A new Harvard University study published Tuesday in the New England Journal of Medicine estimates that the real death toll from Hurricane María in Puerto Rico could be over 4,600 people. This estimate is 70 times the official government count of 64 recognized deaths, the absurdly low number upheld by officials in San Juan and the Trump administration.
The leading cause of death according to the study was from disruptions to medical services. This finding was consistent across all categories irrespective of the remoteness of the location, with 31 percent of households reporting a medical issue. The study found that “the most frequently reported problems were an inability to access medications (14.4 percent of households) and the need for respiratory equipment requiring electricity (9.5 percent), but many households also reported problems with closed medical facilities (8.6 percent) or absent doctors (6.1 percent). In the most remote category, 8.8 percent of households reported that they had been unable to reach 911 services by telephone.”
In the end researchers calculated that 4,645 more people died in the final months of 2017 than in the same time frame a year prior, an increase of 62 percent. The study concluded, “the official death count of 64 is a substantial underestimate of the true burden of mortality after Hurricane Maria.”
As harrowing as the results of the study are, the researchers note that their estimate is likely too conservative. They explain that “subsequent adjustments for survivor bias and household-size distributions increase this estimate to more than 5,000.”
The statistical data from the report provides important scientific backing to what everyone on the island and around the world already knows: that the true scale of fatalities is far beyond the number claimed by government officials. It also underscores the fact that the Trump administration and both the Republicans and Democrats have been engaged in a cover-up to justify their criminal response to the ongoing public health catastrophe.
In the aftermath of the storm, devastating reports emerged of residents who relied on electricity for treatment such as dialysis dying in their homes in the weeks and months that the longest and largest blackout in US history unfolded on the island. Scores of people lost their lives in mudslides that ran through towns and residents across the island were faced with dire living conditions, as exemplified by Dorado, where residents out of desperation drank contaminated water.
The Harvard study not only provides the most comprehensive look at the death toll, but also begins to document in empirical terms some of the daily hardships of everyday life since the storm. In the course of their study, researchers found that, on average, households went 84 days without electricity, 68 days without running water and 41 days without cellular telephone coverage in the period between the hurricane on September 20 and December 31, 2017.
The study also found that in the most remote areas, 83 percent of households were without electricity for the entire time period they were evaluating. The researchers noted that many survey respondents were still without running water and electricity at the time of the sampling. To this day, roughly 150,000 homes and businesses are still waiting for electricity, with blackouts regularly taking out electricity for huge swaths of the island, and in some cases the entire island.
The Harvard study is only the latest in a series of independent investigations into the real death toll. Shortly after the storm, CNN conducted a survey by phone of funeral homes and reported 499 hurricane-related deaths. The New York Times compared official death records from September and October of 2017 and found that there were more than 1,000 excess deaths compared with the average for 2015 and 2016. Researchers at Penn State University as well as a team at the Center for Investigative Journalism in Puerto Rico counted death certificates, all producing figures that towered above the official government toll.
While valuable in exposing the absurd official government count, these previous studies were extremely limited in the type of data they were able to collect. Reports from funeral homes could not account for those who buried their dead without assistance due to lack of electricity or blocked roads. The study conducted by Penn State was done based on death certificates. However, in Puerto Rico, every disaster-related death must be confirmed by the Institute of Forensic Sciences. This requires that bodies be brought to San Juan or that a medical examiner travel to the local municipality to verify the death, often delaying the issuance of death certificates.
What is most unique and valuable about the new Harvard study is that it is the first which provides data drawn from on-the-ground research. Without a doubt, the Harvard study is the most accurate to date. The methods used to gather the data are the same as those used to assess deaths in war-ravaged Mosul by Dr. Gilbert Burnham, a professor of international health at Johns Hopkins University.
The study was conducted by randomly selecting 3,299 households in Puerto Rico, varying the houses proportionally between rural and urban communities. Residents were asked in person about all deaths and causes of death from the time Hurricane Maria made landfall on September 20 to the final day of the study in December 2017.
The evidence put forward in this study highlights just one feature of the ongoing humanitarian crisis. The exposure reveals more starkly the corrupt and criminal role of the government of the US territory, headed by Governor Ricardo Rosselló, and both parties in Washington. Together they have done everything in their power to paper over the destruction of Puerto Rican society and facilitate its plundering by corporate interests and the banks.
In his trip to the island last October, President Trump could hardly contain his indifference to the working class, telling the people of Puerto Rico that the destruction from Hurricane María did not constitute “a real catastrophe like Katrina” because the death count was so low. At that point the government had certified only 16 deaths. In fact, the real death toll in Puerto Rico far surpasses the 1,833 killed by Hurricane Katrina and the subsequent flooding in 2005.