Synergy is when two or more agents come together to create a reaction greater than any one of them could have achieved on their own. It can be good or bad, depending on the desired outcome.

The synergy between Donald Trump and the coronavirus pandemic is a disaster.

Writing at the Advocate, John Casey summarizes this deadly synergy: “As this crisis deteriorates, becomes unmanageable and inexplicably horrible, so will Trump’s behavior. A perfect storm that will unravel an unprepared, unrelatable, and unsympathetic president. A fairy tale turned into the horror of all horror stories.”

As many of America’s and the world’s leading mental health experts have repeatedly warned, Trump is mentally unwell to the extreme. He has publicly and repeatedly shown that he is a malignant narcissist, a pathological liar and a delusional fabulist. He is detached from reality and appears to live in his own fantasy world. His lack of empathy, care and concern for others can reasonably be described as sociopathic.

The coronavirus pandemic is one of the greatest threats to public health — and perhaps even modern human civilization — of the last century. Many millions of people may directly die from the virus in the United States and around the world. The global economy is collapsing into a state that may be worse than the Great Depression of the 1930s. To defeat the coronavirus will require patient and wise leadership based on facts, reason, and expertise. Because the coronavirus is a public health crisis it is a problem of science and empirical knowledge. It cannot be wished away or prayed away or eliminated through other forms of magical thinking.

For many reasons, including his mental health, overall temperament, values and intelligence, Donald Trump is existentially ill-equipped to handle this emergency and defeat the coronavirus pandemic.

Dr. Bandy Lee is perhaps the leading voice among those who have warned the American people and the world that Donald Trump’s presidency would result in disaster. She is a professor of psychiatry at the Yale University School of Medicine and editor of the bestselling book “The Dangerous Case of Donald Trump.”

In our most recent conversation, Lee contended that explains the pressures of the coronavirus pandemic are making Donald Trump’s various mental pathologies worse and more dangerous. She explained her view that Trump, aided by Fox News and other parts of the right-wing echo chamber, is creating a collective state of mental illness among his cult members that is making the coronavirus even more lethal.

As she has done before, Lee argued that Donald Trump is the most dangerous person on the planet and expressed her concern he may use the coronavirus pandemic to start or inflame mass violence in order to keep himself in power permanently.

This conversation has been edited for clarity and length.

For several years you have been one of the most prominent public voices warning the American people and the world about the dangers represented by Donald Trump. Now, facing the coronavirus pandemic, where are we as a country and people, relative to the events you predicted would result from Trump’s presidency?

This a real crisis, both in terms of Trump’s presidency and in terms of his psyche. At first Trump tried to manage the coronavirus in his mind by pretending that it was nothing. It was something that would go away in no time; the virus would somehow magically disappear. That is Trump’s fantasy world. When that wasn’t happening, and the stock market was in crisis and tumult, Trump then tried to look like he was in charge by giving a speech to the whole country. Trump continues to have these televised speeches and press conferences to make it look like he is control of the coronavirus crisis, all while he has Mike Pence and other government officials praise him on TV.

Trump is not in touch with reality. He cannot control the coronavirus with his mind and by living in a fantasy world, as he has done for most of the crisis. Mental health professionals have been warning for years that Trump’s mental health issues would lead to such a dire situation. Trump is not showing just a lack of presidential leadership. What he is doing is so irresponsible and inept that having him as president is in some ways worse than having no leadership in the country at all. Trump is spreading disinformation, suppressing reality, and threatening those experts and other people who are telling him things about the coronavirus pandemic that he doesn’t want to hear.

Now we in America and around the world are living through the horrible results of Trump’s behavior. His mental health issues are translating directly into deaths and widespread calamity.

Watching Donald Trump’s evasion of responsibility for making the coronavirus much worse, his emotional distance, lack of care and concern, and general lack of interest, it seems clear that he is a likely sociopath. He does not appear to be a human being who is capable of empathy or sympathy for other people. He appears incapable of feeling guilt when his actions hurt people.

