How Many Covid Deaths? Don’t Ask President Trump

The president has expressed skepticism about the fatality figures reported to him by his own experts.


A body is moved into a van outside of Bronx Lebanon Hospital Center in the Bronx, NY last month.Credit...Dave Sanders for The New York Times

May 17, 2020

The fatality numbers are, to be sure, heartbreaking: more than 85,000 Americans dead and more than 1.4 million infected. But many public health experts, including some within the Trump administration, have been stressing that, if anything, Covid-19 deaths and cases are being undercounted.

Appearing before a Senate committee on Tuesday, Dr. Anthony Fauci, the nation’s top infectious disease expert and a key member of the president’s coronavirus task force, told lawmakers that the real death toll was “almost certainly higher” than the official count. (The hearing was conducted virtually because Dr. Fauci, two other members of the task force who were testifying and the committee’s chairman, Senator Lamar Alexander, were all self-quarantining after possible exposure to the virus.)

Despite this, President Trump and some top administration officials seem to suspect that the number of Covid-19 deaths is being overstated. Debate over the accuracy of the data being put out by the Centers for Disease Control and Prevention has become a hot topic at the White House, according to reporting this week from Axios, to the point that the task force is reassessing the mortality numbers as part of “a much larger review of data quality issues,” an administration official told The Times.

The White House needs to be transparent about this review and about any underlying concerns. 

Understanding how many Americans this disease has claimed is vital to organizing the response to it — and to honoring those lost to it. Like so much about the pandemic, questions about the death toll have become a source of public confusion and partisan friction — one that the president has done nothing to tamp down.

In recent weeks, Mr. Trump has been venting his unhappiness about the number of reported deaths from Covid-19, including, on occasion, publicly. In his April 15 news briefing, he suggested that New York City was misattributing deaths from other causes to the virus. “I see this morning where New York added 3,000 deaths because they died,” the president said. “Rather than ‘heart attack,’ they say, ‘heart attack caused by this.’”

 

More tartly, on April 26, the president retweeted a conservative commentator who was suggesting that the same dark political forces who’d launched “three failed coup attempts” against Mr. Trump were now manipulating the pandemic data: “Do you really think these lunatics wouldn’t inflate the mortality rates by underreporting the infection rates in an attempt to steal the election?”

Then again, on other days, the president has expressed confidence that the official counts are accurate.

 

Part of the problem may be understanding the numbers in context. Early on, the Covid-19 death count was based strictly on victims who had tested positive for the virus. But this system had glaring flaws, most notably the limited availability of testing and the large numbers of people dying at home without a doctor in attendance. Beginning in mid-April, many states — responding to updated guidelines from the C.D.C. — began including “probable” or “presumed” deaths from Covid-19, even if the victim had not been tested.

When New York revised its reporting to include this category, the number of fatalities jumped by more than 3,700, much to Mr. Trump’s dismay.

 

This is not the first time that the president has challenged unwelcome numbers. Following Hurricane Maria, which devastated Puerto Rico in 2017, the initial death counts from the storm were in the double digits. Later, more comprehensive analyses revised the toll to close to 3,000. Mr. Trump rejected the revision, denouncing it as part of a partisan plot to embarrass him.

 

Other top administration officials are said to share Mr. Trump’s concerns that the fatality rate and infection numbers are being overstated, possibly by as much as 25 percent. Some blame the inaccuracies on outdated data systems at the C.D.C. Others suspect that states may be intentionally padding their numbers for financial reasons. (Medicare is paying a 20 percent premium for coronavirus patients.) Beyond the White House, Mr. Trump’s more conspiratorial fans are warning that this is the work of Democrats and the Deep State.

Tensions were not soothed by an internal report by the C.D.C., which The Times brought to light earlier this month, showing pandemic deaths on track to hit 3,000 a day by June 1.

In recent days, Dr. Deborah Birx, the coronavirus response coordinator, has urged the C.D.C. to review its way of counting the coronavirus dead, several officials told The Daily Beast. Specifically, some in the White House are unhappy about some states’ shifting to include probable cases in their mortality counts, and the officials said that they were being urged to narrow their reporting criteria.

As the president pushes states to ease social distancing restrictions and restart the economy, there is a pressing need for accurate information about the progress of the pandemic. If the White House thinks the death toll is too high and should be adjusted, it owes people an explanation of why it is taking a position contrary to the conclusions of its own public health experts.