WASHINGTON — Facing a grim reality of surging coronavirus cases, President Donald Trump is making premature assertions about relatively low death rates in the U.S. and revising history about how seriously he viewed the threat, including the need for ventilators.
A look at his claims:
TRUMP: "So we have more cases than anybody, but we're doing really well, and we also have a very low — relative to other countries — very low mortality rate. And there are reasons for that." — interview Monday with "Fox & Friends."
TRUMP: "We've been doing more test — tests than any other country anywhere in the world. It's one of the reasons that we have more cases than other countries, because we've been testing. It's also one of the reasons that we're just about the lowest in terms of mortality rate." — news briefing Sunday.
THE FACTS: His suggestion that the U.S. response is better than other countries' because its mortality rate is "just about the lowest" is unsupported and misleading.
It's too early to know the real death rate from COVID-19 in any country. Look at a count kept by Johns Hopkins University, and you can divide the number of recorded deaths with the number of reported cases. But that math provides a completely unreliable measurement of death rates, and the Johns Hopkins tally is not intended to be that.
First, the count changes every day as new infections and deaths are recorded.
More importantly, every country is testing differently. Knowing the real denominator, the true number of people who become infected, is key to determining what portion of them die. Some countries, the U.S. among them, have had trouble making enough tests available. When there's a shortage of tests, the sickest get tested first. And even with a good supply of tests, someone who's otherwise healthy and has mild symptoms may not be tested and thus go uncounted.
The result is a hodgepodge of numbers that get sorted out as the crisis diminishes. Indeed, initial death rates were thought to be as high as 4% in parts of China. But a report published Monday in The Lancet Infectious Diseases calculated that 1.38% actually is the best estimate of deaths among confirmed cases across China and that accounting for unconfirmed cases could drop that rate below 1%.
U.S. infectious-disease expert Dr. Anthony Fauci has estimated that the death rate in the U.S. might hit around 1%, which would be 10 times higher than mortality from a typical flu season.
Whatever the actual percentage, the more people who become infected, the higher the numbers of deaths, one reason authorities are stressing social distancing measures to stem the virus' spread and prevent hospitals from being overwhelmed by a surge of patients. And in each country, the age and overall health of the population are factors, too. Italy, for example, has the world's second-oldest population, and seniors are at an especially high risk of death.
FEDERAL AID FOR STATES
TRUMP: "I get on calls, and I get on a lot of the governor calls where we'll have all 50 governors plus where we have some territories also, but we have 50 governors. And I'll tell you what, if you could listen to those calls, you'd never hear a complaint." — interview with "Fox & Friends."
THE FACTS: That's false, by his own accounting. He's complained about the complaints of governors. And The Associated Press has heard governors complaining to Trump privately on the phone.
"Some of these governors take, take, take and then they complain," Trump groused in an interview Thursday on Fox News Channel's "Hannity." Of Democratic Gov. Gretchen Whitmer of Michigan, he said, "All she does is sit there and blame the federal government." And he said Washington Gov. Jay Inslee, also a Democrat, "should be doing more," adding, "He's always complaining."
"You know," Trump said from the White House, "we don't like to see the complaints."
On a private conference call Thursday with governors, Inslee urged Trump to use his full authority to spur production of necessary medical equipment, according to an audio recording of the call obtained by the AP. Trump replied that the federal government is merely the "backup."
"I don't want you to be the backup quarterback; we need to be Tom Brady here," Inslee replied, invoking the football star.
The nation's governors have been pressing the president to do more to bolster supplies, despite the perceived risks of speaking out. They have pleaded with him to use the Defense Production Act to force companies to manufacture critical equipment and begged for help in obtaining supplies like masks and testing agents.
On Friday, Trump told reporters that he wants governors "to be appreciative" of the federal government's efforts because "we have done a hell of a job."
Still, in a conference call with Trump on Monday, several governors made clear the federal government wasn't doing enough.
Every governor understands "we are way behind the curve on test kits," Inslee said in the recording.
Republican Gov. Larry Hogan of Maryland voiced appreciation for the $2.2 trillion economic stimulus bill that Trump signed into law last week and the president's acknowledgement that states will need more help. But he emphasized that governors are "still frustrated" about a scarcity of medical supplies.
YAMICHE ALCINDOR, "PBS NewsHour" reporter, at White House briefing Sunday: "You've said repeatedly that you think that some of the equipment that governors are requesting, they don't actually need. You said New York might not need 30,000" ventilators.
TRUMP: "I didn't say that."
ALCINDOR: "You said it on Sean Hannity's Fox News."
TRUMP: "I didn't say — come on."
THE FACTS: He did say that.
In his interview Thursday with Hannity, Trump pointed out that New York Gov. Andrew Cuomo, a Democrat, had said he wanted "30,000 of them, 30,000."
