Study: Many more died after Maria

SAN JUAN, Puerto Rico — A new study contends that many more deaths than normal occurred in Puerto Rico in the three months after Hurricane Maria devastated the island, mostly because of problems getting medicines or medical care.

Researchers surveyed a small sample of neighborhoods and from that estimated that up to 4,600 more deaths than usual occurred, far more than earlier studies have suggested. At least one independent expert questioned the methods and the number in the study.

“This estimate could be off by thousands. Easily,” said Donald Berry, a professor of biostatistics at the University of Texas MD Anderson Cancer Center, in an email.

The research was published online in the New England Journal of Medicine. It’s the latest study to analyze how many people died during or after the Category 4 storm that hit the U.S. territory in September, causing an estimated $100 billion in damage. Researchers led by Harvard University called the official toll of 64 deaths a “substantial underestimate.”

Maria caused the longest blackout in U.S. history, leaving the entire island of 3.3 million people without power, including those in hospitals and nursing homes who relied on respirators. Researchers surveyed 3,299 households and used the findings to extrapolate to the whole island.

“Indirect deaths resulting from worsening of chronic conditions or from delayed medical treatments may not be captured on death certificates,” researchers said.

They calculated 4,645 more people died in the three months after Maria compared with the same period in 2016.