Relations between President TrumpDonald John TrumpPro-Trump outside groups raise .8 million in AprilBiden wins Oregon primaryGraham to release report on his probe into Russia investigation before electionMORE and Speaker Nancy PelosiNancy PelosiThe Hill’s Coronavirus Report: CDC Director Redfield responds to Navarro criticism; Mnuchin and Powell brief Senate panelPelosi on calling Trump ‘morbidly obese’: ‘I didn’t know that he would be so sensitive’Trump calls Pelosi a ‘sick woman’ after her remarks on his weightMORE (D-Calif.) are melting down just as the debate over the next phase of coronavirus relief is heating up.

While tensions between the two have been heightened for months, the relationship took an especially nasty turn Monday after the Democratic leader characterized the famously image-conscious president as morbidly obese while panning his decision to take an unproven treatment for the coronavirus.

Trump at first dismissed Pelosis comments about his weight, telling reporters Tuesday after a lunch on Capitol Hill with GOP senators, I dont respond to her. I think shes a waste of time.

Five minutes later, Trump resumed his personal attacks against Pelosi.

Pelosi is a sick woman. Shes got a lot of problems, a lot of mental problems, Trump said, railing against the Democrats investigation into Russias election interference.

Pelosi, meanwhile, claimed later, I didnt know that he would be so sensitive.

Hes always talking about other peoples … their weight, their pounds, Pelosi said during an interview with MSNBCs Nicolle Wallace hours later.

The sharp sniping is on one level just garden-variety politics between two party leaders, each of whom is fighting for the advantage in an election year when voter turnout will be crucial.

Yet the conflict also arises at a delicate moment in the coronavirus response, as experts call for more action to relieve an economy left shattered by the public health crisis.

We need to be prepared to act further, Jerome Powell, chairman of the Federal Reserve, told a Senate committee Tuesday.

With that in mind, Democrats are cheering Pelosis decision to confront Trump head on, viewing it as a base-energizing boon heading into negotiations over another mammoth relief bill.

Her timing is best-of-class, one Democratic aide told The Hill on Tuesday.

Yet Pelosis strategy has also irritated Republicans, who were already loath to move quickly on the next phase of pandemic aid.

I will never refer to a president about being morbid in any shape or form if Im Speaker of the House and it comes from a Democrat,   as well. No, I would not as Speaker use those terms, said House Minority Leader Kevin McCarthyKevin Owen McCarthyTrump campaign launches new fundraising program with House RepublicansMcCarthy blasts Pelosi’s comments on Trump’s weightGOP senator predicts a ‘less than 50 percent chance of passing another bill’ MORE (R-Calif.).

Pelosi and Trump have not been speaking to one another as they battle over how to help the country survive a pandemic that has killed more than 91,000 people in the U.S. and led to nearly 37 million people applying for unemployment assistance.

While the lack of direct contact has become routine over much of the past year exacerbated by Pelosis decision to impeach Trump in December the avoidance and open disdain between them is all the more striking in the middle of the worst pandemic in a century.

The parties did unite to pass four coronavirus relief bills over the past two months, with Trump largely ceding negotiations to Treasury Secretary Steven MnuchinSteven Terner MnuchinGOP lawmakers call for new sanctions on senior Chinese officialsOn The Money: Powell, Mnuchin split on benefits of easing COVID-19 restrictions | Warren, Mnuchin spar over Treasury’s 0B bailout fund | Fight emerges over unemployment benefits in next relief billSenators press Mnuchin, Powell over scope of coronavirus bailoutsMORE, whos viewed by Democratic leaders as an honest broker.

But the fifth round is shaping up to be the fiercest battle yet, with the sides at odds over the size, substance, pace and necessity of another aid package.

House Democrats are pressing for another $3 trillion in help for states, workers, businesses and families a package that passed through the lower chamber Friday.

Republicans have blasted the legislation as a liberal fantasy, saying its both too expensive and not targeted specifically enough toward the crisis at hand. They want to wait for the trillions of dollars already approved by Congress to go out the door before moving on to another enormous spending package.

This week wasnt the first time that Pelosi has criticized Trumps personal health decisions during the coronavirus pandemic.

Pelosi suggested earlier this month that Trump isnt wearing a mask in defiance of his own administrations public guidelines because of a vanity thing, I guess.

The Monday remarks were more pointed, with Pelosi telling CNNs Anderson Cooper that Trump could be at higher risk of complications for taking the anti-malaria drug hydroxychloroquine because of his septuagenarian status and his, shall we say, weight group morbidly obese, they say.

Based on data from his medical exam released last year, Trump, 73, narrowly qualifies as obese with a listed height of 6 feet, 3 inches and a weight of 243 pounds.

Bad blood between congressional leaders and opposing presidents is hardly a new phenomenon. Senate Majority Leader Mitch McConnellAddison (Mitch) Mitchell McConnellDemocrats to probe Trump’s replacement of top Transportation Dept. watchdogMcConnell: Trump ‘certainly within his authority’ to fire IGsGOP senator predicts a ‘less than 50 percent chance of passing another bill’ MORE (R-Ky.) famously feuded with former President Obama, seeking to block virtually every piece of legislation championed by the White House in order to deny the Democratic president any claims to victory.

Yet even Obama and McConnell would talk periodically. And despite the antipathy from conservatives in the House, Obama and then-Speaker John BoehnerJohn Andrew BoehnerThe partisan divide on crisis aidCongress must continue to move onlineBottom LineMORE (R-Ohio) golfed together and even met secretly at the White House to try to strike a grand bargain spending deal.

Trump and Pelosi, by contrast, rarely interact. And when they do, the meetings routinely turn into disasters.

The two havent even been in the same room together since early February at the National Prayer Breakfast. And they havent had any sort of extended conversation since an October meeting at the White House on Syria, a Pelosi spokesman confirmed Tuesday.

Their most recent conversation took place a few weeks after Democrats launched their impeachment inquiry last fall.

Pelosi walked out of the October White House meeting on Syria after Trump insulted her in front of other congressional leaders although the two sides never even agreed upon whether he called her a third rate or third grade politician.

Five months earlier, Trump walked out of a meeting with Pelosi and other Democratic leaders on infrastructure legislation because she had hours earlier accused him of engaging in a cover-up.

They last saw each other at the National Prayer Breakfast, two days after Pelosi ripped up Trumps State of the Union address and he appeared to snub her attempt at a handshake.

I dont like people who use their faith as justification for doing what they know is wrong. Nor do I like people who say I pray for you when they know thats not so, Trump said at the traditionally nonpartisan breakfast as Pelosi sat five seats away.

A month later, Trump declined to attend the annual St. Patricks Day luncheon at the Capitol another traditionally nonpartisan event with the White House saying that he will not participate in moments where [Pelosi] so often chooses to drive discord and disunity.