–2,980 Blanchard estimate based on breakouts and sources below.
Summary of U.S. State and Territorial Deaths
New Jersey ( 3)
Puerto Rico (2,975)
US Virgin Islands ( 2)
Caribbean (other than PR and US VA) (27-33)
–31 Dominica. Wikipedia. “Hurricane Maria.” Sidebar “Hurricane Maria”, 2-3-2018.[1]
–27 “ Sep 18 (Commonwealth of Dominica, an independent sovereign island.).[2]
— 5 Dominican Republic (additionally 1 missing). Wikipedia. “Hurricane Maria.” 2-3-2018
— 2 Guadeloupe (French insular region in Leeward Island group, Lesser Antilles).[3]
New Jersey ( 3)
–3 Drownings in coastal rip tides. NBC New York 4. “3 Drown Off Jersey Shore…” 9-25-2017.[4]
–1 Long Branch. Person drowned.
–1 O Street Beach, Sep 24. Woman, 44, from Seaside Park, pulled away from shore.
–1 Point Pleasant, Sep 24, Male, 60, drowned off Point Pleasant.
Puerto Rico (2,975)
— 2,975 PR official estimated death toll based on George Washington University investigation.[5]
— 1,230 Excess deaths, Sep-Nov. Alexis Santos, PA State University demographer.[6]
–491 September
–584 October
–155 November
— 1,085 Excess deaths for Sep-Oct 2017 (over 2010-2016 established death figures).[7]
— 1,052 Robles, et al. “Official Toll in Puerto Rico: 64. Actual…May be 1,052.” NYT, 12-10-2017.[8]
–~1000 Newsweek (Maria Perez/Linley Sanders). “Puerto Rico is ‘Broken’…” 12-28-2017.
— 985 Excess deaths over 2016 rate, 40 days after Hurricane Maria.[9]
— 499 CNN. “We surveyed 112 Puerto Rican funeral homes…hurricane death toll…” 11-20-2017.[10]
— ~450 Shankar. “Real death toll in Puerto Rico is probably 450…” USA Today, 10-18-2017.[11]
— 124 (64 fatalities, 60 missing). Wikipedia. “Hurricane Maria,” 2-3-2018. Accessed 2-4-2018
— 102 (55 official deaths and 47 unofficial “deaths related to the hurricane…”[12]
— 93 Blanchard tally of Locality and/or Cause of Death breakouts below.
— 81 Vox. “Everything that’s been reported about deaths in Puerto Rico is at…” 10-11-2017.
— 64 Official death toll as of Dec 9.[13]
— 62 Official death toll, Dec 2 with addition of deaths due to CO, suicide, vehicle, and fall.[14]
— 60 Vox. “Puerto Rico finally updated the Hurricane Maria death toll to 34.” 10-3-2017.[15]
— 58 Algona Radio. “Puerto Rico’s Hurricane Maria death toll rises to 58.” 12-1-2017.
— 55 Official list as of 11-6-2017. (Pascual and Wiscovitch, 11-16-2017.)
— 54 AP. “Hurricane death toll in Puerto Rico increases to 54.” Fox News, 11-2-2017.
— 51 CBS/AP. “Puerto Rico’s death toll from Hurricane Maria increases to 51.” 10-24-2017.
— 49 AP. “Hurricane Maria death toll rises to 49 in Puerto Rico.” Wash. Post, 10-20-2017.
— 48 AP. “Puerto Rico raises Hurricane Maria death toll to 48.” ABC News, 10-14-2017.
— 45 NY Daily News. “”Members of Congress call for investigation into…” 10-12-2017.
— 43 Thomson Reuters. “Puerto Rico’s death toll from Hurricane Maria…” CBC, 10-10-2017.
— 36 Weather Channel. “Puerto Rico’s Maria Death Toll Climbs to 36…” 10-6-2017.
— 34 AP. “Puerto Rico raises hurricane’s official death count…” Miami Herald, 10-4-2017.[16]
— 18 NBC. “Half of hurricane-ravaged Puerto Rico faces lack of drinking water.” 9-28-2017.
— 16 AP. “In Puerto Rico, death toll…Maria.” WJLA, ABC7, Washington DC, 9-25-2017.[17]
Breakouts of Hurricane Maria-Related Deaths in PR by Locality and/or Cause of Death:
— 2 Aguada. Angel L. Lorenzo González, 47 and Héctor L. Matías Torres, 52 (official list).[18]
— 3 Aguadilla. Arida Ruiz Gonzalez, 73, Leonardo Enchautegul Flores, 74, Daniel Martinez, 45.[19]
–1 Infection after hospital canceled operation due to storm; death reported Oct 10.[20]
— 4 Añasco. “…at least four people drowned as they tried to rescue people after the storm.”[21]
— 1 Arecibo. Maximilliano Feliciano, 68 (official list). (Pascual and Wiscovitch, 11-16-2017.)
— 3 Barceloneta. Sick persons; lack of “access to the proper medical care after the hurricane.[22]
— 4 Bayamón (official list). (Pascual and Wiscovitch, 11-16-2017.)[23]
— 4 Caguas.[24] Cited is Mayor of Caguas as told to the Washington Post.[25]
–1 Diabetic “died in a hurricane shelter because he didn’t have access to medical care.”
–1 Dialysis treatment unavailable after storm; person died.[26]
–2 Suicides.
— 2 Canóvanas. “…mayor reported that two elderly people died from panic attacks.”[27]
— 5 Carolina. (Four names on official list of 55 as of 11-6-2017.)[28]
–1 Heart attack. Person suffering chest pains could not get treatment and died.[29]
–1 Pneumonia/collapse of right kidney; could not be transported to hosp. during storm.[30]
–1 Stroke on Sep 21, died Sep 25 after inability to receive adequate medical care.[31]
— 2 Cataño. Lucia Torres Vargas, 95, and Juan Enrique Mora Quiñones, 75 (official list).[32]
— 1 Cayey. Male died from inhaling gases from a gas lamp which accidentally fell at home.[33]
— 1 Fajardo. Roberto Serrano Rosa, 65 (official list). (Pascual and Wiscovitch, 11-16-2017.)
— 1 Guaynabo. Aura Rivas Flores, 92 (official list). (Pascual and Wiscovitch, 11-16-2017.)
— 1 Hormigueros. Ramón Jorge Morales, 64 (official list). (Pascual/Wiscovitch, 11-16-2017.)
— 1 Humacao. Betshida Colón, 61 (official list). (Pascual and Wiscovitch, 11-16-2017.)
–18 Jayuya. Vox. “Everything…about deaths…[PR]…at odds with…official count.” 10-11-2017.
— 1 Landslide. Male. (The only Jayuya death “included in the government death count.”)[34]
–17 Lack of “water, oxygen, or dialysis treatments.” (None included in official list.)
— 1 Juana Díaz. Bernardo Santiago Acosta, 80 (official list). (Pascual/Wiscovitch, 11-16-2017.)
— 2 Juncos.
–1 Respiratory. Person with respiratory problems could not get treatment and died.[35]
–1 Cause not noted. Two Juncos deaths from Juncos were on official list when at 55.[36]
— 2 Lajas.
–1 Man dies in shelter due to lack of oxygen for his oxygen respirator.[37]
–1 Person fell from a roof. Death reported Oct 10.[38]
— 1 Las Marías. Louis Cintrón Goden, 42 (official list). (Pascual and Wiscovitch, 11-16-2017.)
— 1 Moca. Driver “whose car fell through an area of the road that had collapsed.”[39]
— 1 Old San Juan, Oct 6. Elizabeth Colón, 60, leptospirosis. (Pascual/Wiscovitch, 11-16-2017.)
— 1 Orocovis, Sep 20. Teodoro Colón, 83, dependent on oxygen, lost when electricity failed.[40]
— 1 Patillas. Doel Ramos Baez, 37 (official list). (Pascual and Wiscovitch, 11-16-2017.)
— 1 Rincón. Harry Arce Tirado, 30 (official list). (Pascual and Wiscovitch, 11-16-2017.)
— 1 Rio Grande. Miguel Angel Orlando Pacheco, 62 (official list). (Pascual/Wiscovitch, 11-16-2017.)
— 1 San Germán; reported Oct 10. Roof falls on man clearing debris.[41]
— 3 San Juan. Martín Lozada Rivera, 64, Santiago Faura, and Molly Rosado Rodriguez, 54.[42]
–1 Sep 26. Power ran out in hospital due to lack of diesel fuel.[43]
— 1 San Lorenzo. Suicide after losing job.[44] (Official count of 55 showed 1 San Lorenzo death.)[45]
— 1 San Sebastian. Noted as accident involving trees.[46]
— 9 Toa Baja. Drownings. Vox. “Everything…about deaths in Puerto Rico…at odds…” 10-11-2017.[47]
–8 Drownings. NY Daily News. “Puerto Rico’s…death toll climbs…” 9-22-2017.
