On September 22, the United States hit the grim milestone of 200,000 American deaths due to COVID-19. But despite the magnitude of this toll, Donald Trump continues to minimize the pandemic. On September 21, he argued that “it affects virtually nobody” – a lie that is even more dangerous, as the fate of the Affordable Care Act (ACA) hangs in the balance after the death of Supreme Court Justice Ruth Bader Ginsburg.

The 6.7 million Americans that have contracted and survived COVID-19 now have a preexisting condition that necessitates health insurance coverage to protect them. But Trump has only reacted with undisguised glee at the prospect of installing a new Supreme Court justice. And he has already promised that any Supreme Court justice he would nominate would vote to strike down the ACA.

This week, COVID-19 is on the rise in at least 22 states. The pandemic is far from over – yet Trump and his Republican enablers have put the passage of meaningful coronavirus relief on the back burner to prioritize the immediate confirmation of a still-unnamed Supreme Court justice.

• During the same (maskless) campaign rally where Trump claimed that the virus “affects virtually nobody,” he also repeated the lies that the virus affects “nobody young,” and that it affects mainly “elderly people with heart problems and other problems.” Of course, his lies directly contradict his own admissions to reporter Bob Woodward that “it’s not just old people, Bob … [it also affects] plenty of young people.”

• On September 24, Trump announced that he would sign executive orders that would purportedly address health care protections for COVID-19 and those who have preexisting conditions. Experts largely dismiss the toothless orders as “little more than a public relations ploy” and yet another promise that lacks the substantive policy detail to substantiate his claim.

• The New York Times reported on September 19 that U.S. Secretary of Health and Human Services (HHS) and Trump loyalist Alex M. Azar II barred the Food and Drug Administration (FDA) and other federal health agencies from signing any new rules regarding the country’s vaccines, foods, medicines, medical devices, and other products.

• Trump raised his attacks on the FDA again on September 23, when he accused the agency of playing politics over its plan to tighten the guidelines for the authorization of a vaccine. He told reporters that the White House “may or may not” approve the new guidelines, which underscores the unlikelihood of a vaccine before Election Day.

• Yet Trump remains fixated with promising his base a working vaccine prior to the election. Bloomberg News reported on September 23 that his administration has shifted billions of dollars away from the Centers from Disease Control and Prevention (CDC), the National Strategic Stockpile (which provides health and medical supplies during public health emergencies), and other critical health agencies into its push to fast-track a vaccine.

• The Senate Committee on Health, Education, Labor and Pensions (HELP) convened a hearing on September 23 on the political influence in the approval and timeline for a coronavirus vaccine. Despite recent guidance changes from the CDC and the FDA over the last few weeks, CDC director Dr. Robert Redfield and FDA commissioner Stephen Hahn both disavowed the notion that political pressure has guided their decision-making.

• Olivia Troye, a former aide to Mike Pence, former member of the White House coronavirus response team, and self-described lifelong Republican, last week severely criticized Trump’s interference in the White House’s coronavirus task force. Troye said that Trump’s “flat-out disregard for human life” confirmed that his “main concern was the economy and his reelection.”

• At his September 22 campaign rally, Trump reiterated his call for educators nationwide to “Open your schools; everybody, open your schools.” Evidence continues to mount that Trump’s push to reopen schools has had disastrous consequences: A new study reported that colleges and universities that reopened for in-person classes likely caused about 3,200 cases per day that would likely not have developed had schools not reopened.

• Even though the American public has suffered for too long without continued federal COVID-19 relief, Senate Republicans are singularly focused on filling the late Justice Ginsburg’s seat on the Supreme Court. Despite claims from several Republican senators that “what we need to be focused on right now” is pandemic relief, virtually none of them have come forward to oppose voting on a new Supreme Court nominee while the American public continues to struggle in the absence of urgently needed relief.

The fall surge of COVID-19 cases that experts have predicted for months is already upon us. Yet Trump is fixated on forcing through a Supreme Court nominee who will help to rescind the ACA and strip health care from millions of Americans.

It has never been clearer that this year’s general election is a fight for our lives and that we must vote Trump – and his Republican allies – out of office this November.