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We have a sense today for how deadly Hurricane Maria's impact on Puerto Rico truly was. A new study estimates the number of dead could be around 5,000, which is much higher than the official figure, which was 64. In a moment, we'll hear reaction to the new estimate from San Juan, Puerto Rico. But first, NPR's Richard Harris says the study highlights the long-lingering effects of the storm.
RICHARD HARRIS, BYLINE: The new figure is based on a door-to-door survey of about 3,300 randomly selected households conducted in January. The researchers tallied the reported number of deaths, calculated a death rate and compared that with the death rate from the previous year. The result is a number somewhere between 800 and 8,500 excess deaths with 5,000 being a central figure. Caroline Buckee at the Harvard T. H. Chan School of Public Health is a lead author of the study.
CAROLINE BUCKEE: You know, one of the attractive elements of this type of approach is that it's quick and easy and very cost-effective.
HARRIS: She says it complements the official method, which usually relies on medical examiners who view bodies and determine the cause of death. That catches drownings, tree falls and other obvious storm-related deaths. The survey approach digs deeper and includes lingering causes. Satchit Balsari, an emergency physician and the other lead author, says surveys give a glimpse of the other causes.
SATCHIT BALSARI: There were a range of reasons offered that included just inability to prepare their medicines.
HARRIS: Vital medical equipment that required electricity also failed. Some people said they couldn't call 911.
BALSARI: Or they were unable to reach the health care facilities because roads were damaged or the facilities were closed or the doctors were unavailable.
HARRIS: The results are published online by the New England Journal of Medicine. One drawback of this study is it suggests a huge range, not a concrete number.
RAFAEL IRIZARRY: The reason there is a large uncertainty around that number is because that's a rare event.
HARRIS: Rafael Irizarry is a statistician at Harvard and a co-author of the study. The survey identified 38 deaths after the storm in its sample of 3,300 households. If by chance they had found half a dozen more or fewer, that would change the bottom line substantially. That said, the new statistics are broadly consistent with research based on death records by The New York Times in a recent academic study, Irizarry notes.
IRIZARRY: We have four estimates, and the current government count is the one that is an outlier in terms of being very low.
HARRIS: That's the one that shows 64 deaths. Alexis Santos, a demographer at Penn State University, conducted the previous scientific study and published his results online in November. He found about a thousand deaths for September and October. That's a shorter time period than covered in the Harvard study, which ran through December. He says the Puerto Rican government reacted to his findings by blocking access to government health data.
ALEXIS SANTOS: Under normal circumstances, I could have been given preliminary data already for death counts in 2017. That is not the case. Right now, they are just saying they're not going to share the information with anybody.
HARRIS: So for now it's a waiting game. Puerto Rico funded a study by researchers at the George Washington University. That is running far behind schedule and may now produce results this summer. Richard Harris, NPR News.
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