The mayor of the capital of Puerto Rico has called President Donald Trump “delusional” for claiming thousands of Americans did not die in Hurricane Maria.

Mr Trump tweeted on Thursday that “3000 people did not die in the two hurricanes that hit Puerto Rico” last September – a rejection of his own government’s assessment that 2,975 people died as a result of Hurricane Maria and the months-long recovery that followed.

The president claimed the recently updated death toll was “done by the Democrats in order to make me look as bad as possible,” adding: “If a person died for any reason, like old age, just add them onto the list. Bad politics. I love Puerto Rico!”

San Juan Mayor Carmen Yulín Cruz, who has sparred frequently with Mr Trump about his response to hurricane, responded with a tweet of her own, calling the president “delusional, paranoid, and unhinged from any sense of reality”.

“This is NOT about politics this was always about SAVING LIVES,” she added.

The government updated the death toll from Hurricane Maria last month, in light of the finding by researchers at George Washington University’s Milken Institute School of Public Health that nearly 3,000 more people died in the six months after the storm than usually would have during that period. The results supported a Harvard University study that found thousands more people died as a result of the storm than originally predicted.

Bringing aid to Puerto Rico Show all 20 1 /20 Bringing aid to Puerto Rico Bringing aid to Puerto Rico Crew chief Kenney shelters under the blade of an HH-60 Blackhawk helicopter from 101st Airborne Division's "Dustoff" unit preparing to take off during recovery efforts following Hurricane Maria, in Isla Grande, Puerto Rico, October 6, 2017 Reuters/Lucas Jackson Bringing aid to Puerto Rico An HH-60 Blackhawk helicopter from 101st Airborne Division's "Dustoff" unit takes off behind Crew Chief Alexander Blake and his fellow soldiers during recovery efforts following Hurricane Maria, in Morovis, October 5, 2017 Reuters/Lucas Jackson Bringing aid to Puerto Rico Crew member Bynum stands in tropical rain as a HH-60 Blackhawk helicopter from 101st Airborne Division's "Dustoff" unit prepares to take off during recovery efforts following Hurricane Maria, in Isla Grande, October 6, 2017 Reuters/Lucas Jackson Bringing aid to Puerto Rico UH-60 Blackhawk helicopter pilot Chris Greenway receives a hug from a woman thanking him for water as he works with the First Armored Division's Combat Aviation Brigade during recovery efforts following Hurricane Maria, in Verde de Comerio, October 7, 2017 Reuters/Lucas Jackson Bringing aid to Puerto Rico A man carries a case of water away from an HH-60 Blackhawk helicopter after soldiers working with 101st Airborne Division's "Dustoff" unit dropped off relief supplies during recovery efforts following Hurricane Maria, in Jayuya, October 5, 2017 Reuters/Lucas Jackson Bringing aid to Puerto Rico Crew chief Alexander Blake from 101st Airborne Division's "Dustoff" unit loads water into a helicopter during recovery efforts following Hurricane Maria, in Isla Grande, October 5, 2017 Reuters/Lucas Jackson Bringing aid to Puerto Rico Residents wait for soldiers in UH-60 Blackhawk helicopters from the First Armored Division's Combat Aviation Brigade to deliver food and water during recovery efforts following Hurricane Maria, in San Lorenzo Reuters Bringing aid to Puerto Rico An HH-60 Blackhawk helicopter from 101st Airborne Division's "Dustoff" unit lands in a field to avoid lightning during recovery efforts following Hurricane Maria, in Manati, October 5, 2017 Reuters/Lucas Jackson Bringing aid to Puerto Rico Residents hold their hands aloft to signal that they need water as UH-60 Blackhawk helicopters from the First Armored Division's Combat Aviation Brigade fly past during recovery efforts following Hurricane Maria, near Ciales, October 7, 2017 Reuters/Lucas Jackson Bringing aid to Puerto Rico Tropical rain splashes on a runway as HH-60 Blackhawk helicopters from 101st Airborne Division's "Dustoff" unit wait for weather to clear during recovery efforts following Hurricane