Puerto Rico

Study: Puerto Rico's Post-Hurricane Maria Death Rate At Least 70 Times Higher Than Official Figures

Disasters result from policies adopted and choices made before and after a natural hazard strikes.

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MariaPuertoRicoCliffEstesDreamstime
Cliff Estes/Dreamstime

According to the National Oceanic and Atmospheric Administration's official accounting, 65 people in Puerto Rico died as a result of Hurricane Maria. The agency does note that "hundreds of additional indirect deaths in Puerto Rico may eventually be attributed to Maria's aftermath pending the results of an official government review."

"Hundreds" may be an understatement. A new study in the New England Journal of Medicine estimates the number of such indirect deaths at 4,645 people—more than 70 times higher than the official figure. This is a 62 percent increase in the mortality rate compared with the same period in 2016. It should be no surprise that the death rate for our fellow citizens in Puerto Rico rose after Hurricane Maria blocked most roads and knocked out power, cellular phone service, and potable water supplies for weeks at a time.

The Harvard-based researchers made this calculation based on a randomized survey of 3,299 households asking respondents if anyone they knew had died between September 20 and December 31, 2017. They also asked how they died and whether their deaths could be attributed to the aftermath of Hurricane Maria. Using a survey similar to the Centers for Disease Control and Prevention (CDC) death scene investigation form for post-hurricane deaths, they identified 38 deaths among those households, of which 12 died of causes unrelated to the hurricane. The householders attributed the deaths of 12 people to the interruption of necessary medical services and 3 from medical complications stemming from an injury, trauma, or illness directly due to the hurricane. From there they extrapolated the mortality rate to Puerto Rico's 1,135,000 households.

The full death count may be even worse: The study adds that the estimate "is likely to be an underestimate because of survivor bias."

Counting and attributing deaths that result indirectly from natural disasters is a fraught enterprise. For example, NOAA's initial 2005 report on Hurricane Katrina noted that "the total number of fatalities known, as of this writing, to be either directly or indirectly related to Katrina is 1833." The agency has since lowered its estimate of deaths attributed to Katrina to 1,200 people.

A 2007 study using data from death notices published in the Times-Picayune before and after Hurricane Katrina hit Louisiana in August 2005, however, calculated that the mortality rate for the region rose by 47 percent between January and June of 2006. The researchers found that the monthly rate of death notices in the Times-Picayune averaged 924 per month in 2002–2004, but rose to 1,317 per month between in the first half of 2006. Roughly calculated, that means that there were 2,358 excess deaths in the period after Katrina.

While Puerto Rican public health authorities have acknowledged that 472 more people died in September after Hurricane Maria compared with the same month in the previous year, they did not officially attribute most of those deaths to the effects of the storm. Given the controversy over post-Maria mortality statistics, the Puerto Rican government in February asked researchers at George Washington University to conduct a study to estimate the excess mortality tied to the hurricane.

These researchers are tasked with reviewing and analyzing existing records and death certificates and then estimating the excess mortality from the time the storm hit on September 20 through the end of February 2018. They will also evaluate the current CDC guidelines for identifying mortality during such a disaster and how well Puerto Rican public health officials followed those procedures. Their preliminary report is due in the next month or so.

In a sense, there is no such thing as a natural disaster. There are natural hazards, such as hurricanes and earthquakes, but disasters result from policies adopted and other choices made prior to and after a hazard strikes. In the case of Hurricane Katrina, badly engineered and maintained levees led to the inundation of New Orleans and the deaths of hundreds of people. Hurricane Maria destroyed a decayed electric power grid and badly neglected roads, bridges, and water supply systems made fragile by years of massive fiscal irresponsibility.

Hopefully, having a clearer idea of how many people died at Maria's hands will help the public determine how to prevent the next storm from becoming a humanitarian disaster.

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  1. The Harvard-based researchers made this calculation based on a randomized survey of 3,299 households asking respondents if anyone they knew had died between September 20 and December 31, 2017. They also asked how they died and whether their deaths could be attributed to the aftermath of Hurricane Maria.

    I’m going to assume that the researchers had some kind of mechanism in place to avoid double, triple and quadruple counting here.

    1. Bad assumption.

  2. “The Harvard-based researchers made this calculation based on a randomized survey of 3,299 households asking respondents if anyone they knew had died between September 20 and December 31, 2017. They also asked how they died and whether their deaths could be attributed to the aftermath of Hurricane Maria.”

    If you thought telemarketing was intrusive…

  3. Ten people report seeing the same tornado and it becomes ten tornados and that is how things are reported these days. I want facts not surveys

    1. You could always try reading the study. I’m sure someone of your clear statistics acumen will understand it easily.

    2. Good point. One would think that death certificates would be of value here. Apparently, that idea has not dawned on the government officials.

