Who Were the Puerto Rico 3,000; How Did They Die?

The death rate per 10,000 rises after Hurricane Maria a year ago, but more in line with historical trends before a “displacement adjustment.” Source: George Washington University

So, who were those 3,000 Puerto Ricans who died because of Hurricane Maria last year?  What killed them?  The storm down south and the controversy swirling over our illustrious President’s defensive tweet sent me searching for data.

It turns out there is no list of names.   There is no accounting of what causes of death were attributable to the aftermath of the devastating storm.  In fact, having now scanned the George Washington University report at the heart of this all, I have an itching feeling they missed a big statistical point.

The bottom line is that the researchers developed a model and made a projected estimate of the number of deaths to be expected on the island during the six months following the storm, based on previous year’s death numbers.   They then factored in the fact that a full 8 percent of the population, 280,000 people roughly, left the island following the storm.

With that population change factored in, the “expected” number of deaths was about 3,000 fewer than the 16,000 deaths which were recorded September through February.  Those 3,000 “excess” deaths above the projection are the one’s being attributed to the effects of the storm.  I’m rounding because their report admits the projection is not exact.  The chart I included above notes the higher death rate per 10,000 people.

There are not 3,000 death certificates noting hurricane-related causes (loss of electricity, stress, poor transportation response) and the authors chide the local medical community for not being sufficiently exact in filling out their death certificates.  So they are left with models and projections and estimates, which have translated into MSM-accepted Truth.

Here’s my question, the itch not addressed in the report, that I saw:   Who left?  Who departed following the storm?  Would the elderly, infirm and impoverished have been the ones to decamp to the mainland?  Or would they have been the one’s left behind?  Doesn’t the shift in the baseline also at least in part explain this?  The death rate really only jumped dramatically when you reduce the baseline population.

Had those people who left stayed, the number of deaths might have been the same (and then more in line with past history.)  Are they assuming mortality should have gone down after the migration but didn’t, and that’s a sign the storm continued to kill 500 more per month?

We estimate that in mid-September 2017 there were 3,327,917 inhabitants and in mid-February 2018 there were 3,048,173 inhabitants of Puerto Rico, representing a population reduction by approximately 8%. We factored this into the migration “displacement scenario” and compared it with a “census scenario,” which assumed no displacement from migration in the hurricane’s aftermath. We found that, historically, mortality slowly decreased until August 2017, and that rates increased for the period of September 2017 through February 2018, with the most dramatic increase shown in the displacement scenario accounting for post-hurricane migration (emphasis added).”

No question, the number of deaths from this kind of disaster is not – and never has been – limited to the people killed at the height of the storm.  But are the numbers being fudged here just a bit?  You must consider who could and would leave and who could not, and the population left behind.  But that takes away this wonderful cudgel for beating Trump (and it’s his own damn fault for taking the bait).

Gee, if you take a population and subtract 8 percent – most of them younger, healthy and affluent – is there anyplace in the world where you would NOT see an uptick in the death rate among those left behind?  Just asking.

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26 responses to “Who Were the Puerto Rico 3,000; How Did They Die?

  1. I think you’re on to a good analysis and yes a “model” instead of actual hard data is problematical but maybe more analysis is needed….

    For instance, .. if you were sick and need kidney dialysis but lost your transportation or the facility that provided it to you no longer functioned because it lacked electricity – what would happen to you? If you died, would your death be recorded as kidney failure or a lack of access to dialysis because the facility no longer was there?

    Ditto with a lot of other medical conditions such as Diabetes Type II medicines which require refrigeration.

    If you need regular medical care and/or prescriptions and/or electricity or refrigeration for your medicines and equipment – and you don’t get them – and you die – does your death get recorded as a hurricane-related death?

    How would you ACTUALLY figure out among the folks who died – that they died after troubles getting their needed medical care?

    The people that left Puerto Rico .. I can guarantee you were not old and poor… whose living conditions were more like the poor we have in Western Virginia – who, by the way, also lack access to timely medical care.

    If we had a big disaster in the US and people could not get access to medical care for weeks.. would we call that a “hurricane-related” death?

  2. That is a very interesting hypothesis. Unfortunately, there seems to be little appetite for nuance and complexity these days. Few really do the math and “facts” are adopted and touted without question based on whether they fit one’s worldview.

