Even before the COVID-19 pandemic, Donald Trump was a threat to public health.

On numerous occasions, he sought to undermine or outright appeal the Affordable Care Act, which would take away health care from 20,000,000 Americans and return us to the days when health care companies could deny coverage based on pre-existing conditions.

He attacked Planned Parenthood, cut funding for family planning, restricted research that could help make advances in the race for cures for Parkinson’s, diabetes, and HIV, gutted school lunch health standards, and failed to take meaningful action to address the opioid crisis roiling America.

Then, in late 2019 began what would become perhaps his greatest failing. Trump was warned of the threat posed by the novel coronavirus. Yet he repeatedly downplayed it and said it would just disappear. Then, as the virus began spreading in the United States in early 2020, and as states, municipalities, and businesses shut down in order to protect our people, he repeatedly undermined public health efforts, calling for the rapid re-opening of the economy without a plan for getting the virus under control or showing much concern about getting it under control either.

Trump repeatedly promoted untested and potentially dangerous drugs as quack cures, seeking short-term, simple, quick, thoughtless fixes to a complex problem that required long term planning, focus, and real thought. He floated bizarre ideas like injecting people with disinfectant. And when that failed him, he blamed the World Health Organization, or the Chinese.

In a matter of weeks, Trump went from saying the virus was just infecting a handful of people and would go away to boasting that 100,000 to 200,000 Americans dying from it would mean he had done a “very good job.”

Against the advice and pleas of health officials, Trump held a campaign rally in Tulsa, Oklahoma in June. Attendees were not socially distanced and many didn’t wear masks. At the rally, Trump told of how he instructed his own government to slow down testing so there wouldn’t be so many cases. One of Trump’s higher profile supporters, Herman Cain, attended the rally and proudly flouted mask recommendations. In just over a month, he would be dead from COVID-19.

Trump’s response to the coronavirus has been a failure of horrific proportions. As thousands die each week, Trump spends his time golfing, watching TV, and raging on Twitter at everyone from cable news hosts to tire companies. He has no plan to cure the virus or re-open safely. Meanwhile, he’s still trying to repeal the Affordable Care Act, putting 20,000,000 Americans’ health care at risk in the middle of a deadly pandemic.

Joe Biden is a compassionate leader who will mount an effective crisis response and elevate the voices of scientists, public health experts, and first responders because he has done it before. Simply put, the health of all Americans depends on a Biden victory.