In early December 2017, the official death count in Puerto Rico stood at 64, 6 but several independent investigations concluded that additional deaths attributable to the hurricane were in excess of 1000 in the months of September and October. However, public health surveillance is extremely challenging when infrastructure and health systems are severely damaged. 5 Accurate estimates of deaths, injuries, illness, and displacement in the aftermath of a disaster such as Hurricane Maria are critical to the immediate response, as well as for future risk reduction and preparedness planning. 4 Thousands of persons were displaced from their homes, seeking shelter elsewhere in Puerto Rico or on the mainland United States. 1-3 Maria caused an estimated $90 billion in damages, making it the third costliest tropical cyclone in the United States since 1900. It compounded the destruction caused by Hurricane Irma 2 weeks earlier, damaging roads and interrupting the water supply, electricity, telecommunications networks, and access to medical care. The tropical cyclone Hurricane Maria made landfall in Puerto Rico, a territory of the United States, on September 20, 2017. Chan School of Public Health and others.) Introduction This household-based survey suggests that the number of excess deaths related to Hurricane Maria in Puerto Rico is more than 70 times the official estimate. Hurricane-related migration was substantial. The mortality rate remained high through the end of December 2017, and one third of the deaths were attributed to delayed or interrupted health care. However, this number is likely to be an underestimate because of survivor bias. This rate yielded a total of 4645 excess deaths during this period (95% CI, 793 to 8498), equivalent to a 62% increase in the mortality rate as compared with the same period in 2016. Resultsįrom the survey data, we estimated a mortality rate of 14.3 deaths (95% confidence interval, 9.8 to 18.9) per 1000 persons from September 20 through December 31, 2017. We calculated excess deaths by comparing our estimated post-hurricane mortality rate with official rates for the same period in 2016. Respondents were asked about displacement, infrastructure loss, and causes of death. Using a representative, stratified sample, we surveyed 3299 randomly chosen households across Puerto Rico to produce an independent estimate of all-cause mortality after the hurricane. In September 2017, Hurricane Maria caused massive infrastructural damage to Puerto Rico, but its effect on mortality remains contentious. The death toll can be difficult to assess in the aftermath of a major disaster. Quantifying the effect of natural disasters on society is critical for recovery of public health services and infrastructure. The most trusted, influential source of new medical knowledge and clinical best practices in the world. Information and tools for librarians about site license offerings. Valuable tools for building a rewarding career in health care. The authorized source of trusted medical research and education for the Chinese-language medical community. The most advanced way to teach, practice, and assess clinical reasoning skills. Information, resources, and support needed to approach rotations - and life as a resident. The most effective and engaging way for clinicians to learn, improve their practice, and prepare for board exams. NEW! Peer-reviewed journal featuring in-depth articles to accelerate the transformation of health care delivery.Ĭoncise summaries and expert physician commentary that busy clinicians need to enhance patient care. NEW! A digital journal for innovative original research and fresh, bold ideas in clinical trial design and clinical decision-making.
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