"All right. Think of this," Trump went on. "You know, you go to hospitals. They'll have one in a hospital. And now, all of a sudden, everybody's asking for these vast numbers."
Trump then suggested that pleas for more ventilators were exaggerated. "I have a feeling that a lot of the numbers that are being said in some areas are just bigger than they're going to be," he said.
"I don't believe you need 40,000 or 30,000 ventilators," Trump continued. "You know, you're going to major hospitals sometimes, they'll have two ventilators. And now, all of a sudden, they're saying, can we order 30,000 ventilators?"
By the following day as coronavirus cases grew, he switched gears and invoked the Defense Production Act to force General Motors to produce ventilators for coronavirus patients while calling on Twitter for GM to "START MAKING VENTILATORS, NOW!!!!!!" and Ford to "GET GOING ON VENTILATORS, FAST!!!!!!"
When Trump was asked by reporters Friday why he invoked the act if the ventilators won't be needed, he said that he thought there is a good chance there'll be enough and that if there ends up being a surplus, the ventilators could be sent to other countries.
TRUMP, asserting he got immediate results from GM after invoking the Defense Production Act: "Those companies have come into line. They're doing a great job. They're working very hard ... around the clock. ... And, by the way, General Motors is doing a fantastic job. I don't think we have to worry about General Motors now." — news briefing Sunday.
THE FACTS: Trump's action didn't spur dramatic transformation by GM. The automaker has been moving rapidly, fronting millions in capital, and says it's still proceeding on the same course.
GM had expected to start making ventilators in mid-April, increasing to a rate of 10,000 per month as quickly as it can, in partnership with Ventec Life Systems, a small Seattle-area ventilator maker.
GM got into the ventilator business March 18 — before Trump's order on March 27 — after being approached by a coalition of CEOs trying to organize companies to respond to the COVID-19 outbreak. The organization introduced GM to Ventec, which makes small portable ventilators in Bothell, Washington.
GM pulled together manufacturing experts, engineers and purchasing specialists, and the next day had people at Ventec's facility. A few days later, GM assigned more engineers and purchasing experts to figure out how it could make Ventec's machines and help round out parts supplies.
TRUMP: "I stopped some very, very infected, very, very sick people, thousands coming in from China long earlier than anybody thought, including the experts. Nobody thought we should do it except me. And I stopped everybody. We stopped it cold." — interview with "Fox & Friends."
THE FACTS: He didn't "stop cold" all the people infected with coronavirus from entering the U.S.; there were gaps in containment and initial delays in testing, leading to the U.S. rising last week to No. 1 globally in the number of people infected by COVID-19.
Nor did Trump decide on his own to impose travel restrictions on China — he followed a consensus recommendation by his public health advisers.
His order in late January temporarily barred entry by foreign nationals who had traveled in China within the previous 14 days, with exceptions for the immediate family of U.S. citizens and permanent residents. Americans returning from China were allowed back for two more weeks. They were given enhanced screenings. But screenings can miss people who are carrying the virus but showing no symptoms.
TRUMP: "We inherited a broken test — the whole thing was broken. And we rebuilt it." — interview Monday with "Fox & Friends."
TRUMP: "This administration inherited a broken system, a system that was obsolete, a system that didn't work. It was OK for a tiny, small group of people, but once you got beyond that, it didn't work." — news briefing Monday.
THE FACTS: Trump appears to be repeating a false accusation that a restrictive policy introduced by the Obama administration hampered initial testing during the COVID-19 outbreak.
Food and Drug Administration guidance drafted in 2014 called for tighter regulation of laboratory-developed tests, a market traditionally not overseen by the agency. Trump says that step made it more difficult to come out with a coronavirus test. But that guidance never took effect. And if it had, it would not have applied to public health emergencies like the current one.
The Trump administration's action in early March instead undid a policy that its own FDA put in place. That action let labs run by companies, universities and hospitals develop and use coronavirus diagnostic tests before the agency reviews them, speeding up the supply. Previously, the FDA had only authorized use of a government test developed by the Centers for Disease Control and Prevention.
The CDC in January developed a test kit and sent it to state and county public health labs, so they could test more people. But most of those kits proved to be faulty, delaying diagnosis of many people who unwittingly spread the disease.
TRUMP, on why he thinks South Korea does more COVID-19 testing per capita than the U.S.: "I know South Korea better than anybody. It's a — very tight. Do you know how many people are in Seoul? Do you know how big the city of Seoul is? Thirty-eight million people." — news briefing Monday.
THE FACTS: That's wrong. The city of Seoul has a population of 10 million. Seoul's greater metropolitan area is home to 25 million people, still far from Trump's assertion of 38 million. South Korea's population is 51 million.
Associated Press writers Matthew Perrone in Washington, Tom Krisher in Detroit, Alan Suderman in Richmond, Va., and Amanda Seitz in Chicago contributed to this report.