Some deaths were more quickly attributed to Hurricane Maria—like that of Officer Luis Angel Gonzalez Lorenzo.
Photo: AP

A long-awaited study the Puerto Rican government commissioned to determine the number of deaths attributable to Hurricane Maria is finally here. To no one’s surprise, Puerto Rico’s official death toll of 64 was a serious understatement.

Researchers from George Washington University’s Milken Institute School of Public Health and University of Puerto Rico concluded the hurricane resulted in the deaths of 2,975 people.

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This estimate varies from the death tolls estimated in previous reports conducted by other scientists using different methodologies. Among these reports, the estimated body count ranges from just over 1,000 to nearly 5,000.

The new report used the Puerto Rico Vital Statistics Records, which includes death certificates, to determine how many deaths occurred from September 2017 and February 2018. The researchers then compared this number with past mortality patterns in Puerto Rico from 2010 to 2017 to estimate the excess mortality due to the storm. The team also took a critical look at the guidelines the Centers for Disease Control and Prevention lays out to report deaths following a natural disaster. Finally, the study examined the Puerto Rican government’s crisis and emergency communication methods before and after the disaster.

Hurricane Maria at its strongest
Image: NOAA

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The study is sure to note that while Hurricane Maria impacted everyone on the island, those in lower-income neighborhoods were 60 percent more likely to be at risk of dying over this period. Males older than 65 saw a 35 percent higher chance of dying, as well.

“Certain groups—those in lower income areas and the elderly—faced the highest risk,” said Carlos Santos-Burgoa, the project’s principal investigator and a global health professor at the institute, in a press release. “We hope this report and its recommendations will help build the island’s resilience and pave the way toward a plan that will protect all sectors of society in times of natural disasters.”

Part of the issue with the island’s early death count was that physicians weren’t aware of how to properly handle death certificates—and the importance they take on during such tragedies. The Puerto Rican government was, in part, at fault for failing to properly communicate the importance of death certificate reporting. So is the medical training in Puerto Rico, per the paper.

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The study’s authors advise the Puerto Rican government to develop a routine process in response to future natural disasters that prioritizes “the welfare of all.” The island’s Department of Health must be clear about who will lead future mortality assessment efforts before future crises hit.

The list of recommendations goes on and on. Overall, it’s clear the government has a long way to go in order to adequately protect the U.S. citizens who call Puerto Rico home. This hurricane season is going by quietly enough so far, but it’s not yet over. Puerto Rico’s got to be prepared next time.

Its fragile electrical grid is back up, but bad weather could knock it out again. The lack of power was a major contributor to deaths, as people lost access to medical devices and refrigeration for medicine.

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The people of Puerto Rico deserve better. This report is a first step in the government’s reconciliation with the role it played in their suffering.