Anyone who paid more attention to Hurricane Maria than Trump did — a low bar — would know that the official death tolls were being challenged soon after the storm. By Sept. 28, just eight days after landfall, the Center for Investigative Journalism, a Puerto Rico-based nonprofit newsroom, had already published its first piece calling into doubt the number of fatalities, which then stood at only 16. The article referenced “dozens” of uncounted deaths and anticipated that “the number could rise to the hundreds.”

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To even think, as Trump alleged in his tweet, that the Democratic Party was somehow pulling the strings at a time when communication even within Puerto Rico was extremely difficult, strains credulity. It is a conspiracy theory on a par with birtherism, of which he is also a putative father. Here, however, he is not disputing the authenticity of a birth certificate, but rather of thousands of death certificates and of the pain felt by the people whose family members’ names appear on them.

To be fair, Trump has been aided in his delusions by local government officials. Gov. Ricardo Rosselló, during the president’s Oct. 3 visit to Puerto Rico, happily cheered him on and told him that the death toll then stood at only “sixteen, certified.” That very evening, the government revised the count to 34 but, conveniently, only after Air Force One had taken off.

When CNN arrived at a similar conclusion regarding the suspiciously low death toll later in October, Puerto Rico’s public safety secretary, Héctor Pesquera, told reporters that “any insinuation the count is intentionally kept low is horses---.” Puerto Rico’s health secretary, Rafael Rodríguez Mercado, in responding to questions regarding the earliest reports of uncounted fatalities, said Sept. 29 that “people die in hospitals every day for any number of reasons.” He added that these were “things that are unavoidable.”

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Is it any wonder, then, that Trump, whose tendency toward confirmation bias is well known by now, would regurgitate many of these ideas to state that “if a person died for any reason, like old age, just add them onto the list”? His remarks would also seem to deny researchers’ very basic conclusions regarding the aftermath of Maria — namely, that the 1,000 to 3,500 estimated excess deaths that occurred in the months after the storm when compared to previous years could not be explained by any other means.

People died; that’s a fact. More people died — many thousands more — than in the same period during any previous year; that’s also a fact. Does Trump have any other explanation to account for this anomaly? Witnesses, such as myself, to the collapse of our health system and good old common sense offer only one possible reason: the hurricane, and the lackluster response by federal and local authorities.

This string of events has led many of us in Puerto Rico to wonder whether a concerted effort to cover up the true death toll was indeed undertaken by officials in San Juan and Washington. But our fear is that the death toll is higher than reported, not lower. Not even the wildest conspiracy theory kicking around here on the island has suggested that the whole thing was blown out of proportion to make Trump look bad.

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We feel powerless and outraged by the president’s blithe disregard for our well-being — not as American citizens, but simply as his fellow men and women. There can be no middle ground on this matter: You either stand with those who have suffered so much, or you stand with a man who has never known want and who is incapable of imagining the lives of those who have.