(CD) — A study published Tuesday in The New England Journal of Medicine estimates that nearly 6,000 people died in Puerto Rico after Hurricane Maria, with a survey indicating the mortality rate is likely more than 70 times the highly contested official death toll of 64.

Researchers with the Harvard T.H. Chan School of Public Health and Beth Israel Deaconess Medical Center surveyed thousands of survivors and initially estimated that at least 4,645 people died between when the storm struck the U.S. territory on September 20, 2017 and the end of the year.

A key line from that Puerto Rico study: Their estimate of 4,645 dead after Hurricane Maria “is likely to be conservative.” In terms of loss of human life, that’s a tragedy deadlier than 9/11, and it happened right under our noses. https://t.co/sQmL8H2ivZ — Matt Pearce ? (@mattdpearce) May 29, 2018

However, considering that they could not survey people who lived alone and died due to the hurricane, researchers adjusted the estimate to 5,740. Citing the Centers for Disease Control and Prevention (CDC), the study says deaths can be attributed to the storm “if they are caused by forces related to the event, such as flying debris, or if they are caused by unsafe or unhealthy conditions resulting in injury, illness, or loss of necessary medical services.”

The findings bolster a series of damning independent reports that have disputed the official death toll. Pressure from those reports pushed Puerto Rico Gov. Ricardo Rosselló to recruit researchers from George Washington University to review the government’s process of accessing deaths tied to the hurricane and produce an analysis that is expected to be released in the coming weeks.

Pointing to that government-funded analysis, the Harvard study notes that its findings “will serve as an important independent comparison to official statistics from death-registry data, which are currently being reevaluated, and underscore the inattention of the U.S. government to the frail infrastructure of Puerto Rico.”

The hurricane decimated the island’s infrastructure, particularly its debt-riddenelectrical system. According to the National Hurricane Center (pdf), Maria caused an estimated $90 billion in damage, making it the third-costliest tropical storm since 1900, behind Katrina in 2005 and Harvey, which struck the Southern United States last year.

At least 4,645 people died in Puerto Rico as a result of Hurricane Maria and its aftermath, per a new @Harvard study. That's more than twice the Katrina death toll. Yet the official government count still stands at 64. It's as if those folks never existed. https://t.co/MX8ra422EG — Jamil Smith (@JamilSmith) May 29, 2018

Despite the widespread devastation and the humanitarian crisis that followed, accounts from journalists and locals have shown that the response by the Trump administration and Republican-controlled Congress has been largely inadequate. The Harvard researchers found that “delayed or prevented access to medical care” was the “primary cause” of post-Maria deaths, accounting for about a third of all deaths reported by surviviors.

As San Juan Mayor Carmen Yulín Cruz, a fierce critic of the federal relief efforts, declared six months after the storm, “things are not what they should be…due to neglect and bureaucracy.”

Rep. Luis Gutiérrez (D-Ill.)—who has also sharply criticized the administration’s response and spent months advocating for greater government investment in recovery efforts—said the Harvard study “confirms my worst nightmares,” calling it “confirmation of an American tragedy.”

While Puerto Ricans and sympathetic politicians fight for the funds to rebuild the island, the region is bracing for this year’s hurricane season amid warnings that territory is not prepared for another intense tropical storm.

Puerto Rico, Day 251:

—Tens of thousands of people are still w/o power

—Tens of thousands of people are still w/o clean water

—At least 4,645 people are dead

—For these people and their families, Hurricane Maria is still a humanitarian emergency Hurricane season starts in 3 days https://t.co/1BsQ6E9QKL — Eric Holthaus (@EricHolthaus) May 29, 2018

“This isn’t over,” tweeted novelist Laila Lalami in response to the study. “Puerto Rico is still struggling with services.”

By Jessica Corbett / Creative Commons / Common Dreams / Report a typo

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