As recorded, [Trump's statement that he wanted to 'play down' CV19 early in 2020] reads like a cold-blooded confession that Trump intentionally concealed deadly knowledge at a time—February and March—when that knowledge could have saved lives. But you can reach that conclusion only if you believe that Trump knows things the way fully rational people know them: as statements about reality that exist independently from the speaker. Trump’s mind does not work that way. He does not observe the world and then use words to describe it. He speaks the words he wishes you to believe, and then trusts the world to conform to his wishes.
I think the problem is that our theory of mind leads us astray with Trump: we try to build a model of what he must be like in our heads and that model is entirely wrong. Trump is not really a person at all, he's the remains of a person who has collapsed in on himself. Insofar as this carcass can be said to be aware it is aware only of itself: the outside world and all the people in it are merely dim shadows and reflections of its internal processes.
Trump is the end state after a person no longer has the strength to prevent their mind collapsing under the gravitational force of their own vanity.