When the leader of the “free world” promotes a quack who states that gynecological problems are caused by sex with demons, you know the free world is in big, big trouble.

What else can you say when President Trump touts Dr. Stella Immanuel, who claims “spirit husbands” and “spirit wives” visit humans in their dreams, and cause fibroids and impotence? Trump retweeted a video in which Immanuel insists that hydroxychloroquine is a “cure” for COVID-19 and says masks are not needed. Never mind that this dangerous fakery has been repeatedly rebuffed by medical studies and Trump’s own advisers, including Dr. Anthony Fauci. Trump found the spirits doctor “very impressive.”

Even when queried about Immanuel’s bizarre theories Trump doubled down. “I thought her voice was an important voice, but I know nothing about her” (italics mine), he told reporters. Of course, Immanuel’s Fire Power Ministries sermons are readily available on YouTube. Buoyed by Trump tweets, her ravings about the DNA of space aliens were flooding social media and cable news by the time the president claimed ignorance.

The Stella Immanuel saga is not just another sick Trump joke we can ignore because there have been so many. No other president in our lifetime (or perhaps ever) would have praised a fraudster who claimed “demon sperm” was infecting our medicine. A president who promotes quacks is himself a purveyor of quackery.

This madness illustrates how far Trump is removed from reality - and how dangerous he is to America’s national security should he win a second term.

I stress national security because so much has been written about the threat that Trump redux would present to our democratic institutions. But it’s also important to confront how four more Trump years would undermine country’s safety and security — as well as its global standing — as he promotes fraudsters at home and abroad.

Here are three examples of the dangers Trump quackery would pose.

First, dealing with the pandemic. By January, Trump’s willful refusal to devise a national strategy for containing the virus probably means the situation will be worse than at present. “If Trump is reelected there will be no prospect of any international cooperation to deal with this, just a presidential effort to change the subject,” says Thomas Wright, director of the Brookings Institution’s Center on the United States and Europe.

Even if advances are made with potential vaccines, Trump’s open disdain for science has emboldened anti-vaxxers, and encouraged many to believe in crank therapies like a hydroxychloroquine “cure”. If America got embroiled in vaccine wars as it has in mask wars, virus outbreaks would continue.

Moreover, Trump’s America First approach might lead him to try to hoard or buy up vaccine, while rebuffing vital international cooperation to help distribute it at affordable prices.

“The next two years will be crucial for international cooperation in vaccine distribution, dealing with hot spots and economic recovery,” Wright told me. “Trump would be super nationalistic, which would have more lasting consequences.” Unless a vaccine receives worldwide distribution, the global economy won’t recover, global travel will be constrained, and the disease will continue to migrate.

Second, dealing with post COVID-19 geopolitics. Trump’s hold on reality in dealing with allies is as lacking as when he promotes medical hucksters. “We have a president who looks up to a [Russian leader Vladimir] Putin and [Brazilian President Jair] Bolsonaro, while he can’t stand British, French, and German leaders,” says Rep. Brendan Boyle (D., Pa.), who sits on the House Foreign Affairs Committee.

Indeed, Trump has ordered the reduction of U.S. troops based in Germany from 36,000 to 24,000 because he thinks German defense spending is too low. But moving the troops will cost more than keeping them there, and demonstrates Trump’s disdain for his democratic partners. The plan is “a slap in the face at a friend and ally” and “a gift to Russia,” Sen. Mitt Romney (R., Utah) told reporters.

Trump’s estimation of who are America’s friends and who are foes is as limited as his grasp of Stella Immanuel’s skills.

Third, leaving America alone at a time when international cooperation is more vital than ever. Not only will Trump likely quit NATO if he wins in 2020, but he has threatened to bring troops home from South Korea. Just as he is blustering about a new Cold War with China, he is wrecking the alliances America needs to contain potential Chinese aggression under Xi Jinping.

And Trump is abandoning vital international cooperation in dealing with climate change or future pandemics, convinced that he alone has the smarts to deal with global problems.

Indeed, his mystical belief in his own greatness is as deluded as the fantasies of Stella Immanuel. His enthusiasm for her may reflect his appreciation for a fellow fantasist. Or his frequent embrace of conspiracy theorists.

But Trump’s delusions are far more dangerous to U.S. security than those of a charlatan denouncing “demon sperm.”

Trudy Rubin will be on vacation until Aug. 17.