When touting his chief of staff Mark Meadows onstage in North Carolina this month, President Trump gave an unusual compliment for a risky move.

“He follows me,” Trump said of his helicopter ride to Walter Reed National Military Medical Center after testing positive for the coronavirus. “I said, ‘You know what? I just tested positive.’ He didn’t care. He was in that helicopter.”

Meadows, after seven months on the job, has developed a close and durable relationship with Trump, who regularly calls his top aide eight or 10 times a day, according to current and former administration officials. He has largely avoided the will-he-won’t-he-be-fired chatter that dominated the tenures of his three predecessors.

But with Trump trailing Democratic challenger Joe Biden and the coronavirus pandemic surging again, Meadows’s uneven handling of the pandemic response and other West Wing crises has dismayed many staffers and campaign officials, who say he has largely proved to be an ineffective chief of staff, instead serving more as a political adviser and confidant.

White House Chief of Staff Mark Meadows on Oct. 25 said the United States wouldn’t contain the coronavirus, as some aides to the vice president tested positive. (The Washington Post)

Meadows provoked controversy again on Sunday when he broadly declared defeat in the fight against the coronavirus: “We’re not going to control the pandemic,” he said on CNN’s “State of the Union.” “We are going to control the fact that we get vaccines, therapeutics and other mitigations.”

He also played a role last week in working to keep a lid on news of a spreading coronavirus outbreak in the office of Vice President Pence, with at least five aides or advisers infected as of Sunday.

Meadows — previously a fixture in Washington’s social scene even as he led the anti-Washington House Freedom Caucus — has served in the job through the most tumultuous period of the presidency, amid a pandemic that has killed at least 224,000, an economic retraction, racial unrest in American cities and a raucous election season.

Many of those with whom he works, however, say the former House lawmaker has struggled with the management challenges of the chief-of-staff position — sending mixed messages in stimulus negotiations, bungling aspects of Trump’s recent coronavirus hospitalization and regularly failing to communicate inside the West Wing and with many other parts of the administration.

A spokesman for Meadows declined to make him available for an on-the-record interview. This accounting is based on interviews with 18 White House officials, Trump advisers, Capitol Hill aides and others, many of whom spoke on the condition of anonymity to reveal internal deliberations.

“Since becoming the President’s chief of staff, Mark Meadows has proven time and again that there is no doubt he’s up to the job, and is a tremendous asset as the President works around-the-clock to deliver real results to the American people,” said Judd Deere, a White House spokesman.

Meadows, for his part, has told others that he consults “The Gatekeepers,” a book on presidential chiefs of staff by Chris Whipple. Whipple was recently spotted in the West Wing for meetings, officials said.

Whipple, however, does not agree with Deere.

“It’s hard to count the ways Meadows has failed as chief of staff,” Whipple said. “It’s been an unmitigated disaster.”

Leon Panetta, who was chief of staff for President Bill Clinton, said the challenges of being an election-year chief of staff — coupled with 2020 being a calamitous year and working for a difficult boss such as Trump — was almost too much to handle.

“I think Mark Meadows is doing the best he can under very difficult circumstances trying to keep the place halfway rational. It doesn’t always work, but he’s trying the best he can,” Panetta said. “They have to constantly tiptoe past the cemetery, trying to figure out what the hell he wants. This president is totally unleashed from any kind of anchor.”

Frustrations in the West Wing boiled over earlier this month when Trump went to Walter Reed National Military Medical Center after contracting the novel coronavirus. Meadows, as the president noted, was the only aide to fly with him on Oct. 2 to the Bethesda hospital.

Four senior administration officials said there was no communication for several days from Meadows to the staff about the president’s condition; whether the West Wing would partially close and whether they should work from home; what precautions were in place after the widespread infections; or how many other staffers had the virus.

Meadows slept near Trump at Walter Reed in an ICU bed and largely kept his communication limited to the president rather than talking to other administration officials, the officials said. One day after Trump was admitted, the president’s doctor held a news conference on the hospital steps to say the president was recovering quickly. He refused to answer some questions and misled reporters on whether Trump had taken supplemental oxygen.

Minutes later, Meadows contradicted the president’s doctor on his health condition, telling reporters anonymously — sourced as a person familiar with the president’s health — that the president’s vital signs had struggled and a “clear path to recovery” was uncertain. Meadows’s role was given away when camera footage emerged of him speaking to the reporters, even as other officials tried to deny the comments because they did not realize Meadows was the person giving them.

On Oct. 4, Meadows helped orchestrate the trip for the still-infected president to ride in his motorcade to wave at his fans outside Walter Reed without telling other staffers, meaning the president went without a protective press pool.

