As a candidate for president, Donald Trump showed little inclination to behave in ways commonly expected of those seeking the land’s highest office. “You know how easy it is to be presidential?” he asked rhetorically at one rally. “You would be so bored . . . if I came like a stiff, you guys wouldn’t be here tonight.” It was this aversion to behavioral norms that led so many to speculate about Trump’s response in the event that his mettle was ever truly tested—a global pandemic, say, or war with North Korea. According to a new report, however, the president’s own 9/11 has already come and gone—and was barely acknowledged by either the governing administration or the American public. A study published in the New England Journal of Medicine on Tuesday revealed that the death toll from Puerto Rico’s Hurricane Maria is an estimated 4,645, a figure more than 70 times higher than the official toll of 64. Not only does the report, whose figures may yet be an underestimation, emphasize the cataclysmic horrors Puerto Rico’s residents have suffered since Maria, it also directly counters the narrative proffered by Trump: that his response to the disaster was exceptionally effective.

At first, the president appeared to blame the (largely Democratic) islanders for the destruction caused by the storm, which saw winds of up to 155 m.p.h. flatten homes, damage hospitals and airports, and blow out electricity and water supplies. “Texas & Florida are doing great but Puerto Rico, which was already suffering from broken infrastructure & massive debt, is in deep trouble,” he tweeted. “It’s [sic] old electrical grid, which was in terrible shape, was devastated. Much of the Island was destroyed, with billions of dollars owed to Wall Street and the banks which, sadly, must be dealt with. Food, water and medical are top priorities - and doing well.” He soon changed tack, making several statements praising the work his administration was doing to help victims of Maria, whose death toll he compared favorably to Hurricane Katrina’s. “We’ve saved a lot of lives. If you look at the—every death is a horror. But if you look at a real catastrophe like Katrina, and you look at the tremendous—hundred and hundred and hundreds of people that died,” he said, eager to contrast himself with President George W. Bush. “And you look at what happened here with really a storm that was totally overpowering. Nobody’s ever seen anything like this. And what is your death count at this point, 17? . . . Sixteen versus literally thousands of people.”

Behind the scenes, Trump was reportedly less focused on the effectiveness of the relief effort than its P.R. potential, using calls and meetings intended to update him on the situation to urge Federal Emergency Management Agency (FEMA) administrator Brock Long to punctuate his agency’s progress on TV. Long is a central figure to understanding the startling chasm between Trump’s interpretation of his response to Maria, and the reality of the storm’s astronomical death toll. As Politco writes, after Hurricane Harvey hit Texas, Long sent Mike Byrne, a leading light at FEMA, down to Houston. But when Maria struck, Byrne was kept in recovering Texas for three weeks before being deployed to Puerto Rico, a decision that struck many as symbolic of the double standard that has shaped the different responses to the two disasters. The double standard was evident in the material response to each storm as well: per federal data, FEMA initially approved more than $141.8 million in federal assistance for Texas nine days after the storm, compared to $6 million for Puerto Rico in the same time period. Within six days of Harvey, 73 helicopters had been deployed over Houston; it took at least three weeks for more than 70 helicopters arrive in Puerto Rico. FEMA approved permanent disaster work for Harvey victims in just 10 days; it took 43 days for victims of Maria. The list of discrepancies goes on and on.

It is, admittedly, somewhat fruitless to draw direct parallels between the two storms. Maria was the third major hurricane to hit the United States in less than a month, and Puerto Rico’s comparatively far-flung location, shaky infrastructure, and fiscal woes likely complicated the Trump administration’s response. But Trump’s own response is less ambiguous. In the eight days after Harvey, he visited Houston twice; it took him almost two weeks to get to Puerto Rico. When he finally arrived, he commemorated the occasion by tossing paper towels into a crowd—an image that was supplemented by his altercation with San Juan Mayor Carmen Yulín Cruz, who criticized the White House’s sparse efforts. “The Mayor of San Juan, who was very complimentary only a few days ago, has now been told by the Democrats that you must be nasty to Trump,” Trump tweeted from his golf club in Bedminster, New Jersey. “Such poor leadership ability by the Mayor of San Juan, and others in Puerto Rico, who are not able to get their workers to help. They want everything to be done for them when it should be a community effort.”