By what % has the death rate increased due to Trump?
April 5, 2020 10:08 AM   Subscribe

A friend posted that Trump was solely to blame for Covid-19 deaths. Despite Pres. #45's malicious incompetence, wilful ignorance, etc., I think this claim is significantly extravagant. By what percentage has or will the rate of death increased because of this Administration?

If he had acted sooner, If he had shown smart leadership/ by example, If he had decent staff, If he understood science, If the pandemic office was staffed, etc. Additional metrics welcome.
Presidential politics + Pandemic = strife, so please try to be factual and give citations or otherwise show your work.
posted by theora55 to Law & Government (21 answers total) 3 users marked this as a favorite
 
This seems like a very difficult question to answer at this point in time because the pandemic is ongoing and we don't/can't know what the rate of death will turn out to be.

I think the way to answer your question as best as possible would be to compare the death rate in the U.S. to other similar countries who have had smarter leadership and better responses, aka Germany and Canada. That will give you some idea, though we can't really know yet where in "the curve" various countries are.

I think you're definitely right that your friend's claim is much too bold. An easy way to prove that is to consider that even the countries with the best/most effective response have had some people die.
posted by overglow at 10:21 AM on April 5 [4 favorites]


One common comparison is the US and South Korea, because both countries experienced their first recorded COVID case in the same day. South Korea took early action to prevent the spread of the disease and has had 183 deaths. The US is currently at 9,241 deaths and that number is increasing rapidly. It’s true that the US population is about 6.3 times that of South Korea’s but the US’s number of COVID deaths is *50* times Korea’s
posted by horizons at 10:21 AM on April 5 [36 favorites]


Provisional Death Counts for Coronavirus Disease (COVID-19), data from the CDC's National Center for Health Statistics. "The provisional data presented on this page include the weekly provisional count of deaths in the United States due to COVID-19, deaths from all causes and percent of expected deaths (i.e., number of deaths received over number of deaths expected based on data from previous years), pneumonia deaths (excluding pneumonia deaths involving influenza), and pneumonia deaths involving COVID-19; (a) by week ending date, (b) by age at death, and (c) by specific jurisdictions. "
posted by MonkeyToes at 10:26 AM on April 5 [1 favorite]


Beyond some number that can probably be characterized as "pretty big" it is really impossible to say at this time.
posted by slkinsey at 11:36 AM on April 5


I'd love guesstimates about an actual number though I know it's far too soon for accuracy.
posted by theora55 at 11:53 AM on April 5


I wanted to say it might be useful to compare the infection rate to that of Trumpless countries, but then I remembered that a big part of our problem was that only the elite were being tested, and that tests still seem to be intermittently applied, so the number of infected is unknown. While Trump can't be responsible for all the COVID deaths, It's certainly true that there are a lot of people who would be alive now, and a lot more who would be alive in the future, if he had not screwed the pooch as he did.
posted by Kirth Gerson at 11:56 AM on April 5 [1 favorite]


I think there won't be a really good answer to this question until someone's PhD thesis 15 years down the line, but.....

The best tool we have at the moment are the projections by the Institute for Health Metrics and Evaluation (IHME) which you can find at healthdata.org. These have shown pretty good tracking on the upswing, but the model performance at the peak and on the downswing are unproven, and don't match what we see in Italy and Spain. But still, it's what we've got.

I think that a fair estimate of what a very good Federal response could have accomplished is to compare to the two states that have done the best: Washington and California. Using the IHME estimates of deaths through July, these two states have about the same rate of deaths, 1 death per approx 7800 population. Their estimate for all US deaths is 1 death per 3500. So, in rough terms, the number of deaths will be twice what we might have hoped for.

Much as I hate to say it, not everything is the fault of the Trump administration. The Democratic Mayor of NYC was slow to act. And the growth rates in most of Europe are pretty comparable to the US. They top out sooner mostly due to smaller populations.
posted by SemiSalt at 11:57 AM on April 5 [2 favorites]


The comparison to other countries isn't necessarily an accurate metric of the administration's failures. You need to also consider that, Trump or no Trump, the US lacks a robust functioning public health system. It is also administratively divided into a byzantine system of states, counties, and municipalities, each of which has a poorly defined set of responsibilities and capabilities with regard to emergency management. There's also the fact that there is no universal heath care for those under 65. On the other hand, the general lack of functioning public transit probably slowed the spread.

I agree with the general sentiment that this question has no straightforward answer, and probably never will.
posted by mr_roboto at 12:02 PM on April 5 [3 favorites]


It's going to be difficult to say for a long time, and in general I think it's been unwise all through this pandemic for people to attach to it their existing political beliefs—i.e. it did not make universal-healthcare people (like me!) look good to say "Well, look at Europe, people aren't afraid to go get care" when Italy was the first place in the West to blow up. Some experts did well, other experts did an amount of damage it'll take a long time for us to tally up by telling people not to wear masks, etc.

