I don't think he's insane (well, he might be - I should say I don't think this is proof that he's insane). I think he's dumb. I think he's being told something, not really understanding it, and then doing a really bad job of trying to repeat it to the public. Because there's more than a kernel of truth underlying what he's saying.
We never dropped our rate of confirmed cases more than 25-30% from the peak rate, and have had climbing case rates for several weeks now. However, hospitalization and fatality rates have been declining consistently since mid-April, and by over 70%. Somewhere in there we got one drug approved that has had modest success moderating the severe cases, but that can't explain those kinds of declines. There has probably been some demographic shift, but that doesn't fully explain the decline either. I also think that the magnitude of the demographic shift has been wildly overstated by the media. All3 said his family had covid and only had cold symptoms. In March and April those people couldn't get tested. Now, in most places, they can. By and large people with mild symptoms skew younger, so observed confirmed case rates in younger people will climb when testing becomes more available. Younger people are probably also exposing themselves to more risk (though I see plenty of older people in my area doing things like congregating on porches with their neighbors, and have since it was blatantly against the law here, or not wearing a mask in the grocery store, which is still against the law), but changes in testing policy are definitely playing a role in observed shifts. Certainly nobody should have been buying it when, at the peak of the outbreak in New York, almost nobody under 20 was testing positive. It's highly unlikely that kids were just going to be immune. We just weren't testing them.
So the point of all this is that much of the perception of lack of improvement, based on confirmed cases, was probably a bit misleading. I think that epidemiologists in the Federal government knew this. Trump was probably getting briefings along the lines of "We do think things are getting better, we're testing more so observed case rates aren't declining very much, but we think that real case rates are probably declining. We don't want to broadcast this information to the public because our priority is protecting lives, and if we tell people things are getting better then they'll behave even more stupidly than they already are." But Trump's priority isn't pushing behavior in the direction of saving the greatest number of lives, it's pushing behavior to accrue the maximum number of votes in November. He's not that altruistic. So he's trying to change the messaging, and he's actually dumb enough to think the right thing to do isn't just tell people to focus on death and hospitalization rates but actually to test less.
Like I said, he's dumb.
Also, I do think it's pretty clear at this point that in many areas real case rates are actually rising now. But I also think they were declining much more, and for much longer, than many people recognized.
Also, I apologize for any typos I missed. My 9 month old has been banging on my keyboard.