The Lancet's politically damaging report that more than 650,000 Iraqis have died since 2003 was swiftly dismissed by the White House. But the fact that October is proving the cruellest month for American soldiers, with an average 3.5 deaths a day so far, is deadlier domestic ammunition for the Democrats.
On related fronts, both American conservatives and Arab reformers worry that, burned by its Iraq experience, the Bush administration is reverting to old thinking - containment, deterrence, and maintenance of the Middle East status quo. And in Britain as in the US, Iraq is now a handy tool in the nuclear proliferation debate. Tony Blair is derided for seeing weapons in Baghdad when, actually, they were in North Korea all along. So who, his opponents ask, can trust him on Iran?
Such political and strategic games reflect a changed state of mind. Although the troops are still there, much of European and US opinion now seems to feel it has entered the "post-Iraq" period. The world has moved on to other issues, it is argued. Relatively soon, both Mr Bush and Mr Blair will be gone. And media interest has diminished, partly because of the evident dangers to reporters but also because the "story" has grown repetitive.
But inside Iraq, the picture appears very different to those who still care to look. As daily sectarian bloodshed, militia anarchy and political incompetence reach unprecedented levels, it seems likely that the worst is yet to come.
One sign came last week when the Shia parliamentary majority rejected Sunni opposition and passed a law allowing partition into autonomous federal regions. It is but a small step from there to national disintegration.
Another grim omen was the indefinite postponement at the weekend of a long-awaited "national reconciliation conference", an initiative central to the prime minister Nuri al-Maliki's efforts for a new start. Almost simultaneously, Sunni insurgents, including al-Qaida, announced the formation of an Iraqi Islamic state.
Policymakers agree the US approach has to change. The argument is about how, and to what end. The focus of the former secretary of state James Baker's Iraq Study Group, currently examining the issue at Mr Bush's behest, is not how to make Iraq a glowing success but how to prevent it becoming a permanent failure endangering US interests. Options under discussion include asking Iran and Syria for help and containment via a phased withdrawal to friendly neighbouring countries
"The starting point is to recognise that Iraq is not going to be a democratic, unified country that serves as a model for the region," Dennis Ross, the Clinton administration's Middle East negotiator, told the Washington Post. Whatever happened, the US should set a withdrawal timetable, he said. That sounds very much like Gen Dannatt's "lowered ambitions".
In a report for the Centre for Strategic and International Studies, Anthony Cordesman takes a more holistic approach reflecting Washington's responsibilities as well as its self-interest. He discusses a wide range of measures, including international military and economic incentives to facilitate Iraqi reconciliation. And he warns that new remedies are urgently required.
"Iraq is already in a state of serious civil war and current efforts at political compromise and improving security at best are buying time," he says. "There is a critical risk that Iraq will drift into a major civil conflict over the coming months ... The US cannot simply 'stay the course' and rely on existing actions and strategy. It needs new options."