    This is probably an area that will get additional analysis after the period of maximum impact. In that way, it may be similar to the after-the-fact analysis of the 2000 presidential voting results in Florida, where the outcomes were not what the strategists thought they would be.

  3. Very good point, and one I have not seen on the blogosphere before now. I strongly suspect that the researchers set up their model, found the answers they were looking for (which just happened to align with their political sympathies), and stopped right there. I don’t know if their study was peer reviewed or not, but it it was, the review was useless. The authors need to go back and address the glaring deficiency that you raised.

    Of course the MSM jumped all over the study, reported on it uncritically and then bashed Trump for questioning the findings. The researchers look like idiots, Trump looks like an idiot (for the deficiency of his response), and the media look like idiots. What a country will live in.

    The object lesson is much bigger than the one incident itself. The lesson is that you can’t take anything at face value. We’ve always known that Trump is a charlatan, so that’s not news. What is news is that many so-called scientists are charlatans, as is almost every practicing member of the mainstream media. Like the most convincing spinners of mistruth, they believe every word they’re saying. They cannot see past their own self-deception.

  4. “The researchers look like idiots, Trump looks like an idiot (for the deficiency of his response), and the media look like idiots. What a country will live in.”

    I would add that the rest of us are idiots also – if we expect the researchers or MSM or Trump to be telling us what the truth from on high is. I especially find that problematical with Mr. Trump.

    But this is not rocket science. There are direct deaths from hurricanes and there are indirect deaths and we are aware of them.

    In the parts of the US where there are high quality rescue capabilities as well as a safety net that scoops up those who will die if they do not have electricity – we take responsibility for those folks who will be harmed in a disaster if we don’t go get them and make sure they get continuing care.

    But what did we do in Puerto Rico?

    Someone can say that it’s the State’s responsibility but then what is FEMA for? FEMA provides things like bottled water and even trailers for folks to live in – but what is FEMAs responsibilities with respect to – people who need Kidney dialysis or refrigerated drugs?

    We had this issue before – in Katrina and then again last year in Houston.

    It’s more than a question of what FEMA ( or other govt agencies like the Coast Guard) are or are not responsible for. The question is do they render the same assistance no matter whether it is Houston or Florida or Puerto Rico?

    so no.. I do not blame the MSM or the researchers. ALL OF US have some level of responsibility to THINK for ourselves about these issues and not expect someone to feed us the “truth”.. that’s our job and I have to say,more than a few of us shirk that responsibility and blame others.. shamelessly..

  5. To the extent there is validity to this method, it also applies to all the similar natural disasters before and after. The migration impact is easier to track on an island, perhaps, but there is always out-migration (and in the case of Katrina my assumption about who departed might be blown to hell, because getting in a car to skedaddle from N.O. is far easier than leaving P.R.)

    The political part of all this is mainly Trump’s doing, with his initial claim to have conducted The Best Ever Disaster Response in the History of the World, and then hyper-sensitivity when this came out. There is nothing in the report in any way critical of the disaster response, no effort to imply things were worse in P.R. than following a similar situation somewhere else.

  6. “The political part of all this is mainly Trump’s doing, with his initial claim to have conducted The Best Ever Disaster Response in the History of the World, and then hyper-sensitivity when this came out. There is nothing in the report in any way critical of the disaster response, no effort to imply things were worse in P.R. than following a similar situation somewhere else.”

    In fact, the response of FEMA under the Trump administration to this unprecedented series of Hurricanes last season was extraordinarily successful by reason of the competence of FEMA at the time of these events and also because of extraordinary local civil competence in states like Texas.

    In stark contrast, the debacle in PR was caused by confluence of an extraordinary, indeed an unprecedented, series of hurricanes that hit the island as well as the long standing and extraordinary incompetence and corruption of the local PR. government and civil society there. The fault for the ensuing debacle overwhelming resides on onshore with PR, its lack of governance and civil society, not by reason of incompetence offshore.

    As usual, however, the usual suspects, including a public university uses typical propaganda tactics to gin up garbage that target scapegoats to insure that real problems are never exposed to the light of day or solved, but instead fester and worsen so they can regularly be milked for political advantage.

