Hurricane Maria and its aftermath in Puerto Rico led to at least 4,645 deaths. That estimate is 72 times what had been the official tally.
Puerto Rico is a U.S. territory in the Caribbean Sea. The 2017 hurricane hit the island last September 20. Prolonged winds blowing at more than 252 kilometers (157 miles) per hour and massive rains downed trees. They also destroyed houses, schools, stores, roads, bridges and hospitals. The damage left islanders without power — many of them for more than six months.
People who initially survived the Category 5 storm still faced plenty of risks. More people died from September 20 to December 31 of last year than during the same time period in 2016. The death rate — or number of deaths for every 1000 people — was up by 62 percent. Researchers described how they arrived at their new numbers May 29 in the New England Journal of Medicine.
One third of the hurricane-related deaths came from delayed or interrupted medical care. Some people could not get needed medicines. Damaged roads made travel to get food or to reach doctors hard, if not impossible. Medical facilities closed. And with no electricity, machines to help patients breathe or to filter their blood no longer worked.
Medical examiners are doctors who report an official cause of death. What they put on official death certificates linked only 64 deaths to the storm. Other groups had estimated that number was low, perhaps by 1,000 or more.
The new study surveyed communities across the island for a more complete assessment. Researchers picked 3,299 households at random. Between January 17 and February 24, they asked residents in each household about deaths and any delays in medical care. They also asked whether these people had trouble getting water, power or cell-phone service. By now understanding how hurricane damage had made access to health care worse, the researchers could tie more deaths to the storm.
The researchers say communities need to review how they count deaths that happen during or after natural disasters. That way, officials can get a better gauge of risks. It can also offer lessons on how best to prepare for the next disaster.