The Center for Puerto Rican (CPI) Studies of The City University of New York have released a report stating that deaths in Puerto Rico have been underestimated. The increased deaths are due to the powerful windstorms that barreled over the island destroying the island’s infrastructure. They note that 985 additional people died during the same time period then in 2016 over the past 40 days. When you add the impacts from Hurricane Irma that number increases to 1,065.
And if the entire months of September and October are included (since Hurricane Irma also passed through the island days before María), the figure rises to 1,065 deaths—despite the fact that Puerto Rico would have lost over 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 September 20, the day when the historic Category 4 storm struck the entire island with 155-mile-per-hour winds that left Puerto Rico without power, the average daily death rate increased by 43% with peaks of about 80% on days like September 21 and 25. In October, deaths increased by 23.3%.
The majority of these deaths were men and women over 50 years old 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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In September, the highest peak of increase in deaths was seen among people between 70 and 79 years old. In October, that peak pertained to people over 90 years old.
However, the October data also showed significant increases in deaths for people between 30 to 39 years old (36%), and also between 40 to 49 years old (23.3%).
The CPI continues, noting that the “official count of 62 is due to poor methodology in reporting deaths since the storm.
Demographer José A. López, the only person at the registry in charge of analyzing this data, said in an interview with the CPI that the trend of 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 to document causes of death in a disaster is not working and must be reformed. Last week, as part of an investigation of the failures in the process of accounting for deaths linked to María, López and the Department of Health appeared before Puerto Rico’s Senate to request that a dialogue begin about this issue and that they lead the process to change the system.
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. Most death certificates, therefore, do not include additional information about the other circumstances that could lead to the medical decompensation and eventual death or acceleration of that person’s 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.
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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% 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 2017 and 2,906 in October 2017, compared to 2,367 for September 2016 and 2,357 for October 2016.