    To the degree that blame was not cast expressly in the university report, you can be sure that the bogus report was only the first part of a larger highly organized propaganda attack designed to work in sequence for cumulative on several levels. How do we know this? We see this all the time now. For example, many of events on the 1st anniversary of the August 11/12, 2017 events in Charlottesville, Virginia, were ginned up for political advantage.

    Such is the world we now live in. The generation and coordination of university research and mainstream reporting, here it is garbage called university research used by the media to discredit by lie and splattered all over the heroic federal and local responders to last years unprecedented hurricane season. Before the usual suspects move on to sex, including alleged she said / he said sex 35 years ago by a Supreme Court nominee when he was in the tenth grade, more garbage all weaponized to smear then blasted by national media into the public arena.

  7. If you look at Florence right now -you will see that FIRST , people were told to leave – and they COULD – and DID.. you cannot do this near as easy on an island. That’s simple common sense – you don’t have to be all bound up in political/partisan idiocy to not see that… I would hope.

    SECOND – for the ones that did not leave – there is a phalanx of local, state and Federal responders.. there’s even the so-called Cajun Navy – civilians bringing their own boats to rescue folks. Won’t see much of that on an island that is hundreds of miles from the mainland and no one can escape that island near as easy as they can flee in North and South Carolina!

    THIRD – on the mainland – getting the electricity back on is a top priority AS WELL AS – finding and evacuating those with medical conditions and especially those with medical conditions that need electricity and refrigeration. In the richer states – there may well be more “competent” help but in the poorer states – the level and scope of available help may not be as much or good. The question is – if it is not – do the Feds sit back and call them incompetent for their insufficient response? They apparently did
    take that stance with Puerto Rico… i.e. remote, poor, incompetent state – a virtual _hit-hole , screw them. don’t want to die? Don’t be poor or live on an island or we will stand by and watch you die then argue that you did not die because of the hurricane!.. yes indeed….

    The simple fact is that Puerto Rico is one of the poorest and most remote and inaccessible “states” in the USA – and yes – they are not as “competent” as other states … duly noted… and because of that – we let folks die… who needed help… that we did have.. and do have ..and are rendering it right now for the victims of Florence…

    We don’t need a University Professor or their critics to tell us this.. we just need a little common sense to use our own brains to see it on our own… and I’m NOT directing this at anyone in particular in this blog or otherwise..

    here’s the simple reality – people with medical conditions that need electricity, refrigeration, oxygen, etc – WILL DIE if they do not get timely help.

    That’s a DUH… you don’t need to do a Research to understand that!

    People may recall that in New Orleans as well as Florida – people in nursing homes actually did die – in a span of hours and days… it Puerto Rico -this went on for weeks and months.

    What is wrong with us that we can’t see this ourselves and instead we argue about “research” and politics?

    • But this study in no way proves that is what happened. It is silent about that, simply criticizing those recording the deaths for not being that specific. No reason to doubt it did happen, but 3,000 instances?

  8. Jim,
    Good points! I’m a little confused, however. The authors of the study state that they are controlling for socioeconomic class–the issue you raised. They state (p. iii):
    “The results of our analysis of total excess mortality
    by socio-demographic subgroups show that every
    social stratum and age group was affected by excess
    mortality. However, the impact differed by age and
    socioeconomic status. The risk of death was 45%
    higher and persistent until the end of the study
    period for populations living in low socioeconomic
    development municipalities, and older males (65+)
    experienced continuous elevated risk of death
    through February. Overall, we estimate that 40%
    of municipalities experienced significantly higher
    mortality in the study period than in the comparable
    period of the previous two years.”
    To the extent they did control for this, their estimates will be more accurate than you imply.

    • Before or after the “displacement” adjustment? Perhaps if they had included a bit more info it would turn out my suspicions were unfounded. Nowhere in the report do they report the actual death tallies for 2014-15, 2015-16, 2016-17 (pre-storm) to compare with 2017-18. The only data I see compares actual 2017-18 with the number they determine should have been the count after some displacement adjustment. When people don’t show me the numbers, a little bell starts dinging in my head….

      I suspect if the hard count of death certificates had shown a spike of 3,000 deaths there would been no funky math behind some displacement adjustment. And if it did I’d be more likely to accept their rather giant leap to a conclusion.

      • Of course you are right. And the understated non-judgemental approach here of your post and comments are right too.

