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Puerto Rico’s Governor Ricardo Rossello raised the island’s official death toll from Hurricane Maria from 64 to 2,975, making the September 2017 storm one of the deadliest in U.S. history.  The announcement came following the release of an independent study ordered by the Rossello administration that found the number of people who succumbed in the months after the storm had been severely undercounted.

The new estimate of nearly 3,000 dead in the six months after Maria devastated the island and knocked out the entire electrical grid was made by researchers with the Milken Institute School of Public Health at George Washington University.  While Puerto Rico is now putting the death toll at 2,975, other studies show the actual death toll from Hurricane Maria may be considerably higher. In May, a study published in The New England Journal of Medicine found the death toll to be at least 4,645—and perhaps as high as 5,740.

The George Washington researchers said the official count from the Sept. 20 hurricane was low in part because doctors were not trained in how to classify deaths after a disaster.  Researchers reported that physicians and others told them that Puerto Rico’s government did not notify them about federal guidelines on how to document deaths related to a major disaster.

The number of deaths from September 2017 to February 2018 was 22 percent higher than the same period in previous years.  Researchers said they counted deaths over the span of six months — a much longer period than usual — because so many people were without power during that time.  Their reasoning is that the loss of power for such an extended period of time and severe devastation forced people to exert themselves physically or were exposed to intense heat without fans or air conditioning.

There is no national standard for how to count disaster-related deaths. While the National Hurricane Center reports only direct deaths, such as those caused by flying debris or drowning, some local governments may include indirect deaths from such things as heart attacks and house fires.

Puerto Rico’s government released data in June showing increases in several illnesses in 2017 that could have been linked to the storm: Cases of sepsis, a serious bloodstream infection usually caused by bacteria, rose from 708 in 2016 to 835 last year. Deaths from diabetes went from 3,151 to 3,250, and deaths from heart illnesses increased from 5,417 to 5,586.

The study also found that government emergency plans in place when Maria hit were not designed for hurricanes greater than a Category 1. Maria was a Category 4 with 154 mph winds and the damage was estimated at more than $100 billion.  Researchers made several recommendations, including more emergency planning and government training for doctors on filling out death certificates.  They also said the public health system needs to be strengthened.  It remains to be seen whether Puerto Rico can adopt any of the recommendations since the island is trying to restructure a portion of its more than $70 billion public debt amid a 12-year recession.

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