The Numbers Being Where They Are: Cause-of-Death Reporting and the 2020 Election

June 4th 2020

Donald Trump & Mike Pence at Coronavirus Update Briefing (The White House)

By Jonathan D. Simon

On March 6, when the national death toll from COVID-19 stood at 15, Donald Trump visited the Centers for Disease Control in Atlanta and held forth on a variety of aspects of the soon-to-be pandemic. When asked about a ship with infected passengers that lay at anchor off the coast of California – specifically, whether he supported plans to offload the ill for treatment on land – the president demurred. He didn’t cotton to the idea of bringing ashore COVID victims because he didn’t want them adding to the official national count of the ill and, potentially, dead. “I like the numbers being where they are,” Trump said. “I don’t need to have the numbers double because of one ship that wasn’t our fault.” 

With the current official COVID-19 death toll in the U.S. having passed 100,000, and with a case count of over 1.7 million, Trump’s wishes on March 6 seem almost absurdly antediluvian, a bit like Noah saying, “Tell me you didn’t feel a drop.” But that simple statement – “I like the numbers being where they are” – is a key to understanding the dynamics of the 2020 election, a big piece of the ground on which the campaigns will do battle, and the likely outcome this November. 

Let’s be honest: there are some brutally cynical calculations going on in the heads of those on both ends of the political spectrum about how the COVID crisis will play out. Trump and the GOP were quick to grasp that if they didn’t “open up” the economy sooner rather than later, their November prospects would be grim at best. On the other hand, if the consequence of opening and mingling was a ballooning of COVID cases -- and, more significantly, COVID-attributed deaths – their political outlook would become even grimmer. 

The imperative, then, was to save the economy while keeping “the numbers” of COVID dead, if not exactly “where they are,” then at an “acceptably” low level. And to pull this off without conceding an inch in the new culture war, in which Trump had turned wearing a facemask and observing distancing guidelines into symbols of weakness, and now also in the face of mass civil unrest and congregation. Although there is much still unknown about the epidemiology of this virus, basic science strongly suggests that the opening of the U.S. economy (and streets) Trump-style, with masks and distancing scorned, will send the COVID death toll rocketing to unacceptably high levels, barring some sort of either divine or accounting intervention. 

Meanwhile, the political hopes of Joe Biden and the Democrats rest conversely on either economic or public-health disaster. Either the economy must remain battered through November or its reckless opening result in a death toll high enough to sink Trump. Because our best scientific understanding at this point is that maskless economic salvation and an acceptable death toll are effectively incompatible, Trump’s desired both/and outcome is a kind of long-term magical thinking. Even in the short term, though, Trump faces the formidable problem of persuading enough Americans to resume their role as workers and consumers to fuel the economic revival he needs. 

For Trump and the GOP, therefore, an acceptably low COVID death toll is essential, both when the dust settles in November and right now to coax workers and consumers back to their posts. Fortunately for Trump, the protocols for death cause-attribution are, in practice, highly flexible. Especially among the old, for whom COVID is most likely to be fatal, other reportable causes are almost always at hand: pneumonia, heart failure, stroke, etc. Death certificates have suddenly become political documents; nursing and assisted-living facilities can be, and in some places have already been, taken off the COVID books.

Given the stakes and the fierce will to hold onto power by virtually any means, is it surprising that mass maskless mingling in GOP-governed states like Georgia and Florida seems to be defying all scientific expectation, as the COVID-attributed case and death rates stay stable or decline – and remain mysteriously well below their blue-state counterparts?

At some point, as with Puerto Rico’s Hurricane Maria, excess-death statistics will paint a more accurate, and likely more devastating, picture of the toll in lives of Trump’s economy “gamble.” But that reporting process is slow and can be made still slower. If it is pushed beyond November it will be politically nugatory. In the short term, of course, Americans will have only the official death-certificate numbers to go by in deciding whether shopping and dining out are worth the risk. Especially in red states, they may well be misled into taking a far greater risk than they know.

Because millions of Americans regard the threat of a Trump re-election and descent into authoritarianism as greater than the threat of COVID at its worst, it would be easy enough to see how many would, in effect, be “rooting for the virus.” What they’re really rooting for, however, is an honest accounting of COVID’s toll on health and life and of the true impact of Trump’s choices. If it comes at all, that accounting may not come in time to matter.

Jonathan Simon is author of “CODE RED: Computerized Elections and The War on American Democracy.”