        But I am not so constrained. Here are my views:

        This George Washington University study is very typical of the academic studies nowadays that are carefully designed and built to achieve a predetermined conclusion driven not by facts, but by blind ideology, and to sell that ideology and its goals to other people. In other less refined circles, this sort of study is called propaganda.

        Remember, the key to propaganda, and the art of the con generally, is that you do not win your desired result by facts. You win your desired result by framing it within assertions that tell people want they want to hear and to believe. Tell them things that affirm their own biases.

        If you do that skillfully, or just have the knack for it, you can get most people moving along the road you have designed such that they think it leads them to their own grand cosmic vision. Thus your build coalitions of people who Eric Hoffer labelled True Believers, those who then will willingly believe most anything you want them to believe, irrespective of facts or proof. This you might call today ARTFUL MEME BUILDING.

        So what might be the ingredients here, just speculating:

        Trump is a bad man – he is white, he is rich, he is vulgar, a bully and a bigot, and he doesn’t now care about the poor, the brown, the black, the Hispanic, the vulnerable, the exploited, the dispossessed and disadvantaged, or whatever grievance you are selling today.

        The poor people of PR are his perfect victims, and a election is coming up. So Trump to build his base not only created 3 hurricanes via pulling out of the Paris Accords he also refused to help the poor brown people on PR with all the disadvantaged combinations you can dream up, listed above.

        Bingo!

        So, armed with this perfect meme, the George Washington university professors built a written Tower of Babel built on little more than gibberish to create the perfect meme they and their friends could run with. It is very appealing, you want to believe it, it is hard to refute, and it looks very authoritative to many people who do not know better or do not want to know better.

        Instead these people, the true believers, want to feel good about themselves by signalling to all their friends their virtue and their great compassionate caring the disadvantaged strangers in PR, particularly those who have been exploited and discriminated by classes of rich powerful white people who they the true believers do not like or agree with, in this case Donald Trump and his voters.

        And now is the time to do it, its hurricane season with a mid-term election coming up. Perfect timing!

        Thus the Academics here gain great credibility and celebrity too among their friends and allied cults. And their professional standings go up along with the hip factor ratings of George Washington University.

        • “Visions are not inherently dogmatic and the social sciences are not inherently unscientific in their methods. To explain the levels of dogmatism and resistance to facts found in too many writings in the social sciences – and still more so in the humanities and in the popular media- it is necessary to explore what purposes are served by these visions, by their evasions of particular evidence, and – especially in the case of the humanities – by their denigration of the very concepts of evidence and cognitive meaning. Similarly, not only are particular achievements denigrated, the very concept of achievement is denigrated by being downgraded to “privilege” not only as regards people but also as regards writings that have earned the respect of successive generations of readers and treated as no more worthy of special attention or study than the popular culture of the moment or alternative writings more ideologically in tune with the times.

          Just as ancient tyrants gave the people bread and circuses, in exchange for their loyalty, so visions can acquire a tyrannical sway over people’s minds by offering them an exalted sense of themselves in exchange for their loyalty in the vision through all the vicissitudes of facts to the contrary. This self-exaltation can take many forms on many issues.

          Whether the issue is crime, auto safety, income statistics, military defense, or over population theories, the one consistency among them is that the conclusion reached exalt those who share the vision over the great unwashed who do not … (This leads to) unremitting efforts put into propagandizing or into demonizing those with alternative views.”

          See “The Quest for Cosmic Justice” by Thomas Sowell, 1999.

          “Man’s natural tendency to conspire is matched by his own instinctive readiness to oppress. We naturally prefer our own kind: our family, our village, our tribe, our religion, or nation. To an important degree, this preference is desirable, for the loyalties that inspire reinforce our necessary obligations to those who depend on us for their livelihood or from whom we have acquired our identity. But these loyalties tend to run amok. (They) are a principal cause of war, terrorism (and oppression of all sorts and kinds) …

          … Within higher education one finds today many but not all of the most serious threats to certain liberal values: the harassment of unpopular views, the use of force to prevent, certain persons from speaking, the adoption of quota systems either to reduce admissions of certain kinds of students or to enhance the admissions of other kinds, and the politicization of the university to make it an arena for the exchange of manifestos rather than a forum for the discussion of ideas.

          The liberal values that have become precarious in the very institutions that once defended them are those of civility, free speech, equality of opportunity, and the maintenance of a realm of privacy and intimacy safe from the constant assaults of the political and the societal.”

