In a flurry of tweets and remarks, President Donald Trump continued to distort the facts on the coronavirus pandemic:
- In a series of comments focused on the surging number of COVID-19 cases elsewhere in the world, Trump left the misleading impression that the U.S. is doing better than several countries seeing recent upticks in cases. But nearly all of the nations he mentioned still have fewer new daily per capita cases than the U.S.
- The president said Dr. Anthony Fauci, a coronavirus task force member, was "wrong" that Europe was more successful in reducing new cases partly because countries had more restrictive lockdowns than the U.S. Instead, Trump inaccurately insisted that the U.S. has more cases because of more testing.
- Trump repeated the misleading claim that COVID-19 cases are "up" in the U.S. "because of BIG Testing." Cases are high because of ongoing transmission, not just because of testing. Coronavirus task force coordinator Dr. Deborah Birx said that the recent outbreaks, unlike those in the early days of the pandemic, are "extraordinarily widespread."
Resurgences in Other Countries
In recent remarks, Trump has noted that other nations are currently experiencing worrisome upticks in coronavirus cases. While this is true, his emphasis and description of these surges could leave audiences incorrectly believing the U.S. is in better shape than certain parts of Europe and Asia.
In a July 30 press briefing, for example, the president referred to "tremendous problems" occurring across the globe.
Trump, July 30: All over the world, they’re having tremendous problems. A resurgence has taken place in many countries that people thought were doing well. Despite a wide range of approaches to the pandemic between countries, this resurgence in cases is occurring throughout large portions of our planet — in Japan, China, Australia, Belgium, Spain, France, Germany, Hong Kong — places where they thought it was — they had really done great. It came back. And in a couple of cases, it came back very strongly.
He then gave a few eye-popping statistics of the amount of growth in coronavirus cases in select countries.
"Since the beginning of June," he said, "daily new cases have increased by a factor of 14 times in Israel; 35 times — that’s 35 times — in Japan; and nearly 30 times in Australia, just to name a few. These were countries that were doing incredibly well; leadership was being praised."
Later, in an Aug. 2 tweet, Trump retweeted information about a state of disaster declaration in Victoria, Australia, adding, “Big China Virus breakouts all over the World, including nations which were thought to have done a great job. The Fake News doesn’t report this. USA will be stronger than ever before, and soon!"
The following day, Trump alluded to other countries having a "major second wave" of cases in another tweet, and said that the U.S had handled the virus "MUCH better."
The White House did not respond to our request for more information, so we are not sure which exact days or the source he used in making his comparisons. The factor increases Trump cited are in line, if not lower, than the numbers from Our World in Data, a project based at the University of Oxford. But importantly, the large changes are only possible because those countries had very few new coronavirus cases in early June.
Japan, for instance, had only 33 new cases on June 1, which increased some 34 times to 1,126 cases by July 30, the day of Trump’s remarks. Similarly, Australia and Israel had only 10 and 59 cases, respectively, on June 1, which rose 28 and 34 times to 278 and 2,001 cases on July 30.
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In contrast, the U.S. didn’t experience such a large change — less than a 4-fold increase — but started and ended with more daily cases: 19,807 new cases on June 1 and 74,985 new cases on July 30.
Adjusted for population, only Israel is similar to the U.S. in terms of new COVID-19 cases, and had a slightly higher seven-day average figure than the U.S. on July 30. As of Aug. 4, Israel has dipped below the U.S.; Australia has more than nine times fewer new cases per capita than the U.S. and Japan has more than 16 times fewer cases, per Our World in Data’s seven-day rolling average.
Importantly, all of the nations Trump singled out for having resurgences successfully reduced their case numbers to low levels in May and June, which the U.S. did not manage to do.
And even with the rise in cases now, all the nations Trump mentioned, other than Israel, are far below the U.S.’s seven-day average per capita case count of 183 cases per million people per day.
Hong Kong, which is not included in Our World of Data, is posting no more than 150 cases per day, per Worldometer, or about 20 cases per million people. The U.S. has more than nine times that many new daily cases per million people.
And while Trump repeatedly suggests that the U.S. has more cases because of more testing, it isn’t true that these other nations aren’t testing as much. With the exception of Hong Kong, all of the nations singled out by Trump have been conducting more tests per coronavirus case identified than the U.S.
