Anyone who feared that Donald Trump would become subdued after testing positive for Covid-19 could take comfort in the more than 60 tweets the president issued on Tuesday, his first full day at the White House after a four-day hospital stay. The tweets were frantic, angry, and often incoherent. They showed that Trump’s personality has certainly not been tamed by his health problems. In fact, he has become even more Trumpian than before. They also highlight the chaos that is engulfing the executive branch of government in the last month before the presidential election.

Crucially, Trump keeps changing his mind on Twitter about the stimulus deal he is negotiating with congressional Democrats. On Sunday, he had pushed the idea that the stimulus was a high priority, tweeting, “OUR GREAT USA WANTS & NEEDS STIMULUS. WORK TOGETHER AND GET IT DONE. Thank you!”

But on Tuesday, Trump abruptly changed his mind. In a series of tweets he wrote:

Nancy Pelosi is asking for $2.4 Trillion Dollars to bailout poorly run, high crime, Democrat States, money that is in no way related to COVID-19. We made a very generous offer of $1.6 Trillion Dollars and, as usual, she is not negotiating in good faith. I am rejecting their request, and looking to the future of our Country. I have instructed my representatives to stop negotiating until after the election when, immediately after I win, we will pass a major Stimulus Bill that focuses on hardworking Americans and Small Business.

The suggestion that stimulus would only come after Trump wins the election carried the overtones of a threat, with the president withholding economic relief unless voters support him.

Trump’s comments came as a shock to Wall Street and some Republicans. As The Washington Post reported, “Trump’s tweets sent the stock market lower, as many businesses, households and investors had been hoping for a jolt of fiscal stimulus amid signs the economy had lost momentum. The Dow Jones industrial average ended down 376 points, or 1.3 percent. The Nasdaq and S&P 500 also fell.” According to Washington Post reporter Jeff Stein, “Some GOP aides/officials [were] stunned and baffled by Trump’s sudden move to cut off stimulus negotiations.” One Republican told Stein, “It’s very strange, very strange. Didn’t [Trump] just tell us all we should do this urgently?”

Adding to the confusion was Trump contradicting himself on Twitter a few hours after these initial tweets, with statements suggesting he was open to a stimulus after all. As Zach Carter of HuffPost summed up the day’s events, “Trump boisterously pulls the plug on economic relief talks with Democrats and explicitly ties his decision to the election (!!!), then calls for HUNDREDS OF BILLIONS OF DOLLARS in economic aid, right now, plus stimulus checks for everyone.”

House Speaker Nancy Pelosi, the target of many of Trump’s insults, commented, “Clearly, the White House is in complete disarray.” Pelosi also raised the possibility that steroids, which have been prescribed to Trump to help strengthen his lungs, are clouding his judgment.

Nor was Pelosi alone in these speculations. As The New York Times reports, “Some White House staff members wondered whether Mr. Trump’s behavior was spurred by a cocktail of drugs he has been taking to treat the coronavirus, including dexamethasone, a steroid that can cause mood swings and can give a false level of energy and a sense of euphoria.”

The pharmacological explanation has to be considered alongside Trump’s known patterns of behavior. The steroids might be making Trump shout louder, but he still has the same basic message. Many of his tweets are reiterations of standard parts of his repertoire: complaints that the Russia investigation was a “hoax” and calls for the arrest of political enemies. One retweet was a photoshopped image of the late actor Chris Farley (playing the Saturday Night Live character Matt Foley) yelling at Attorney General Bill Barr, “For the love of God, arrest somebody!”

The rapid release of Trump’s tweets, their frequent incoherence, and their unwavering undercurrent of anger do suggest a president who is more frantic than before. California Congressman Jared Huffman cited two tweets with contradictory messages, one calling for the declassification of Russiagate material and the other claiming (falsely) that the material has long been declassified. Huffman concluded that “Trump is not well. And there is no one around him who is able to question him at this point. I am genuinely worried.”

Trump’s mental state is likely to be agitated by the circumstances around him. His poll numbers continue to lag and the White House is now depleted because of the Covid-19 outbreak, with more than a dozen political staffers testing positive.

A New York Times report paints a grim picture of the impact of Covid-19 on working conditions in the administration:

The White House that President Trump woke up in on Tuesday morning was in full-blown chaos, even by the standards of the havoc of the Trump era.

Aides said the president’s voice was stronger after his return from the hospital Monday night, but at times he still sounded as if he was trying to catch air. The West Wing was mostly empty, cleared of advisers who were out sick with the coronavirus themselves or told to work from home rather than in the capital’s most famous virus hot spot. Staff members in the White House residence were in full personal protective equipment, including yellow gowns, surgical masks and disposable protective eye covers.

Trump’s current stress level could be coming from a variety of sources: his illness, the medicine he’s being prescribed, worries about the election, a demoralized staff, and a bleak working environment. All of which suggests that Trump feels under siege and is using his Twitter account, even more than usual, to lash out and try to create the illusion that he’s still dominant. The danger is that the more wounded Trump becomes, the more erratic and unstable he’ll be. Even if he loses the election—or rather, especially if he loses the election—Trump is going to go down fighting. He’s not afraid to take all of us down with him.