Here’s a run-down of what you need to know about the health and science topics discussed in the final presidential debate. (Pixabay/)

The third presidential debate went much smoother than the first, but it was still somewhat of a mess when it comes to factual accuracy. The evening was littered with misleading or outright false statements. With the country still battling a pandemic that has resulted in the deaths of nearly 300,000 Americans, directly or indirectly, it’s crucial that we’re clear on the facts. Here are some of the key science and health issues discussed last night, and where the nation actually stands on them.

COVID-19

President Trump opened his remarks on COVID-19 with a series of statements and below are a few highlighted points:

  • That 2.2 million people were projected to die
  • That the mortality rate is down 85 percent
  • That spikes in Florida, Texas, and Arizona are now gone
  • That a vaccine is coming—or is actually ready—and is going to be announced in weeks

Here’s the truth:

A report from Imperial College London did project that 2.2 million people could die in the US if no actions were taken at all to stop the spread of the virus, assuming 81 percent of the population were infected based on an R0 value (the number of people an infected individual is likely to infect, on average) of 2.4. That 2.4 number was base on very early growth, and simple measures like washing hands and wearing a mask dropped the R0 significantly. Even the deadly 1918 flu pandemic only infected 28 percent of the US population. More importantly, this stat doesn’t suggest that reopening options are limited to opening everything or locking everything down. Even the team at Imperial College London didn’t recommend a full shutdown.

The mortality rate from COVID-19 has indeed fallen, and the specific number 85 percent may be accurate—but it doesn’t mean that we’ve learned how to treat or cure the disease. Though we have gotten better at treating COVID, there’s also been a massive change in testing. At the beginning of the pandemic the US had woefully small testing capacity. Now, with far more robust testing abilities, the country has been able to detect minor cases of COVID-19, which means the proportion of people we see dying from the virus has shrunk compared to the total number of cases. In that way, mortality rates seem to go down even without a change in our ability to treat the disease.

Texas and Florida did see recent spikes in coronavirus cases which have since passed, but both states are still seeing consistently high infection rates and are now trending upwards again. Arizona has lower numbers overall since its last spike, but again has an upward trend in case counts.

A vaccine is indeed coming, at some point, but it’s extremely unlikely that one will arrive in the next few weeks. Many top health officials have stated that one is unlikely before next summer, and even Pfizer, one of the pharmaceutical companies Trump cited, has explicitly said it wouldn’t even apply for emergency authorization of its vaccine before the third week of November. Further, even when a vaccine is approved (if that does happen), it will take time to roll out any vaccine to enough of the population to end the pandemic, which means most of us shouldn’t expected to get vaccinated until at least the middle of 2021.

Former Vice President Joe Biden also cited a couple of statistics, including that there are roughly 1,000 deaths and 70,000 cases each day. Both numbers are a bit high, though not necessarily inaccurate. On October 22, there were in fact 75,000 new cases, though the average number has varied and been below 70,000 at times. On the same day there were 828 new deaths, just shy of what Biden said, though the death rate has varied substantially.

President Trump also went on to state that 99.9 percent of young people recover from COVID-19, and also that 99 percent of people in general recover. It’s true that people aged 25 to 44 have an average mortality rate of 0.1 percent, though older folks die at much higher rates. It’s also true that a one percent overall mortality rate is within the realm of estimates experts currently have. But Trump cited the statistic as evidence that the disease isn’t a problem—in reality, if one percent of the US population dies, that means 700,000 to 1.5 million deaths. So the issue here isn’t so much that the statement is wrong as that the interpretation of the facts is dangerous.

Biden and Trump went on to debate various points of the shutdowns, especially with regard to the economic impact the virus and the lockdowns have had. Though it’s not clear yet exactly which countries will come out on top, it’s worth noting that, if anything, there’s a negative correlation between COVID-19 death rates and economic decline—that is, the countries with the highest mortality rates have had the biggest economic downturns. That suggests that there is no evidence of some kind of trade-off between protecting citizens’s health and protecting the economy.

Healthcare

One of the more policy-centric parts of the debate centered on health insurance. It’s a topic that many Americans have a massive vested interest in, but it’s also an intimidating one, especially given how confusing the US system is. A central point of contention had to do with Joe Biden’s position on healthcare, which is worth clarifying.