–1 Man on errand swept off his feet near town center by flood water.[48]
–1 Man drowns on far side of the river.[49]
–1 Mile or two away from town center. Man dies of apparent heart attack in bathtub.[50]
–1 Leptospirosis bacterial infection. Jesus Miranda Matos.[51]
— 1 Trujillo Alto. Higinio Calderón Mercado, 93 (official list). (Pascual/Wiscovitch, 11-16-2017.)
— 3 Utuado, Sep 20. Mudslide; elderly bedridden sisters. (Cites El Nuevo Dia News.)[52]
— 2 Vega Alta. Ramón Rivera Pino and Jorge Antonio Pabón Orona, 25 (official list).[53]
— 1 Vega Baja. Accident involving trees.[54] Gretchen G. Miranda Negrón, 49 (official list).[55]
— 1 Vieques, Oct 25. Drowning; boat sank.[56]
— 1 Villalba. Ramón Antonio Mercado Garcia, 60 (official list). (Pascual/Wiscovitch, 11-16-2017.)
— 1 Yabucoa. Luis Manuel Santana Ruiz, 73 (official list). (Pascual/Wiscovitch, 11-16-2017.)
— 1 Location not noted, Oct 20. Leptospirosis (bacterial disease spread through animal urine).[57]
— 2 Locations not noted. Leptospirosis (these are in addition to the one reported Oct 20.).[58]
US Virgin Islands ( 2)
–2 Virgin Islands Daily News. “Five hurricane-related deaths confirmed.” 10-3-2017.
–Anna’s Retreat, Sep 20. Drowning; Maurice Jackson, 66; flooding at his home.
–Estate Frenchman’s Bay. Buried by mudslide in home; Ralph Evert III, 57.[59]
–1 New York Daily News. “Puerto Rico’s…Maria death toll…at least 13.” 9-22-2017.
Narrative Information
GWU Milken Institute of Public Health Report — Executive Summary: “In order to accurately estimate the excess number of deaths due to Hurricane María, the Governor of Puerto Rico sought an independent assessment of mortality and commissioned The George Washington University Milken Institute School of Public Health (GW SPH) to complete the assessment.
“The project had the following objectives: 1) assess the excess total mortality adjusting for demographic variables and seasonality, report a point estimate and confidence interval and make recommendations; 2) evaluate the implementation of Centers for Disease Control and Prevention (CDC) guidelines for mortality reporting in disasters and identify areas of opportunity for improvement; and 3) assess crisis and mortality communication plans and actions by the government as well as understand experiences and perceptions of key participant groups to make recommendations based on communications best practices.
“We implemented the project as three studies, each with specific yet complementary methodologies. Our excess mortality study analyzed past mortality patterns (mortality registration and population census data from 2010 to 2017) in order to predict the expected mortality if Hurricane María had not occurred (predicted mortality) and compare this figure to the actual deaths that occurred (observed mortality). The difference between those two numbers is the estimate of excess mortality due to the hurricane. We developed a series of generalized linear models (GLMs) with monthly data for the pre-hurricane period of July 2010-August 2017, accounting for trends in population size and distribution over this period in terms of age, sex, seasonality and residence by municipal level of socioeconomic development.
“Our estimates also considered Puerto Rico’s consistently high emigration during the prior decade and dramatic population displacement after the hurricane. We used the model results to project forward mortality that would have been expected if the hurricane had not occurred for two scenarios—if the population had not changed (census scenario), and explicitly accounting for massive post-hurricane population displacement from the island (displacement scenario). For observed mortality, we used records for all deaths occurring from September 2017-February 2018, provided by the Puerto Rico Vital Statistics Records (PRVSR) division of the Puerto Rico Department of Health (DoH). The estimates of excess all-cause mortality attributable to the hurricane are the result of comparing the projections for the census and displacement scenarios to observed mortality in the vital registration data…. [p. i.]
“Total excess mortality post-hurricane using the migration displacement scenario is estimated to be 2,975 (95% CI: 2,658-3,290) for the total study period of September 2017 through February 2018….” [p. iii.] (Milken Institute School of Public Health, George Washington University. Ascertainment of the Estimated Excess Mortality From Hurricanfe Maria in Puerto Rico. 2018.)
Santos-Lozada: “….As of Dec. 29, the Department of Public Safety had certified 64 deaths due to Hurricane Maria. However, estimates reported by CNN,[60] The New York Times[61] and others tell a very different story. I was part of the team of demographers that developed the first independent estimates of excess deaths, with the objective of informing the public. Like the estimates published by those media outlets, our numbers contrasted significantly with the official figure. The most shocking results from our study[62] suggest that deaths in September and October were 25 percent above the historical patterns – with about 1,085 added deaths following the hurricane.
“Determining the number of excess deaths after a natural disaster is not only a mathematical exercise. Undercounting deaths reduces the attention to the crisis Puerto Ricans live day by day. It can also delay international recovery efforts and the approval of policies to help those who need it the most.…
“Our study compared preliminary data from the Department of Public Safety with historical patterns for the same months in the past decade. In other words, we compared the number of deaths in September and October last year with data from the same period of time in 2010 to 2016. This is how we concluded that there were 1,085 extra deaths, in excess of historical ranges.
“So why are more than 1,000 deaths missing from the official count? My colleagues and I suspect it may come down to how deaths are recorded by government officials. In Puerto Rico, deaths are recorded using international classifications.[63] This system doesn’t capture all of the circumstances surrounding a death that happens following a natural disaster. The death may have been accelerated by some conditions – like difficulty communicating during the emergency.
“Deaths associated with a particular natural disaster can be classified as direct or indirect deaths. According to the Center for Disease Control and Prevention, direct deaths are those “directly attributable to the forces of the disaster or by the direct consequences of these forces, such as structural collapse, flying debris or radiation exposure.” “Indirect deaths” may be associated with any unsafe or unhealthy conditions before, during and after the natural disaster.
“For example, Hurricane Maria destroyed Puerto Rico’s power grid. So, someone whose life depended on a dialysis machine would no longer be able to use one. In official certificates, their death would be classified as kidney-related and not attributed to the hurricane – even though the death was accelerated by lack of resources required by the patient to stay alive. The same would happen to someone whose life depended on respiratory aid. Their death would be classified as pulmonary-related.
“Or, say a person feels chest pain and suspects a heart attack. Their immediate reaction might be to call 911. A working communications structure may be able to get help in time and save a life. But in the days following Hurricane Maria, only 25 percent of the cell-phone towers were working. Communication was virtually impossible. Under the international system, a death resulting from these circumstances would be classified as a result of a cardiovascular conditions, and would not be attributed to the hurricane either….
“Following the impact of hurricanes Harvey, Irma and Maria, the CDC published guidelines[64] that state and territorial governments should follow to determine if a death is related or not to a specific event. Following these guidelines could provide the government of Puerto Rico with a more realistic death count. It remains to be seen if the new count will follow this protocol.
“An accurate death count could be used to inform policies, supplement requests for aid in the national and international context and inform local governments as they prepare for future natural disasters that may impact Puerto Rico, particularly extreme weather events now that climate change is expected to worsen. Hurricane Maria was the first storm to destroy the power grid in Puerto Rico. Puerto Rico is six months away from the next hurricane season…
“Finally, minimized figures could weaken efforts to provide relief to communities affected by the hurricane at the local and international level….” (Santos-Lozada. “Why Puerto Rico’s death toll from Hurricane Maria is…much higher than officials thought.” The Conversation, 1-3-2018.)
Sep 28: “Leovigildo Cotté died after not receiving the oxygen he needed at the only shelter that exists in the town of Lajas on the southern coast of Puerto Rico, which has been without electricity since Hurricane Maria careened through a week ago….
“Cotté is one of the unaccounted victims of Maria, the potent hurricane that devastated all of Puerto Rico with sustained winds and gusts of up to 200 miles per hour. On Wednesday, the Puerto Rico government, maintained that the official number of deaths as a result of the catastrophe was 16. But the Center for Investigative Journalism (CPI, for its initials in Spanish) has confirmed that there are dozens of hurricane-related deaths and the number could rise to the hundreds.
“The storm-related fatalities are mounting with each passing day, and official numbers are not counting patients who are not receiving dialysis, oxygen and other essential services.
“Among those at risk are people such as Pedro Fontánez, 79, who is bedridden at the Pavía Hospital in Santurce in San Juan and was due to be released even though he lacks electricity at home to support the oxygen and gastric tube-feeding he needs to keep him alive. His daughter, Nilka Fontánez, went to the government’s Emergency Operations Center desperately seeking help, but was told they were not accepting patients….
“The dead are at the hospital morgues, which are at capacity and in remote places where the government has yet to go. In many cases, families are unaware of the deaths. The government’s Demographic Registry is responsible for certifying deaths so bodies can be removed by funeral homes, many of which are not operating because of lack of resources. The agency began to certify some of the dead Monday, Health Secretary Rafael Rodríguez-Mercado confirmed in an interview.
“Public Safety Secretary Héctor Pesquera told the CPI that the names of the dead because of the hurricane will not be revealed until relatives can be notified. The continuing lack of communication has kept many people from knowing the whereabouts of their families. Since the storm’s immediate aftermath, many people have gone daily to radio stations so the on-air personalities can announce the names of family members with whom they have been unable to communicate.
