As hurricane season begins this week, experts are still trying to count the number of deaths caused by last year’s devastating Hurricane Maria in Puerto Rico. The latest estimate: roughly 4,600, many of them from delayed medical care.

Residents of Puerto Rico died at a significantly higher rate during the three months following the hurricane than they did in the previous year, according to the results of a new study by a group of independent researchers from Harvard T.H. Chan School of Public Health and other institutions.

The researchers say their estimate, published Tuesday in the New England Journal of Medicine, remains imprecise, with more definitive studies still to come. But the findings, which used methods that have not been previously …show more content…
“It helped that a lot of them were psychology students, because they were going to be dealing with families in distress,” said Dr. Satchit Balsari, a research fellow at Harvard FXB Center for Health and Human Rights and one of the study’s senior authors.

The researchers found that many people had been displaced from their homes and had endured months without essential utilities, especially in remote areas. Those challenges affected the researchers, too, who downloaded digital map data before traveling to areas that still lacked cell service in early 2018.

The surveyors used off-road vehicles because of the continuing threat of landslides in mountain areas. In part of Culebra, a small island off the main island of Puerto Rico, they arrived planning to interview 35 households. Only one person remained. “It was a bathroom and half a room,” said Domingo J. Marqués, an associate professor of psychology at Albizu University San Juan, who helped conduct the study with his students and who himself lacked power and running water for months after the hurricane. “All the other houses were …show more content…
“They didn’t show any sign of coming down in the several months following the hurricane that we were looking at,” said Caroline Buckee, an associate professor of epidemiology at the Harvard School of Public Health and the study’s other senior author.

“There is clearly an excess mortality, and let’s not argue very specific numbers,” said Dr. Gilbert Burnham, a professor of international health and founder of the Center for Humanitarian Health at Johns Hopkins University, who was not involved in the research, but has performed similar studies assessing deaths, including in Mosul, Iraq.

Dr. Burnham said that despite the study’s limitations, including the difficulty of estimating Puerto Rico’s total population in light of migration, and the possible oversampling of smaller populations in more remote areas, such surveys “should become a standard activity in post-disaster situations,” because they help reveal vulnerabilities that can be addressed to save