          See “On Character, Essays by James Q. Wilson”. 1995

  9. Unfortunate that the data truncates at Feb ’18. Carrying the analysis forward to current could give insight into your thesis.

  10. If you think (as i do) the GW method is a stretch, check out how Harvard tried to claim more than 4,600 deaths “from Maria” and got the media to bite.

    https://www.politifact.com/truth-o-meter/article/2018/jun/05/fact-checking-death-toll-estimates-hurricane-maria/

    Was just on weather.com looking at Florence info, but noted elsewhere they use the 2,975 from the GW study – which GW always calls an estimate based on projections – as “the official death count.” This is just bogus. An “official” death count based on math modeling?

    Now, apparently looking at some other info the actual delta between the period after the storm and the same period the year before was about 1,100. That’s a figure that makes more sense – no doubt there were people who died from medical complications, other issues that would have been present absent the hurricane damage. But even then, as the black line on that chart shows, there are normal variations and its never a flat line so you can’t just say “all this was the hurricane.”

    Fake news or just stupid? Sometimes just stupid.

    • I believe I saw somewhere that the Governor of P.R. accepted the 3000 estimate (or the Harvard estimate?) as the new “official” number. Be that as it may, Izzo has it right: “Unfortunately, there seems to be little appetite for nuance and complexity these days.”

  11. If Hillary Clinton had won the election would the Washington Post publish and highlight this story? Or anyone else in the mainstream media today publish and highlight this story? If so, who?

    As Steve points out, the subjectivity of the death count, and causal connections given rise to it, given the lack of records, and the inherent and incredible complexity of events, gives a very width birth for statistical error, whether it be intentional or otherwise.

    Please also recall how the student loans default statistics were hidden during the Obama administration starting in 2015, and how so many statistics and news events are blown out of proportion, or conveniently forgotten, by the main stream media during a Republican Administration, and how the reverse occurs during a Democratic one.

    Plus there is the well known and verified corruption of much university research today, a problem that has grown exponentially over the past two decades, as confirmed by numerous studies now within the academy itself. And outside auditors as well. Many studies cannot be replicated even when peer reviewed and published in reputable Academic journals.

    This particular study has so many subjective points of analysis its worthless, for the purposes for which it will be used by the vast majority of the mainstream media. Unless of course you believe the Washington Post.

    This big data analysis has many wonderful benefit, assessing blame on a President in office for 7 months before a storm is not one of them. But you can sure that is the only reason the Washington Post published and highlighted this story.

    • The National Association of Scholars (NAS) recently published a report The Irreproducibility Crisis of Modern Science: Causes, Consequences, and the Road to Reform on April 17, 2018.

      It introduced that report saying: “A reproducibility crisis afflicts a wide range of scientific and social-scientific disciplines, from epidemiology to social psychology. Improper use of statistics, arbitrary research techniques, lack of accountability, political groupthink, and a scientific culture biased toward producing positive results together have produced a critical state of affairs. Many supposedly scientific results cannot be reproduced in subsequent investigations.

      This study examines the different aspects of the reproducibility crisis of modern science. The report also includes a series of policy recommendations, scientific and political, for alleviating the reproducibility crisis. We invite readers to consider our findings and submit responses in the form of articles via email to [email protected].”

  12. Reed, I grant you the MSM choose which articles to hype. But the controversy over storm damage and death tolls in P.R. goes a lot deeper than Trump — so yes, if HC had won, I think they would have published this story. I’m glad to see GW giving some attention to the gross underestimate originally put out by the P.R. government and coming up with its own estimate by, admittedly, a crude but (absent any better data) rational method. The way the P.R. government tried to manipulate FEMA to get its decrepit infrastructure and corrupt, bankrupt economy rebuilt at federal (our) expense was shameful. But it’s equally shameful that current P.R. government claims that “we are doing a good job and everything’s under control” were ever taken at face value back here in the States.

  13. Pingback: Puerto Rican Body Count, Soros, and Bad Science - Liberty Nation

  14. Acbar – please point to historical examples of elected political leadership staring into the cameras during or after a crisis and saying “we f&%$#d up.” They all stand there with Rosie Scenario on their arm until the weight of evidence crushes them, at which point they look for someone else to blame.