“A week after Maria, the government of Puerto Rico is struggling to supply basic services, such as fuel, road access and electricity. It provides a progress report of the efforts through a daily press conference at the Emergency Operations Center in San Juan. But not discussed is that the number of deaths resulting from the disaster are much higher than the 16 or 19 that have been given as the official tally.
“CPI sources in half a dozen hospitals said those bodies are piling up at the morgues of the 69 hospitals in Puerto Rico, of which 70 percent are not operating. The majority of the hospital morgues that provided information — including Doctor’s Center in Bayamón and Santurce, Pavía Hospital in Santurce, Manatí Medical Center, Dr. Pila in Ponce, Río Piedras Medical Center, Mayagüez Medical Center and the HIMA hospitals in Caguas and Bayamón — are at full capacity. Those hospitals are among the 18 that are partially operational….
“CPI also has learned that the Institute of Forensic Sciences is also full of bodies and that 25 of those are hurricane victims. On Tuesday, the IFS reported that it had increased its storage capacity for bodies with a trailer that was obtained through The Morgue federal program. It’s unclear what is happening with the deceased who are at the morgues of the 51 hospitals that have had to close their doors.
“Secretary Rodríguez-Mercado acknowledged that hospital morgues are full. He said the accumulated bodies cannot be removed from the morgues by funeral homes until the deaths can be certified by the Demographic Registry, which barely began operating from regional emergency centers Monday.
“Rodríguez-Mercado said that he documented seven additional hurricane-related deaths at three hospitals on the island’s western region he was able to visit on Monday, even as the official death toll remains at at least 16.
“Rodríguez-Mercado did not know the status of the situation at the hospitals in Ponce on the southern coast because the region remains completely cut off from communications. But he planned to go to there to explore the matter. ‘We’re finding dead people, people who have been buried, [people] have made common graves,’ Rodríguez-Mercado told CPI. ‘We’ve been told people have buried their family members because they’re in places that have yet to be reached.’….
“Hospitals that had to close their doors after the storm have more than 4,000 beds. Asked what happened to those patients, where they were transferred, the health secretary responded with a sincere, “I don’t know.”
“Another looming problem is that patients are arriving in critical condition, with ventilators, for example, and with poorly documented records of medical procedures at the hospitals where patients were originally admitted. For that reason, and because of the limited resources and fuel to power generators, the majority of hospitals that are currently “operational” are not accepting transfers or new patients, sources said. The Río Piedras Medical Center in the capital, the government’s main hospital for this disaster, has been operating at half capacity….
“Meanwhile, the dead continue to accumulate. ‘We’re fighting. I would love for the government to understand that it has to open dialysis centers. If they don’t receive the service, the patients’ health is compromised quickly and they die. And yes, they have died,” said Armando Rodríguez, vice president of the Grupo HIMA medical provider. He confirmed that the morgues of his two hospitals in Bayamón and Caguas are above capacity.
“Meanwhile, thousands of doctors and nurses are at home unable to work, said Dr. Joaquín Vargas, president of the Puerto Rico Primary Physicians Groups Association, who was at the COE to see if the government would set up an operations center where they could at least answer calls from citizens.
“The CPI also has learned that a large portion of specialized physicians is unable to work because hospitals don’t have supplies and the ability to conduct their procedures, nor basic resources such as fuel or electricity to run their medical practices.”[65] (Miami Herald (Omaya Sosa Pascual). “Hurricane Maria’s death toll in Puerto Rico is higher than official count, experts say.” 9-28-2017.)
Oct 10: “The death toll in Puerto Rico attributed to Hurricane Maria has reached 43, an official said on Tuesday, up from 39 previously reported, as islanders continue to fall victim to infections, bad road conditions and other consequences of the storm.
“Ramon Rosario, secretary of public affairs and public policy, also told reporters that the island now has 16 per cent of electricity service restored, up from 15 per cent on Monday [Oct 9].
“Maria slammed into the Caribbean island on Sept. 20 as the most powerful hurricane to hit the U.S. territory in nearly 90 years. It knocked out electricity to the whole island and caused widespread damage to homes and infrastructure….
“Of the four newly reported deaths, one was a person who was operated on for an infection but died, another was killed in a car accident caused by road damage and a third died when a damaged roof fell on him while he was clearing debris from a road, Rosario said. He did not give details of the fourth death.” (Thomson Reuters. “Puerto Rico’s death toll from Hurricane Maria rises to 43, power outages remain.” CBC, Canada, 10-10-2017.)
Oct 11: “Death tolls are the primary way we understand the impact of a disaster. And for nearly two weeks after Hurricane Maria hit Puerto Rico, as a humanitarian crisis was intensifying, the death toll was frozen at 16…. The death toll from the hurricane is now up to 45, according to Gov. Ricardo Rosselló. But 90 percent of the 3.4 million American citizens on the island still don’t have power, and 35 percent still don’t have water to drink or bathe in. And given how deadly power outages can be, 45 deaths seems low, according to disaster experts.
“At Vox, we decided to compare what the government has been saying with other reports of deaths from the ground. We searched Google News for reports of deaths in English and Spanish media from Puerto Rico since Hurricane Maria. We found reports of a total of 81 deaths linked directly or indirectly to the hurricane. Of those, 45 were the deaths certified by the government. The remaining 36 deaths were confirmed by local public officials or funeral directors, according to the reports. We also found another 450 reported deaths, most of causes still unknown, and reports of at least 69 people still missing.
“The broader issue here relates to how storm deaths are counted. There are clear deaths from the storm, clear deaths indirectly from the storm, and then deaths that are harder to determine — for instance, a sick patient who died in a hospital experiencing frequent power outages. And then there’s the issue of how effective authorities are at finding and investigating the deaths to make sure they’re included in the count. The breakdown of these categories suggests that the government is being much more cautious in designating deaths as directly or indirectly hurricane-related, given the public information available.
“At a Sunday news conference, Karixia Ortiz, press officer for the Department of Public Safety, said that “every death must be confirmed by the Institute of Forensic Science, which means either the bodies have to be brought to San Juan to do an autopsy or a medical examiner must be dispatched to the local municipality to verify the death,” according to an audio recording obtained by Huffington Post.
“John Mutter, a disaster researcher at Columbia University who studied the death toll in the aftermath of Hurricane Katrina, says he’s skeptical of this methodology. “This is the way to go about it if you want to come up with smallest number possible,” he said, adding he suspects the death toll in Puerto Rico from Maria should already be in the hundreds based on what’s known about the conditions on the ground.
“Our review of reports certainly suggests the real death toll is far higher than what the government has, thus far, estimated:
In our search of local and US news reports, we found 36 deaths attributed to the hurricane in addition to the official 43. We cross-checked news accounts with the official death reports to make sure they didn’t overlap.
NPR reported an additional 49 bodies with unidentified cause of death sent to a hospital morgue since the storm.
The Los Angeles Times reported 50 more deaths than normal in one region in the three days after the hurricane.
Puerto Rico’s Center for Investigative Reporting reported 69 hospital morgues are at “capacity.” Exact figure is unknown.
According to El Vocero newspaper, 350 bodies are being stored at the Institute of Forensic Sciences (equivalent to the state medical examiner’s office), many of which are still awaiting autopsies. In the report, Héctor Pesquera, secretary of the Puerto Rico Department of Public Safety, did not say how many, if any, of the cadavers were there before the storm. (On Sunday, Pesquera denied claims that there was a backlog of unexamined bodies.)
“ ‘I don’t think there will be hundreds of deaths, but we will see,’ Pesquera told reporters on Sunday. ‘We can’t speculate if there will be 100 or 200.’
“Meanwhile, the situation on the ground remains life-threatening in some areas. And reporters and first responders are continuing to paint a much more aggressive picture about life and death on the island….
“There are no state or federal guidelines in the US for calculating storm death tolls for the medical examiners usually responsible for determining what constitutes a storm-related death….
“Because we’ve had trouble reaching officials in Puerto Rico, it’s been difficult to decipher what exactly the process is for documenting and attributing deaths to disasters. But it is clear that the hurricane has disrupted it and that the government is now insisting that every body be inspected directly by the Institute of Forensic Sciences in San Juan before any death is attributed to the storm….” (Vox (Eliza Barclay and Alexia Fernandez Campbell). “Everything that’s been reported about deaths in Puerto Rico is at odds with the official count.” 10-11-2017.)
Oct 12: “Puerto Rico’s death toll from Hurricane Maria could be substantially higher than the 45 fatalities reported by the government, experts said….
“Adding to the headache are communication breakdowns that some experts believe is keeping the officially reported death toll astonishingly lower — possibly by hundreds.
“In a letter to the Department of Homeland Security, Reps. Nydia Velasquez (D-NY) and Bennie Thompson (D-MS) said they’re concerned the death toll in Puerto Rico is being “woefully underreported,” and demanded an urgent review, citing reports that up to 450 people may have died….
