Even before the New England Journal of Medicine published a study estimating a death toll on Puerto Rico shockingly higher than the official count, the fact that Donald Trump’s mishandling of the response to Hurricane Maria hasn’t been a bigger scandal, with a larger impact on his standing, has been a troubling real-world exhibit in this horror show of a presidency. This administration’s efforts to downplay the crisis from the get-go — a power grid in tatters, water supplies disrupted, medicine in short supply — even when faced with widespread reporting to the contrary may still be our most terrifying example to date of what happens when a presidency dedicated to propaganda and manipulation of reality meets an actual, undeniable emergency.

There is also a case to be made that media coverage of the disaster did not match the challenge. The fact that Puerto Rico is not a state also muddied the public’s understanding of the situation, despite pretty effective efforts by politicians, activists, and victims to remind us all that Puerto Ricans are actually American citizens. (Much more can be said about this — but the idea that some Americans live in political entities that are not states, and so lack the political influence that comes with that status, is a totally undemocratic absurdity — and it is no coincidence that in the case of Puerto Rico, this situation is the toxic aftermath of the Spanish-American War and un-American ambitions of empire.)

You’d have to be willfully blind to think that the president’s animus towards Hispanics, and the fact that Puerto Rico’s political power is so limited, didn’t play a part in the White House’s neglect of the island. This is horrifying to contemplate: but the ultimate basis of the horror is the same whether or not you accept this particular indictment, since no matter the motivations, many preventable American deaths likely occurred due to incompetence at the highest levels of our government. The question now is whether our political system will hold the president to account for this.

The larger backdrop, of course, is a White House beset by scandal and worse, from an EPA administrator who rips off taxpayers and enables climate change denialism, to a president who appears beholden to Russian interests in what is likely the most far-reaching and earth-shattering political scandal in American history. Throw in his evident antipathy for democracy in America, and it is no longer surprising that any particularly horrid scandal might not find the purchase it deserves in our public discourse. But the Puerto Rico disaster is singular at this point, in that we are now learning that it involved a massively underreported death toll that brings the president’s incompetence into blinding view, and challenges the conscience and empathy of every American to stick up for our fellow citizens when our government has failed them. There is nothing conservative in downplaying the deaths of American citizens, and there is nothing liberal in downplaying such a story because it might not have the traction of other lines of attack against the president. In a way analogous to the Russian meddling and Trump campaign collusion, what happened in Puerto Rico goes to the heart of whether we are a country with a basic sense of patriotism and shared humanity, or merely a collection of tribes and power centers battling it out to sit on some metaphorical Iron Throne.

Hurricane Katrina and the drowning of New Orleans is a clear parallel to the plight of Puerto Rico; in both, racism and incompetence by those trusted to lead resulted directly in an unforgivable loss of life. But as with Katrina, I trust that Americans will eventually absorb the full tragedy of what transpired in Puerto Rico, and understand that what happened to Americans there could happen to Americans on the mainland as well. Opponents of this presidency need to remind fellow citizens of President Trump’s repeated displays of incompetence and indifference, from downplaying the number of deaths to claiming credit for saving the island, as when he tweeted, “Nobody could have done what I’ve done for #PuertoRico with so little appreciation. So much work!” — self-puffery based on a mendacious and sociopathic assessment of the reality of the island’s plight. And we will need campaign ads in 2018 and beyond that show the president tossing paper towels to Puerto Ricans in his personal “let them eat Highly Absorbent Bounty” moment that captures both the insufficiency of the government response and the president's personal responsibility for this failure.