HURRICANE HAZARD AT PUERTO RICO

Eight months after Hurricane Maria tore through Puerto Rico, Harvard researchers estimate the death toll to be about 70 times greater than initially thought, according to a new study.

HURRICANE HAZARD AT PUERTO RICO – Researchers from Harvard’s T.H. Chan School of Public Health visited more than 3,000 homes across Puerto Rico over the course of about a month. What they found was staggering. Instead of the initial estimated 64 deaths, there were likely more than 4,000 — many due to inaccessible medical care, according to a new study published yesterday in the New England Journal of Medicine. But the estimations remain imprecise. The death toll could range from about 800 to more than 8,000 people, the study found.

“They were counting deaths that attributed the disaster as the cause of death on the death certificate,” said Harvard biostatistics professor Rafael Irizarry, one of the study’s authors. “There are CDC guidelines however that talk about a slightly extended definition.”

He added, “We believe that definition has not been applied as it should have been.”

Boston Medical Center psychiatrist Dr. Lisa Fortuna — a Puerto Rico native who witnessed the dire aftermath of Hurricane Maria last year — said the new numbers come as no surprise. She saw people on horseback desperately seeking medical care, diabetics with dwindling insulin supplies.

“When I was in Puerto Rico, everyone felt there was likely an underestimate,” said Fortuna, who took a two-week trip to the island to deliver medical supplies. “People with dependence on insulin and oxygen, later had died. Because of the consequences on their health, they were already fragile folks.

“There was a massive lack of access to care,” Fortuna said. “A lot of elderly died and children with chronic illnesses died because of it.”

According to researchers, estimates immediately following disasters are often skewed, and future numbers should use different methodologies to get a fuller picture.

Of those interviewed, about 15 percent reported that someone in their household was unable to get medicine for at least a day following the storm. About 10 percent estimated a household member had issues with breathing equipment due to power outages. Fewer than 10 percent reported closed medical facilities and 6 percent were unable to access doctors.

A third of deaths were caused by a delay or complete lack of medical care, the study found.

Researchers are advocating for this method to be used after future disasters to get more accurate estimates.

“I think the thing about this study is this shows you can do this relatively quickly and cheaply,” said Caroline Buckee, a Harvard epidemiologist and author on the paper. “For sure we think it could be a sensible approach for the future.”

Source: bostonherald.com

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