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In Texas and Florida, which were hit past year by hurricanes Harvey and Irma, state and local response efforts were already in place and running smoothly, Long said. If the numbers found in the study are accurate, Maria would be the deadliest hurricane in recent US history, surpassing 2005's Hurricane Katrina, which killed 1,833 people, USA Today reported.

The official death toll stands at 64.

Flouting the grim reality on the ground in Puerto Rico, President Trump used the low official death count to laud himself and his administration's post-hurricane relief efforts as somehow being great.

SAN JUAN, Puerto Rico (AP) - A new study contends that many more deaths than normal occurred in Puerto Rico in the three months after Hurricane Maria devastated the island, mostly because of problems getting medicines or medical care.

For reference, Hurricane Katrina resulted in the death of 1,833 people, according to reports provided by the Federal Emergency Management Agency and other authorities.

There are two things the federal government must do in the wake of this study.

"This is clearly 5,000 deaths due to negligence by the federal government". This is not simply a math exercise.

The Puerto Rican government is working on its own study, but it is way behind schedule. Almost 90,000 more people died that year in the Sichuan quake in China, according to the United Nations International Strategy for Disaster Reduction.

Harvard School Of Public Health: "Study estimates a prolonged increase in death rate in Puerto Rico in months following Hurricane Maria" - "The mortality rate in Puerto Rico rose by 62% [95% confidence interval (CI) 11% to 114%] after Hurricane Maria, according to a new study led by researchers from Harvard T.H. Chan School of Public Health".

And with Friday's official arrival of hurricane season, Davila wonders whether Puerto Ricans will be better prepared. Hurricane season starts in June.

"I've been to Puerto Rico many times as, I think, most of you have known".

Harvard University researchers released a report this week that said at least 4,645 deaths are attributable to the storm. Reporters like CNN's Leyla Santiago kept close, but the news cycle never stopped spinning.

The study was based on in-person interviews. "In its survey of over 3,200 Puerto Rican households, the team behind the new study tried to get around those difficulties by asking families directly about the deaths of loved ones". "But I consider it a great honor, maybe because I know so many people from Puerto Rico that are such great people". The report has suggested that in order for the USA to mobilise an "appropriate response operation" and "account for the fate of those affected", the country should "review how disaster-related deaths will be counted". The count included suicides.At the same time, the Center for Investigative Journalism said it found 985 additional deaths during September and October. And scandalous when governments - like Puerto Rico's - get them so drastically wrong.Puerto Rico is a part of the United States, and the deaths of 4,645 Americans from a natural disaster is a national tragedy.

"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.

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