In the abstract, it always seemed incongruous to refer to Donald Trump as “anti-elite.” The guy had billions of dollars and lived in a spacious penthouse suite in Manhattan at the top of a building that bore his name. But that’s not what “elite” meant in the context of Republican politics in 2015. What “elite” meant was that there was a party establishment that remained tethered — however shakily at times — to certain views of policy and politicking that followed from tradition and a shared sense of reality. What “anti-elite” meant was that someone was willing to chuck all of that, to treat the unserious complaints that filled hours of coverage on Fox News and hundreds of words on Breitbart as accurate and actionable. “Anti-elite” didn’t mean that someone had no power, it instead meant that the person was willing to elevate inaccurate, exciting and dangerous popular views over staid, boring and unexciting realities.

There’s not much use in spending a lot of time articulating how Trump manifested this particular sense of anti-elitism. The Washington Post’s fact-checking team spent years doing so. Trump would say and do things that his base wanted before he would say or do things that they didn’t, even if the latter was real and the former wasn’t. In doing so, he made it increasingly difficult for others in his party to do anything else. No one wanted to be the Republican telling the base uncomfortable truths when Trump was energetically telling them comfortable falsehoods.

Trump’s success was rooted not only in his willingness to say things that other Republicans wouldn’t but in the fact that the base of his party had been conditioned to treat establishment and expert opinions with suspicion. The pre-Trump GOP was walking a tricky path between casting the government as untrustworthy and unworthy of respect even as it often controlled all or part of that same government. Even once he was president, Trump worked to create a sense of distance between himself and the establishment, hyping his followers as the real “elites.”

The emergence of the coronavirus pandemic in the year that Trump sought reelection heightened that. He was able to cast experts like Anthony S. Fauci, the government’s leading infectious-disease expert, as someone not to be trusted. Trump ran a parallel medical advisory process, hyping such things as hydroxychloroquine and making promises about the quick resolution of the pandemic, all with an eye toward convincing voters that all would soon be well. It didn’t work overall, but he did succeed in ensuring that Republicans were broadly dismissive of the risk posed by the virus and more likely than other groups to see mask-wearing or vaccines as unimportant.

What he did, really, is create a system in which individual assessments of the pandemic are given primacy over actual expertise. His reinforcement of the idea that the experts had nothing more to offer compared with someone’s Facebook feed tied his own hands in an uncomfortable way: He would love to get credit for the vaccines that could contain the pandemic but, as he showed at a rally this month, is unwilling to tell his followers that the urgency of protection outweighs their interest in feeling as though they are smarter than medical professionals.

Trump’s approach to the pandemic created a system in which other leaders could demonstrate similar skepticism about expert advice and reap rewards from the Republican base. Florida Gov. Ron DeSantis (R) is struggling to contain a surge of cases in his state that his chest-thumping rejection of containment measures has exacerbated, but he still leads in polls of possible non-Trump 2024 Republican primary contenders. (DeSantis’s response to the surge? Prioritize treatment post-infection instead of prevention pre-infection.)

Others have built or reinforced images as iconoclasts by echoing Trump’s skepticism about the pandemic. Sen. Ron Johnson (R-Wis.) has embraced a variety of surreal claims by Trump, including about the 2020 presidential election. He has also downplayed the need for people to get vaccinated, taking a die-and-let-live approach to the process. In recent weeks, he has been a vocal advocate for ivermectin, an anti-parasite medication that has replaced hydroxychloroquine as The Medicine They Don’t Want You to Know About.

In a radio interview this month, Johnson offered incredibly bad advice for dealing with the coronavirus and covid-19, the disease it causes.

“I don’t care what drug will work,” he said. “Try a bunch of them.”

In defense of his assertion about the efficacy of ivermectin in particular, he pointed to a database of post-vaccination adverse reactions that has become a focal point of vaccine skepticism. The database, called the Vaccine Adverse Event Reporting System, or VAERS, includes a number of adverse reactions that have followed coronavirus vaccinations — that anyone can submit and that have almost entirely not been shown to have been linked to the vaccine itself. But Johnson, in an effort to present himself as smarter-than-the-experts, uses those unverified reports as reason to inculcate doubt about the vaccine even as he suggests that people just go ahead and take a deworming medication mostly used to kill parasites in livestock.

The Food and Drug Administration recommended against ivermectin in March. In an article that begins with a photo of a veterinarian tending to a horse, the agency points out that it “has not approved ivermectin for use in treating or preventing COVID-19 in humans” and that “taking large doses of this drug is dangerous and can cause serious harm.”

On the one hand, you have the FDA saying, “Never use medications intended for animals on yourself.” On the other hand, you have a business executive turned senator saying “try a bunch” of medications. The immediate, obvious response should be “Well, I think I’ll trust the experts on drug administration.” Often, though, the response has been “Heck yeah, no one is going to tell me which horse medications I can or can’t ingest.”

Sen. Rand Paul (R-Ky.) is at least in the medical community, but the advice he offers isn’t much better. At a town hall meeting last week, Paul suggested that he was still weighing the utility of ivermectin even as he only wanly endorsed vaccination.

He blamed anti-Trump sentiment for there being unclear research on ivermectin’s effectiveness in treating covid-19.

“The hatred for Trump deranged these people so much that they’re unwilling to objectively study it,” Paul claimed. “So someone like me that’s in the middle on it, I can’t tell you because they will not study ivermectin. They will not study hydroxychloroquine without the taint of their hatred for Donald Trump.”

He was responding to a woman who said she’d hoarded a quantity of ivermectin just in case. Paul could have pointed to the FDA’s five-month-old recommendation against her using it. Instead, he told her that “I don’t know if it works, but I keep an open mind” while suggesting that politics was preventing the government from even looking into it.

There has been research on both ivermectin and hydroxychloroquine. Trials have repeatedly failed to show efficacy of the latter drug in treating covid; one study on ivermectin was retracted, and others have not proved its utility. Paul has also embraced “natural immunity” in the face of what he has called “government propaganda for vaccine mandates” — significantly downplaying that achieving immunity by contracting the virus has the significant possible downside of dying of covid.

The Kentucky senator is not a newcomer to any the-elites-get-it-wrong discourse. He has long positioned himself at the libertarian edge of his party’s caucus, so a rejection of the advice emerging from officialdom is on brand. It’s also true, though, that his public debates with Fauci over the origins of the virus, for example, have boosted his visibility. Paul was mentioned on Fox News 38 times from May through July of last year, according to an analysis of Internet Archive closed-captioning data by Global Database of Events, Language and Tone. From May through July of 2021, he was mentioned 395 times, 241 of them in the context of his repeated feuds with Fauci.

Numerous states have recently reported increased calls to poison control from ivermectin overdoses or are reporting that the drug is selling out of feed and ranch stores. A police chief in Georgia who’d rejected vaccinations and touted ivermectin recently died of covid, contributing to a recent pattern of mocking those who are embracing the drug or head-shaking at others who’ve died after speaking out against containment measures.

James Hamblin of the Yale School of Public Health reflected on the embrace of ivermectin in a recent essay.

“The tragedy is that people are clearly afraid of COVID-19, and they are trying to protect themselves and/or people they love. They’ve fallen victim to people who don’t care if they live or die,” Hamblin wrote. Later, he added: “I don’t blame vaccine-hesitant people who are uncertain. I do blame people who profit from misleading and misinforming them.”

That profit isn’t only economic. There’s also a proven political profit offered to those who treat expert opinion as something against which to push back.