(CNN) A new clash between Donald Trump's political goals and his duties to public health threatens to deprive America of presidential leadership in the critical weeks that will decide if a second wave of Covid-19 swamps the country this winter.
As the US death toll from the pandemic passed 200,000, Dr. Anthony Fauci warned Tuesday that he was worried that the high base level of infections could make it difficult to keep the virus under control in the colder months.
While the government's top infectious diseases specialist, who has been marginalized by Trump, said serious trouble was not "inevitable," he added at the Citizen by CNN conference that "it's not acceptable to not realize that we are entering into a risk period and we've got to act accordingly."
Fauci spoke while medical indicators head in a perilous direction as the US approaches its 7 millionth infection. Cases are rising in 24 states, Washington, DC, and two territories. Wisconsin's Gov. Tony Evers warned Tuesday of a "new and dangerous stage" of the pandemic in the crucial swing state, where Trump held a rally last week. And there are now more than 59,000 cases of coronavirus on college campuses, after many schools decided to open despite adopting insufficient safety measures.
Notre Dame canceled its game on Saturday against Wake Forest after seven Fighting Irish players tested positive for the virus. The move comes just a week after Trump claimed he had orchestrated the return of football for many of Notre Dame's Midwest (and battleground state) neighbors in the Big Ten conference.
But there is no visible sign of concern from the White House about this potential pivot point on which thousands of lives may depend. That may be because it coincides with the moment of highest tension in a presidential race in which the President is trying to convince voters that the worst of the emergency has passed.
"I think we've done an amazing job ... in my opinion we're rounding the turn," the President said in an interview with a local Fox station in Detroit in which he continued to minimize the danger. On Monday, he had claimed the virus "affects virtually nobody" while doubling down on previous claims that young people are "virtually immune" -- a staggering comment on the eve of such a tragic milestone.
Asked about the 200,000 deaths as he headed out to another campaign event Tuesday in Pittsburgh, with a non-socially distanced crowd, the President said "it's a shame" but claimed he had nevertheless saved millions of lives.
And on Tuesday evening, the President mocked his election opponent, Democratic nominee Joe Biden, who has been observing the safety protocols recommended by Trump's government, for wearing a mask.
"Is he going to walk in with a mask?" Trump said, looking ahead to next week's first presidential debate.
"I'll be honest. He feels good about it. He feels good about the mask, and that's OK. You know it, whatever makes you feel good," he added.
When he's not skipping around the country to take part in packed rallies that flout public safety guidelines, the President is far more enthusiastically focused on his quest to fill a sudden Supreme Court vacancy before the election than he is on working to mitigate the grim winter that experts fear.
The situation is mirroring Trump's long failure to recognize the scale of the pandemic -- or at least to share with Americans his understanding of its gravity -- and unwillingness to make statements that contradict the false political reality in which he's led a world-beating response to the crisis.
It also suggests that there is little or nothing Trump plans to do to avert what may be a very difficult few months, even as top medical experts like Fauci plead with Americans to limit indoor gatherings, to wear masks and to take precautions. In some ways, Trump has to keep up the illusion of a return to normality for only another six weeks, until Election Day. If he wins on November 3, he will have even less incentive to intervene. And if he loses, he would seem unlikely to launch a major eleventh hour initiative to take the virus seriously.
While the White House was conducting often-daily coronavirus task force meetings in the early months of the pandemic, there is almost no high-level advice being offered to Americans as this crucial moment looms. What public health messaging there is is often tainted by Trump's political influence. And this week's withdrawal by the Centers for Disease Control and Prevention of new advice on how Covid-19 is transmitted offered another example of the chaos that has marked the government's failed pandemic response.
Trump's repeated predictions that a vaccine will be available before or around Election Day significantly outpace the optimism of most health experts and understate the complicated, months-long process that will be needed to get it to most Americans -- even if public trust has not been irreversibly damaged by the administration's erratic approach to the pandemic.
The President has in recent days taken to highlighting an alarming rise of new Covid-19 cases in Europe, which, according to most criteria, did a far better job of suppressing the virus in its initial assault than the United States did. But he appears not to have considered that signs of a second wave abroad could be a worrying omen on this side of the Atlantic, which has a far higher baseline of infections and did not enjoy Europe's summer respite.
One problem going into the high-risk months of fall and winter remains the lack of a national testing and tracing program, which would have been vital in finding sources of infection early and isolating carriers of the virus to prevent them from seeding wider outbreaks.
"Even now, we can't perform the number of tests our nation needs," said Dr. Ashish Jha, dean of Brown University's School of Public Health, on Tuesday.
"The failure to effectively and fully implement these public health measures have meant that we have more cases and more deaths than any nation in the world," Jha told the US Joint Economic Committee.
"Most high-income countries -- not all, but most -- have managed to both save lives and jobs," Jha said. "We have struggled in both areas."
Biden, who has elected not to hold Trump-style rallies, which he argues are irresponsible and endanger supporters and others, is seeking to put the pandemic at the center of the election.
The issue was one of several key topics named by "Fox News Sunday" anchor Chris Wallace for the first presidential debate he will host in Ohio next week. Biden's running mate, Sen. Kamala Harris of California, on Tuesday marked the 200,000 deaths mark in a tweet.
"A tragic milestone. My heart aches for the families and friends of the 200,000 Americans who will never get to see or hold their loved one again. Know that @JoeBiden, myself, and the nation are keeping you in our hearts," Harris wrote.