Trump disputes Puerto Rico’s hurricane death toll. Here’s how they are calculated

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• Judy Woodruff:

  While the federal government prepares for Hurricane Florence, President Trump is talking about one of last year's big storms.

  As John Yang reports, the president is defending the response to Hurricane Maria, which devastated the U.S. territory of Puerto Rico.

• John Yang:

  In the weeks after the storm hit, the Puerto Rican government said 64 people died on the island. But mounting evidence suggested that figure failed to take full account of the deadly effects of prolonged power failure, blocked roads and interrupted health care.

  Studies estimated the death toll ranged from 800 to more than 4,600.

  Puerto Rico Governor Ricardo Rossello commissioned George Washington University's Public Health School to look into the question. Last month, Rossello accepted the study's conclusion that nearly 3,000 people died as a result of the storm's effects.

  Today, President Trump said, "3,000 people didn't die in the two hurricanes that hit Puerto Rico. When I left the island after the storm had hit, they had anywhere from six to 18 deaths."

  In fact, when Air Force One left Puerto Rico, the death toll stood at 45. Mr. Trump said the higher Estimates "were done by the Democrats in order to make me look as bad as possible. If a person died for any reason, like old age, just add them onto the list."

  Republican response was largely muted. One exception, Florida Governor Rick Scott, a candidate for the U.S. Senate, who said, "I disagree with POTUS. An independent study said thousands were lost."

  We're joined now by Philip Bump, a Washington Post national correspondent who focuses on the numbers behind politics.

  Phil, thanks for being with us.

  As we heard in the tape, this new higher estimate from George Washington University, how was that reached? How was that number reached?

• Philip Bump:

  So, the conclusion they reached was that there was a range, and 3,000 was the most likely value that they came up with.

  And that range was determined by looking essentially at what the normal level of mortality was on Puerto Rico and how that level of mortality had increased in the months after the storm, for about six months after the storm.

  So, essentially, if, say, 100 people died normally in a November in Puerto Rico, if, after the storm, 150 had died, they basically would take a — estimate about 50 additional people had died. It was that sort of analysis they did for an extended period after the storm that allowed them to come up with this value.

• John Yang:

  And I should say that George Washington University's School of Public Health put out a statement that said, "We stand by the science underlying or study. We are confident that the number, 2,975, is the most accurate and unbiased estimate of excess mortality to date."

  So this wasn't a list. They didn't go counting death certificates over this time.

• Philip Bump:

  That's right. That's exactly right.

  And, in fact, that probably wouldn't even have worked. One of the things — I spoke with researchers from the University of Delaware's Disaster Recovery Center last year, in anticipation that this might become a problem. And the thing that was pointed out to me is that most of these causes of death — if, for example, someone has diabetes, and their insulin that needs to be kept refrigerated, they can't keep it refrigerated because they lose electricity because of the storm, and unfortunately die as a result of that, the cause of death that is listed on their death certificate is not going to be they died as a result of Hurricane Maria.

  It's going to be that they died because of diabetes. And so all of the causes of death that would be listed on those death certificates anyway might not necessarily reflect the true reason that they died at the point that they did, which was the after-effects of the storm.

• John Yang:

  So, two points coming out of that. Number one is that when the president said that they just added people onto the list, there was no list.

• Philip Bump:

  That's exactly right. That was — that was just political rhetoric.

• John Yang:

  And, secondly, you have written a lot about the complexities of reaching death tolls, figuring out death tolls…

• Philip Bump:

  Right…

• John Yang:

  … after natural disasters.

  And talk about that, sort of the direct effects of people — deaths from direct effects and sort of the indirect effects.

• Philip Bump:

  So, the direct effects of dying from the storm are, for example, going outside during the storm and having a tree hit you in the head, being in your home and having — having a flooding and drowning as a result of it.

  We are pretty familiar with those direct effects, obviously lamentable and tragic. What we're really talking about here is that period afterward, that period of months, where Puerto Rico, much of Puerto Rico lacked electricity, last potable water, lacked clear roads, which was a problem.

  The Post in may told the story of a woman who died in her home, in part because they couldn't reach medical workers because cell phones were working, and in part because the ambulance got caught in traffic because traffic lights weren't working.

  These are the sorts of deaths that are a direct result of the storm, but which aren't directly attributable to the storm itself, those — two-day period.

  And the remarkable thing about what the president did today is, he asked us to focus only on those direct effects from the storm and ignore the preventable deaths that happened in the weeks and months afterward, the preventable deaths that were ultimately the responsibility of the federal and local government to prevent.

• John Yang:

  And you said — you tweeted this afternoon that when you spoke to researchers last year, they were concerned about how President Trump might use this sort of uncertainty about the exact number for political reasons.

• Philip Bump:

  Well, I wouldn't say that they expressed that they themselves were concerned how Trump would do this.

  But they did note that it wasn't uncommon for death tolls from these sorts of disasters to become political footballs. And as part of our conversation, I was up front when I spoke with them that this could be something which could be politically problematic down the road.

  And so we had a conversation in which they noted that these things are never able to be pinpoint-accurate, simply because of the way that these deaths occur. And, as a result of that, they often become subject to political machinations.

  It's unusual, however, that we see that in the United States. After Katrina, for example, there wasn't much debate. There was an accepted figure that, I will note, was calculated in much the same way that this one was.

• John Yang:

  Philip Bump at The Washington Post, thanks so much for being with us.

• Philip Bump:

  Of course.