. @realDonaldTrump's "anaemic response led the US to become the current epicentre of the global covid-19 pandemic, with almost one third of the world’s cases and a still rising number of new daily cases." @GYamey and I in @bmj_latest. 1/ https://www.bmj.com/content/369/bmj.m1643

"On 23 January 2020, the World Health Organization told all governments to get ready for the transmission of a novel coronavirus in their countries. “Be prepared,” it said..." 2/

"But US President Donald Trump was unmoved by WHO’s warning, downplaying the threat and calling criticisms of his failure to act “a new hoax.” 3/

"Dismissing prescient advice on pandemic preparedness from the outgoing administration of the former president, Barack Obama, the Trump administration went on to weaken the nation’s pandemic response capabilities in multiple ways." 4/

"After the US confirmed its first case of covid-19 on 22 January 2020, Trump responded with false reassurances, delayed federal action, and the denigration of science." 5/

"China’s quarantine and lockdown measures bought the Trump administration time to scale up its preparedness efforts...The federal government did none of these things." 6/

"In the face of PPE shortages, the CDC was left advising health workers to use bandanas. Governors have been forced into “an ‘eBay-style’ bidding war” against each other to secure ventilators and PPE." 7/

"The CDC produced a faulty covid-19 test and took weeks to realise and fix the mistake.15 All this time, the US could have used a WHO approved covid-19 test that the organisation was shipping worldwide." 8/

"Trump’s anti-scientific pronouncements during covid-19 have been particularly perilous. On 28 February, he said that the coronavirus would soon disappear on its own 'like a miracle.'" 9/

"On 21 March, he promoted the anti-malarial drug hydroxychloroquine for 'use immediately' as a treatment, despite the lack of evidence for its effectiveness." 10/

"On the day that the CDC advised the public to wear face masks, Trump said he would not wear one himself." 11/

"On 23 April, Trump suggested that injecting disinfectant or bringing 'light inside the body' could cure covid-19, prompting experts to urgently warn the public against inhaling or ingesting bleach." 12/

"But Trump’s arguably most dangerous act was to call last week for mass public protests by his supporters to 'liberate' states from their stay-at-home orders, specifically targeting states with Democratic governors." 13/

"Washington state governor Jay Inslee, Trump is 'putting millions of people in danger of contracting covid-19. His unhinged rantings and calls for people to ‘liberate’ states could also lead to violence.' 14/

"Trump has sought to deflect blame on Obama, Democrats, China, and, most recently, WHO, halting funding to the organisation...He has refused to acknowledge any failings of his own, famously saying, 'I take no responsibility at all.'" 15/

"US is likely to experience years of mass unemployment, multiple cycles of stay-at-home orders, a rise in reported & unreported mental health conditions, other excess deaths otherwise avoided outside of a crisis & other social dislocations in response to epidemic resurgence." 16/

"We know that Trump will not—indeed cannot—rescue us. US citizens are 'alone against the virus.'" 17/

"To get through this, the US will need unprecedented social mobilisation. The dislocations call for a new social movement, inspired by the AIDS movement of the last 40 years" 18/

"—one that pushes local, state, and federal leaders to provide universal health coverage, universal sick pay, and rent and food assistance, focusing particularly on people who are poor, homeless, marginalised and those in jail or juvenile and immigration centres." 19/

"Trump’s astounding incompetence was a political determinant of the US covid-19 epidemic. A new 'politics of care' could be the corrective." 20/