May 6, 2020 - Politics & Policy

Trump and some top aides question accuracy of virus death toll

Trump at a factory in Phoenix that makes N-95 masks. Photo: Brendan Smialowski/AFP via Getty Images

President Trump has complained to advisers about the way coronavirus deaths are being calculated, suggesting the real numbers are actually lower — and a number of his senior aides share this view, according to sources with direct knowledge.

What's next: A senior administration official said he expects the president to begin publicly questioning the death toll as it closes in on his predictions for the final death count and damages him politically.

  • The U.S. death toll has surpassed 71,000, with more than 1.2 million confirmed cases, according to the latest figures.
  • Trump's engagement could amplify a partisan gulf we saw in this week's Axios-Ipsos Coronavirus Index over believing the death statistics.

Reality check: There is no evidence the death rate has been exaggerated, and experts believe coronavirus deaths in the U.S. are being undercounted — not overcounted.

Behind the scenes: The official said Trump has vented that the numbers seem inflated and has brought up New York's addition of more than 3,000 unconfirmed but suspected COVID-19 cases to its death toll.

  • Some members of the president's team believe the government has created a distorting financial incentive for hospitals to identify coronavirus cases, the official also said.
  • A second senior official said they shared this concern.
  • Medicare is giving hospitals a 20% bonus for their treatment of coronavirus patients as a way to help them make up for the money they’re losing because they’ve had to postpone a lot of non-coronavirus care.
  • Intentionally misdiagnosing patients with coronavirus would be fraud, and so far no one in the administration has publicly leveled such an accusation.

The other side: A senior White House official pushed back, saying this of the president's thinking: "Skepticism isn't the right way to frame it. The numbers have been revised up to include presumptive cases — meaning deaths that are believed to be related to COVID but not known for sure."

  • "So he's expressed the need to properly convey that to American people so they're not startled by why numbers ticked up."
  • Another senior administration official said this concern about the death count was not confined to Trump and was in fact shared by a number of his senior staff and has been a subject of discussion for weeks.
  • "With something like this virus, where you've got this weird coagulation in the lungs ... we need more autopsies," the official said.
  • "America's out of practice of how to deal with something like this and to report it accurately. ... We don't have uniform reporting standards in the United States or internationally. And we're not getting good data."

The number of people dying over the past few weeks, in many parts of the country, is a lot higher than average, suggesting that the official count of coronavirus-related deaths is still missing tens of thousands of people.

Between the lines: Until mid-April, a person was only identified as having died from the coronavirus if they had tested positive for the coronavirus and then died.

  • But testing in the U.S. has been inadequate. Many people who have the virus weren’t able to get tested; those patients weren’t recorded as official coronavirus cases, and therefore weren’t counted as coronavirus deaths if they died.
  • Last month, the Centers for Disease Control said it would include “probable” coronavirus deaths in the official tally — cases in which no formal diagnosis is available, but doctors believe a patient died from COVID-19.
  • Some states do not report probable deaths to the CDC, but among those that do, the change did make a difference: Probable cases added roughly 3,700 people to New York’s official death toll.

What they're saying: Experts believe the formal death count is inaccurately low because:

  • Testing problems persisted for so long and still persist.
  • Some states don’t count probable deaths.
  • There are still thousands of “excess deaths” even after accounting for probable coronavirus cases.

Go deeper

U.S. coronavirus updates

Data: The Center for Systems Science and Engineering at Johns Hopkins; Map: Andrew Witherspoon/Axios. This graphic includes "probable deaths" that New York City began reporting on April 14.

More than 100,000 Americans have died of the coronavirus, according to data from Johns Hopkins — a milestone that puts the death toll far beyond some of the most tragic events in U.S. history.

By the numbers: Over 1.6 million have tested positive in the U.S. Nearly 354,000 Americans have recovered and over 15.1 million tests have been conducted. California became the fourth state with at least 100,000 reported cases of the coronavirus on Wednesday, along with Illinois, New Jersey and New York.

The pandemic’s health side effects are growing

Illustration: Sarah Grillo/Axios

Nearly half of Americans said that either they or someone in their household has skipped or delayed needed medical care because of the coronavirus, according to new polling by the Kaiser Family Foundation.

Why it matters: Shutting down elective medical care may have been necessary, particularly in coronavirus hotspots, but will have lasting effects on some patients.

Coronavirus dashboard

Illustration: Sarah Grillo/Axios

  1. Global: Total confirmed cases as of 8 p.m. ET: 5,682,389 — Total deaths: 354,944 — Total recoveries — 2,337,385Map.
  2. U.S.: Total confirmed cases as of 8 p.m. ET: 1,697,459 — Total deaths: 100,276 — Total recoveries: 391,508 — Total tested: 15,192,481Map.
  3. Public health: Fauci says data is "really quite evident" against hydroxychloroquine — Nearly half of Americans say someone in their household has delayed medical care.
  4. States: California hospitals strained by patients in MexicoTexas Supreme Court blocks mail-in expansion to state voters.
  5. Business: MGM plans to reopen major Las Vegas resorts in June — African American business owners have seen less relief from PPP, Goldman Sachs says.
  6. Tech: AI will help in the pandemic — but it might not be in time for this one.
  7. 1 🎶 thing: Local music venues get rocked by coronavirus.
  8. 🎧 Podcast: Trump vs. Twitter ... vs. Trump.
  9. What should I do? When you can be around others after contracting the coronavirus — Traveling, asthma, dishes, disinfectants and being contagiousMasks, lending books and self-isolatingExercise, laundry, what counts as soap — Pets, moving and personal healthAnswers about the virus from Axios expertsWhat to know about social distancingHow to minimize your risk.
  10. Other resources: CDC on how to avoid the virus, what to do if you get it, the right mask to wear.

Subscribe to Mike Allen's Axios AM to follow our coronavirus coverage each morning from your inbox.

Updated 2 hours ago - Politics & Policy