In a chilling new interview, former health advisor to the Donald Trump White House Dr. Deborah Birx said that the United States’ death toll could have been “decreased substantially” had White House officials taken the virus more seriously.

“I look at it this way. The first time we have an excuse,” Birx said to Dr. Sanjay Gupta. “There were about a hundred thousand deaths that came from that original surge. All of the rest of them, in my mind, could have been mitigated or decreased substantially.”

Alongside Birx, five other government medical advisors commented on the U.S.’s lack of preparedness for the COVID-19 pandemic and how once the situation became dire, the White House put public health second to economic and political considerations.

Birx said that her and colleagues’ warnings to the Trump White House fell on deaf ears. In the same interview series, Dr. Anthony Fauci told Gupta that Trump’s insistence on opening the country against the advice of health experts was “a punch to the chest.”

Trump’s loud efforts for the premature lifting of pandemic restrictions led many conservative governors to mirror the president’s actions, leading to the second and third United States surges of COVID-19 cases. Trump’s early insistence on making face masks a political issue led many to treat the public health measure like acts of personal protests.

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