In an Aug. 3 press briefing, the president again noted "very significant flare ups" in Spain, Germany, France, Australia, Japan and Hong Kong, and in response to a question about the state of the pandemic in the U.S., said, "I think we’re doing very well, and I think that we have done as well as any nation."
"If you really look, if you take a look at what’s going on, especially now with all these flareups and nations that they were talking about," he said. "Don’t forget, we’re much bigger, other than India and China. China’s having a massive flareup right down. India has a tremendous problem. Other countries have problems."
The U.S., by a variety of metrics, has not "done as well as any nation."
The outbreaks in numerous countries have been smaller and led to fewer deaths, even when including more recent upticks. South Korea, for instance, quickly brought its number of cases down after a burst of infections in March and has largely kept it that way, limiting the total number of cases to fewer than 15,000 and deaths to 301. Australia’s outbreak has also been puny by comparison, with fewer than 20,000 cumulative COVID-19 cases and 232 deaths as of Aug. 4.
The U.S., meanwhile, has racked up more than 4.7 million cases and more than 156,000 deaths, according to the COVID-19 dashboard from Johns Hopkins University. That works out to 14,240 cases per million U.S. residents, versus 281 per million in South Korea and 718 per million in Australia.
As of Aug. 4, the U.S. had a mortality rate of 47.5 per 100,000 people, but Australia (0.93), Japan (0.8), South Korea (0.58) all have mortality rates of less than 1 person per 100,000, according to Johns Hopkins.
In an interview with Axios that aired Aug. 3, Trump objected to focusing on deaths as a proportion of the population, pointing instead to deaths as a proportion of total cases. "You have to go by the cases," he said, claiming that the statistic showed the U.S. is "lower than Europe."
The U.S. has a case-fatality rate of 3.3%, lower than many countries in Europe, including France, Spain and Germany. But there are also many countries with lower rates than the U.S., including Australia (1.2%), Japan (2.5%), Israel (0.7%) and South Korea (2.1%).
That measure shows how deadly the disease has been for those who have been identified as infected, but looking at deaths per 100,000 population shows how the disease has affected the total population of a country.
Nor is the current situation in the U.S. particularly rosy. On July 29, researchers at Johns Hopkins released a report urging changes to America’s pandemic response. "Unlike many countries in the world," the authors wrote, "the United States is not currently on course to get control of this epidemic."
All countries must be prepared for resurgences in COVID-19 cases, which at times may grow rapidly. But Trump omits the fact that viral transmission in the U.S. never declined substantially, unlike many of the countries experiencing upticks, and that there are more new daily per capita cases in the U.S. than in virtually all of the nations he highlighted.
Fauci on Europe’s Shutdown
The president also claimed in a tweet that Dr. Anthony Fauci, director of the National Institute of Allergy and Infectious Diseases, was "wrong" in saying in a July 31 congressional hearing that more restrictive lockdowns in European countries led to a sharper decline in cases than what the U.S. has achieved. Trump falsely claimed the difference was due to testing. "We have more cases because we have tested far more than any other country," he said.
In the congressional hearing, Fauci was asked by Rep. James Clyburn, chairman of the House Select Subcommittee on the Coronavirus Crisis, "why Europe has largely contained the virus" while "the United States has seen a continued rise in new cases?" Clyburn showed a chart of the daily new confirmed coronavirus cases per million people for the U.S. and Europe.
Fauci, July 31: The answer to that question is really somewhat complex but I’ll try maybe to very briefly go through what I believe are at least some of the factors that were involved. If you look at what happened in Europe when they shut down or locked down or went to shelter in place, however you want to describe it, they really did it to the tune of about 95 plus percent of the country did that. When you actually look at what we did even though we shut down, even though it created a great deal of difficulty, we really functionally shut down only about 50% in the sense of the totality of the country. Which means when we reached our peak as they did, they came down almost to a low baseline as you’ve shown very clearly.
But take a look at what happened to our baseline, we came up, down and then we plateaued at about 20,000 cases a day. So, we started off with a very difficult baseline of transmission that was going on at the time that we tried to open up the country.