Maria, in Isla Grande, October 6, 2017 Reuters/Lucas Jackson Bringing aid to Puerto Rico Pilot Eldwin Bocanegra Torres speaks with residents isolated by landslides in the mountains after unloading water and food from a helicopter during recovery efforts following Hurricane Maria, near Utuado, October 10, 2017 Reuters/Lucas Jackson Bringing aid to Puerto Rico Residents stand in front of wind-damaged trees as they wait for soldiers in UH-60 Blackhawk helicopters from the First Armored Division's Combat Aviation Brigade to deliver food and water during recovery efforts following Hurricane Maria, in San Lorenzo, October 7, 2017 Reuters/Lucas Jackson Bringing aid to Puerto Rico The contents of a home are seen from the air during recovery efforts following Hurricane Maria near Utuado, October 10, 2017 Reuters/Lucas Jackson Bringing aid to Puerto Rico Thomas looks out of the window of an HH-60 Blackhawk helicopter from 101st Airborne Division's "Dustoff" unit, loaded with relief supplies, during recovery efforts following Hurricane Maria in Isla Grande, October 6, 2017 Reuters/Lucas Jackson Bringing aid to Puerto Rico A message written on the rooftop is seen from the air during recovery efforts following Hurricane Maria near Humacao, October 10, 2017 Reuters/Lucas Jackson Bringing aid to Puerto Rico A HH-60 Blackhawk helicopter from 101st Airborne Division's "Dustoff" unit lands in a field during recovery efforts following Hurricane Maria in San Sebastian, October 6, 2017 Reuters/Lucas Jackson Bringing aid to Puerto Rico Sergeant First Class Eladio Tirado, who is from Puerto Rico, looks for a landing spot for a UH-60 Blackhawk helicopter from the First Armored Division's Combat Aviation Brigade, during recovery efforts following Hurricane Maria near Ciales, October 7, 2017 Reuters/Lucas Jackson Bringing aid to Puerto Rico Boys carry water away from an HH-60 Blackhawk helicopter after soldiers working with the U.S. Army's 101st Airborne Division's "Dustoff" unit dropped off relief supplies during recovery efforts following Hurricane Maria, in Jayuya, October 5, 2017 Reuters/Lucas Jackson Bringing aid to Puerto Rico Sergeant First Class Eladio Tirado from the First Armored Division's Combat Aviation Brigade, who is from Puerto Rico, speaks with residents as he helps during recovery efforts following Hurricane Maria, in San Lorenzo, October 7, 2017 Reuters/Lucas Jackson Bringing aid to Puerto Rico Residents peek through a fence at helicopters from 101st Airborne Division's "Dustoff" unit that had parked in a locked field during recovery efforts following Hurricane Maria, in Lares, October 6, 2017 Reuters/Lucas Jackson

But Mr Trump has refused to back down from his claim that the government did a “great job” in its response to Puerto Rico, where power was only fully restored in August – nearly a year after the hurricane hit.

On Tuesday, days after the Government Accountability Office released a report showing that more than half the federal workers deployed to disaster zones at the time were known to be unqualified, Mr Trump called the recovery effort “incredibly successful”.

"It was one of the best jobs that's ever been done with respect to what this is all about,” he said at a briefing.

President Trump says federal gov’t is 'ready' for Hurricane Florence, and reflects on what he describes as 'incredibly successful' response to Puerto Rico hurricane

Ms Yulín Cruz was an outspoken critic of the administration's response to Hurricane Maria in the direct aftermath of the storm, as well as in the months that followed. She first earned the president’s ire in a press conference days after the hurricane hit, when she begged for help and claimed the government was “killing us with the inefficiency”.

The politicians seem not to have lost their animosity in the intervening months, with Mr Trump calling the mayor “totally incompetent” in a tweet on Wednesday.

“We got A Pluses for our recent hurricane work in Texas and Florida (and did an unappreciated great job in Puerto Rico, even though an inaccessible island with very poor electricity and a totally incompetent Mayor of San Juan),” he wrote.