacks and enablers have failed the most basic tests of governance and leadership. He acted too slowly to stop the spread of the virus or give hospitals the resources they needed. He didn’t come up with a plan for mass testing or contact tracing. Instead of using the powers of the federal government to coordinate a national response and save lives, he hid behind governors and left states to fend for themselves.

In the absence of anything approaching an actual plan, all he has given the country is performative messaging. And that messaging has been a disaster. Trump is the single largest driver of coronavirus misinformation worldwide. He called it a hoax (it wasn’t); he said it would magically go away (it didn’t); he told people to inject bleach (don’t); he mocked people for wearing masks (wear a mask); he said only older people die from the virus and children are immune (none of that is true). Even after he got Covid-19 and recovered—thanks to the socialized medicine taxpayers provided him—he refused to embrace basic science and reason; instead he ripped off his mask, parading about the White House balcony like some orange Übermensch. He ended his failed reelection campaign by barnstorming around the country holding superspreader events that are thought to have caused 30,000 infections and 700 deaths.

And now? Now he hides out in the White House, nursing his bruised ego with Big Macs and revenge fantasies. He stokes his clown coup—tweeting, filing lawsuits, refusing to allow a smooth transition to the Biden administration—all the while allowing the virus to run amok. This is the real Trump surge: a surge not of mythical lost ballots but of flagrant, fast-replicating disease. Trump is a walking biological weapon.

And yet, somehow, even all of this—the bleach, the rallies, the unconscionable disregard for life—fails to capture the full scope of the harm he’s done to this country. Trump’s anti-science sociopathy has been embraced by so many other political actors. His messaging, his attitude, his culture-war-mongering have filtered down throughout our country, to our national shame.

We’re in a race to the bottom, and Republicans aren’t the only ones playing. Governors, including Democratic ones, reopened bars, restaurants, and gyms. That was unnecessary and dangerous, but it’s not surprising that without any support from the federal government in terms of messaging (or stimulus to keep local economies going), many states prioritized getting back to normal over keeping people safe. Meanwhile, it’s hard to persuade people to limit themselves to essential travel when everyone else seems to be going about their business as usual. When deranged hordes go to death-cult rallies and football games, it’s hard to prevent regular folks from going to visit their grandmothers. And when Trump administration officials are out there drinking coronavirus Jell-O shots out of each other’s belly buttons—and only the Black guy Herman Cain dies—it’s no wonder some people think it’s OK to go inside a bar to grab a drink.

Unfortunately, Covid-19 doesn’t kill only those who taunted it.

A good leader would have tried to persuade people to protect themselves from the virus. A great leader would have inspired the nation to make sacrifices for others. Instead, we have Trump, and he has led us into this hell of sickness and death.

Even after he’s removed from the White House (and he will be removed on January 20), Trump will continue to use the media—Twitter, Fox News, Newsmax—to poison the well against public health. There will be a vaccine for the coronavirus eventually, but there is no cure for what Trump has done to our society, no inoculation from the disinformation he spreads, and no way to bring back the lives he’s already cost us.

The coronavirus is a pathogen. Trump is the plague.