How the second Trump administration could prove even deadlier than the first

Dramatic reductions of government services and expertise mean surviving this presidency will be more than a figurative challenge for millions.

The late comedian Norm MacDonald once deadpanned that O.J. Simpson’s lawyers had asked to skip a hearing and proceed to trial because they were eager to get their client acquitted of murder and “back to doing what he does best: killing people.”

Much the same could be said of Donald Trump’s portentous return to the nation’s highest office. The man who presided over one of the world’s heaviest Covid-19 tolls during his first term has, in his second, promptly resumed decreasing what Ebenezer Scrooge called the “surplus population,” only this time with no need for assistance from a novel respiratory virus. From hobbling the government’s capacity to predict and respond to natural disasters to unraveling the greatest public health achievements of the past century, this administration is promising to reap lives with grimmer efficiency and enterprise than his last one.

(Amr Taha / Unsplash)

That so many were caught unprepared for Texas’ deadly recent flash floods, for example, rightly raised suspicions about Trump’s hollowing out of the federal government, which left local National Weather Service offices without a warning coordination meteorologist, a meteorologist in charge, a senior hydrologist and other officials — none of which is atypical since Elon Musk’s purge stripped the agency of about 15 percent of its staff. The administration has also eliminated about a quarter of the Federal Emergency Management Agency, threatened to dismantle it entirely after the current hurricane season and put it under the direction of a man who told some of the remaining personnel that he didn’t know such a season existed.

It’s not yet clear whether or how the weather service vacancies affected the response to this particular disaster. But the floods are a reminder that the careless decimation of the agencies responsible for foreseeing, preparing for and dealing with catastrophe, particularly in an era of escalating climatic extremes, will cost lives if it hasn’t already.

Not all the consequences of Musk’s depredations are quite so hard to predict or quantify, though. A study published in the Lancet last week found that laying waste to the U.S. Agency for International Development, formerly the world’s largest source of foreign aid, will allow AIDS, malaria and other diseases to kill over a million more people this year and 14 million by 2030, about a third of them children under 5.

Since collaborating on this fine work, Musk and Trump have ironically parted ways over the One Big Beautiful Bill Act, whose silly title belies its deadly determination to deprive vulnerable Americans of food and medicine in the name of tax breaks for the rich. Signed into law on the Fourth of July, the legislation proves that the president doesn’t need the world’s richest man to help him cull the populace; he has other willing accomplices, like Congress.

Researchers at the University of Pennsylvania and NYU found that the law’s provisions restricting food aid under the federal Supplemental Nutrition Assistance Program would cause an additional 93,000 premature deaths over the next 14 years. Worse, Penn and Yale researches estimated that the legislation would cause more than 50,000 preventable deaths a year by denying millions of Americans health care coverage under Medicaid and Affordable Care Act marketplaces as well as delaying nursing home staffing requirements.

These dark prognostications may prove rosy given that measles cases just reached a level not seen this century in what one expert called a “harbinger of things to come.” Trump health secretary and noted measles enthusiast Robert F. Kennedy Jr. has made anti-vaccination disinformation official policy, firing government immunization experts en masse and warning women and children away from Covid shots. The American Academy of Pediatrics and other public health groups noted in a lawsuit filed this week that the latter directive “will cause preventable deaths” and “is but one example of the Secretary’s agenda to dismantle the … science- and evidence-based vaccine infrastructure that has prevented the deaths of untold millions of Americans.” And all this is just in time for the rise of “Nimbus,” the latest highly contagious Covid subvariant!

It’s fitting that we find ourselves once again lost in this more familiar nimbus of pre-apocalyptic ignorance and ill-preparedness for whatever fate might have in store for the feckless. The last time we ushered Trump out of office, albeit with considerable difficulty, the pandemic was taking lives in the United States at a higher rate than in 90 percent of the world’s countries.

Time was when needlessly killing people was roundly frowned upon in American politics. But Trump’s notorious boast that he could shoot someone on Fifth Avenue without fear of consequences turns out to have been wrong in an unexpected way: by being a gross understatement.