Since winning the US election, President-elect Donald Trump has named a slew of hardliners and China hawks to key cabinet positions. Many appointments look like a victory of loyalty over competence.

The most egregious, perhaps, is his selection of Robert F. Kennedy Jr, an environmental activist who has spread misinformation on vaccines, to lead the country’s top health agency, the Department of Health and Human Services. It is an appointment that has echoes of the old chestnut about putting Dracula in charge of the blood bank.

Kennedy has promoted conspiracy theories that the COVID-19 vaccines were developed to control people via microchips, endorsed the false notion that antidepressants are linked to school shootings, and last month promised to gut the US Food and Drug Administration for its “aggressive suppression” of psychedelics, peptides, stem cells, raw milk, sunshine.

Doctors and researchers have proven that risks from disease are generally far greater than the risks from vaccines, but Trump’s occasional penchant for folk medicine – his advice to COVID-19 patients to inject bleach helped lead to the richest nation recording 1.2 million pandemic deaths – sits easy alongside Kennedy’s anti-Hippocratic eccentricities.

Kennedy’s appointment is illustrative of Trump’s willingness to toss proverbial bombs in Washington’s corridors. Before unveiling Kennedy, Trump named three picks united by their outstanding inexperience: Pete Hegseth, a Fox News personality, is his choice for defence secretary; former Democratic lawmaker turned Republican Tulsi Gabbard, accused of amplifying Russian propaganda with no skin whatsoever in the spy trade, is up for director of national intelligence; and, most astoundingly, former Republican congressman Matt Gaetz – a political bomb-thrower who previously faced federal and congressional investigations into alleged sexual misconduct, illicit drug use and other ethical breaches – has been tapped for US attorney-general.

Gaetz’s nomination prompted former Republican House speaker Kevin McCarthy, whom Gaetz helped to dump last year, to predict the attorney-general pick will be rejected by the Republican Senate next year. But Trump has urged the Senate to circumvent convention and allow it.

There are other wildcard nominations, including a Trump golf partner and a governor famed for shooting her dog. Some, however, are relatively uncontroversial, including Marco Rubio, a senator for Florida, as secretary of state, and Susie Wiles, a veteran Republican operative and senior campaign adviser, as White House chief of staff.

Under Trump the US may come to be perceived as a sliding power increasingly in the process of turning in on itself. The world can only look with trepidation on his cabinet and wonder if his assortment of oddball and worthy candidates will hold.

But Trump’s cabinet picks, be they good, mad or indifferent, indicate he has finally learnt what works for him. After spending his first term as president and the years since battling criminal indictments and bureaucracy, Trump thinks his credo to get government out of American lives can be achieved by surrounding himself with men and women whose unquestioning loyalty will enable his instincts.