  4. Hopefully, having a clearer idea of how many people died at Maria’s hands will help the public determine how to prevent the next storm from becoming a humanitarian disaster.

    Only if the government doesn’t get in the public’s way.

    1. The only way to prevent humanitarian disasters is to elect a Democrat president. Once that is done, all you will see is good solid reporting about how amazingly well every problem is handled.

      Sure, Fox will put out some fake news but that can be ignored…

    2. The ‘government’ of PR is well and truly an extension of the public. Manana culture is endemic to the island.

  5. Hopefully, having a clearer idea of how many people died at Maria’s hands will help the public determine how to prevent the next storm from becoming a humanitarian disaster.

    When you think about it, the NTSB does a remarkable job investigating commercial aviation mishaps and helping avoid any future repeats. Airlines and manufacturers generally work with the agency – sometimes against their near-term self-interests – to fix any problem that would result in further accidents.

    1. Private airlines vs public agencies… in Puerto Rico…

      1. Puerto Rico is American. If we can fix New Orleans – which I can only assume has happened by now – then Puerto Rican infrastructure and disaster recovery potential can be similarly fixed.

        1. New Orleans is still there, so nothing’s been fixed.

        2. If we can fix New Orleans

          How on Earth would anybody be able to tell?

        3. New Orleans has largely been restored to its natural state. PR will as well.

          1. sooo…back to a swampy backwater?

        4. New Orleans was fixed when Brad Pitt and Angelina Jolie moved in and spent a weekend or two working with Habitat for Humanity.

          They divorced, so Puerto Rico is screwed.

        5. From what I have heard Puerto Rico’s local government is unusually corrupt for a USA political subdivision, but not unusually so for a Latin American polity.

          1. Sounds about right.

        6. I’ve been to Nola lately, and no it’s not really ‘recovered’ but it’s a whole lot better. Although, ‘a whole lot better’ in terms of Nola really is pretty damn subjective.

          The moral of that story? Don’t build below sea level, jackasses.

          1. New Orleans is still be low sea level, the levees are still marginal. The east side still looks like a war zone, but that is the new normal. Oh, yeah, and speaking of constant neglect and misappropriation of funds, the city has gone from 40% of all the drinking water being lost from the system due to leaks in the old clay pipes, up to 50% lost. But who’s counting?

            1. somebody , cause how do you get to 50% from 40% unless it’s by counting? asking for a friend.

    2. The difference is that NTSB has no enforcement authority. They recommend action, and wise companies, airlines, etc. tend to fix problems before the iron fist of the FAA rolls into action 4 years late to the party. Anyone who didn’t bother to anticipate the FAA’s demands will be in panic mode to fix the problems.

      As for PR, I think they’re probably too busy trying to the the fucking lights turned back on to be worried about this current hurricane season.

      1. Being only an advisory agency, the NTSB may be the best agency in Washington.

        1. To borrow from Sheridan, the only good agency is a dead agency.

        2. I would bet a dollar that it may be the most effective at its work as well.

          1. Better that there be no NTSB.

            Hopefully you are not of the folks deluded enough to think that civilizational collapse would ensue the interment of the NTSB.

            1. I’m not sure what you’re trying to say, but i take it you want no government at all. If the NTSB went away, the FAA (at least for the aviation component) would absorb its duties, and do a shit job while spending more and taking longer.

  6. I think the better method is to count the total number of deaths immediately after the hurricane and compare it to the prior year.

    How do you count an evacuee who was killed in a car accident in Tampa?

  7. Study: Puerto Rico’s Post-Hurricane Maria Death Rate At Least 70 Times Higher Than Official Figures

    I blame global warming.

  8. Like Haiti, Puerto Rico will be making bank off this for the next 20 years.

    1. When i think of a place that is really rolling in dough, i think of Haiti.

      1. Same here. After I was informed by all the celebrities that Haiti Is Great Already, I learned that they have not 3, but 4 public universities! Can you believe that? Four universities in one country!

      2. Haiti is definitely rolling in dough, if by dough you mean the mud that the locals use to bake their bread.

    2. What I meant is the various charities that have been fundraising off of the disasters, and the residents of these shitholes that continue looking for assistance years later.

      I used to work for the Red Cross. Up until I left last year there were still daily calls looking for assistance after their earthquake. Their earthquake was in 2010.

      And if you don’t think that many in Haiti, and the US, made boatloads of cash during the relief efforts, nothing I say will change your mind.

      1. Very true, but that’s not the same thing as “Haiti” or “Puerto Rico” making bank, which would imply that either the local government’s general fund or the people at large are benefiting.

      2. Oh god, you worked for Red Cross up until last year? That means you survived all the layoffs. Wise move leaving though.

