August 28. 2018 10:53PM

Hurricane Maria's death toll officially raised from 64 to 2,975

By ARELIS R. HERNÁNDEZ, JOEL ACHENBACH
The Washington Post


SAN JUAN, P.R. — Hurricane Maria’s devastation in Puerto Rico led to a spike in mortality across the U.S. territory, with an estimated 2,975 excess deaths in the six months after the storm made landfall, according to a sweeping report from George Washington University released Tuesday.

The study, requested by the governor of Puerto Rico, is based on mortality data that compares the deaths from September 2017 to February 2018 with death rates in previous years, adjusted to take into consideration the hundreds of thousands of Puerto Ricans who evacuated the island after the storm struck on Sept. 20.

The official Puerto Rico government death toll from Maria had stood at 64 for months, though officials acknowledged that the actual number of deaths linked to the storm and its impact on all aspects of the island’s infrastructure was likely far higher.

“The federal government has been, and will continue to be, supportive of Governor Rossello’s efforts to ensure a full accountability and transparency of fatalities resulting from last year’s hurricanes,” White House spokesman Sarah Sanders said in a statement.

In June, the government of Puerto Rico released mortality data that showed that about 1,400 more deaths than normal were reported from September through the end of 2017. The new study bumps that number upward, to 2,098; the study found that nearly 900 excess deaths were reported in January and February, highlighting the slow recovery hampered by communication challenges, political infighting and difficulties with power restoration.

In poorer areas, mortality rates remained elevated, the study found. Much of Puerto Rico continued to have no electricity for months, and the U.S. and territorial governments struggled to carry out disaster recovery efforts.

The GWU researchers decided to look at six months of data because they assumed that, during that time period, the elevated mortality rate would return to a normal level. But in a briefing at the university Tuesday, the leaders of the research effort said that in low-income areas the mortality rate remained somewhat elevated even after six months. They said further investigation of mortality rates after February could push the estimate even higher.

“We did not capture the entire epidemic. There may have still been a few in March,” said Lynn Goldman, dean of the Milken Institute School of Public Health.

The lack of power, intermittent water service and damage to roadways and bridges cut off entire communities from basic necessities. But the GWU report does not specify why people died; it is a statistical study. The researchers did not go household to household, though they said they hope to conduct a more detailed investigation in the future if funding permits. It is unclear who would fund the study and what role the Puerto Rico government would play.

“We can come up with a hundred different hypotheses,” Goldman said. “What we don’t have is the ability today to tell you these are the factors that caused this.”

She threw out a few possibilities: “Many people still did not have power restored to their homes. We do know that when there is a loss of power, that causes a number of issues, everything from having to operate medical equipment, to having to do work manually that normally a machine would do.”

The GWU report estimates that 2,658 to 3,290 excess deaths occurred between September and February. The poorer and older the resident, the higher the risk for death, especially among men older than 65.

Eighteen municipalities spread across metropolitan San Juan, western Puerto Rico and Vieques experienced some of the highest increases in mortality. Maria’s aftermath resulted in chaos for the territory’s physicians and funeral directors.

Morgues were overwhelmed and families were left waiting for up to 27 days for a death certificate.