The Washington PostDemocracy Dies in Darkness

A better pandemic response might have saved hundreds of thousands of lives — and Trump’s presidency

President Donald Trump holds up his face mask during the first presidential debate at Case Western University and Cleveland Clinic, in Cleveland. (Julio Cortez/AP)

One year after the coronavirus pandemic began, the United States has been reshaped in remarkable ways. One of every 600 people alive at the beginning of last year has died of covid-19, the disease caused by the virus. Millions more have been infected with it, with some part of that group enduring lingering symptoms. Millions of people remain out of work.

The ship is turning. Multiple massive economic support packages have passed — the most recent by the Democratic-controlled Congress and White House. Millions more people have been vaccinated against the virus than have contracted it over the past several months. But there’s still the nagging question: What could have been different?

Such questions are hard to answer in real time, depending on the slow gathering and analysis of information. But we're starting to find some answers, including ones that offer a pointed political lesson.

It’s likely that the government’s response to the pandemic led to hundreds of thousands of deaths that could have been prevented. And it’s likely that the pandemic response cost Donald Trump the presidency.

The first point is a particularly contentious one. In the past, there's been analysis comparing the U.S. response to other countries, finding it lacking. Last summer, for example, researchers compared the American response to other countries, showing how their more muscular approaches tamped down the relative death toll.

More recently, research from Andrew Atkeson of the University of California at Los Angeles determined that implementation of robust efforts to halt the spread of the virus last May — widespread testing, mask mandates — could have held the country’s death toll below 300,000 in total. His model estimates that the country will reach 672,000 deaths overall as vaccines are rolled out, one of every 490 Americans alive at the beginning of last year. That’s a gap of nearly 400,000 deaths.

Trump didn't embrace such mechanisms. The Centers for Disease Control and Prevention were recommending the wearing of masks as early as April of last year, but Trump declined to do so. That helped bolster a partisan response to the pandemic, with Trump advocating for states to stay hands off — largely, it seems, out of concern that reductions in economic activity would hurt his reelection bid.

Other research suggests that it was instead the lax approach to the pandemic that led to Trump’s eventual defeat. His own pollster, Tony Fabrizio, produced research showing how those who voted against Trump were more likely to view his response to the pandemic critically. There’s necessarily a chicken-egg question here, with preexisting Trump skeptics probably being less likely to say that they thought he did a good job on the pandemic. But there’s a correlation.

That idea, though, is reinforced by other research, including a paper released this month from researchers at the Peterson Institute for International Economics. That analysis, conducted by Marcus Noland and Eva Yiwen Zhang, considered three indicators: deaths per confirmed case, change in the number of people working or seeking work, and the share of employment in sectors harder hit by the pandemic (such as food service).

In one counterfactual — What if there had been no pandemic? — the results are stark.

“Trump’s vote share increased by 2 percentage points on average across counties nationally,” the researchers find. “Of this shift, 8 percent comes from the COVID-19 case fatality rate, 12 percent from the effect via COVID-19-vulnerable industries, and 80 percent from the decline in the labor force.”

That is more than enough for Trump to have been reelected.

But the pandemic happened. So two other counterfactuals address the more realistic question of how a less-severe pandemic would have played out. Had those three indicators been 30 percent better, Trump again wins, though more narrowly. Were they only 20 percent better, Trump’s victory narrows further — leading to an electoral college tie.

Both this analysis and the one from Atkeson are necessarily simpler than reality. Even the idea that there's a clean way to describe a 20 percent reduction in the severity of the pandemic is overly neat. But there's nonetheless a throughline that comports with the understood big picture. The pandemic was worse in the United States in 2020 than it was in most Western countries as a function of population. Had it not been, it seems obvious that the effect on Trump would have been positive.

This question of how pandemic response and leadership intermingle is itself a complicated one. It trickles down to the state level, with governors arguing for their own efforts and against those of their peers. But comparing state responses with one another suffers from a central flaw: that the national benchmark for success was almost certainly low.

A lot has changed over the past year. But imagine how different this moment now would be if the U.S. response to the pandemic had been one in which hundreds of thousands of fewer people died and the economic toll was reduced by a third. To suggest that nothing would be different seems unwarranted.