  9. Como se dice “oops”?

    1. Yo creo que la respuesta es Sparky.

  10. Any high schooler would know not to put more than one significant digit on such an extreme extrapolation. At most, two. However, to put it down to the ones place is out and out deception.

    Plus, in cases of trauma, you don’t have survivor bias. You have trauma bias. People remember the worst. They also blame major incidents for things that might have happened anyway. Yes, uncle Joe died because he didn’t get medical help, but he would have died anyway due to the heart attack. You are comparing reality to an alternate future that didn’t happen. That is fraught with error.

    1. ^^^This. Plus Puerto Ricans know way more people than the US. There’s no six degrees of separation, it’s more like two. If someone in your apartment building’s cousin died, well, yes, you knew the cousin.

    2. Sure, but a near two orders of magnitude difference is a significant discrepancy. If one group said 65 and the other said 130, we might say they just rounded differently, didn’t catch double counts, and/or didn’t correct enough for survivor bias, but if one person says ’65 dead’ and the other says ‘4500 dead’ we can be pretty certain that they disagree as to the actual number of dead (especially for such a recent event in modern history). At which point, the bona fide number is more of a detail relative to the actual story. Even if we know the number to factually be precisely between 65 and 4550 at 2308 or whatever, the story is that 2300 people died and the government says only 65 did while the people the government is supposed to serve says it feels like 4500 died because of the storm.

  11. Puerto Rico has always been a welfare country where much of the population sits around all day. There is also more poverty on that island than any US state.

    The fact that more Puerto Ricans live off island than on the island, is very telling.

    1. I lived in Puerto Rico for twenty years. While the unemployment rate is high, working “off the books” is common and preferred in some cases. It’s crazy, but in a welfare state you end up working hard, unless you work for the government, which a lot of Puerto Ricans do.

      1. About a third of the workforce in Puerto Rico are government employees.

        1. so they’re really, really fucked…

  12. When I hear stories like this about dead people, I wonder where the bodies are. Did the researchers follow up and confirm some real-live dead people or just do interviewers and fiddle numbers?

    1. “Burrrp”

      Crocodylus acutus

      1. Now there’s an idea that should have been included as an assumption in the study to bolster credibility given the lack of actual body counting.

        1. I think unmarked hastily-dug graves, bureaucratic legerdemain, mudslides and flooding probably play a greater role in rendering corpse-counting impractical than the efforts of a grateful local crocodilian community, but yes, the study should probably have spelled that out a little bit more.

      2. That’s a hell’va way to dispose of those who die in the months after the event. . .

        1. Not all heroes wear capes, and not all charitable NGOs operating in the Caribbean are human. Or endothermic.

    2. Seems like the most accurate way to figure out a death count. From there you review the cause of death to decipher whether it was related to or caused by the event. A limited survey an extrapolation is fine for an estimate, but is hardly the sort of data to accept over accurate record keeping especially when the extrapolation produces a result so disconnected from the observed trend. Seems like a criticism that can also be applied to climate change alarmism…
      Fwiw, I thought the official death count for the storm was over 1000 to begin with.

      1. This misses the point and is being exceedingly generous, from a libertarian perspective to a government known to be highly corrupt and poor at maintenance and record keeping.

        Sure, 4550 people is a high estimate and 500 is likely a low one but it says a lot that the government says one person died and the people living in the neighborhoods scraping by says it feels more like 10 died. If Trump said 500,000 people attended the inauguration and the media says only 50K (which, IIRC, they generally refrained from providing a general number other than ‘less than what he said’),is the story who’s right(erer) or the fact that neither one of them can agree or be relied upon to tell anything resembling the truth?

    3. That’s why Gawd invented death certificates. . .

  13. According to the CIA World Fact Book, Puerto Rico’s Death Rate (deaths/1000 population) was 8.8 in 2016 and 8.6 in 2017.

  14. All these death tolls mean nothing without some kind of context.
    X no. of people died during snow storm from heart attacks this weekend. How many people die of heart attacks every weekend there is not a storm?
    X no. of hunters died opening weekend of deer season. Again, how many people die every weekend of heart attacks when it is not opening deer season?
    X no. of people died in car accidents during the storm. How many people die in car accidents when there is no storm?
    Just because some one dies doing a certain activity does not mean that the activity killed them.
    Most of these people had underlying conditions, and many would have died anyway. Now if a tree falls on you and you are pinned and then high water drowns you, you died of the storm.

    1. Most of these people had underlying conditions, and many would have died anyway. Now if a tree falls on you and you are pinned and then high water drowns you, you died of the storm.

      Technically everyone, including the person who drowned pinned under a tree had underlying conditions that were going to kill them anyway.

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