WASHINGTON — It was a warm summer Wednesday, Election Day was looming and President Trump was even angrier than usual at the relentless focus on the coronavirus pandemic.
“You’re killing me! This whole thing is! We’ve got all the damn cases,” Mr. Trump yelled at Jared Kushner, his son-in-law and senior adviser, during a gathering of top aides in the Oval Office on Aug. 19. “I want to do what Mexico does. They don’t give you a test till you get to the emergency room and you’re vomiting.”
Mexico’s record in fighting the virus was hardly one for the United States to emulate. But the president had long seen testing not as a vital way to track and contain the pandemic but as a mechanism for making him look bad by driving up the number of known cases.
And on that day he was especially furious after being informed by Dr. Francis S. Collins, the head of the National Institutes of Health, that it would be days before the government could give emergency approval to the use of convalescent plasma as a treatment, something Mr. Trump was eager to promote as a personal victory going into the Republican National Convention the following week.
“They’re Democrats! They’re against me!” he said, convinced that the government’s top doctors and scientists were conspiring to undermine him. “They want to wait!”
Throughout late summer and fall, in the heat of a re-election campaign that he would go on to lose, and in the face of mounting evidence of a surge in infections and deaths far worse than in the spring, Mr. Trump’s management of the crisis — unsteady, unscientific and colored by politics all year — was in effect reduced to a single question: What would it mean for him?
The result, according to interviews with more than two dozen current and former administration officials and others in contact with the White House, was a lose-lose situation. Mr. Trump not only ended up soundly defeated by Joseph R. Biden Jr., but missed his chance to show that he could rise to the moment in the final chapter of his presidency and meet the defining challenge of his tenure.
Efforts by his aides to persuade him to promote mask wearing, among the simplest and most effective ways to curb the spread of the disease, were derailed by his conviction that his political base would rebel against anything that would smack of limiting their personal freedom. Even his own campaign’s polling data to the contrary could not sway him.
His explicit demand for a vaccine by Election Day — a push that came to a head in a contentious Oval Office meeting with top health aides in late September — became a misguided substitute for warning the nation that failure to adhere to social distancing and other mitigation efforts would contribute to a slow-rolling disaster this winter.
His concern? That the man he called “Sleepy Joe” Biden, who was leading him in the polls, would get credit for a vaccine, not him.
The government’s public health experts were all but silenced by the arrival in August of Dr. Scott W. Atlas, the Stanford professor of neuroradiology recruited after appearances on Fox News.
With Dr. Deborah L. Birx, the coordinator of the White House virus task force, losing influence and often on the road, Dr. Atlas became the sole doctor Mr. Trump listened to. His theories, some of which scientists viewed as bordering on the crackpot, were exactly what the president wanted to hear: The virus is overblown, the number of deaths is exaggerated, testing is overrated, lockdowns do more harm than good.
As the gap between politics and science grew, the infighting that Mr. Trump had allowed to plague the administration’s response from the beginning only intensified. Threats of firings worsened the leadership vacuum as key figures undercut each other and distanced themselves from responsibility.
The administration had some positive stories to tell. Mr. Trump’s vaccine development program, Operation Warp Speed, had helped drive the pharmaceutical industry’s remarkably fast progress in developing several promising approaches. By the end of the year, two highly effective vaccines would be approved for emergency use, providing hope for 2021.
The White House rejected any suggestions that the president’s response had fallen short, saying he had worked to provide adequate testing, protective equipment and hospital capacity and that the vaccine development program had succeeded in record time.
“President Trump has led the largest mobilization of the public and private sectors since WWII to defeat Covid-19 and save lives,” said Brian Morgenstern, a White House spokesman.
But Mr. Trump’s unwillingness to put aside his political self-centeredness as Americans died by the thousands each day or to embrace the steps necessary to deal with the crisis remains confounding even to some administration officials. “Making masks a culture war issue was the dumbest thing imaginable,” one former senior adviser said.
His own bout with…