Aides also said Meadows knew about a positive coronavirus result for top Trump aide Hope Hicks for more than eight hours before it was disclosed to the public on Oct. 1 — and before the president left for a fundraiser that day in New Jersey. A person close to Meadows said the White House did not plan to disclose publicly the condition of aides who became sick but always planned to disclose the information if the president became infected.

Some aides and advisers, such as Kellyanne Conway and Chris Christie, have encouraged the president to take a different tone on the coronavirus after his hospitalization, hoping to improve his poll numbers and change his image on an issue that is a political albatross.

Meadows has long resisted mask-wearing and other coronavirus precautions recommended by the Centers for Disease Control and Prevention and has been more focused on economic rather than public-health issues, telling others that his work on keeping the economy afloat was the most challenging of his tenure. Earlier this year, aides say, Meadows tried to move the president’s schedule away from the coronavirus and “move on,” in the words of a senior administration official with direct knowledge of internal discussions. He has not usually attended meetings of the coronavirus task force, officials said, and has battled with infectious-disease director Anthony S. Fauci and other administration scientists.

Meadows has encouraged large campaign events and has not forced staff to follow all CDC guidelines, leaving some allies, such as Scott Gottlieb, the former FDA commissioner, saying that the chief of staff should have done more to protect the president.

He also has helped empower Scott Atlas, a Fox News commentator and radiologist who espouses disputed theories, in the West Wing.

“His complete inability to tell the president hard truths about the coronavirus crisis and his complete abdication of his responsibility to tell the president hard truths has been a significant failure,” Whipple said.

Unlike the three previous chiefs of staff, Meadows has an easy rapport with the president, aides say, often joining Trump in decrying news coverage and probes of issues, such as Russian election interference, that they view as unfair. He has also done less than other chiefs of staff to manage Trump’s tweets, officials say.

People close to Trump say the president likes Meadows because he executes the president’s wishes — or is an “implementer,” in the words of one official close to Trump. For example, Meadows was heavily involved this summer in the deployment of the military across Washington after nights of protests and looting.

Meadows travels with the president on almost every trip, unlike his predecessors, and often joins him in the private presidential cabin on Air Force One. And he has forged strong ties with Dan Scavino, an influential adviser who manages the president’s social media message, and has not battled as aggressively with Jared Kushner, the president’s son-in-law, as previous chiefs.

Some staffers say Meadows acts more like a politician himself than a staffer. He has distributed challenge coins — a memorial trinket — with his name emboldened on them to others, including staff on Air Force One. He brings his wife, Debbie, and other family members on Air Force One, taking seats that would usually be reserved for other West Wing staffers. He recently sat behind Amy Coney Barrett, the Supreme Court nominee, during her hearings on Capitol Hill, startling other staffers. He speaks with the media far more often than his predecessors.

He has also reduced the number of senior staff meetings in the White House, telling aides it was better to have smaller and fewer meetings to minimize leaks, as the president desired. A person close to Meadows said he has now caught three people who spoke to the news media without authorization.

Some aides in the White House say that such key offices as the Domestic Policy Council are largely dormant under Meadows. He has pursued some policies, such as a bid to create $200 drug cards for Medicare recipients ahead of the election, largely on his own; aides note those cards have now come under legal scrutiny and won’t be delivered before Election Day. A number of aides said it was unclear how policy was made in the West Wing under his tenure.

Meadows has been a deeply political chief of staff, regularly reviewing campaign data with Trump, attending fundraisers and approving campaign travel.

Meadows is particularly involved in legislative affairs and has cut Amy Swonger, the head of the office, out of most meetings with Trump. Meadows has told members of Congress to instead interact with John Fleming, his senior adviser, or aide Cassidy Hutchinson, who accompanied him to meetings with House Speaker Nancy Pelosi (D-Calif.).

At times, senators and Pelosi’s office have grown frustrated with his unclear role in talks involving coronavirus stimulus measures. Meadows has told the president that a deal is unlikely, even as he has pressed ahead with negotiations. Aides say Meadows has forged a bond with Treasury Secretary Steven Mnuchin, despite their dramatically different political backgrounds and different views on a stimulus package.

Senate Majority Leader Mitch McConnell (R-Ky.) said he approved of the way Meadows handled stimulus negotiations and the nomination of Amy Coney Barrett as a Supreme Court justice to replace the late Ruth Bader Ginsburg.

“I think he’s done an outstanding job,” McConnell said.

But other GOP senators have appeared puzzled by Meadows’s role.

“Maybe he just needed to get out of the White House,” Sen. Roy Blunt of Missouri recently said when asked why Meadows was at a Senate lunch. “I don’t know.”

Seung Min Kim contributed to this report.