How many dead? Only after the coronavirus had claimed more than 60,000 lives—Donald Trump’s previous estimate for how many Americans might die—did the president acknowledge that the toll could rise to 100,000. The projections keep changing, and the question of whether authorities are even counting correctly looms ever larger. The United States has a duty to make an accurate tally, and not just because Americans need to know how many people to grieve.
Why do people die? This isn’t just a philosophical or religious question. For crisis-response experts, it also has tactical implications. Why did that person die, while this person didn’t? Attributing a fatality to an earthquake, hurricane, or some other catastrophe explains only so much, because people experiencing these events do so in widely varied ways. To know what ended someone’s life may help give their family peace, but it also teaches the living how to spare others the same fate. We learn from the dead.
Recently, the Centers for Disease Control and Prevention reported that a large number of “excess deaths” occurred across five weeks in March and April. Even excluding deaths already attributed to the coronavirus, states hit hard by the pandemic have recorded many more fatalities than normal. Thousands of Americans may have died of undiagnosed COVID-19 or because they could not or did not get medical treatment. Were any of these deaths the result of shortages of personal protective equipment? Could any of them be tied to travel or attendance at so-called super-spreader events? Would closer adherence to social-distancing rules have saved them? Without knowing what happened in these cases, experts miss out on potentially lifesaving insights.
The passage of time may bring clarity—or not. After the Tampa Bay Times found that Florida’s medical examiners were reporting 10 percent more COVID-19 deaths than the state health department was, the latter intervened to muzzle the former. On Tuesday, the White House indicated that it would disband its coronavirus task force; while Trump has abandoned the idea for now, the trial balloon clearly underscored his desire to make the problem go away rather than reckon honestly with what has happened. Sure enough, Axios reported yesterday that Trump thinks the death toll, now past 71,000, has been exaggerated.
To Americans’ great misfortune, their president has a way of turning everything, absolutely everything, into a commentary on his own performance. Death counts are no exception. Previously, Trump insisted that 60,000 to 70,000 deaths would be a victory, relative to the 2.2 million that some models predicted. He all but forces the public to look at the numbers in similar Trump-centric terms.
In an interview with Chris Wallace on Fox News Sunday, the White House coronavirus-response coordinator, Deborah Birx, finally rejected Trump’s rosy projections. “Our projections have always been between 100,000 and 240,000 American lives lost,” she said, “and that’s with full mitigation and us learning from each other of how to social distance.” When I heard that, I caught myself thinking: We told you so. I am among those who are alarmed by Trump’s handling of the pandemic and believe that the country’s failure to enact anything close to “full mitigation”—that is, a national shutdown accompanied by widespread testing and contact tracing—has needlessly endangered a lot of people. But We told you so is a Trumpian way of thinking. It presumes that somehow everything about American life is a competition between two teams, that even body counts are numbers on a scoreboard, and that one side loses and one side wins.
The more the numbers shift around and become politicized, the easier they are for the American public to tune out. In Puerto Rico after Hurricane Maria in 2017, the official death toll was initially reported at 64 and then revised to nearly 3,000. Harvard researchers published an estimate of 4,645. Can anyone on the mainland truly understand the tragedy? The lingering question marks are a perceptual barrier. Likewise, the projected death counts being bandied about during the coronavirus pandemic, while enormous, also sound speculative enough—100,000 deaths? 240,000? 2.2 million?—that Trump and others who are insisting on a quick reopening can ignore them.
When experts can learn from the dead, they can save lives in the future. In 1978, a massive blizzard hit the Eastern Seaboard, pounding the region with heavy snow for a remarkable 33 hours. By the end, about 100 people were killed, and another 4,500 injured. Some of those casualties had surprising causes. After traffic on Interstate 95 stalled and commuters huddled in their cars, more than a dozen people died of carbon-monoxide poisoning because the snow had piled up fast enough to cover their exhaust pipes. That experience helps explain why—when major winter storms are predicted—governors across New England initiate travel bans early on.
In 2004, a major earthquake—measuring at 9.1 in magnitude, and lasting more than eight minutes—shook the ocean floor off the coast of northern Sumatra, Indonesia. Massive tsunami waves in the Indian Ocean, some 100 feet high, headed toward the shore. Across 14 countries, more than 225,000 people would perish. Accounts by experts and journalists suggest that distance from the shore wasn’t the only factor that determined who lived and who died. When a tsunami forms, it draws water from the shoreline that recedes dramatically. For some people near the water, this was a curiosity; for others, it was an omen. The former stayed put. The latter dispersed.
How did they know to flee? Researchers found intriguing patterns. Many older, more established communities had higher survival rates. Residents had learned, via accounts passed on from generation to generation, of previous tsunamis—including several devastating ones from the early 20th century. Unlike recent immigrants or Western travelers staying at fancy hotels, many who survived benefited from a civic understanding grounded in what their ancestors had experienced. Today, the nations stricken by the 2004 tsunami have coastal-alert systems and post educational materials at immigration offices, airports, and hotels explaining what many didn’t know in 2004: When the water recedes, run for the hills.
One other tragedy holds a lesson for our current one. In 2005, most of the city of New Orleans was inundated when its levees failed. After George W. Bush pushed his hapless FEMA administrator out, he put Admiral Thad Allen, the former commandant of the Coast Guard, in charge of overseeing the federal emergency-management effort. In an interview a decade later, I asked him to reflect on the point when he felt that he had a grip on the situation—and assumed the answer might be the return of fresh water, food, or electricity. Without missing a beat, he said the turning point was when his team could identify and tend to the dead. “When we had done that,” he told me, “I felt it was time to look at long-term recovery.”
Making sense of the deaths that have occurred during the coronavirus pandemic is just as important. During the pandemic, the U.S. has appeared broken, unable to respond in a manner worthy of so mighty a nation. A proper accounting provides more than a modicum of closure. The dead can still speak to us and, when the next virus comes, guide us toward how to do better.
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