Months into Trump's presidency, dozens of medical experts formed a commission to study the health impacts of his policies for The Lancet, a highly-respected British medical journal.  The Lancet Commission on Public Policy and Health in the Trump Era found that roughly 40% of coronavirus deaths in the United States could have been prevented if the average death rate matched that of other wealthy nations.

"We became concerned that even within a few weeks of him coming into office he had started to implement policies which we thought would be deadly," Dr. Steffie Woolhandler, a health policy expert at the CUNY School of Public Health at Hunter College and co-chair of the commission, said in an interview with Salon. "And now that we're in 2021, we have actual data and, in fact, his policy has been very deadly."

Instead of galvanizing the public to fight the pandemic, the report said, Trump "publicly dismissed its threat (despite privately acknowledging it), discouraged action as infection spread, and eschewed international cooperation."

"His refusal to develop a national strategy worsened shortages of personal protective equipment and diagnostic tests," the researchers added. "President Trump politicized mask-wearing and school re-openings and convened indoor events attended by thousands, where masks were discouraged and physical distancing was impossible."

But the commission went further, finding that life expectancy in the U.S. has diverged from other major industrial nations since the 1980s, despite continuous economic growth. As a result, the country sees more unnecessary deaths each year than all the 2020 coronavirus deaths combined.

"In 2018, 461,000 Americans died who would still be alive if our life expectancy were as long as in other wealthy nations," Woolhandler said. "So COVID killed about 400,000 people in 2020, which was horrible. But every single year, the United States was losing that many people relative to other developed nations, because our policymakers had failed to create the conditions for health."

There's little doubt that the coronavirus pandemic and Trump's mismanagement has significantly worsened that trend, particularly in communities of color. The pandemic has increased the life expectancy gap between Black and white people by more than 50%, the report said. The average Latino life expectancy in the U.S. has fallen by 3.5 years since the start of the pandemic.

"Overall, in the USA, Black and Latinx people have incurred more total years of potential life lost than white people because of COVID-19, although the white population is three to four times larger," the researchers wrote.