  15. Here’s the URL for the study: https://prstudy.publichealth.gwu.edu/sites/prstudy.publichealth.gwu.edu/files/reports/PR%20PROJECT%20REPORT%20FINAL%20Aug%2031%202018%20AGM%200933hrs.pdf

    In their discussion of the study’s methodology, the authors write:

    “Any estimation or comparison of mortality over time has to consider the population’s age and sex distribution and seasonality. Similarly, it is important to take into account changes in population size. In the case of Puerto Rico we reviewed in- and out migration over the last decade and the net migration result was negative. The increase in out-migration has affected the population’s demographics, and the storm accelerated this trend.”

    Then they describe how they adjusted their methodology:

    To estimate counterfactual mortality under the census and displacement scenarios, we developed a series of generalized linear (GLM) overdispersed log-linear regression models using the historical registration data from July 2010 to August 2017. These models account for trends in population size and distribution over this period in terms of age, sex and residence by municipal-level socioeconomic development. We used the model results to project forward mortality that would have been expected if the storm had not occurred and the population had not changed (the census scenario), and explicitly accounting for the massive population displacement away from the island occurring during this period (the displacement scenario).

    Now, advanced statistics is all hocus pocus to me. I have no idea what “generalized linear (GLM) overdispersed log-linear regression models” means. But it does appear that they have anticipated your criticism. Am I missing something?

  16. Reed, This would be a story regardless of who is in White House. Perhaps stridence is higher, but Trump doubling down on original, comically low numbers, brings it onto himself. Pols rarely say I f*cked up, but there are ways to say we could have and will do better. Those ways apparently not part of Trump’s repetoire.

    • Yes, he is a vulgar and often offensive in manner, not the kind of guy who you or I might want hang around, but I suggest that is not the point on which we should hang our judgements on the future of a nation and its people, or by which you judge the results a man achieves, or the consequences that he brings to all those in a nation. On that we can all profitable disagree.

  17. I would take a different approach to criticizing the study, which has been used, as you rightly say, as a cudgel against the Trump administration. In effect, the authors are moving the goalposts. By redefining hurricane-related deaths, they inflate the number astronomically. So, now we are comparing new-methodology numbers for Hurricane Maria in Puerto Rico to old-methodology numbers for other hurricanes in the United States. The unstated but implied sub-text, of course, is that the racist Trump administration doesn’t care about the lives of “brown people” in Puerto Rico.

    Needless to say, such comparisons are unfair because no one has conducted a similar exercise gauging the impact of other hurricanes. We are comparing apples to oranges.

    Another set of questions arises from this study. Let’s assume the numbers are a fair and accurate representation, and that 3,000 additional lives were lost. Who bears the moral onus for this tragedy? In our hyper-partisan society, many will blame the Trump administration for an inadequate response. Once again, the critics are moving the goal posts. In the past the legal responsibility of FEMA has been respond to natural disasters and help clean them up. Now the expectation is that FEMA and other federal agencies must step in to remedy the deficiencies of the state (territorial) government, which in the case of Puerto Rico was in functional bankruptcy, along with a failed electric system and (most likely) a failing health care system.

    • I agree with you totally.

      Your lucid explanation was implicit in my comments, such as “this big data analysis has many wonderful benefit, assessing blame on a President in office for 7 months before a storm is not one of them” though I did make those concerns explicit and should have.

      Instead I hoped over it to go after my view of the motivation for what should have been the obvious flaw, or clarification to the finding, in the study to those doing the study. Did they fail to see it? If so, why? If they saw it, why did they not explain it, making is findings and consequences crystal clean as you have just done, rather that allowing their study to be mis-characterized?

      The irony here is the study might have had real value, one that could be used in fixing problems, instead of appearing to hand a politically motivated stunt to Trump haters. Unfortunately this is business as usual in DC, and elsewhere. Today far too many universities have their incestuous relationships with Liberal activists generally, and in DC in particular, since that is where huge volumes of liberal driven “research” monies come from, and where power exchanges between the two great liberal factions occur, a corrupt academy and liberal political faction .

  18. Sorry for Typo corrections to above first and second paras.:

    …assessing blame on a President in office for 7 months before a storm is not one of them” though I did NOT make those concerns explicit and should have.

    Instead I HOPPED over it to go after my view of the motivation for what should have been the obvious flaw …

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