It’s official. In the 40 days after Hurricane Maria hit Puerto Rico, at least 985 additional people died, when compared to the same period in 2016.
And if the entire months of September and October are included (since Hurricane Irma also passed through the island days before Maria), the figure rises to 1,065 deaths — despite the fact that Puerto Rico lost more than 100,000 inhabitants due to migration this year, according to estimates from the Center for Puerto Rican Studies of The City University of New York.
Since Sept. 20, the day the historic Category 4 storm struck the entire island with 155 mph winds that left Puerto Rico without power, the average daily death rate increased by 43 percent, with peaks of about 80 percent on days like Sept. 21 and 25. In October, deaths increased by 23.3 percent.
The majority of the deaths were men and women over 50 who died in hospitals and nursing homes from conditions such as diabetes, Alzheimer's, kidney disease, hypertension, pneumonia and other respiratory diseases. When compared to the same time period from 2016, there was a significant increase in deaths, especially in hospitals and nursing homes.
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This information — made public Thursday for the first time by the Center for Investigative Journalism from data provided by the island’s Demographic Registry — presents an official overview of the magnitude and profile of deaths recorded after Hurricane Maria.
Although September saw increases in deaths for all groups over the age of 50, in October increases occurred in all groups over the age of 18.
In September, the highest increase in deaths was among people between 70 and 79. In October, the peak was among those older than 90.
However, the October data also showed significant increases in deaths for people between 30 to 39 years old (36 percent), and between 40 to 49 years old (23.3 percent).
This new data confirms the findings of a Sept. 28 CPI story, revealing that at that time there were dozens and possibly hundreds of deaths linked to the hurricane, contrary to the official government death toll, which remained at 16 victims during the first two weeks of the emergency. Today, more than two months after the catastrophe, the official death count stands at 62, due to the poor methodology being used to analyze and account for cases, according to reporting by the CPI.
The revelation of the new data also coincides with accounts from relatives’ reports of victims that point to problems with essential health services such as dialysis, ventilators, oxygen, and other critical circumstances caused by the lack of electricity in homes and hospitals throughout Puerto Rico.
Demographer José A. López, the only person at the registry in charge of analyzing this data, told CPI that increase in deaths in the first two post-Maria months is significant. He also said the government’s inability to link more deaths to the hurricane shows that the current process of documenting causes of death in a disaster is not working and must be reformed. Last week, as part of an investigation into the failures in the process of accounting for deaths linked to Maria, López and the Department of Health appeared before Puerto Rico’s Senate to request that a dialogue begin about the issue and that they lead to changing the system.
“We have realized with this process [from Hurricane Maria] that there is a need to strengthen the documentation of the causes of death and the circumstances surrounding the causes of death that have caused this issue. That has to be documented,” López said.
“We need to have a serious and honest discussion of all the sectors involved,” he added, noting that there is a lack of understanding of the process and its importance on the island.
According to López, from the point of view of public health, any increase of more than 15 percent in mortality trends must be studied to find an explanation, because it is indicative that something atypical is happening. In the case of some contagious diseases, for example, when there’s a 3 percent increase, “we have to run,” he added.
“It’s important because once we have a clearer picture of Puerto Rico’s mortality rate, this allows us to plan and carry out work plans to improve public health and prevent deaths, especially when this type of event will continue to occur. According to scientists, global warming is boiling the Caribbean,” López said.
Currently, linking a death to a disaster depends almost exclusively on a physician making an annotation related to the hurricane in the death certificate and listing the clinical cause of death, but both doctors and hospitals maintain that their responsibility and knowledge are strictly tied to the clinical cause of death. Furthermore, in most cases, the doctor who certifies the death may not be the same doctor who was in charge of the patient. So most death certificates do not include additional information about the other circumstances that could lead to death — such as the stress caused by an emergency; lack of power, transportation services or medications; lack of access to health services; changes in diet; and increases in ambient temperatures, among others.
Although the data provided on Wednesday by the Demographic Registry is preliminary until the official year ends with a final review, at the time of this publication the figures for September and October are 98 percent complete. Data for November, when a good part of the population still lived without electricity, is not yet available. According to this current data, 2,883 deaths were registered in September and 2,906 in October, compared to 2,367 for September 2016 and 2,357 for October 2016.
This story was made possible by the Futuro Media Group as part of a collaboration supported by the Ford Foundation. English version by Julio Ricardo Varela | Latino USA