There he goes again: Trump cites non-existent 'AIDS vaccine' as proof we can quickly come up with a COVID vaccine.

President Trump, in his willful ignorance, is spreading misinformation about the COVID-19 outbreak so consistently that The New York Times has wondered (rhetorically, I trust; of course it isn't true literally) whether he's actively trying to spread it. We could hardly have a worse president at this particular moment in history. And now, he's branching off into AIDS. 

It was a typical word salad from the man who complains that Joe Biden is inarticulate: 

“These are the people — the best, the smartest, the most brilliant anywhere... And they've come up with the AIDS vaccine. They've come up with — or the AIDS. And they — as you know, there's various things, and now various companies are involved. But the therapeutic for AIDS — AIDS was a death sentence, and now people live a life with a pill. It's an incredible thing,

Presumably, President Trump was referring to PrEP, a pill that helps reduce the transmission of the HIV virus through sex for anybody except women who have sex often (it may help them too, but has not been adequately tested in that population), and also for IV drug users. It is a preventative rather than a treatment for AIDS, and it is for people who do not have the virus, not those they do. Doubtless, Mr. Trump was conflating it with the other wonderful treatments which have, thank God, made AIDS something other than the death sentence it once was.

In any event, it is not a vaccine. It must be taken daily and its effectiveness disappears when the drug is no longer in the bloodstream. The two brands on the market, Truvada®, and Descovy® are both extremely expensive, vary in effectiveness depending on the method of transmission through which potential transmission occurs, and are utterly dependent on proper and regular use. The idea that PrEP can function as a one-time treatment that confers actual immunity, as a vaccine would, is extremely dangerous because people who take it under that assumption and do not follow up with the daily prescribed doses are not protected.

PrEP is a wonderful thing. So are the other techniques which have been developed and which allow people with HIV to live relatively normal lives. AIDS is no longer a death sentence, for which all people of goodwill rejoice, and the president is right to admire how far medical science has gone in treating that particular virus. Further, he is right to extol the brilliance and resourcefulness of the people who have made this so. Dr. Fauci is optimistic about the possible development of a vaccine by the end of the year, especially given the resources being directed toward that goal and the single-mindedness that drives the world's effort to deal with the COVID crisis.

There is no guarantee that if a vaccine is developed it will confer absolute immunity to the SARS-CoV-2 virus. It may only reduce the seriousness of symptoms and may not prevent infection at all. Or it may simply make it harder for a vaccinated person to be infected by the virus. But even that would be a major victory that would be, as Mr. Trump himself once said of hydroxychloroquine, a treatment that by now has been widely tested, found to be useless, and to actually make it more likely that a COVID patient who is given it will die- a "game-changer."

We all pray for an early end to this scourge. We all pray for the earliest possible development of a vaccine that is as effective as possible, and its distribution to the world's population as rapidly and efficiently as possible. Those who know what they're talking about are reasonably optimistic that we can do all this far more rapidly with COVID than we have ever been able to do with any previous virus. Mr. President, as our Jewish friends say, "From your mouth to God's ears!"

But there may well be people who are led by his remarks to think that PrEP is a vaccine, or even acts like a vaccine, and as a result don't understand that rather than being a shot or other one-time medication that conveys some degree of immunity it's a daily medication that is only effective as long as you keep up with your daily doses, and die as a result. That's the problem with the presidency; the "bully pulpit," as Theodore Roosevelt called it, reaches a lot of ears, and there is an inclination on the part of more people than not to believe the person who occupies that pulpit and act accordingly.

Fewer people believe Donald Trump than believe most presidents because of the almost ridiculously high percentage of the things he says that have proven over the years to simply not be true. Sometimes they're outright, bald-faced lies. Sometimes they're hyperbole that misfires for the same reason that what seems to be hyperbole on the left about abolishing or "defunding" the police has misfired. The purpose of words is to communicate things, and hyperbole carries with it not only the danger but even the likelihood that it won't be recognized as hyperbole. The same thing happened with "Believe all women." It's best just to say what you mean.

But if we're going to start believing the president again, we need to have a president we can believe. The incumbent considers himself an expert on everything when he actually knows very little about most things. And the reason why a president says things that aren't true- whether intentional deceit or ignorance or a simple human mistake- is in many ways not relevant.

When the president says something, we need to be able to believe him without turning off our minds and uncritically believing everything he says.  He needs to be both reliable and accountable. Mr. Trump is not the first and refuses to be the second. That is a problem.

Hopefully, nobody will die because they think that taking PrEP, they are taking a vaccine.  But an awful lot of people believe even now that hydroxychloroquine is an effective treatment for COVID. And this is an administration in which to even correct the president when he passes on misinformation is dangerous. Disagree with the most unsound and counterproductive aspect of Trumpist ideology and if you work for the Executive Branch you may lose your job.

Joe Biden has been known to stretch the truth on occasion, too, and even to do so outrageously. But I expect that he will be willing to be held accountable when he does, and will apologize rather than double down and become hostile when he is shown to be wrong.

That, itself, would be a major improvement over the status quo.