Thirteen days ago, Hurricane Maria trashed Puerto Rico, demolishing its already weak power, communications, and transportation infrastructure. The storm quickly gave way to a humanitarian crisis, with many of Puerto Rico’s residents struggling to access food, water, and fuel to run generators and cars. Help has been slow to arrive. And with each passing day, we’re learning more about the frightening conditions on the ground, from the sick being turned away from barely functioning hospitals to mothers desperate for water for their babies.

But for the past week, one figure was disquietingly absent: an accurate death toll.

Until Tuesday evening, when Gov. Ricardo Rossello updated it to 34, the official death count was stuck at 16. That prompted President Donald Trump to claim Tuesday on his visit to the island that it wasn’t a “real catastrophe” like Hurricane Katrina in New Orleans, which had close to 2,000 deaths.

Yet there is good reason to believe the actual figure is much higher than 34, and will continue to climb.

Omaya Sosa Pascual is a reporter with the Center for Investigative Journalism (CPI) in San Juan. She was skeptical of the government’s figure of 16 and began to call the 69 hospitals around the country, asking them about deaths related to the hurricane.

Pascual spoke to dozens of doctors, administrators, morgue directors, and funeral directors around the country, and wrote up her initial findings in a September 28 report in the Miami Herald. She then got Puerto Rico’s public safety secretary to confirm Monday that there have been dozens more deaths than the official statistic reflects. By her count, there are now an estimated 60 confirmed deaths linked to the hurricane and possibly hundreds more to come.

So why has the government been so slow to document the dead? Is this a cover-up, or just an administrative casualty of the all-encompassing crisis?

The biggest reason we’ve heard little about the fatalities

One part of the answer is simple: The situation is so chaotic that death certificates aren’t being signed, which means deaths aren’t being officially recorded.

“Everything in the government has collapsed,” Pascual told me by phone from the parking lot of a San Juan medical center, one of the few places in the city where she said she could get a reliable cellphone signal. “Some of the people who work in the government lost their homes themselves and aren’t at work. So they can’t do death certificates. The dead can’t be documented because of all the logistics and legal aspects of declaring someone dead.”

Still, she said, “not being able to document it doesn’t mean it’s not happening.”

While officials in San Juan may not be receiving documents of the dead from municipalities that don’t have power or internet, Pascual thinks they could be doing more to gather the data and put out a more accurate update. She explains in her investigation that she was told “the dead are at the hospital morgues, which are at capacity and in remote places where the government has yet to go. In many cases, families are unaware of the deaths.”

For comparison, in the immediate aftermath of Hurricane Harvey, Texas state and county officials provided reporters with an updated number of casualties directly related to the storm daily.

Trump says it’s been “incredible ... the results that we've had with respect to loss of life.” Those words might haunt him.

One problem with not updating the death count is that it can make the situation on the ground seem less dire than it actually is.

On Friday, President Trump took the 16 deaths as an opportunity to congratulate his administration for making “tremendous strides” in its response to the crisis.

“The loss of life — it’s always tragic — but it’s been incredible the results that we’ve had with respect to loss of life,” Trump told reporters at the White House. “People can’t believe how successful that has been, relatively speaking.”

Then on Tuesday, at press briefing in San Juan, he again pointed to the figure of 16 deaths to downplay the crisis on the island.

every death is a horror, but if you look at a real catastrophe like Katrina and you look at the tremendous hundreds and hundreds of people that died and what happened here with a storm that was just totally over-bearing. No one has ever seen anything like that … six people certified. Sixteen people versus in the thousands. You can be very proud of all of your people and all of our people working together. Sixteen versus literally thousands of people. You can be very proud.”

It’s clear that Trump’s response has been anything but successful (read Vox’s Matt Yglesias for more on that). For days, there were few workers from the Federal Emergency Management Agency or troops to help organize and distribute supplies. And most of the fuel delivered as part of the relief effort was stuck in San Juan because roads weren’t passable and truck drivers couldn’t get to work. That means that even the highest-priority facilities — namely, the island’s 69 hospitals — haven’t been able to operate at full capacity.

But there’s even more evidence that Trump’s words could come to haunt him.

John Mutter, a disaster expert at Columbia University who studied the death toll in the aftermath of Hurricane Katrina, told Vox that he suspects the death toll in Puerto Rico from Maria will reach into the hundreds.

Other experts agree: We’re going to have to wait a while for communications to be restored to find out how many are dead. “Sadly the island is so badly damaged that there is no ability to communicate — no way to know the number of people who may have been killed in the storm itself with houses coming down, debris," Stephen E. Flynn, the founding director of the Global Resilience Institute at Northeastern University, told Newsweek.

Other news outlets have collected anecdotes of mounting deaths around the country that aren’t showing up in the official count. Los Angeles Times reporter Molly Hennessy-Fiske had this dispatch from a shelter in the Lajas region:

About 100 people died in the three days after the storm in the Lajas region, twice the typical rate, according to a local funeral director. Eight elderly people have died in Lajas since the storm, at least one directly related to a shortage of medical supplies. “We don’t know if they didn’t have enough medicine, or oxygen — all of them were without electricity after the hurricane,” said funeral director Francisco Velez.

And, tragically, as Carmen Yulín Cruz, mayor of Puerto Rico’s capital San Juan, asserted in an impassioned response to Trump, people may still be dying because the relief effort has been moving so slowly. “I am begging, begging anyone who can hear us to save us from dying,” she said. “If anybody out there is listening to us, we are dying, and you are killing us with the inefficiency.”