“An analysis by Vox published Wednesday found Puerto Rico’s hurricane death toll closer to 81, citing news reports and statements by local officials.
“Both post-storm illnesses and accidents will boost the numbers even further, along with proper death reporting once rural areas can be contacted or accessed, one expert said…
“Citizens have died from a number of post-storm causes such as failing medical help, landslides, falling debris and illnesses such as leptospirosis, which is spread through drinking water tainted by animal urine….
“Volunteer rescue workers also say that the death toll far exceeds official estimates.
“A number of those workers have reported that the morgue in Aguadilla — a coastal town in northwest Puerto Rico — was closed because it could no longer accommodate bodies. Numerous sources said 400 to 500 bodies were in the town’s morgue, and FEMA was sending in freezers to have bodies removed from the facility. FEMA didn’t immediately return a request for comment.
“El Vocero reported last week that another 350 bodies were in the Institute of Forensic Science’s morgue, but it remained unclear how many were from the storm.” (NY Daily News. “Members of Congress call for investigation into underreporting in Puerto Rico death toll.” 10-12-2017.)
Oct 28: “There have been more than 900 cremations in Puerto Rico since Hurricane Maria made landfall on September 20, but the official death toll from the devastating storm is still listed as 51. The number of cremations has increased scrutiny over the Department of Public Safety’s count of deaths related to Hurricane Maria. In a statement provided to ABC News, the Department of Public Safety says that 911 authorized cremations have been carried out between September 20 and October 18.
“The cremations were all carried out after an analysis of several documents including “the death summary, the death certificate, the ballot, the medical summary or a document that certifies and evidence the death cause, and the form that the family completes for requesting a cremation,” according to the statement. All the deaths have been designated as due to natural causes.
“The Department of Public Safety previously said that any increase in the number of deaths listed as related to Hurricane Maria would happen only if a body was sent to San Juan to be examined by a medical examiner or if a medical examiner went to a town to review a body. Hector Pesquera, the secretary for the Department of Public Safety continues to say that the number of deaths related to Hurricane Maria remains at 51.” (ABC News (Hoyos and Schabner). “900-plus cremations since Maria, but hurricane death toll still 51.” 10-29-2017.)
Nov 3: “San Juan mayor Carmen Yulín Cruz estimates the actual death toll in Puerto Rico following Hurricane Maria is far higher than the number of officially reported deaths. ‘It appears, for whatever reason, that the death toll is much higher than what has been reported,’ Cruz said in an appearance on CNN’s ‘The Lead with Jake Tapper.’ The official death toll stands at 54, but Cruz said that the true number of deaths following Hurricane Maria is likely closer to 500. Cruz told Tapper there have been 911 cremations in the U.S. territory in the last month, a far greater number than normal. ‘Usually it’s about half that,’ Cruz said….
“The San Juan mayor said some deaths, like those who die from their respirators losing power, are being categorized as “natural causes” but are in fact related to the damage left by Hurricane Maria.
“BuzzFeed News reported last week that 911 people died following Hurricane Maria, and a spokesperson for the Department of Public Safety said the deaths were not related to the hurricane but were instead caused by ‘natural causes.’ BuzzFeed reported that none of the bodies were examined by a medical examiner for consideration to be included in the Maria death toll. The spokesperson said the classifications of death by ‘natural causes’ were made by reviewing records and not inspection by medical examiners. Those bodies were cremated before medical examiners looked at them.
“Top Democrats called on the Department of Homeland Security earlier this month to provide accurate death counts following the hurricane. ‘We urge you to provide all necessary resources to confirm that storm-related deaths are being counted correctly,’ the senators wrote in the letter to acting Homeland Security Secretary Elaine Duke. The senators argued that the official death toll does not include about 450 people who have died since the hurricane or 69 people who have been reported missing, all of whom have been included in various media reports.” (Carter, Brandon. “San Juan mayor: Hurricane Maria death toll closer to 500 than 50.” The Hill, 11-3-2017.)
Nov 8: “Ponce, P.R. — Almost two months after Hurricane Maria tore through Puerto Rico, there were more signs of how unsettled the situation remains here and how grievous the toll of the storm was….
“On Wednesday [Nov 8], Puerto Rico officials, facing increasing questions about the accuracy of the official death toll from the storm, acknowledged for the first time that 472 more people died this September compared with the same month last year. The storm made landfall on Sept. 20. The government’s official death toll is 55. The numbers confirmed what had been speculated for weeks: After the waters receded and the roads were cleared, people here continued to die at rates far beyond normal.
“As temperatures frequently rose above 90 degrees, the lack of power in nursing homes, private houses and hospitals hit the elderly particularly hard. Soaring temperatures accelerated the deaths of people who were already seriously ill. Ambulances could not arrive, medicines ran out and oxygen tanks that ran on electricity were useless, several funeral directors said.
“Even with the increase in mortality in the weeks after Hurricane Maria, authorities insisted that the official death toll remained at 55: 20 direct deaths; 31 indirect deaths, such as suicides; and four more from leptospirosis, a waterborne bacterial disease.
“The government said it was up to doctors to certify whether other conditions — such as lack of air conditioning or dialysis because of the blackout — contributed to a person’s death. If families believe an error has been made they should file a report, Héctor M. Pesquera, the secretary of public safety, told reporters Wednesday. But the government, he said, would not be influenced by anecdotal reports or suppositions. ‘We are not going to question 29,649 doctors who signed all those death certificates,’ Mr. Pesquera said, referring to the number of people who died in the past year. ‘There’s a process, and there’s the law, and we follow the process and the law.’….” (Robles, Frances. “Puerto Rico Deaths Spike, but Few Are Attributed to Hurricane.” New York Times, 11-8-2017.)
Dec 1: “….Three additional deaths were announced on Wednesday [Nov 29] by the U.S. territory’s Department of Public Safety, bringing the storm death toll there to 58.
“One of the cases was reported in Carolina, regarding a person who was bleeding from the mouth during the hurricane, but could not be transported to the hospital on time,” the Department of Public Safety said in a statement announcing the death toll’s increase. “Later, the person was taken to the hospital, treated, and diagnosed with pneumonia and a collapse of the right kidney. However, days later the person died in the hospital.”
“The second fatality, according to the Department of Public Safety, was reported in Vieques, ‘about a person who died when the boat in which he was traveling sank. However, on October 25, 2017, FURA personnel of the Puerto Rico Police carried out a mission to recover the body of the person who has not yet been identified and who is currently in the Department of Forensic Sciences under the identification process.’
“The third death involved a person who inhaled gases that emanated from a gas lamp when it accidentally fell at his home in Cayey. The unidentified individual also suffered burns.
“The government’s official death toll count has faced scrutiny following the storm. The Department of Public Safety, which is the agency keeping track of the count, said in late October that there had been more than 900 cremations in Puerto Rico following the storm, but they were not counted as a part of the storm-related death toll because those cremated were designated to have died due to natural causes….” (Algona Radio. “Puerto Rico’s Hurricane Maria death toll rises to 58.” 12-1-2017.)
Dec 18: “San Juan, Puerto Rico (CNN) — Puerto Rico is launching an official review of the death count from Hurricane Maria, which devastated this US territory on September 20. Monday’s announcement from the island’s governor follows investigations from CNN[66] and other news outlets that called into question the official death toll of 64.[67] “I welcomed recent news analysis on the number of hurricane-related deaths, and that they may be higher than the official count certified to date,” Gov. Ricardo Rosselló said in a statement. “Those reports used the data provided by the Puerto Rico Demographic Registry, but the Government needs to (investigate) if the increase of the deaths is related directly or indirectly with Hurricane Maria.”
“Last month, CNN surveyed half of the funeral homes in Puerto Rico and found that funeral home directors and staff believe that at least 499 deaths in the first month after the storm were attributable to Hurricane Maria.[68] Reporters surveyed funeral home directors because they have access to death certificates and often speak with family members about the circumstances of a person’s death.
“The New York Times and others subsequently compiled statistics from the island’s Demographic Registry showing that the death toll may be more than 1,000. Those reviews were statistical in nature; they counted excess deaths in 2017 compared with deaths in previous years. Experts have said that such an analysis is a respected way to estimate a storm’s death toll.
“Puerto Rico plans to review all deaths that followed the hurricane, regardless of the cause listed on death certificates, according to the governor’s statement. The government also plans to convene a “panel of experts” to review the process for counting deaths.
“Only one lab in Puerto Rico — the Bureau of Forensic Sciences — certifies deaths as hurricane-related. Pathologists review cases sent to them by doctors, hospitals and other authorities.
“CNN’s investigation found that some doctors and hospitals were not sending all possibly hurricane-related cases to that forensics office for review. Most of the cases in question might have been “indirect” hurricane deaths, meaning the person died because of the conditions the storm created. Such deaths should be classified as hurricane-related, according to the government. The official death toll does include suicides, heart attacks and other such cases….