That is correct. Donald Trump lacks the traits of empathy, sympathy and guilt. Those basic characteristics of humanity have not developed in him. No matter how many lives are impacted by the virus or how many deaths occur, it doesn’t really touch him. Human beings are like objects to Donald Trump. He doesn’t really relate to other people as if they are human beings. For example, we have now learned that Trump and his son-in-law and other family members may be trying to make money off the coronavirus pandemic through testing, the vaccine and the masks. Making money from the coronavirus disaster is more real to Donald Trump than the lives of people being lost to the virus.

How does Trump’s malleable view of reality, his extreme and dangerous fantasies, impact his decision-making?

It’s not that he has a malleable view of reality — if his view of reality was flexible then it could in some ways be productive. Trump actually wishes to hold on to the opposite of reality because he cannot tolerate reality as it exists. In truth, Trump is incompetent and not even able to engage in rational thinking. As such, the most threatening thing to a person whose mind works in such a way is science and facts. Scientific evidence and empirical reality are immutable. They do not change to fit Trump’s desires and whims. This is very threatening to Donald Trump.

When the World Health Organization reported a 3.4% death rate for Coronavirus, Trump could not simply wish it away as being less than 1% — which was his immediate desire. This is all very threatening for him. During Trump’s press conference last Monday, he looked extremely deflated, as if he was finally beaten down by the actual numbers about the coronavirus. The infection rates have skyrocketed, and the stock market is not being easily manipulated by Donald Trump to stop crashing.

Trump’s behavior, his looking beaten down, is what happens to an overinflated self-image when it is confronted with reality. Trump cannot tolerate reality. He cannot last very long without either falling into a deep state of depression or lashing out in massive violence. Those two go hand in hand. We can also imagine that the dangers of such an outcome are not only very present but could actually increase with time as the coronavirus pandemic continues.

Donald Trump may use the coronavirus crisis as an opportunity to expand and secure his power. If he were to lose an election, will he step down from office? Will Trump declare martial law? When reality pushes back against Trump’s fantasy world he is going to fight back as though he is fighting for his life. Donald Trump, with all the powers of the presidency and given his mind and behavior, is the most dangerous man on the planet.

Are you suggesting the coronavirus is an opportunity for Donald Trump to fully take over the country and to end democracy and the rule of law?

Once Trump gets a fuller grasp of the situation, one can imagine that his thoughts will immediately go in that direction. Donald Trump is continually at war with the world and reality. Trump could use the coronavirus as an opportunity to secure his power. Given that the American public is frightened and confused, this could be an opportune moment for such a move.

When the Senate chose not to convict Trump it encouraged him. Such a personality does not settle down. Such a personality is not content with the power he is amassing. Trump’s expectations of power are rising in ways which are uncontrollable. Such behavior is Trump’s megalomania, the uncontrollable expansion of power and control over society that you see when such personalities take power.

There are so many naysayers who say, “Oh, Trump’s not dangerous, he’s bumbling. He hasn’t gotten what he wanted, he can’t even think that way.” How would you respond?

Trump is impaired and, yes, he does seem to be a bumbling fool. But Trump has a massive following and he controls the Republican Party. The problem is that when there is a person like Donald Trump who is impaired in the higher functions of the brain, the lower functions — the primitive or “reptilian” brain — become more powerful than ever before. That part of the human brain is based on fear, on instinct. Those impulses help Trump to control his people, his frenzied irrational followers. Those people are the key to Trump’s power.

This is not a strategy; it is a pathology. Trump’s movement is an actual mental disease spreading across the country. As others have pointed out, Donald Trump leads a cult. The Republicans and his other followers are Trump’s cult members.

It works very much that way because when a person has high levels of exposure to someone with untreated mental pathology, the vector of transmission is not physical, as we are seeing with the coronavirus, but instead through emotional bonds. Donald Trump creates emotional bonds and a condition of dependence on him among the cult members.

