Study Estimates 4600 Dead From Hurricane Maria

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The official death toll is 64. CNN followed with just under 10 minutes of coverage, and Fox covered the report for just 48 seconds. At least one independent expert questioned the methods and the number in the new study. A back-of-the envelope calculation by The Economist of excess mortality above that expected by deaths in previous years puts the toll at about 1,200.

Evacuating and being evacuated also accounted for a significant number of indirect deaths. The most shocking results from our study suggested that deaths in September and October were 25 percent above historical patterns.

Nishant Kishore, graduate student at Harvard's School of Public Health and one of the authors of the study that found the higher-than-reported death toll in Puerto Rico.

Vann Newkirk, staff writer at The Atlantic covering politics and policy, he has reported extensively on Puerto Rico.

Our study compared preliminary data from the Department of Public Safety with historical patterns for the same months in the past decade.

Low-income and elderly people in rural areas where the storm caused some of the heaviest damage are the most vulnerable, health professionals say. The report has suggested that in order for the U.S. to mobilise an "appropriate response operation" and "account for the fate of those affected", the country should "review how disaster-related deaths will be counted". My colleagues and I suspect it may come down to how deaths are recorded by government officials. On Oct. 19 he also bizarrely said, "I would give myself a ten" out of ten for his administration's relief efforts in Puerto Rico. This system doesn't capture all of the circumstances surrounding a death that happens following a natural disaster. She says she's hopeful the next hurricane won't send that sheeting flying.

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In many places across Puerto Rico, federal emergency funds allocated in the aftermath of the disaster made up for years of neglected maintenance, replacing decaying infrastructure with tens of thousands of new poles and hundreds of miles of power lines rushed from the US mainland at a steep premium.

Fredyson Martinez, vice president of the power authority workers' union, said he estimates that roughly 10 percent to 15 percent of the fix work done over the last eight months did not meet basic quality standards. 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. Their death would be classified as pulmonary-related.

"People are not ready for that", Hernandez said. Their immediate reaction might be to call 911.

"It was a huge hurricane", Maria Laboy, of Humacao, said. Communication was virtually impossible. The death toll from Hurricane Katrina in 2005 is still disputed.

I have a few ideas of how to move forward. FEMA has stockpiled 5.4 million liters of water and more than 80,000 tarps, and is distributing them and other emergency supplies to towns across the island so they will be in place for the next disaster.

As another hurricane season nears, homes across Puerto Rico still bear the blue roofing tarp that Samaritan's Purse installed following Hurricane Maria, the ministry reported last week. They chose George Washington University to run this project.

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