“The death toll has real-world ramifications. Experts say public aid follows higher death counts. And the families of people who officially died in Hurricane Maria are eligible to have some of their loved ones’ funeral costs covered by the Federal Emergency Management Agency. According to Puerto Rico’s governor, an accurate death toll also helps the government “identify ways in which we can prevent fatalities in advance of future disasters.”” (CNN/John D. Sutter. “Puerto Rico orders review of deaths after hurricane.” 12-18-2017.)
2018
Jan 4: “Puerto Rico Governor Ricardo Rosselló on Thursday [Jan 4] announced the formation of a task force to examine the number of deaths related to Hurricane María. The group is expected to report its findings, including any revised numbers, in 90 days. Saying it was important to “guarantee transparency” as part of the island’s recovery process, the executive order tasks Public Safety Secretary Héctor Pesquera with creating and coordinating a process, in conjunction with health, forensic and demographic registries, to review deaths following Hurricane María and whether they are related to the devastating storm. Pesquera, who will coordinate the task force, had been highly critical in the past of claims that the death toll was in the hundreds. He called San Juan Mayor Carmen Yulín Cruz “irresponsible” in November when she said that the number could be closer to 500….” (NBC News (Sandra Lilley). “Puerto Rico governor announces task force to examine hurricane-related deaths.” 1-4-2018.)
Feb 22: “San Juan, Puerto Rico — a team of George Washington University researchers will lead an independent investigation into Hurricane Maria’s death toll in Puerto Rico and will examine the methods local government officials used to count hurricane-related fatalities in the aftermath of the September storm, officials here said Thursday [Feb 22]….
“Some estimates say that the hurricane’s lingering effects — long-term loss of power, lack of health care, inaccessibility in some remote areas — have led to hundreds of deaths and heavy criticism of the official tally [64]…. ‘I want to know the truth of the number the same as you do,’ Gov. Ricardo Rosselló said at a news conference here Thursday, saying that there was no effort to intentionally downplay the death county. ‘We want to get as close as the most accurate number as possible.’….
“Power has not yet been restored to parts of the island.
“Puerto Rico’s government is funding the first phase of the $305,000 review, but the group is seeking grant funding to study the process local officials undertook and plans to make recommendations to better understand deaths that are related to natural disasters. They hope the findings will help prevent fatalities in future storms.
“Lynn Goldman, dean of George Washington’s Milken Institute School of Public Health, said that within three months, the research team led by epidemiologist Carlos Santos-Burgoa will be able to determine an approximate death toll. ‘We will call it as we see it, I promise,’ Goldman said. Santos-Burgoa, a former public health minister in Mexico who oversaw the response to the 2009 H1N1 flue outbreak, said he will work with researchers and demographers in collaboration with the University of Puerto Rico to collect data from government sources, death certificates, official demographic statistics and news reports.
“Hundreds of death certificates had to be completed by hand by local officials during telecommunications and power outages, in many cases attributing potentially hurricane-related deaths to natural causes. Goldman said some of those documents will make clear the underlying causes of death, but she expects there will be many cases that researchers will need to investigate further to determine the cause and circumstances.
“Santos-Burgoa cautioned that there always will be a degree of uncertainty surrounding the final estimate of the death toll. Counting deaths related to a hurricane or other natural disasters often is a subjective exercise, and tallies sometimes include people who died while preparing for a storm’s arrival or of natural causes afterward that can’t be linked to the storm itself….
“The scientists plan to deliver their first report within 90 days and full findings within a year. They expect to publish a warehouse of mortality records for the public to peruse, and the group plans to submit its work to peer review.
“Questions surfaced shortly after the government of Puerto Rico released early death toll numbers in September as the island-wide power outage dragged on; the governor ordered a recount in December. Members of Congress, concerned that the Rosselló administration was suppressing the number, asked the Government Accountability Office to audit the territorial government’s methodology. GAO spokesman Charles Young said the agency’s work won’t begin for several months.” (Washington Post (Arelis R. Hernández). “GWU experts tapped to review Hurricane Maria death toll in Puerto Rico.” 2-22-2018.)
Feb 28: “Two months after Hurricane Maria ripped through Puerto Rico, scores of people were still dying in its aftermath, new government data suggest. The data show total deaths in the U.S. territory by month and do not break them down by cause. But month-to-month comparisons with previous years show the number of deaths after the hurricane…was far higher than average. The total number of deaths above average in September, October and November was 1,230, according to Alexis Santos, a demographer at Pennsylvania State University who obtained the data from the Puerto Rico Institute of Statistics and conducted an analysis that he released to the Los Angles Times this week.
“Of those deaths, 491 occurred in September and 584 in October — figures very close to estimates Santos published late last year based on more limited data. The new analysis shows the higher death rate continued into November, the most recent month for which he obtained figures, with 155 more than average. ‘With the limited information available to the academic and policy community, we can say the humanitarian crisis resulting from Hurricane Maria continued affecting the people of Puerto Rico after October,’ Santos said….
“Puerto Rico Gov. Ricardo Rosselló announced last week that the government had hired the Milken Institute School of Public Health at the George Washington University to investigate the death count.
“Puerto Rico’s Center for Investigative Journalism has sued the government requesting access to death certificates and other information that could paint a more complete picture of the reasons for the increase in mortality rates. ‘We have faced multiple difficulties gathering the information related to these deaths,’ said Carla Minet, the center’s director.
“A more detailed analysis would lead to a greater understanding of how people die in hurricanes — whether from the immediate impact of the storm or after-effects such as disease or shortages of food and water — and potentially how to prepare for future storms. ‘To be able to establish public policy that corrects our deficiencies we must have a precise diagnosis,’ Minet said. But for now, they can only make estimates.
“For his analysis, Santos looked at death statistics going back to 2010 to calculate an average death toll for each month and the amount of variation that could be attributed to chance. He then compared those averages to September, October and November of 2017 to calculate the number of unexpected deaths. In October, for example, there were 2,991 deaths, or 24% more than in an average October. The November total was 6.4% higher than average. Santos said that figure offers ‘a first glimpse at where or not the crisis has been mitigated,’ suggesting that it was not. He said the higher death rate in November occurred despite a declining population on the island, which had 3.4 million people before the hurricane. More than 87,000 people are thought to have moved to the U.S. mainland.” (Los Angeles Times (Milton Carrero). “Puerto Rico deaths related to Hurricane Maria continued for months after the storm, data suggest.” 2-28-2018.)
Aug 28: “Puerto Rico’s governor says he’s revising the official death toll from Hurricane Maria in the wake of a report from George Washington University that estimated the storm caused 2,975 deaths. “Even though it is an estimate, we are officially changing, or we are putting an official number to the death toll,” Gov. Ricardo Rosselló told reporters Tuesday. ‘We will take the 2,975 number as the official estimate for the excess deaths as a product of Maria.’ Rosselló acknowledged that the 2,975 statistic is only an estimate, and not a concrete list of names. Moving forward, he said, officials will continue to investigate deaths from the storm and refine the official tally. ‘This is an approximation, a scientific study where the deaths are estimated. We don’t have the names,’ Rosselló said. ‘That is something that will take place throughout this process. And this number can change. It could be less, it could be more, as time passes,’ he said. It could take months or years, he said, to come up with a complete list of storm-related deaths….” (CNN. “Puerto Rico revises Hurricane Maria death toll to 2,975 after study.” 8-28-2018.)
