By Amy B Wang
15 September 2018

(The Washington Post) – “Like magic” and “NO WAY!”

These are the latest phrases President Trump is using to express continuing disbelief that Hurricane Maria could have caused nearly 3,000 excess deaths in Puerto Rico. In his mind — or in his tweets, at least — the death toll remains in the double digits.

Multiple times last week, Trump lashed out at a study from George Washington University’s Milken Institute School of Public Health that estimated 2,975 “excess deaths” occurred on Puerto Rico in the six-month period after Hurricane Maria struck the U.S. territory.

First, on Thursday, Trump falsely accused Democrats of inflating the death toll as a political ploy to make his administration look bad. Late Friday night, the president tweeted again, offering no evidence but alleging that “they” had hired “GWU Research” to arrive at a death toll that was “FIFTY TIMES LAST ORIGINAL NUMBER — NO WAY!”

There are several claims in or related to Trump’s latest pair of tweets that have already been explained or debunked. But because the president this time appears to be questioning the GWU study’s methodology, as well as expressing a strong (read: ALL-CAPS) doubt that a death toll can jump from the tens to the thousands, let’s break those ideas down.

How did GWU researchers arrive at the 2,975 figure?

To reiterate, the GWU study estimated 2,975 “excess deaths” occurred on Puerto Rico in the six-month period after Hurricane Maria struck the U.S. territory. The emphasis here is on the word “excess”: Using projections from past census data, researchers first estimated what the death rate in Puerto Rico would have been between September 2017 and February 2018 had the hurricane not happened at all. They also took into consideration the population change caused by people moving away from the island for good in the months after Hurricane Maria.

Evaluating all those factors, the study concluded that anywhere from 2,658 to 3,290 excess deaths took place between September and February. (The 2,975 number represents the midpoint of that range.) Every social stratum and age group was affected by excess mortality, the study noted, although populations in lower-income areas were hit harder.

As The Washington Post’s Arelis R. Hernández, Samantha Schmidt and Joel Achenbach reported when the study was released, GWU researchers intentionally evaluated a long period of time after the hurricane to see whether the death rate would taper back to normal after a while. It did not:

People continued to die at anomalous rates long after the storm, as the territory struggled with infrastructure failures and political infighting. Nearly 900 excess deaths were reported in January and February of this year. The mortality rates remained high in the poorest areas, the study found.

The GWU report has a limitation: It does not specify how people died. It is a statistical study based on death records and expected mortality rates. The researchers said they hope to conduct a more detailed investigation in the future.

… the leaders of the research effort said that in low-income areas the mortality rate remained somewhat elevated even after six months. They said further investigation of mortality rates after February could push the estimate even higher.

Notably, the study was commissioned by Puerto Rican Gov. Ricardo Rosselló, whose administration had been criticized for its response to the hurricane and for its unwillingness to accept earlier reports of a death toll higher than 64. When the GWU report was released in August, Rosselló, a onetime Trump ally, publicly accepted the findings and promised that his administration would do better.

Trump claims the government response to Hurricane Maria in Puerto an "unsung success", 11 September 2018. Photo: The Washington Post

On Saturday, Lynn R. Goldman, the dean of the Milken Institute School of Public Health, defended the GWU study and denied that politics had played a role in how it was conducted.

“Make no mistake: The death toll did continue to rise in the months after Maria,” Goldman wrote in a guest column for The Post. “In September 2017, when Puerto Rico recorded a total of 2,906 deaths, we found there was an excess of 574 deaths above what would have been expected in a year without the storm. The death toll continued to mount every day, with an excess of 697 deaths in October, 347 in November, 479 in December, 558 in January, and 320 in February, for a total of 2,975.” […]

A joint investigation by the Associated Press, Puerto Rico’s Center for Investigative Journalism and Quartz has, however, detailed names and stories behind 487 of the people in Puerto Rico who died in the aftermath of Hurricane Maria. It is so far “the most extensive record yet of who died and why.” (The emphasis is ours.)

More names and stories are likely to emerge publicly as time goes on, the investigation noted.

“This was a slow-motion, months-long disaster that kept Puerto Ricans from getting the care they needed for treatable ailments, even as President Donald Trump lauded his administration’s response,” the AP reported. […]

Why is the death toll politically important to Trump?

In short, Trump seems to consider the Puerto Rican death toll like an inverse to his inauguration crowd size of 2016: The lower he can get the number, the better he looks. Trump has bragged that the federal response to Maria was “an incredible unsung success,” contrasting it with “a real catastrophe like Katrina,” in which an estimated 1,833 died.

As The Post’s Philip Bump pointed out, Trump’s use of Katrina as a rubric against which his administration should be evaluated “hasn’t held up well” now that the GWU report estimates more than 1,000 more people died in Puerto Rico. [more]

Sorry, Mr. President: The Hurricane Maria death toll in Puerto Rico didn’t grow by ‘magic.’

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