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In July 2014, as the largest Ebola outbreak in history was ravaging West Africa, Donald Trump took to Twitter to complain that two sick American health workers were being flown back to the United States for treatment. “Ebola patient will be brought to the U.S. in a few days—now I know for sure that our leaders are incompetent,” wrote the future leader of free world. “KEEP THEM OUT OF HERE!” Over the months that followed, Trump would tweet about the outbreak more than 50 times.

Trump’s social-media outbursts were among the earliest shots fired in the political war over Ebola. The timing of the Ebola outbreak could not have been more propitious for Republicans, many of whom echoed Trump’s calls for a temporary travel ban. In the run-up to the 2014 midterm elections, the specter of a lethal African virus being spread through the United States by migrants stoked fears not only among the GOP base, but also among many voters who leaned Democratic. By October, two-thirds of respondents to a Washington Post/ABC News poll said they favored restricting travel from Ebola-affected countries.

John Foust is a liberal who supports ObamaCare and opposes Ebola travel ban. Send Conservative @BarbaraComstock to Congress! — Donald J. Trump (@realDonaldTrump) October 28, 2014

I thought about Trump’s Ebola tweets last year as I was completing a memoir about my work treating Ebola in rural Liberia at the height of the outbreak. By early 2016, the Republican presidential primaries were dominating the headlines, and Ebola had long since faded from the front page. But the two events seemed connected to me; it was clear the outbreak had taken its toll on public debate.

The naked and brutal nativism on display at right-wing political rallies obviously had much deeper roots than Ebola. But from my standpoint, the outbreak helped legitimize a kind of language previously relegated to the fringes of American politics. Looking back on the campaign, I firmly believe Ebola was one of the key events that made Trump’s candidacy possible.

Insofar as Trump expresses a coherent political philosophy, those expressions can be found not in policy papers or major addresses, but in his tweets. When examining Trump’s tweets on the Ebola outbreak, the main features of his approach are plainly evident. It’s all right there: The shallowness, willful ignorance, mean-spiritedness, and empty boasting infuse every 140-character burst. And Trump’s views on the issue received massive media attention. His tweets were written up everywhere from Breitbart to USA Today to Mother Jones. He elaborated on them in his regular Fox News appearances.

Ebola patient will be brought to the U.S. in a few days – now I know for sure that our leaders are incompetent. KEEP THEM OUT OF HERE! — Donald J. Trump (@realDonaldTrump) August 1, 2014

Trump’s very first tweet is as clear a display as one could imagine of the kind of arch-nativism that would animate his campaign and the first few months of his presidency. It came on July 31, in response to news that two American medical workers infected with Ebola were being airlifted out of West Africa to the United States for advanced care in the most secure conditions (so-called Biosafety Level 4 facilities). Right from the start, he highlighted the central animus of his foreign policy in an all-caps summary, even when, as in this case, THEM might be US citizens.

Health officials assured the public that Kent Brantly and Nancy Writebol—the doctor and nurse who had braved the outbreak to serve at a hospital on the outskirts of Monrovia—posed little risk of spreading the disease in the United States. But Trump wasn’t satisfied. “The U.S. cannot allow EBOLA infected people back,” he wrote on August 1. “People that go to far away places to help out are great—but must suffer the consequences!” In other words, the Ebola fighters’ “greatness” didn’t override Trump’s desire to see them suffer because of their selfless actions.

The U.S. cannot allow EBOLA infected people back. People that go to far away places to help out are great-but must suffer the consequences! — Donald J. Trump (@realDonaldTrump) August 2, 2014

By that time, it was clear that the outbreak was overwhelming the governments of Liberia, Sierra Leone, and Guinea, and that without substantial international help, the virus would likely spread unchecked across borders. It could turn what was already a substantial regional problem into a profoundly more complicated (and expensive) international crisis. And it meant that resource-wealthy nations needed to provide help to contain the spread.

Trump certainly didn’t want to treat Ebola patients in the United States, but he did initially seem to agree that Americans should provide some sort of medical assistance to the affected countries. “A doctor on NBC Nightly News agreed with me—we should not bring Ebola into our country through two patients, but should bring docs to them,” he wrote on August 4. It was a bizarre statement for someone who just three days earlier had said that doctors who put themselves in harm’s way should be left to “suffer the consequences.” By September, he seemed to have changed his mind entirely about sending help. “Can you believe that the U.S. will be sending 3000 troops to Africa to help with Ebola,” he wrote. “They will come home infected? We have enough problems.”

Listen to Steven Hatch discuss the Ebola crisis on a recent episode of our Inquiring Minds podcast:

Trump wasn’t simply calling for patients infected with Ebola to be excluded from the country. In one August tweet, he wrote, “The U.S. must immediately stop all flights from EBOLA infected countries or the plague will start and spread inside our ‘borders.’ Act fast!” Two days later, he extended his proposed travel ban to all of West Africa. “The bigger problem with Ebola is all of the people coming into the U.S. from West Africa who may be infected with the disease,” he wrote. “STOP FLIGHTS!”