Sources
ABC News (Joshua Hoyos and Dean Schabner). “900-plus cremations since Maria, but hurricane death toll still 51.” 10-29-2017. Accessed 10-29-2017 at: http://abcnews.go.com/US/900-cremations-maria-hurricane-death-toll-51/story?id=50787771
Algona Radio. “Puerto Rico’s Hurricane Maria death toll rises to 58.” 12-1-2017. Accessed 12-2-2017 at: http://algonaradio.com/index.php/2017/12/01/puerto-ricos-hurricane-maria-death-toll-rises-to-58/
Associated Press. “Hurricane death toll in Puerto Rico increases to 54.” Fox News, 11-2-2017. Accessed 11-4-2017 at: http://www.foxnews.com/world/2017/11/01/hurricane-death-toll-in-puerto-rico-increases-to-54.html
Associated Press. “Hurricane Maria death toll rises as storm kicks up ocean on the coast.” Orlando Sentinel, 9-25-2017. Accessed 9-25-2017 at: http://www.orlandosentinel.com/weather/hurricane/os-hurricane-maria-dominica-death-toll-20170925-story.html
Associated Press. “Hurricane Maria death toll rises to 49 in Puerto Rico.” Washington Post, 10-20-2017. Accessed 10-20-2017 at: https://www.washingtonpost.com/world/the_americas/hurricane-maria-death-toll-rises-to-49-in-puerto-rico/2017/10/20/a8d827aa-b5ae-11e7-9b93-b97043e57a22_story.html?utm_term=.99f7bc01922b
Associated Press. “In Puerto Rico, death toll from Hurricane Maria reaches 16.” WJLA, ABC7, Washington DC, 9-25-2017. Accessed 9-26-2017 at: http://wjla.com/news/nation-world/in-puerto-rico-death-toll-from-hurricane-maria-reaches-16
Associated Press. “Puerto Rico raises Hurricane Maria death toll to 48.” ABC News, 10-14-2017. Accessed 10-14-2017 at: http://abcnews.go.com/International/wireStory/puerto-rico-raises-hurricane-maria-death-toll-48-50480190
Associated Press. “Puerto Rico raises hurricane’s official death count to 34.” Miami Herald, 10-4-2017. Accessed 10-4-2017 at: http://www.miamiherald.com/latest-news/article176869231.html
Associated Press. “The Latest: Puerto Rico counts 2 suicides among storm deaths.” Fox News, 10-4-2017. Accessed 10-5-2017 at: http://www.foxnews.com/world/2017/10/04/latest-puerto-rico-counts-2-suicides-among-storm-deaths.html
Carter, Brandon. “San Juan mayor: Hurricane Maria death toll closer to 500 than 50.” The Hill, 11-3-2017. Accessed 11-4-2017 at: http://thehill.com/blogs/blog-briefing-room/news/358730-san-juan-mayor-death-toll-following-hurricane-maria-closer-to
CBS News. “Hurricane Maria gains strength, heads for Bahamas — live updates.” 9-21-2017. Accessed 9-21-2017 at: https://www.cbsnews.com/news/hurricane-maria-path-puerto-rico-latest-update-2017-09-21/
CBS/Associated Press. “Puerto Rico’s death toll from Hurricane Maria increases to 51.” 10-24-2017. Accessed 10-24-2017 at: https://www.cbsnews.com/news/hurricane-maria-puerto-rico-death-toll-increases/
Centers for Disease Control and Prevention. “A Reference Guide for Certification of Deaths in the Event of a Natural, Human-induced, or Chemical/Radiological Disaster.” Vital Statistics Reporting Guidance, Report No. 1, October 2017. CDC, National Center for Health Statistics, 14 pages. Accessed 1-3-2018 at: https://www.cdc.gov/nchs/data/nvss/vsrg/vsrg01.pdf
CNN. “Puerto Rico: Death toll from hurricane climbs to 64 with 2 ‘indirect deaths’.” 12-10-2017. Accessed 12-10-2017 at: http://cw39.com/2017/12/10/puerto-rico-death-toll-from-hurricane-climbs-to-64-with-2-indirect-deaths/
CNN (John D. Sutter). “Puerto Rico orders review of deaths after hurricane.” 12-18-2017. Accessed 1-3-2018 at: http://www.cnn.com/2017/12/18/health/puerto-rico-maria-death-count-review/index.html
CNN (Leyla Santiago, Catherine E. Shoichet and Jason Kravarik). “Puerto Rico revises Hurricane Maria death toll to 2,975 after study.” 8-28-2018. Accessed 8-28-2018 at: https://www.cnn.com/2018/08/28/health/puerto-rico-gw-report-excess-deaths/index.html
CNN (John D. Sutter, Leyla Santiago and Khushbu Shah). “We surveyed 112 Puerto Rican funeral homes to check the accuracy of the hurricane death toll. This is what we found.” 11-20-2017. Accessed 11-28-2017 at: http://www.cnn.com/2017/11/20/health/hurricane-maria-uncounted-deaths-invs/index.html
Los Angeles Times (Milton Carrero). “Puerto Rico deaths related to Hurricane Maria continued for months after the storm, data suggest.” 2-28-2018. Accessed 2-28-2018 at: http://www.latimes.com/nation/la-na-puerto-rico-death-toll-20180228-htmlstory.html
Miami Herald (Omaya Sosa Pascual). “Hurricane Maria’s death toll in Puerto Rico is higher than official count, experts say.” 9-28-2017. Accessed 9-29-2017 at: http://www.miamiherald.com/news/weather/hurricane/article175955031.html
Milken Institute School of Public Health, The George Washington University. Project Report: Ascertainment of the Estimated Excess Mortality From Hurricanfe Maria in Puerto Rico (In Collaboration with the University of Puerto Rico Graduate School of Public Health). Wash., DC: GWU Milken Institute School of Public Health, Aug 2018, 69 pages. Accessed 8-28-2018 at: http://prstudy.publichealth.gwu.edu/sites/prstudy.publichealth.gwu.edu/files/reports/Acertainment%20of%20the%20Estimated%20Excess%20Mortality%20from%20Hurricane%20Maria%20in%20Puerto%20Rico.pdf
NBC4, Washington, DC (Matthew Daly). “Puerto Rico’s Hurricane Maria Death Toll Rises to 43…” 10-10-2017. Accessed 10-10-2017 at: https://www.nbcwashington.com/news/national-international/Puerto-Rico-Hurricane-Maria-Death-Toll-Lawmakers-Seek-Longer-Jones-Act-Waiver-450234693.html
NBC New York 4. “3 Drown Off Jersey Shore, Dozens Rescued Despite ‘No Swimming’ Warning.” 9-25-2017. Accessed 2-4-2018 at: https://www.nbcnewyork.com/news/local/Jersey-Shore-Beach-Swimmer-Rescue-Ban-Ocean–447725023.html
NBC News. “Half of hurricane-ravaged Puerto Rico faces lack of drinking water.” 9-28-2017. Accessed 9-28-2017 at: https://www.aol.com/article/news/2017/09/28/half-of-hurricane-ravaged-puerto-rico-faces-lack-of-drinking-water/23225790/
NBC News (Sandra Lilley). “Puerto Rico governor announces task force to examine hurricane-related deaths.” 1-4-2018. Accessed 1-5-2018 at: https://www.nbcnews.com/storyline/puerto-rico-crisis/puerto-rico-governor-announces-task-force-examine-hurricane-related-deaths-n834756
New York Daily News (Megan Cerullo and Terrence Cullen). “Members of Congress call for investigation into underreporting in Puerto Rico death toll.” 10-12-2017. Accessed 10-13-2017 at: http://www.nydailynews.com/news/national/hurricane-maria-killed-people-puerto-rico-article-1.3558545
New York Daily News (Rich Schapiro). “Puerto Rico’s Hurricane Maria death toll climbs to at least 13.” 9-22-2017. Accessed 9-22-2017 at: http://www.nydailynews.com/news/national/puerto-rico-hurricane-maria-death-toll-climbs-13-article-1.3513516
New York Times. “Hurricane Maria Live Updates: Puerto Rico Loses Power, Officials Say, 9-20-2017. Accessed 9-20-2017 at: https://www.nytimes.com/2017/09/20/us/hurricane-maria-puerto-rico.html
New York Times (Frances Robles, Kenan Davis, Sheri Fink, Sarah Almukhtar). “Official Toll in Puerto Rico: 64. Actual Deaths May Be 1,052.” 12-9-2017. Accessed 1-3-2018 at: https://www.nytimes.com/interactive/2017/12/08/us/puerto-rico-hurricane-maria-death-toll.html
Newsweek (Maria Perez and Linley Sanders). “Puerto Rico is ‘Broken’ 100 Days After Hurricane Maria and Trump is no Help Locals Say.” 12-28-2017. Accessed 12-28-2017 at: http://www.newsweek.com/puerto-rico-recovery-100-days-hurricane-maria-760965
NOAA, National Centers for Environmental Information (NCEI). Billion-Dollar Weather and Climate Disasters: Table of Events. 2018. Accessed 2-4-2018 at: https://www.ncdc.noaa.gov/billions/events/US/1980-2017
Pascual, Omaya Sosa and Jeniffer Wiscovitch (English version by Julio Recardo Varela). “Dozens of Uncounted Deaths from Hurricane Maria Emerge in Puerto Rico.” Puerto Rico: Center for Investigative Journalism, 11-16-2017. Accessed 12-10-2017 at: http://latinousa.org/2017/11/16/dozens-uncounted-deaths-hurricane-maria-emerge-puerto-rico/
Pascual, Omaya Sosa (Center for Investigative Journalism). English version by Julio Ricardo Varela. “Nearly 1,000 More People Died in Puerto Rico After Hurricane Maria.” CPI, 12-7-2017. Accessed 12-10-2017 at: http://latinousa.org/2017/12/07/nearly-1000-people-died-puerto-rico-hurricane-maria/
Resnick, Brian and Eliza Barclay. “What every American needs to know about Puerto Rico’s hurricane disaster.” Vox.com, 9-27-2017. Accessed 9-27-2017 at: https://www.vox.com/science-and-health/2017/9/26/16365994/hurricane-maria-2017-puerto-rico-san-juan-humanitarian-disaster-electricty-fuel-flights-facts
