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Medical journal estimates death toll in Hurricane Maria is 70 times higher than the official count

More than 4,500 people are believed to have been killed in Puerto Rico as a result of Hurricane Maria last year, more than 70 times the official death count, the prestigious New England Journal of Medicine reported Tuesday. That estimate would make the hurricane far deadlier than Hurricane Katrina in 2005, WSB-TV's Brett Rosner said, where 1,833 people died.

The first reports of a discrepancy in the Puerto Rico death toll came late last year, when The New York Times concluded that the true number of casualties could "exceed 1,000," far more than the official count of 64 dead. In The New England Journal of Medicine's survey, researchers contacted 3,299 random households and "from the survey data, we estimated a mortality rate of 14.3 deaths per 1,000 persons from Sept. 20 through Dec. 31, 2017." The researchers add that "this number is likely to be an underestimate because of survivor bias."

Deaths that count towards a total death toll include directly related events, like "flying debris," as well as deaths "caused by unsafe or unhealthy conditions resulting in injury, illness, or loss of necessary medical services." Puerto Rican deaths went underreported because hurricane-related casualties are required to be confirmed by the island's Institute of Forensic Sciences, and indirect deaths often aren't properly represented on official death certificates. Read more about the researchers' methodology at The New England Journal of Medicine.