Fake News is a term popularized by President Donald Trump to characterize the mainstream media. Not all journalists, as the President notes, but the major American media outlets such as CNN, NBC, and the New York Times.

While the media objects to such a characterization, they do little to dispel their new found reputation. Only last week, the New York Times reinforced their fake news label with the story of UN Ambassador Nikki Haley supposedly ordering expensive curtains for her official residence when in reality the curtains were ordered by the Obama administration. The fact that it took two years for curtains to be installed after being ordered is an interesting sidelight of government inefficiency.

A small amount of research and fact checking would have kept the egg off the NY Times’ faces for publishing a bogus story. Was this deliberate or incompetence or both? It makes little difference and the fake news reputation of the NY Times has been reinforced.

This story broke during the time of Hurricane Florence, at one point predicted to be a category 4 or 5 superstorm, but in reality only a category 1 storm when making landfall, a reminder of the unpredictability of hurricanes in both course and strength.

The fake stream media took advantage of the hurricane to push their Trump hatred narrative, this time with the supposed death toll in Puerto Rico due to Hurricane Maria last year. As Hurricane Florence was gaining strength in the Atlantic, the media could not resist the opportunity to trash the President. The Washington Post editorial board declared Trump “complicit” in the hurricane, as if he created and steered it.

I’m sure if Hillary Clinton were president now there would not have been any hurricanes over the past two years. At least that’s the implication.

Conveniently a story was released claiming 3000 deaths in Puerto Rico due to Hurricane Maria, timed perfectly with the Washington Post editorial and Hurricane Florence. The President, in his fashion, punched back over the whopper of a story tying these supposed Puerto Rico deaths to him and his administration’s hurricane response.

The media ran with this story in unison, eclipsing even Nikki Haley’s curtains and Paul Manafort’s deal with Special Counsel Mueller.

The problem is, “The island government raised the official death toll to 2,975 on Tuesday after maintaining for months that 64 people had died as a result of the storm.” Why the sudden change, from 64 to nearly 3000, a 50-fold increase? Other than an opportunity to stick it to President Trump.

This death toll number resulted from a request by the Puerto Rico Governor:

“In order to accurately estimate the excess number of deaths due to Hurricane María, the Governor of Puerto Rico sought an independent assessment of mortality and commissioned The George Washington University Milken Institute School of Public Health to complete the assessment.”

In response, the Milken Institute:

“...developed a series of generalized linear models…to project forward mortality that would have been expected if the hurricane had not occurred.”

In other words, this was a computer model, much like those predicting the strength and track of hurricanes, resulting in the “spaghetti line” plots of all of the potential tracks of an early hurricane. The same models predicted a category 4 storm when it was actually category 1 at landfall.

To calculate the number of deaths, the study “Used records for all deaths occurring from September 2017-February 2018.” Meaning someone with a bad heart or cancer, finally succumbing to their illness months after the hurricane, or a drug overdose or car accident, are all included in that number of deaths dubiously attributed to the hurricane.

Cause of death is based on the death certificate, filled out by a physician. The study found:

“Physician lack of awareness of appropriate death certification practices after a natural disaster…limited the count of deaths that were reported as related to Hurricane María.”

In other words, there is little correlation between the hurricane and cause of death.

How could there be. People die for myriad reasons. The stress of a hurricane may play a role but science is not capable of running two simultaneous scenarios – one with a hurricane and one without one – then comparing the two outcomes.

Imagine if we could do that. What would four years of President Trump look like after the fact compared with four years of President Clinton? Unfortunately that is only the realm of movies and novels, not real life.

This led researchers to take a different approach, to “conclude that excess mortality is a good indicator for impact monitoring during and in the aftermath of a disaster.” Is that valid? Maybe or maybe not.

Perhaps more instructive would be data on the actual death rate in Puerto Rico over the past two decades. The CIA factbook provides such data presented here.

The graph demonstrates that the death rate in Puerto Rico has been rising for most of the past decade, beginning in 2010. What if I suggested this rise in deaths was related to President Obama assuming office in 2009? Or Obamacare signed into law in 2010? Will any US university undertake such a study and conclude that the “excess deaths” from 2010 to 2016 are due to Obama and his policies? Don’t hold your breath.

From the plot one can see that the death rate in Puerto Rico peaked in 2016, then dropped in 2017. What happened in 2016? Could we make the argument that President Trump’s election is responsible for the reduction in deaths from 2016 to 2017? Why not?

More likely, the slowly rising death rate over the past decade is due to other causes, from accidents to lifestyle-related diseases such as diabetes and heart disease. Is the drop from 2016 to 2017 the beginning of a downward trend, or just a blip in an otherwise rising death rate? Time will tell.

The President is not disputing the 3000 deaths number, only the causation. CNN tries to paint Trump as a denier, “Trump falsely claims nearly 3,000 Americans in Puerto Rico did not die.” It’s not that they didn’t die, but instead the reason why they died.

As the President noted, it was a blatant political stunt, to blame the administration’s hurricane response as the cause of these deaths, furthering the left’s talking points that Trump doesn’t care, he hates people of color, he’s incompetent, and so on. As expected, he responded.

The Hurricane Florence death toll, at the time of this writing, is seven. Details are needed to determine association versus causation. As the flooding continues, the death toll will likely rise. Will it suddenly spike from a few dozen to several thousand a year from now, in time for a new hurricane season and another bite of the Trump derangement syndrome apple? Almost certainly.

When the left and the media tries to politicize everything, from weather to gender to sports, they should expect push back. Not from spineless Republicans like House Speaker Paul Ryan, who readily agreed with the media narrative, saying he has "no reason to dispute those numbers."

Instead such pushback is from the only Republican who actually stands up to the media, punching back against fake news. What a refreshing change. And one of the major reasons we have a president named Trump, not Rubio, Kasich, or Jeb!

Brian C Joondeph, MD, MPS, a Denver based physician and writer. Follow him on Facebook,  LinkedIn and Twitter.