Robles, Frances, Kenan Davis, Sheri Fink, Sarah Almukhtar. “Official Toll in Puerto Rico: 64. Actual Deaths May Be 1,052.” New York Times, 12-9-2017. Accessed 12-9-2017 at: https://www.nytimes.com/interactive/2017/12/08/us/puerto-rico-hurricane-maria-death-toll.html
Robles, Frances. “Puerto Rico Deaths Spike, but Few Are Attributed to Hurricane.” New York Times, 11-8-2017. Accessed 11-9-2017 at: https://mobile.nytimes.com/2017/11/08/us/puerto-rico-deaths-fema.html?action=click&module=&pgtype=Homepage
Santos-Lozada, Alexis (Pennsylvania State University) and Jeffrey T. Howard (Independent Researcher). Estimates of excess deaths in Puerto Rico following Hurricane Maria. 11-21-2017. SocArXif Papers. Accessed 12-10-2017 at: https://osf.io/preprints/socarxiv/s7dmu
Santos-Lozada, Alexis R. “Why Puerto Rico’s death toll from Hurricane Maria is so much higher than officials thought.” The Conversation, 1-3-2018. Accessed 1-3-2018 at: http://theconversation.com/why-puerto-ricos-death-toll-from-hurricane-maria-is-so-much-higher-than-officials-thought-89349
Schwartz, Mattathias. “Maria’s Bodies. The hurricane in Puerto Rico has become a man-made disaster, with a death toll threatening to eclipse Katrina’s.” New York Magazine, 12-22-2017. Accessed 12-22-2017 at: http://nymag.com/daily/intelligencer/2017/12/hurricane-maria-man-made-disaster.html
Shankar, Amulya (PRI’s {Public Radio International} The World). “Real death toll in Puerto Rico is probably 450…” USA Today, 10-18-2017. Accessed 12-22-2017 at: https://www.usatoday.com/story/news/world/2017/10/18/real-death-toll-puerto-rico-probably-450-much-higher-than-official-count/774918001/
Swanson, Mark. “PR’s Problematic Review of Hurricane Deaths: Examining Buried Bodies.” Newsmax.com, 12-21-2017. Accessed 12-21-2017 at: https://www.newsmax.com/newsfront/puerto-rico-hurricane-maria-death-toll/2017/12/21/id/833150/
Telemundo PR. “Aumentan a 64 muertes certificadas por María.” 12-9-2017. Accessed 1-3-2018 at: https://www.telemundopr.com/noticias/destacados/Aumentan-a-64-las-muertes-por-el-huracan-Maria-463005263.html
Thomson Reuters. “Puerto Rico’s death toll from Hurricane Maria rises to 43, power outages remain.” CBC, Canada, 10-10-2017. Accessed 10-10-2017 at: http://www.cbc.ca/news/world/puerto-rico-maria-update-1.4347571
Virgin Islands Daily News (Suzanne Carlson). “Five hurricane-related deaths confirmed.” 10-3-2017 [Irma/3, Maria/2]. Accessed 2-4-2018 at: http://www.virginislandsdailynews.com/breaking/five-hurricane-related-deaths-confirmed/article_90b2f60d-7abd-5313-a1da-7c3a4c976fc7.html
Vox (Eliza Barclay and Alexia Fernandez Campbell). “Everything that’s been reported about deaths in Puerto Rico is at odds with the official count.” 10-11-2017. Accessed 10-13-2017 at: https://www.vox.com/science-and-health/2017/10/11/16424356/puerto-rico-official-hurricane-maria-death-toll
Vox (Eliza Barclay). “Puerto Rico finally updated the Hurricane Maria death toll to 34.” 10-3-2017. Accessed 10-4-2017 at: https://www.vox.com/science-and-health/2017/10/2/16392670/puerto-rico-death-toll-trump
Washington Post (Arelis R. Hernández). “GWU experts tapped to review Hurricane Maria death toll in Puerto Rico.” 2-22-2018. Accessed 2-28-2018 at: https://www.washingtonpost.com/national/gwu-experts-tapped-to-review-hurricane-maria-death-toll-in-puerto-rico/2018/02/22/7f0a1c94-17e7-11e8-8b08-027a6ccb38eb_story.html?utm_term=.16a4e7d6f982
Weather Channel. “Puerto Rico’s Maria Death Toll Climbs to 36, Governor…” 10-6-2017. Accessed 10-6-2017 at: https://weather.com/storms/hurricane/news/puerto-rico-death-toll-hurricane-maria
Wikipedia. “Hurricane Maria,” “Deaths and damage by territory” sidebar.” 2-3-2018. Accessed 2-4-2018 at: https://en.wikipedia.org/wiki/Hurricane_Maria#Undercounting_of_fatalities
World Health Organization. “Classification of Diseases.” 11-29-2016. Accessed 1-3-2018 at: http://www.who.int/classifications/icd/en/
[1] Notes another thirty-seven reported missing.
[2] Assoc. Press. “Hurricane Maria death toll rises as storm kicks up ocean on the coast.” Orlando Sentinel, 9-25-2017. Cites Chief of Police of Dominica, and also notes that another 27 were missing.
[3] CBS News. “Hurricane Maria gains strength, heads for Bahamas…” 9-21-2017. Wikipedia. “Hurricane Maria,” 2-3-2018, notes another two people missing.
[4] Concerning all three deaths, “Officials said ‘notifications were made to not go into the water’.”
[5] CNN. “Puerto Rico revises Hurricane Maria death toll to 2,975 after study.” 8-28-2018.
[6] Los Angeles Times (Milton Carrero). “Puerto Rico deaths related to Hurricane Maria continued for months after the storm, data suggest.” 2-28-2018. According to article, Santos “obtained the data from the Puerto Rico Institute of Statistics and conducted an analysis that he released to the Los Angeles Times this week.” [Feb 28 is a Wednesday.]
[7] Santos-Lozada and Howard. Estimates of excess deaths in Puerto Rico following Hurricane Maria. 11-21-2017.
[8] “The Times’s analysis found that in the 42 days after Hurricane Maria made landfall on Sept. 20 as a Category 4 storm, 1,052 more people than usual died across the island. The analysis compared the number of deaths for each day in 2017 with the average of the number of deaths for the same days in 2015 and 2016.”
[9] Pascual. “Nearly 1,000 More People Died in Puerto Rico…Maria.” Ctr. for Investigative Journalism, 12-7-2017.
[10] CNN notes that the 112 responding funeral homes represents about half the island’s total, and are portrayed as “Deaths believed to be storm-related by funeral homes.” Time frame of deaths was Sep 20 to Oct 19.
[11] Cites Vox.
[12] Pascual and Wiscovitch. “Dozens of Uncounted Deaths from Hurricane Maria Emerge in Puerto Rico.” Puerto Rico: Center for Investigative Journalism, 11-16, 2017. “…in the last three weeks — through interviews with mayors, security officials and emergency management from the island’s municipalities, as well as interviews with relatives and a review of death certificates — the Center for Investigative Journalism (CPI) has identified 47 deaths related to the hurricane, in addition to the 55 officially reported by the government of Puerto Rico.”
[13] Robles, et al. “Official Toll in Puerto Rico: 64. Actual…May be 1,052.” NYT, 12-10-2017. A CNN article notes that the figure of 64 reflected an increase of two storm-related deaths: Jose ‘Pepe’ Sanchez, who died during the storm after collapsing and “emergency medical personnel could not make it to the house.” (CNN. “Puerto Rico: Death toll from hurricane climbs to 64 with 2 ‘indirect deaths’.” 12-10-2017.)
[14] CNN. “Puerto Rico: Death toll from hurricane climbs to 64 with 2 ‘indirect deaths’.” 12-10-2017.
[15] We show 60 rather than the 34 in title in that the article cites interview with Omaya Sosa Pascual of CPI: “By her count, there are now an estimated 60 confirmed deaths linked to the hurricane an possibly hundreds more to come.” This is based on her communications with “dozens of doctors, administrators, morgue directors, and funeral directors around the country.” A primary reason for difference between official and unofficial numbers is that a death is not officially recognized until a death certificate is signed and recorded. Quoting Pascual, “Some of the people who work in the government lost their homes themselves and aren’t at work. So they can’t do death certificates. The dead can’t be documented because of all the logistics and legal aspects of declaring someone dead.”
[16] Nineteen direct and fifteen indirect.
[17] Another source, however, in reference to the official death toll of 16 as of Sep 27, writes: “…the Center for Investigative Journalism (CPI, for its initials in Spanish) has confirmed that there are dozens of hurricane-related deaths and the number could rise to the hundreds. The storm-related fatalities are mounting with each passing day, and official numbers are not counting patients who are not receiving dialysis, oxygen and other essential services.” (Miami Herald. “Hurricane Maria’s death toll in Puerto Rico is higher than official count, experts say.” 9-28-2017.)
[18] Pascual/Wiscovitch. “Dozens of Uncounted Deaths…Hurricane Maria Emerge in Puerto Rico.” CPI, 11-16, 2017.
Lorenzo was a police officer who died “when he tried to cross a river in his car…” (Swanson, Mark. “PR’s Problematic Review of Hurricane Deaths: Examining Buried Bodies.” Newsmax.com, 12-21-2017.)
[19] Pascual/Wiscovitch. “Dozens of Uncounted Deaths…Hurricane Maria Emerge in Puerto Rico.” CPI, 11-16, 2017.
[20] NBC4, Washington, DC (Matthew Daly). “Puerto Rico’s Hurricane Maria Death Toll Rises to 43…” 10-10-2017.
[21] Vox. “Everything that’s been reported about deaths in Puerto Rico is at odds with the official count.” 10-11-2017.