A perfect response—shut down all international travel extremely early, test and trace from the beginning—combined with a little luck (I think South Korea would have done extremely well anyway, but it helped that their huge outbreak was an easily traced religious group full of extremely young and low-risk people) could have saved a ton of lives, but that is going to be true a bunch of places, including places with governments your friend likes. (Meanwhile, in Australia, a conservative government that acted very slowly, has its own crowded-beach photos, etc., is presiding over what is so far a very small outbreak.)

Ultimately your friend is probably just blowing off steam, and I'd just ignore it, although (like you) I suspect his or her conclusion is wrong. We're all under a lot of stress and looking for somebody to blame.
posted by Polycarp at 12:28 PM on April 5 [1 favorite]


Trump has been abysmal at managing the crisis. He ignored and opposed the national need for health coverage, ignored intelligence agencies that warned him about the pandemic early, gave lots of tax cuts to people who did not need them, deregulated Obama's everything beneficial, delayed executive responses, spread misinformation and gutted a lot of useful regulatory agencies. He's a tsunami of incompetence. So the virus is hitting much faster, harder and the nation is unable to provide for the common defense, i.e., provide protective equipment, respond in a unified and efficient manner, and the health care systems are getting overwhelmed.

California's two governors make an interesting contrast in leadership. Previous Governor Jerry Brown extended healthcare to all Californians, and left the state with a large surplus in the state coffers. Current Governor Gavin Newsom recognized the threat of the virus wave relatively early, and took very stern measures to ensure that Californians observed the stay at home guidelines, as did the Mayors of San Francisco and Mayor Eric Garcetti of Los Angeles.

If you look at the Johns Hopkins website on the virus, they now have figures on the projected peak and death rate in California, which is flattening the wave of the virus impact. Currently, California seems to have adequate protection for health care workers, beds and ventilators. Lots of pain and suffering averted.

Donald Trump did not literally instigate the virus, but he has most certainly made the crisis exponentially worse with his incompetent, mean spirited and ineffective leadership.
posted by effluvia at 12:53 PM on April 5 [8 favorites]


It’s also interesting to compare to Canada, which in general is easy to make comparisons against as Canada is about 1/10th the population of the USA. Of course as Canadians we have a drastically different health care system, and sane leadership for the most part, but there are many similarities between the countries as well in culture, economics, and even who supplies our PPE. But some of the graphs I’ve seen plotting the various Canada vs USA curves are pretty frightening and do not align to the 1/10 relationship at all. On phone so no links handy unfortunately.
posted by cgg at 1:07 PM on April 5


[Several deleted. Please answer the question asked instead of providing a bunch of tangentially-related articles discussing that, yes, Trump definitely mismanaged this. OP is looking for hard numbers.]
posted by Eyebrows McGee (staff) at 1:52 PM on April 5 [2 favorites]


This article from the Guardian was published on March 11 and reported on a study from the previous week estimating what the impact would have been if China had gone into crisis mode one or two weeks earlier.
Sophisticated modelling of the outbreak suggests that China had 114,325 cases by the end of February 2020, a figure that would have been 67 times higher without interventions such as early detection, isolation of the infected, and travel restrictions.

But if the interventions could have been brought in a week earlier, 66% fewer people would have been infected, the analysis found. The same measures brought in three weeks earlier could have reduced cases by 95% [...]

The study suggests it was crucial to move fast with the interventions China used to contain the outbreak. If testing, isolation and travel bans were brought in one, two or three weeks later than they were, the number of cases could have rocketed three, seven and 18-fold respectively.
You can look at a timeline of measures taken in the US, which had more advance notice than did China (or at least as much, given that China apparently had early knowledge that it didn't make public). It's difficult not to see how isolation and travel restriction measures in the US could have been taken one, two, three weeks earlier, not to mention implementing effective testing and sourcing and distributing PPE, medical supplies, and other materials. If the administration had acted earlier and more decisively the effects of spring break and St. Patrick's Day could also have been minimized, so the figures from the study might be significantly understated with respect to the US. Again, the study came out in early March - the consequences of waiting were not an unknown factor.

Leaving aside everything else Trump did and failed to do and the general state of American infrastructure, just the length of the squandered head start translates directly into tens of thousands of cases in a way that can be estimated. Similar studies to the one linked above focused on the US are probably currently underway.
posted by trig at 2:07 PM on April 5


Last year in Italy a total of 647,000 people died. [Source: istat]. That's just under 1,773 per day. Italy's Covid-19 deaths as of today: 15,887 [Source: Johns Hopkins]. That's just over 346 a day over the past 45 days (more or less when the pandemic swept in to Italy).