Trump is delusional. Trump is not just lying, because simple lying does not have such a powerful effect on an entire population. Trump’s delusions have been induced across an entire population of his supporters and other followers. Now an entire segment of the American people is delusional and detached from reality through Trump. We see this with Trump initially telling the country that the coronavirus is a hoax, that they should go out to restaurants and gatherings, go to work, hug people, etc. Because Trump’s followers revere him, they do what he says.

Trump’s obvious mental pathologies, in combination with the coronavirus, seem like a true disaster for America and the world.

It was bound to happen. The coronavirus just happened to be part of the equation. The coronavirus pandemic is a graphic illustration of how disastrous allowing the mental health pandemic that is Trump’s cult to continue unabated. A mental disease pandemic is now making everything else worse, including the coronavirus. Trump is inspiring very dangerous behavior. It is fanatical.

This is what happens when mental pathology from an influential figure engulfs a large segment of the population. Trump’s followers derive their identity, their sense of meaning in their lives, and how they understand the world from what he says. Trump actually disdains the people who follow him. But Trump will do anything to keep their loyalty because they are the base of his power.

Donald Trump has a pathological, authoritarian relationship with his followers. In that relationship they have lost their personhood, autonomy and even their ability to think for themselves. Trump’s followers are becoming more dependent, more conformist and more servile to him the longer he stays in power.

Trump supporters contact me every day. Several years ago, I was able to converse with them and I was able to challenge their beliefs — not convert them, per se, but at least engage with them as human beings and start a conversation. That has become much more difficult now, because Trump’s supporters are fixed in their thinking. They automatically regurgitate Trump’s talking points. They are unable to hear what other people are saying if it does not support Trump.

You can no longer reason with them. The only solution would be removing Trump from the presidency. That has not happened and therefore the pathology has deepened. With the coronavirus it will come to a point where Trump supporters get sick and die in large numbers. They will still support Donald Trump.

Trump is not a savior, but a human being with flaws. Trump’s followers cannot even conceive of that fact. It cannot even enter their conscious mind because they will block it. If a person tries to explain reality to Trump’s supporters, they will do anything to hold onto their fantasies about Trump and to follow his commands.

Unfortunately, there is a dynamic where mental symptoms are contagious, and individuals start to have the same symptoms of the primary person — even though they usually don’t have a mental health disorder. Mentally unwell leaders influence their followers to behave the same way.

Fox News and the right-wing media have been circulating dangerous lies about the coronavirus. How does that fit into the Trump mental disorder pandemic?

I was watching Fox News some 20 years ago and realized that it would cause a national public mental health crisis in the future. Donald Trump is the result of decades of poisoning people’s minds and manipulating and controlling them.

How will Trump’s followers and other people addicted to Fox News and the right-wing disinformation machine reconcile seeing real people — perhaps even their relatives — get sick and die from the coronavirus with the lies they have been told by their trusted information sources?

The human mind is very powerful. The human mind is capable of turning everything upside down, and Donald Trump has already instructed his followers not to believe what they’re seeing and only to listen to him. Fox News and other right-wing media outlets have been instructing the same thing.

I am very afraid that the coronavirus pandemic will cause many deaths and that Donald Trump will then say that the disease was somehow spread in the United States by the Democrats in order to ruin his re-election chances. Trump’s followers will believe that and blame the Democrats. In their minds the coronavirus will be the Democrats’ fault and not the result of a global disease.

That is another example of how Trump, the Republicans and the broader right-wing movement use stochastic terrorism against Democrats, liberals, nonwhite people, Muslims and any other group or individuals they target as the “enemy.” In that logic, if the Democrats are somehow responsible for the coronavirus then violence against them is both reasonable and necessary.

Donald Trump has violence in mind. He’s a coward. Normally, he would not even wish to go in the direction of violence, but if his survival were threatened — especially his emotional and mental survival and his inflated sense of self — Trump will resort to violence. That violence could be in the form of a civil war or a war in another country. Trump has said such things before. His foreign policy also reflects his violent mind.

My greatest worry is that the more the coronavirus crisis worsens and the more Trump feels threatened as he realizes that he cannot force his delusional reality into being a real one, there is a greater likelihood of him resorting to extreme means.