Trump’s 4 biggest lies about health care from last night’s debate

President Trump and former Vice President Joe Biden sparred over healthcare in the first 2020 presidential debate—and it was filled with falsehoods from Trump.

The first presidential debate of 2020 was a lot to parse through as President Donald Trump and former Vice President Joe Biden interrupted each other and barely touched substantive policy positions, an affair that multiple commentators called an embarrassment to the very concept of presidential debates.

The freewheeling and chaotic standoff was difficult to follow at times, but it was also filled with lies and distortions about health care policy, science, and the state of the coronavirus pandemic—fueled directly by President Trump.

Yes, children and young people can spread COVID

Trump has long downplayed the COVID crisis with dubious claims and outright false statements about how dangerous it is or isn’t. As of Wednesday, more than 205,000 Americans have died from COVID-19, representing nearly a fifth of all COVID deaths in the world.

The President has claimed that coronavirus is only a true danger to the most vulnerable people. He doubled down on that claim Tuesday. “Now we’ve found that elderly people with heart problems and diabetes and different problems are very, very vulnerable. We learned a lot. Young children aren’t, even younger people aren’t,” he said during the debate.

While it’s true that people with respiratory conditions, older people, those with chronic heart conditions, and diabetes are at higher risk—and may have a more severe illness if they contract COVID—that doesn’t mean younger people or even children can’t become sick.

Over the course of the pandemic, according to the most recent Centers for Disease Control (CDC) numbers, nearly 1,800 Americans aged 15 to 34 have died of COVID; another 3,800 between ages 35 and 44; and more than 10,000 between 45 and 54.

The death count scales up considerably among older populations, but that’s true of just about any disease given the realities of aging. And numbers aside, Trump’s claim misses a central point about how a pathogen works: Just because you don’t become extremely sick or die doesn’t mean you can’t spread it to those who might.

It’s become apparent that you can carry coronavirus and pass it on to other people while remaining asymptomatic, especially if you’re younger or a school-age child. But there are 3.3 million people over the age of 65 who live in a household with a school-aged child, according to the Kaiser Family Foundation (KFF). That’s the vulnerable population that Trump referred to during the debate.

You can’t protect people with pre-existing conditions via executive order

The Trump administration hasn’t been shy about expressing its disdain for the Affordable Care Act (ACA), also known as Obamacare. In fact, it’s actively trying to scuttle the entire health law at the Supreme Court while promising to replace it.

The trouble is that what the administration will replace it with has never materialized. Even when the GOP-controlled Senate nearly repealed the ACA back in 2017, the replacement plan was essentially a blank check with a set of guiding principles and the details to be hashed out a later date. Obamacare’s requirement to carry health insurance or pay a fine, the so-called individual mandate, was eventually repealed and has driven the administration’s efforts to invalidate the law.

But that would have far-reaching consequences. The ACA’s Medicaid expansion has helped provide coverage to millions of low-income working Americans who otherwise wouldn’t have qualified. And, critically during a pandemic, Obamacare established that health insurers can’t discriminate against patients with a pre-existing condition.

That latter point became a big subject of debate on Tuesday night. As moderator Chris Wallace told Trump, the President had signed an executive order ostensibly meant to protect people with pre-existing conditions days before the debate. But, as Wallace and health policy experts have noted, that doesn’t really have any staying power. An executive order can’t control the whims of an entire private industry.

Trump pushed back on that notion. “Let me just tell you something. There’s nothing symbolic,” he said in response to Wallace. The facts say otherwise—and insurers would likely be able to discriminate against people who have contracted coronavirus by price gouging or refusing coverage if the ACA were to be overturned in its entirety.

Trump also denied that there are more than 100 million people in the U.S. living with pre-existing conditions even though multiple independent analyses have confirmed that statistic.

A COVID vaccine will almost certainly not be available en masse before next summer

The President insisted that a COVID vaccine is just around the corner for widespread availability and contradicted the statements of both CDC director Dr. Robert Redfield (who is a virologist) and Moncef Slaoui, a former vaccines chief at the drug giant GlaxoSmithKline and the current scientific head of Operation Warp Speed, the Trump administration’s program to spur the development of coronavirus vaccines.

“I disagree with him. No, I disagree with both of them,” Trump told Wallace after the moderator pointed out that both experts have cautioned that a vaccine won’t be available to the public at a large scale until next summer.

Trump responded that companies such as Pfizer, Moderna, and Johnson & Johnson have told him otherwise. “Well, I’ve spoken to the companies, and we can have it a lot sooner. It’s a very political thing because people like this would rather make it political than save lives,” he said.

That’s not what industry executives and public health experts have said. The President may have been referring to statements from companies like Pfizer that they may know whether or not their vaccine candidates are effective by late autumn—but that’s nowhere near the same thing as Trump’s implication that a vaccine will just be out and accessible in the market by November.

If a vaccine proves effective, it may receive an emergency use authorization—but that’s not the same thing as a full Food and Drug Administration (FDA) approval. And then there’s the question of how such a vaccine will be prioritized. The most likely scenario is that it will be given to the most vulnerable populations at first as manufacturing and production of the COVID vaccine scales up. You’re not going to be able to waltz into a CVS and get your coronavirus shot this year in the same way you do a flu shot.

A virus doesn’t have a nationality

President Trump continued to lay the blame for the pandemic on China. He referred to it as “the China plague” during the debate, a tweak on his previous racist statements calling the virus the “Kung-Flu” and the “China virus.”

The outbreak may have originated in China, but a pathogen has no ethnicity. India is now one of the pandemic’s hotspots, and, as mentioned above, the U.S. has done considerably worse than just about every other country in controlling COVID. Travel between continents has spread this highly contagious disease and, the first American cases likely originated from visitors who came from Europe.

The 2009 H1N1 flu epidemic, which killed hundreds of thousands of people worldwide—though nowhere near the number of COVID deaths—originated in the United States and then spread globally. It was not referred to as the “American virus.”

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