What is not clear yet and won't be clear for a while yet is how many more deaths per day are down to Covid-19. But Italy's biggest demographic cohort is 65 and up, which is a major factor in both the normal annual death number and the Covid-19 toll.
posted by chavenet at 2:09 PM on April 5


Keep in mind in your analysis that many claim the death rate is actually *underreported* -- this was mentioned to me by multiple doctors in the NJ/NYC area I spoke to this weekend behalf of a nonprofit I volunteer with. Apparently things are even worse than the news networks are reporting.
posted by shaademaan at 2:20 PM on April 5 [1 favorite]


I think the easiest way to estimate here is to look at the death rate.

Left unchecked this will likely infect 60-80 % of the population and 1-2 % of these people would die. So the top number is roughly 1% of the US population or 3.6 million people.

With effective social distancing in place, we will see the virus infect 20-30% of the population and 1-2% of these people would die. So the "best" number is roughly .3% of the US population or 0.8 million people. Getting this to 100000 would be impressive, but I think it's a pipe dream given the likely penetration in areas that currently think they are not effected and their apparent lack of concern.

[As a side note: This makes me sad that either the models are so bad that they miss the endpoint by so much or that the people in charge are really not being honest. Every time they say "we hope it will be better" leads me to believe it's the latter... Notice we are very different from some of the countries that have traced down and isolated the people with the virus and effectively stopped the infection. This is really the only way to dramatically reduce the percentage of population that eventually gets infected, but we lost that battle many weeks ago in the US.]

In both of these potential outcomes I've used 1-2% - this is where you can measure the effectiveness of a response. If we do not have adequate hospital beds, or if the rate of infection means we reach 20% in a few days rather than a few weeks, then the fatality rate will go way up. Those deaths could absolutely be prevented on the time scale we have had to prepare. So when all is said and done and we have adequate testing so we know how many people were infected - you can attribute any deaths beyond 1% of the number of people infected to a botched response.

On the good side of things - NY/NJ are churning out people who have antibodies by the 1000s a day, so when the exponential infection growth in the rest of the country starts to really kick in we will have some people ready to help. (And knowing many of them, I'm sure their response will not be "not my problem")
posted by NoDef at 2:50 PM on April 5


From the NYT: "The federal government does not expect to produce a final tally of coronavirus deaths until 2021, when it publishes an annual compilation of the country’s leading causes of death.

"A New York Times tally of known Covid-related deaths, based on reports from state and local officials, showed 9,470 deaths as of Sunday. On Friday, the National Center for Health Statistics, part of the C.D.C., began publishing preliminary estimates of coronavirus deaths, although a spokesman said that information would have a “lag of 1-2 weeks.” Its first estimate noted 1,150 deaths, based on the number of death certificates that included Covid-19 as an underlying disease."
posted by MonkeyToes at 6:11 PM on April 5


#1. You could take any of the countries here (Economist) and just scale fatalities to population and then subtract. For example, there is no reason the U.S. couldn't be doing as well as South Korea or Japan (western democracies, far more densely populated than the U.S.) or China (far, far larger in population than the U.S.).

So you can figure out the death rate per capita for those countries, then subtract that from the U.S. death rate per capita, then multiply by the U.S. population to get an estimate of the excess fatality rate for the U.S. over those countries.

Doing that exercise, we get:

U.S. CV19 Excess Death Rate (so far) compared with:

* Germany: 3238 excess deaths in the U.S.
* South Korea: 8380 excess deaths in the U.S.
* Japan: 9216 excess deaths in the U.S.
* China: 8657 excess deaths in the U.S.

So--looking at somewhere well into the thousands of excess deaths in the U.S. compared with those other countries.

I've given exact digits in the table, but in reality the error bar is quite large. So maybe something like 6000 +/-3000 is our number and error range.

Another point worth making, though, is in the countries/areas that have a complete meltdown of the healthcare system due to Covid19, the Covid deaths themselves are only part of the total--and in fact around 30% of the total if I recall.

That is because of at least two reasons: #1. Not all CV19 deaths are caught in the official statistics and #2. People with other life threatening illnesses and events are not able to get the treatment they need due to the healthcare meltdown. Treatment is delayed at best or simply not available at all.

This seems theoretical but I have personally had two fairly serious nonelective type minor surgeries delayed indefinitely, and both are the type of things that might very well lead to health complications on down the line. More to the point, my close relative with stage 4 breast cancer has had an extremely vital procedure postponed twice, and it now appears to be cancelled altogether. And this in a state that has less than 150 coronavirus cases in hospital and roughly one bazillion empty hospital beds right now. So we're pre-emptively cancelling essential life-saving outpatient treatments for severely ill cancer patients "just in case".

