Hurricane Maria Puerto Rico Death Toll Over 4,500: Study

A new study from Harvard estimates that over 4,500 people died in Puerto Rico as a result of Hurricane Maria, nearly 70 times the official government death toll of 64. The study, published in the New England Journal of Medicine, puts the death toll at 4,645.

The authors of the study write that their estimate of the death toll is likely conservative and adjustments for certain factors increases it to over 5,000. The study found that interruption of medical care was the primary cause of high death rates in the months after the hurricane. Chronically ill patients who use pharmaceutical and mechanical support dependent on electricity are particularly vulnerable to a disruption in basic utilities, the researchers write.

In the study, the authors explain that direct causes of death related to a disaster are easier to assign but indirect causes of death from worsening of chronic conditions or delayed medical treatments may not appear on death certificates.

"These difficulties pose substantial challenges for the accurate and timely estimation of official all-cause hurricane-related mortality," the study says.

Between Sept. 20, 2017 and Dec. 31, 2017, there was a 62 percent increase in the mortality rate when compared to the same time period for 2016.

The study also found a strong positive association between remoteness and the length of time without electricity, water or cellphone coverage. According to the study, on average, households went 84 days without electricity, 68 days without water and 41 days without cellphone coverage. Irrespective of how remote a household was, the study found that 31 percent reported an issue with disruption to medical services. The most common problem was an inability to access medications, followed by the need for respiratory equipment requiring electricity and closed medical facilities or absent doctors.

To calculate the number of deaths related to Hurricane Maria, the study used a randomized survey of 3,299 households from Jan. 17 to Feb. 24.

According to The Washington Post, Puerto Rico Gov. Ricardo Roselló has enlisted the help of experts at George Washington University to review the government's death certification process. That was after reports from news organizations that put the death toll at over 1,000. According to the Post, an initial report from GW will be released in the coming weeks.

Hurricane Maria devastated the island of Puerto Rico when it made landfall on Sept. 20, knocking out power to virtually the entire American territory. According to the study in the NEJM, the hurricane caused an estimated $90 billions in damages.

You can read the full NEJM study here.

Photo: A man bikes past refrigerated FEMA trailers, which served as a morgue overflow following Hurricane Maria, outside the Institute of Forensic Sciences on December 23, 2017 in San Juan, Puerto Rico. Barely three months after Hurricane Maria made landfall, approximately one-third of the devastated island is still without electricity. While the official death toll from the massive storm remains at 64, The New York Times recently reported the actual toll for the storm and its aftermath likely stands at more than 1,000. A recount was ordered by the governor as the holiday season approached. (Photo by Mario Tama/Getty Images News/Getty Images)