President Donald Trump walks out of Walter Reed National Military...

President Donald Trump walks out of Walter Reed National Military Medical Center to return to the White House after receiving treatments for COVID-19 on Monday in Bethesda, Md. Credit: AP/Evan Vucci

In the late 1970s, after suffering a series of strokes and other medical crises that left him increasingly weak and incoherent, Soviet leader Leonid Brezhnev wrote a boastful diary entry about his recent doctor's visit: "[They] checked [my] brain cells, said everything was good, you should be envied and congratulated[,] you're strong and healthy."

During his shortened hospital stay with COVID-19, Donald Trump tweeted that he was feeling "better than 20 years ago," while his physician (who has praised the president's "incredible genes") announced that he was "doing great" — a rosy assessment called into question by his repeated bouts on oxygen and an intensive course of treatment.

Trump's obsession with projecting the appearance of good health echoes a similar fixation among the ailing leadership of the late Soviet Union, whose leaders died in rapid succession in the early 1980s while insisting on their own (and the country's) perfect condition. Like his Communist counterparts, Trump's predilection for pageantry offers a hollow illusion of vitality while letting potentially fatal problems fester.

Brezhnev had been General Secretary of the Soviet Communist Party since 1964, and saw his health decline considerably following a 1976 stroke. According to some accounts, he also suffered from heart failure, as well as an addiction to sedatives and sleeping pills. Kremlin doctors struggled to rouse Brezhnev for official meetings and televised appearances, which broadcast his slurred speech and shaking hands to millions of viewers.

With information about his deteriorating condition restricted to the Politburo, Soviet citizens filled in the blanks with rumors and jokes that cast the general secretary as dying, dead or perpetually regenerated. According to one joke, Brezhnev's daily routine began with reanimation, followed by makeup, a banquet, an awards ceremony and concluding in clinical death.

As Brezhnev's mind and body failed, an adoring cult grew around him that stoked his ego. Paeans to Comrade Brezhnev's "unflagging energy, principles and vision" appeared on the front pages of major newspapers, while official ceremonies hailed "Dear Leonid Ilich" with extended applause and kisses. Obsequious peers in the Politburo granted him medals including the glittering Order of Victory, a diamond-encrusted military decoration from World War II that was dubiously awarded in honor of his minor role as a political commissar on the southern front.

After Brezhnev's death by heart attack in 1982 at age 75, Yuri Andropov spent 15 months in office before dying of kidney failure in 1984 at 69. His replacement was Konstantin Chernenko, who was already seriously ill when he took over at age 72. Both leaders, like Brezhnev, hid the reality of their condition from the public. In February 1985, Chernenko was shown on television receiving the results of elections to the Supreme Soviet in a peach-colored office that was in fact the disguised foyer of his hospital room. Party officials congratulated him on claiming victory with 100% of the vote; the ill leader, laboring to breathe, read a short speech praising the country for successfully fulfilling all of its plans. A month later, in March 1985, he died from a combination of severe emphysema, congestive heart failure and cirrhosis of the liver.

Late Soviet leaders' denial of sickness and glowing self-image were part of their inability to acknowledge greater signs of ill health — and to address a troubled health care system. The Soviet establishment framed premature death as the domain of the depraved capitalist West (seen, for example, in disparaging press coverage of the AIDS crisis). For decades, the party proclaimed that socialist medicine was the best in the world while failing to invest adequately in health care. Though premature death (above all from alcoholism and cardiovascular disease) consistently kept male life expectancy below 65, the state proved incapable of acknowledging its failings. As life expectancy indicators declined in the 1970s, mortality rates simply vanished from Soviet discourse, and earlier gains continued to be trumpeted as evidence of the country's strength.

This trend has a disturbing parallel with America's contemporary predicament and Trump's efforts to conceal his battle with COVID-19. While Trump's health is chronicled by obsessive media coverage and White House updates, the details of his condition remain murky. Data about his test results and the condition of his lungs has been supplanted by the sort of absurdist political theater common among Soviet leaders. In his own spectacle of repressed infirmity, Trump signed a blank piece of paper in a conference room at Walter Reed National Military Medical Center to prove that, in his daughter Ivanka's words, "nothing can stop him from working for the American people. RELENTLESS!"

As in the Soviet Union, the leadership's concealment of illness and projection of strength is tied to the state's failure to foster healthy lives for its people. Despite the fact that the U.S. spends more on health care than any country in the world, life expectancy has been on the decline for several years, due largely to an increase in "deaths of despair" from drug overdoses, suicide and alcoholism (centered in pro-Trump regions like the Ohio Valley).

In place of solutions, Trump offers empty promises of national invigoration that mask his administration's failure to address the social and economic crises that have reduced longevity and made the coronavirus outbreak particularly deadly (especially among older people and poor communities of color). The president has framed the virus as a foreign plague that justifies his administration's xenophobic policies while encouraging states to reopen and attempting to dismantle the Affordable Care Act.

Rather than marshaling the country's resources to improve public health, Trump has refused to wear a mask and told Americans not to fear a disease that has already killed over 210,000 of their fellow citizens. In this late Soviet redux, Trump lets the country get sicker while enjoying elite medical care that flatters his vanity, paid for by taxpayers who can't afford anything like it.

The Soviet outcome of this strategy doesn't bode well for the country. The Communist leadership's gilded facade of good health was brought down by Mikhail Gorbachev, who in 1986 launched a sweeping reform program that exposed the country's rot and inadvertently destroyed the system itself.

Seventy-seven-year-old Joe Biden, like Trump, belongs to a gerontocratic political class that has struggled to adapt to a changing world. Yet for all his weaknesses, Biden recognizes the severity of the pandemic and the necessity of securing adequate care for all citizens. It remains to be seen whether Trump will get four more years to accelerate American decline. What's certain is that denial of sickness offers little chance of health — and a historical lesson in ruin.

Neumeyer is a historian of Russia and Eastern Europe and fellow at the European University Institute, where she is writing a book about death and despair in late Soviet culture. This piece was written for The Washington Post.