Donald Trump is best understood as an influencer, in the sense that he doesn’t really do shit, at least not things like accomplishing tasks or performing labor, physical or mental. As a very big rich boy floating through life on a raft of his father’s money, America’s bronzed and lowing lie machine’s interests in business or government are limited to himself: That is, branding and promotion.

This political “brand”—demonizing outsiders, denigrating experts and making rash and outlandish promises to vulnerable people that even a snake oil salesman would find immoral—is not original. Every thuggish political hack currently running an important country follows some version of this formula. This is because, as the regrettable 20th century demonstrated, this formula works. And so an individual who is quite likely infirm or unstable and who has politics as sophisticated as those of a bored and spoiled child frying ants with a magnifying glass is in nominal control of the United States, a patently dangerous situation that has become normal—and dangerous to everybody, including those who swallow the rhetoric.

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Trump is promoting white-nationalist conspiracy theories. These have inspired mass killings. Trump also encourages people to shun possibly the most significant breakthrough in medicine. A direct line can be drawn from Williamsburg, Brooklyn— where a measles outbreak, caused by a mass refusal to vaccinate children for this disease, has caused a public-health crisis—to the president and other braying sophists.

In Williamsburg, home to one of New York City’s communities of ultra-Orthodox Jewish people, a coordinated and baseless scare campaign—led by rabbis peddling debunked conspiracy theories, including the claim that vaccines are linked to autism—is convincing Hasidim to shun vaccinations. (The outbreak seems to have started after a traveler returned to New York from Israel, where many religious Jews also shun vaccinations, and where a baby girl whose parents refused to vaccinate her died, the country’s first measles death in 15 years.) Mayor Bill de Blasio has declared a public-health emergency and is employing the courts, where resistors plan to fight the mandatory shots with a lawsuit. Neither data nor compulsion are working. Nor is a counter-campaign, led by Hasidic nurses. This episode shows how difficult it is for facts to recover and overtake fake news once the false narrative spreads—especially if the false narrative slides neatly into a groove prepared by, say, the president of the United States.

How did we get here? And how does the doctrine of anti-vaxxing persist when close to 300 people have fallen ill? Why were anti-vaxxing videos so popular and so lucrative on social media that YouTube had to be shamed into de-monetizing them? At the core is distrust of outsiders and dismissal of expertise. At the core of anti-vaxxing are the same values promoted by Donald Trump and Fox News in their ouroboros of bullshit.

As Laurie Garrett, the Pulitzer Prize-winning author of The Coming Plague recently pointed out in Foreign Policy, “[t]here is a strong link between the rise of populism and anti-vaccination sentiments.” Economic anxieties like the 2008 financial meltdown have convinced people that nobody knows what they are talking about. Despite reams of data to the contrary, this has created the vector for far-right charlatans to convince their people both that foreigners are the enemy, and that government vaccination programs are bogus.

The irony is that Trump is right about disease spreading in the United States, but completely wrong about the source. In an attempt to stir up a xenophobic panic, Trump has claimed that migrants arriving in the country from the global south carry with them infectious diseases. There is absolutely no source for this, no data or even anecdotes, aside from patently racist beliefs about migrants and danger and film. There is no sign or science that newcomers to the United States refuse life-saving vaccinations when they are available. They often come here because the situation in their home country has deteriorated to a level of chaos where vaccines are no longer available.

Meanwhile, those who do refuse vaccinations are often bathed in privilege. Abuse of this status imperils others. Rich people in Silicon Valley, tweeting buffoons in Trump’s inner circle, rabid MAGA automatons auditioning for roles in the Barry Goldwater administration—these are the people spreading diseases in the United States, and doing so because the brand-conscious president is spreading his gospel that smart people are dumb and wrong like rancid margarine across a moldering crust of bread.