Fauci went on to say that some states reopened "very well" and others didn’t, and the latter "led to the surging that you’re showing on your chart there. And one of the reasons is not doing some of the things that [CDC Director] Dr. Redfield mentioned in his opening statement, universal wearing of masks, avoiding crowds, forced physical distancing, et cetera, et cetera. So it’s a complicated reason why those charts are that way and hopefully as we’re going forward we can turn those around and I do believe we can."
Here’s a version of the chart Clyburn showed:
Trump’s alternative explanation for the difference — "We have more cases because we have tested far more than any other country" — reminded us of the president’s claim in a July "Fox News Sunday" interview that other countries, later mentioning Europe, are only testing for COVID-19 if someone is "really sick" and that the "massive" testing in the U.S. "skews the numbers." As we found, many countries, including in Europe, have conducted more tests per confirmed case than the U.S.
Jeffrey Shaman, an epidemiologist at Columbia University’s Mailman School of Public Health, told us in an email that "tests per confirmed case provides an indication of how aggressively a country is testing. And many countries are at much higher rates than the US."
As of Aug. 3, the U.S. had conducted 12.3 tests per confirmed case of COVID-19, using the seven-day rolling average figures from Our World in Data. That’s fewer tests per case than 20-some European countries, with the exclusion of France and Sweden – though the available information for those two countries dates back to early July and May.
Among the countries the president has recently mentioned, Spain has conducted 16.3 tests per confirmed case as of July 30, and Germany has done 39 as of July 26. Israel (26.4), Japan (22.3) and Australia (244.8) all have conducted more tests per confirmed case.
Testing Not Sole Cause of Increase in Cases
Trump once again made the misleading claim, in an Aug. 3 tweet, that coronavirus cases in the U.S. have gone "up because of BIG Testing." As we’ve written, increased testing will lead to more cases, but it doesn’t account for all of the uptick in some parts of the country. The percentage of tests that were positive also went up in many states.
When we looked into this issue in June, Katherine Ellingson, an epidemiologist at the University of Arizona, told us that the data on cases and testing “suggests that community transmission is increasing, and that increasing case counts are not simply an artifact of testing.”
In some of the hard-hit states, the percentage of tests that were positive increased significantly this summer. For example, in Arizona, the seven-day average for the test positivity rate, as analyzed by Johns Hopkins University, was around 7% in mid-May, spiked to more than 27% in July and has now declined to 18%.
Florida had a 5% positivity rate or lower for nearly all of May, but for most of July into August, the rate has been above 18%. In Texas, the positivity rate was around 5% at the end of May, hit nearly 18% in July and was about 12% to 14% in recent days.
As of Aug. 4, Johns Hopkins University shows 33 states experiencing an increase in the seven-day positivity rate.
Trump chooses to focus instead on states that are below 5%. He said in an Aug. 3 press briefing: "Meanwhile, 18 states continue to have very low case numbers and low test positivity rates under 5%," mentioning Alaska, Connecticut, Delaware, Illinois, Maine, Massachusetts, Montana, New Jersey and New York, among others.
Some areas also have seen increases in COVID-19 hospitalizations and deaths, which should not occur if additional testing is the only driver of more coronavirus cases.
Two members of the White House’s coronavirus task force also have contradicted Trump’s claims about testing. Dr. Deborah Birx, the coordinator of the task force, said on CNN’s “State of the Union” on Aug. 2 that the U.S. was in a "new phase" of the outbreak and that the virus was "more widespread."
"What we are seeing today is different from March and April. It is extraordinarily widespread. It’s into the rural as equal urban areas," Birx said. "To everybody who lives in a rural area, you are not immune or protected from this virus."
She recommended those in multigenerational households in areas where there is an outbreak "consider wearing a mask at home, assuming that you’re positive, if you have individuals in your households with comorbidities."
Fauci told members of the House in that July 31 hearing: "We see, if you do more testing, you’re going to see more cases. But the increases that we’re seeing are real increasing in cases, as also reflected by increasing in hospitalization and increasing in deaths."
The seven-day rolling average of deaths per million people in the United States has gone up, from less than or around 2 in late June and early July to 3.38 on July 31, the day Fauci made his remarks, according to Our World in Data.