We must immediately stop all air traffic coming from the Ebola infected areas of Africa—before it is too late. — Donald J. Trump (@realDonaldTrump) September 16, 2014

The Ebola panic in the United States reached new heights in early October, after an infected Liberian man named Thomas Eric Duncan entered the country. He was symptom-free at the time of his flight but became ill several days after arriving. He sought treatment at a Dallas hospital, which led to two nurses contracting the virus. Trump, who would spend much of the 2016 campaign portraying immigrants as rapists and murderers, used the opportunity to imply that Duncan came to the United States with sinister motives. “The Ebola patient who came into our country knew exactly what he was doing,” Trump tweeted. “Came into contact with over 100 people. Here we go—I told you so!”

The Duncan chapter was without any question the low point in the US Ebola story. Multiple mistakes occurred not only in Dallas, but in Liberia as well, as Duncan slipped through the screens designed to prevent people exposed to the virus from leaving the country. (He had accompanied the daughter of his landlord to a hospital in Monrovia, and she later died of the disease.) Nearly everything that could have gone wrong with Duncan did go wrong. Nevertheless, the only people who contracted the disease from him were the two nurses who cared for him. They, in turn, passed it along to no one. Duncan died, but both nurses made full recoveries.

An Ebola infection on US soil certainly isn’t a trivial matter, but it was by no means the calamity that Trump, along with tens of millions of his fellow Americans, assumed it was. Public health experts, including Thomas Frieden, director of the Centers for Disease Control and Prevention, repeatedly called for calm, arguing that the United States was well prepared to contain the virus and that closing down borders would simply make the outbreak harder to manage. President Barack Obama echoed these statements. Trump accused the CDC of lying about the threat posed by the disease. He portrayed Frieden’s and Obama’s leadership as feckless, even though Frieden’s assessment would prove to be considerably more accurate than Trump’s.

Ebola is much easier to transmit than the CDC and government representatives are admitting. Spreading all over Africa-and fast. Stop flights — Donald J. Trump (@realDonaldTrump) October 2, 2014

The new Ebola czar will report to the WH & NSA adviser Susan Rice. More mismanagement & duplicity with CDC. Obama is terrible executive. — Donald J. Trump (@realDonaldTrump) October 17, 2014

Trump’s tweets reached a fever pitch on October 23 and 24, when Craig Spencer, a returning doctor who had treated Ebola patients in Guinea, fell ill with the disease in New York City. According to Spencer’s account, the moment he became symptomatic he isolated himself and informed public health authorities. Before he became symptomatic, he was a threat to no one, and once he did, his isolation ensured that he was not a threat. If Duncan’s situation was a worst-case scenario, Spencer’s was exactly how the experts had hoped to deal with travelers from the affected countries.

This did not stop Trump from becoming unhinged, tweeting about the incident seven times in two days. He railed against what he regarded as the foolishness of US policy and accused Spencer of being “selfish” for having the temerity to eat at a restaurant prior to becoming ill. That a billionaire who has never made any appreciable personal sacrifices for others could have the chutzpah to make such charges is revealing. It also foreshadowed his temper tantrums against the family of Humayun Khan, a Muslim US Army captain of Pakistani descent who died trying to thwart a car bombing in Iraq. Trump publicly attacked Khan’s parents last year after they criticized his anti-Muslim rhetoric.

If this doctor, who so recklessly flew into New York from West Africa,has Ebola,then Obama should apologize to the American people & resign! — Donald J. Trump (@realDonaldTrump) October 23, 2014

The Ebola doctor who just flew to N.Y. from West Africa and went on the subway, bowling and dining is a very SELFISH man-should have known! — Donald J. Trump (@realDonaldTrump) October 24, 2014

But if Trump’s outbursts against Spencer reveal his weird personal accounting of what constitutes altruism, his final Ebola tweet was a clear portent of future policy. On November 10, just as the news of the West African outbreak was starting to recede, he repeated his dire warnings of the threat of Ebola on US soil by noting that an infected person can spread it to two others “at a minimum.” He then added, “STOP THE FLIGHTS! NO VISAS FROM EBOLA STRICKEN COUNTRIES!”

On the campaign trail, Trump infamously called for a “total and complete shutdown of Muslims entering the United States,” ostensibly in an effort to prevent terrorism. Once in office, he issued executive orders suspending immigration by refugees and citizens of several majority-Muslim countries. Perhaps given enough time, new circumstances will allow him to revisit his 2014 threat and add sub-Saharan Africa to the list.

A single Ebola carrier infects 2 others at a minimum. STOP THE FLIGHTS! NO VISAS FROM EBOLA STRICKEN COUNTRIES! — Donald J. Trump (@realDonaldTrump) November 10, 2014

Trump’s Ebola tweets are useful not only for their ability to illuminate how subsequent events that shocked the political establishment came to be, but also because they provide a clear road map for how he will respond to the next biological crisis. Ebola may have been the most dramatic such crisis of the past generation, but others have also generated substantial alarm. The swine flu pandemic of 2009, the avian influenza outbreaks in East Asia, and the SARS epidemic are just a few of the cases that have required international cooperation.

How will Trump deal with these unforeseen hazards? Will his instinct to resort to border-closing as a first-line policy lead to more suffering? Will his penchant for denigrating people who choose to serve others intimidate health care workers who might otherwise volunteer in such moments? Will he continue to reject any form of scientific expertise?

We’re not even 100 days into the new administration, but the evidence so far is not reassuring. Whatever the next biological agent, Trump may well take a dangerous situation and make it worse—both abroad and at home.