Trump repeatedly claimed that Biden’s plan would give everyone socialized medicine, but Biden’s protests were accurate: He is not suggesting a socialized approach to healthcare. Socialized medicine would have the government both pay for and provide healthcare, much like it does in the UK. Biden’s plan involves both public and private options. A Medicare-like plan would provide low- or zero-cost insurance to low-income people, and the subsidies introduced under the Affordable Care Act (ACA) would enable slightly higher-income folks who make too much to qualify for Medicare to still get affordable healthcare. It would also enable Medicare to negotiate drug prices, with the intention being that the ability to bargain on the marketplace on behalf of nearly 60 million Americans would bring those prices down—and it would do so for everyone, not just Medicare enrollees (this is exactly how many other countries have such low drug prices).

But Biden’s plan would also allow private insurers to continue offering plans for those who want to have better insurance and can afford to pay for it. Despite the apparent perception among Americans that most other countries have socialized medicine, many of them have a mix of private and public options. That combination allows them to do exactly what Biden is proposing: Offer affordable healthcare to everyone, while also enabling those with more means to access higher levels of insurance.

Trump has repeatedly said that he would offer better healthcare, but hasn’t provided any actual details on what that plan would entail. So in lieu of details that we can analyze, we’re left to look at his record.

Last night, the president claimed that premiums have gone down. It’s unclear which premiums he’s talking about, but he made a similar statement earlier in October about Medicare premiums. If that is what he meant, the statement is misleading. Though technically premiums have gone down, because of the way Medicare works many individuals don’t actually pay for their premiums for certain parts of their plan. Most everyone pays Part B premiums, though, and those costs went up under both Obama and Trump (but faster in Trump’s tenure than during Obama’s). He may also be referring to ACA premiums, which have come down slightly under this administration—but only because the Trump administration initially pushed them higher.

Overall, under the Trump administration more Americans are uninsured, especially low-income families, and his proposals to make healthcare cheaper do so by cutting benefits, not making good care more affordable.

Climate change

The section on climate change was perhaps the most confusing last night, at least for science. Trump made a series of claims, including that wind turbines kill “all the birds” and that Biden’s environmental plan would involve turning big windows into small windows.

More importantly, the president claimed up front that the US has seen the lowest carbon emissions it has had in 35 years. It’s true that carbon dioxide emissions have declined 15 percent since 2005, but this has largely been due to market forces as natural gas has replaced coal plans and ignores the fact that 2018 also saw the biggest spike in carbon emissions this century. The Trump administration has consistently cut the Environmental Protection Agency’s ability to protect our planet, and has made systematic changes that enable organizations to evade the Endangered Species Act, the Clean Air Act, and the Clean Water Act. Prosecutions under those last two acts have dropped by at least half since Trump took office. Air pollution kills more people now than it ever did under President Obama.

Biden, meanwhile, noted that we’re going to pass the climatological point of no return in 8 to 10 years, which isn’t inaccurate but is on the pessimistic side of the range of scientific projections. Some say the point won’t come until as late as 2045. He is correct, however, in his overall impression: hat we absolutely must take action to mitigate the climate crisis, and we must do it now.

Unlike what Trump said, Biden’s climate plan does not involve replacing big windows with small windows. It does involve upgrading four million buildings and 2 million homes to become more energy efficient (thus creating many good-paying jobs), but modern windows are plenty energy-efficient, which is why anyone who deals with windows for a living has no clue what Trump is talking about. Rest assured, you will keep your large windows if Biden is elected.

The claims about wind energy were also fairly misleading. While it’s true that wind is an inconsistent source of electricity, no one is suggesting that we rely solely on wind power. Grids are designed specifically to provide a stable power supply, and in fact the US has ramped up reliance on renewables without compromising reliability.

Wind turbines in particular, despite the president’s claim, are a very safe form of clean energy. They do not cause cancer, unlike coal-powered plants, and though there are certainly emissions associated with their manufacturing process, the typical wind project repays its carbon footprint in six months or less. Turbines do kill some 234,000 birds each year, but they are far from the biggest threat to birds. Collisions with glass buildings cause 6.6 million bird deaths each year in the US, while cats kill 2.4 billion. In fact, Trump himself is a threat to birds—his administration has attempted to gut the Migratory Bird Treaty Act, which specifically protects birds from environmental impacts like those posed by wind turbines.

Don’t forget to vote

The debate last night ended with a simple plea: don’t forget to vote. Here at Popular Science, we want to help you vote well, so read up on the issues and figure out who you want to vote for. Election day is November 3rd, but many of you could vote right now. Don’t be the person who accidentally leaves their ballot on their kitchen counter. More people didn’t vote in the last presidential election than voted for their candidate—if even half of those people had cast a ballot, it could have massively changed the election.

By ASNF