[22] Vox. “Everything that’s been reported about deaths in Puerto Rico is at odds with the official count.” 10-11-2017. Cites “The director of federal programs for the town of Barceloneta as told to Primera Hora. Two had cancer.
[23] Identified from official list of 55 deaths as of 11-6-2017 as: Enrique Acevedo Rivera, 81, David Serrano Hernandez, 57, Wesley Negron Adorno, 29, Merairis Class Adorno, 34.
[24] The official list of deaths when total was at 55 noted 3 for Caguas: Luz Maria Ortiz Ortiz, 72, Héctor Luis Merced Hernández, 59, and Emma Díaz Morales, 65.
[25] Vox. “Everything that’s been reported about deaths in Puerto Rico is at odds with the official count.” 10-11-2017
[26] Associated Press. “Puerto Rico raises Hurricane Maria death toll to 48.” ABC News, 10-14-2017.
[27] “The official death count only mentioned one person who died from respiratory problems.” (Vox. “Everything that’s been reported about deaths in Puerto Rico is at odds with the official count.” 10-11-2017.) Pascual and Wiscovitch identify the person on the official death list of 55 as on 11–6-2017 as Rosa Cintrón Irizarry, 69.
[28] These four names are Tomás Quintana Ortiz, 70; Vicenta Hernández Guzmán, 90; Kayla Damaris Santiago Cabrera, 38; and Benigno De Jesús Ortiz, 68. The fifth person, not on official list, is Salvador Rosa Montañez, 72.
[29] Associated Press. “Puerto Rico raises Hurricane Maria death toll to 48.” ABC News, 10-14-2017.
[30] Algona Radio. “Puerto Rico’s Hurricane Maria death toll rises to 58.” 12-1-2017.
[31] Pascual/Wiscovitch. “Dozens of Uncounted Deaths…Hurricane Maria Emerge in Puerto Rico.” CPI, 11-16-2017. Victim identified as Salvador Rosa Montañez, male, 72.
[32] Pascual/Wiscovitch. “Dozens of Uncounted Deaths…Hurricane Maria Emerge in Puerto Rico.” CPI, 11-16, 2017.
[33] Algona Radio. “Puerto Rico’s Hurricane Maria death toll rises to 58.” 12-1-2017. Official death of Quintin Videl Roldan, 89, without noting cause of death, is noted as one of 55 such deaths in: Pascual/Wiscovitch. “Dozens of Uncounted Deaths…Hurricane Maria Emerge in Puerto Rico.” CPI, 11-16, 2017 — the only official Cayey death.
[34] The only official death in Jayuya when list was at 55 was José Antonio Rivera Santiago, 58. List reproduced in: Pascual/Wiscovitch. “Dozens of Uncounted Deaths…Hurricane Maria Emerge in Puerto Rico.” CPI, 11-16-2017.
[35] Associated Press. “Puerto Rico raises Hurricane Maria death toll to 48.” ABC News, 10-14-2017.
[36] The two persons were Francisca Del Valle, 75, and Lidia Rivera Saldana, 94. (Pascual/Wiscovitch. “Dozens of Uncounted Deaths…Hurricane Maria Emerge in Puerto Rico.” CPI, 11-16-2017.)
[37] Victim identified as Leovigildo Cotté. Miami Herald (Omaya Sosa Pascual). “Hurricane Maria’s death toll in Puerto Rico is higher than official county, experts say.” 9-28-2017.
[38] NBC4, Washington, DC (Matthew Daly). “Puerto Rico’s Hurricane Maria Death Toll Rises to 43…” 10-10-2017.
[39] NBC4, Washington, DC (Matthew Daly). “Puerto Rico’s Hurricane Maria Death Toll Rises to 43…” 10-10-2017. Presumably death of Obed Rivera Crespo, 71, whose name is on the official death list of 55 as of 11-6-2017.
[40] Pascual/Wiscovitch. “Dozens of Uncounted Deaths…Hurricane Maria Emerge in Puerto Rico.” CPI, 11-16-2017.
[41] Thomson Reuters. “Puerto Rico’s death toll from Hurricane Maria rises to 43…” CBC, Canada, 10-10-2017; NBC4, Washington, DC (Matthew Daly). “Puerto Rico’s Hurricane Maria Death Toll Rises to 43…” 10-10-2017. The official death list includes the death of Gabriel Omar Rodríguez, 27, in San Germán, the only listing for locality.
[42] Official death toll of 55 as of 11-6-2017 shows three San Juan deaths. Noted in Pascual/Wiscovitch, 11-16-2017. Schwartz, in New York Magazine, notes a doctor told him two patients died in a hospital near San Juan “when there weren’t enough staff on hand to operate the pumps” [hand-operated pumps used when mechanical ventilators were inoperable due to loss of electricity.]
[43] Resnick and Barclay. “What every American needs to know about Puerto Rico’s hurricane disaster.” 9-27-2017.
[44] Associated Press. “Hurricane death toll in Puerto Rico increases to 54.” Fox News, 11-2-2017.
[45] Pascual/Wiscovitch. “Dozens of Uncounted Deaths…Hurricane Maria Emerge in Puerto Rico.” CPI, 11-16, 2017. Identified victim as Miguel Omar Coos Medina, 36.
[46] Associated Press. “Hurricane death toll in Puerto Rico increases to 54.” Fox News, 11-2-2017. Perhaps a reference to the death of Juan J. Valentín Fuentes, 33, who was the only person from San Sebastián on the official list of 55.
[47] “The mayor of Toa Baja told El Nuevo Día newspaper that at least nine people died after the storm. One man was dragged by a flood current [presumably drowned], and eight others drowned. Residents confirmed these deaths to reporters and named some of the victims. The official death count only includes one drowning in Toa Baja.” Pascual and Wiscovitch identify that person as Harold Cancel Rosa, 55, from the official death list of 55 as of 11-6-2017.
[48] Schwartz, Mattathias. “Maria’s Bodies,” New York Magazine, 12-22-2017.
[49] Schwartz, Mattathias. “Maria’s Bodies,” New York Magazine, 12-22-2017.
[50] Schwartz, Mattathias. “Maria’s Bodies,” New York Magazine, 12-22-2017.
[51] Schwartz, Mattathias. “Maria’s Bodies,” New York Magazine, 12-22-2017.
[52] NY Daily News. “Puerto Rico’s…Maria death toll climbs to at least 13.” 9-22-2017.
[53] Pascual/Wiscovitch. “Dozens of Uncounted Deaths…Hurricane Maria Emerge in Puerto Rico.” CPI, 11-16, 2017.
[54] Associated Press. “Hurricane death toll in Puerto Rico increases to 54.” Fox News, 11-2-2017.
[55] Pascual/Wiscovitch. “Dozens of Uncounted Deaths…Hurricane Maria Emerge in Puerto Rico.” CPI, 11-16, 2017.
[56] Algona Radio. “Puerto Rico’s Hurricane Maria death toll rises to 58.” 12-1-2017.
[57] Associated Press. “Hurricane Maria death toll rises to 49 in Puerto Rico.” Washington Post, 10-20-2017.
[58] CBS/Associated Press. “Puerto Rico’s death toll from Hurricane Maria increases to 51.” 10-24-2017. Report notes that “authorities have said they are investigating at least 74 other suspected cases of the disease.” Also note “Several previous fatalities have also been linked to the infections.”
[59] Mr. Evert “died due to asphyxiation and blunt force trauma after being trapped in his home by a mudslide…his body was found on Sept. 24.” Cites Attorney General Claude Walker press release.
[60] CNN (John D. Sutter). “Puerto Rico orders review of deaths after hurricane.” 12-18-2017.
[61] New York Times. “Official Toll in Puerto Rico: 64. Actual Deaths May Be 1,052.” 12-9-2017.
[62] Santos-Lozada, Alexis (Pennsylvania State University) and Jeffrey T. Howard (Independent Researcher). Estimates of excess deaths in Puerto Rico following Hurricane Maria. 11-21-2017.
[63] Highlighted term takes one to World Health Organization page on “Classification of Diseases.” 11-29-2016.
[64] Centers for Disease Control and Prevention. “A Reference Guide for Certification of Deaths in the Event of a Natural, Human-induced, or Chemical/Radiological Disaster.” Vital Statistics Reporting Guidance, Report No. 1, October 2017. CDC, National Center for Health Statistics.
[65] “The Center for Investigative Journalism (CPI), located at the School of Law at Interamerican University of Puerto Rico, is an independent, nonprofit organization that promotes and defends the citizens’ right of access to information through journalistic research, education and the promotion of transparency of public and private authorities.”
[66] CNN . “We surveyed 112 Puerto Rican funeral homes to check the accuracy of the hurricane death toll. This is what we found.” 11-20-2017.
[67] CNN. “Puerto Rico: Death toll from hurricane climbs to 64 with 2 ‘indirect deaths’.” 12-10-2017.
[68] CNN. “We surveyed 112 Puerto Rican funeral homes…hurricane death toll…” 11-20-2017
