Hurricane Maria devastated Puerto Rico a year ago, but since then most of us here on the mainland have dreamed the disaster away. Here’s something to wake us up: instead of the government’s announced death toll of 64, a study published by the New England Journal of Medicine estimated a staggering 4,645 people were killed by the hurricane or its aftereffects.
Will you remember now?
The study (full text here) used a representative sampling technique to figure out the “excess” death toll, meaning the number of deaths that could be attributed to the disaster of Hurricane Maria. The researchers sampled over 3,000 households, estimated the mortality rate based on those surveys, and then compared it to the mortality rate from same period during the year before the hurricane. Their conclusion:
Our results indicate that the official death count of 64 is a substantial underestimate of the true burden of mortality after Hurricane Maria. Our estimate of 4,645 excess deaths from September 20 through December 31, 2017, is likely to be conservative since subsequent adjustments for survivor bias and household-size distributions increase this estimate to more than 5,000.
A “substantial underestimate” indeed. That figure of 64, compared with the suggested true death toll, is positively Soviet in its brazen untruthfulness. Carmen Yulin Cruz, the mayor of San Juan who tried to take President Trump to task over his pitiful response to the crisis, had this to say:
These deaths & the negligence that contributed to them cannot be forgotten. This was, & continues to be, a violation of our human rights.
— Carmen Yulín Cruz (@CarmenYulinCruz) May 29, 2018
Living in this country sometimes feels like being stuck at the bottom of a well; we can see the sky above, but only dimly and distorted by the heavy and suffocating waters. But sometimes the waters still and we can see clearly. The truth is that somewhere around 5,000 Americans may have died during and after Hurricane Maria. The truth is that the federal government’s response was faulty, inadequate, and absolutely unforgivable. And the truth is that the government has been unable or unwilling to give us the true death toll.
I’m sure some of you would like to dismiss the researchers’ findings as faulty or wrong, and that’s fine. It’s good to question research when we see it. But let me put on my academic librarian hat to tell you why I think this is quite plausible. Warning: information science ahead.
First, the New England Journal of Medicine is a very well-respected publication, and studies published there go through rigorous peer review. In short, other experts look at this and try to figure out whether the science is good. This clearly passed.
But wait, you say! Doesn’t peer review fail sometimes? Absolutely. Remember when The Lancet published a phony study linking the MMR vaccine to autism in the 1990s? That somehow got past peer reviewers and was out there for years before being discredited and removed. But that study had a tiny sample size (only a few individuals) and lousy methods. This study surveyed a large number of households, accounts for potential biases, and the conclusions are strikingly plausible.
For example, the survey reported that most deaths were caused by “interruption of medical care,” which absolutely is consistent with the widespread collapse of the Puerto Rican health system after the hurricane.
That said, it’s a survey and not a hard count of death certificates, so it can’t be wholly accurate. Is 4,645 the true number of deaths? Likely not. But did far, far more Americans die than the government said? Absolutely.
Hurricane Maria was one of the worst disasters in U.S. history. Our federal government largely ignored it, as did many states, most of the news media, and the mainland public at large. This is inexcusable. There must be accountability, there must be a real national reckoning, and Puerto Rico must receive the federal aid it so desperately needs to rebuild and prepare for the next storm.
Some states with high populations of Puerto Ricans, Connecticut included, did work to house and help refugees and send aid to the island. But it’s clear now that none of us did enough.
A year ago, a hurricane destroyed a part of our country. As many as 5,000 may have died from it. Remember that it happened, and remember who was to blame, if nothing else.