As President Donald Trump entered the final year of his term last January, the U.S. recorded its first confirmed case of COVID-19. Not to worry, Trump insisted, his administration had the virus “totally under control.” Now, in his final hours in office, after a year of presidential denials of reality and responsibility, the pandemic’s U.S. death toll has eclipsed 400,000. And the loss of lives is accelerating. “This is just one step on an ominous path of fatalities,” said Dr. Irwin Redlener, director of the National Center for Disaster Preparedness at Columbia University and one of many public health experts who contend the Trump administration’s handling of the crisis led to thousands of avoidable deaths.