If we're already doing that now, imagine what we'll be doing when the shit really hits the fan.

I've read an article about this recently, analyzing Italy and comparing it to Puerto Rico. In Puerto Rico, the actual fatality total was many, many times higher than the officially reported "hurricane fatality" total. Similarly in the region of Italy analyzed, the overall fatality rate spiked massively at the time of the CV19 crisis and then un-spiked as soon as CV19 hospital visits & deaths went down.

Unfortunately I can't find that article again, but perhaps someone else will remember it and link. This Economist article might be the one I'm thinking about but I can't access it now to verify.

The thing is, that "excess death spike" will most assuredly be far, far worse in countries like Italy, Spain, Iran, sections of China, and sections of the U.S., where government management of the situation has allowed the pandemic to blossom out of control.

So the excess death spike is going to be harder to quantify, because countries like Germany, Japan, and South Korea probably aren't seeing much of this multiplier going on, while Italy, Spain, Iran, and the U.S.--especially the areas or states hardest hit--are certainly going to experience a pretty hefty multiplier.

So that's the wildcard. But you definitely have to count it as a major and completely avoidable result of the mismanagement of the CV19 response from the top.

Just as a WAG on this, if you assume that South Korea and Japan are experiencing a mild 1.25X multiplier for fatalities, Germany is say 1.8X, but the U.S. is going the Italy route and will experience a 3X multiplier, our excess death calculation looks more like this:

CV19 Total Excess Death Rate (all causes, assuming multiplier of 1.25X SK & JP, 1.8X Germany, 3X U.S.) estimate:

* US vs Germany: U.S. has 17160 excess deaths so far
* US vs South Korea: U.S. has 26876 excess deaths so far
* US vs Japan: U.S. has 28045 excess deaths so far

Now we're clearly into the 10s of thousands of excess deaths. Again, there is a very very large error bar but we might be talking 25000 +/-10000 excess deaths so far, as a reasonable estimate.

Again, as others have mentioned, you'll have to make your own assessment of how much of this excess death count is due personally to Trump and how much to our generally screwed up system.
posted by flug at 10:13 PM on April 5


The problem with looking at current excess deaths is it's... completely useless. it will change drastically day-by-day, because there is no place in the US where the death count is growing at an obviously non-exponential rate.

In places like Washington, where cases were first detected, and strong measures were taken quickly, the growth rate is something like a doubling every 8 days.

For the US as a whole, the fact that it's doubling every 3 days is attributable to paces that have poor or slow or not good enough responses. And at this point, that rapid growth accounts for most of the deaths and rising fast towards "pretty much all of them."

However, that is likely overstating how many lives will ultimately be saved by even the best responses. Eventually, a significant fraction of the population will be infected and the number of infections wills start to peak when a significant enough fraction of new exposures are to people who already had it and have some limited immunity. Or if somehow we lock things down enough that the virus isn't able to spread. But I'll be honest, it's not looking that way anywhere in the US.

Given how things re now, there is no plausible chance of a vaccine being developed before the virus peaks. A large percentage of the population will be infected and some of them will die. Just because someone has been delayed from getting it now, doesn't mean they won't be exposed later. Much will come down to how deadly this thing is untreated, and how many people cannot be treated due to medical services being overwhelmed, and how close to "not overwhelmed" social isolation measures can achieve. It's anyone's guess as to how that patchwork mess is going to play out in America.

And ultimately, the question of responsibility is not a scientific question, it is a political question. How do you assess how much Trump's words contribute to Florida officials not taking actions to shut things down and to the individuals who decided to go party over spring break and ended up spreading coronavirus far and wide? And so many individual incidents like that, that add up to make the whole?

On the other hand, it's not hard to claim honestly that the actions and inactions of those governing America are killing and will kill a ghastly number of Americans. Unless you claim the president has no responsibility whatsoever for this country, some percentage of deaths that wouldn't have happened yet in a "good response" scenario is their fault. And no matter what percentage you pick, it's a lot.

And truthfully, a significant fraction of Washington's quick response was not government response, it was things like Amazon (and other tech companies) going work from home within like a day of there being a confirmed case in their offices - and this is the exact same company who refuses to do anything when dozens of their warehouse workers are testing positive at a one location in New York. So sometimes people responding well and making it much much worse are the same people, depending on their interests.

It's a mess, and there's plenty of blame to go around.
posted by Zalzidrax at 1:49 PM on April 6




Preliminary Numbers on Excess Deaths from The Lancet
posted by theora55 at 7:30 PM on May 14


« Older Video conferencing with password/PIN protected...   |   Audiobooks that scratch the Pratchett itch? Newer »

You are not logged in, either login or create an account to post comments