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Mourners carry the casket of Wilfredo Torres Rivera, 58, who died October 13 after jumping off a bridge into a lake, three weeks after Hurricane Maria, on October 19, 2017 in Utuado, Puerto Rico. Credit: Mario Tama/Getty Images

Officials still don't have an agreed upon number of storm-related casualties from Hurricane Maria, which slammed the island of Puerto Rico on Sept. 20, 2017, causing massive destruction to the island's infrastructure and knocking out the entire power grid.

Why it matters: Now a new study, published in the New England Journal of Medicine on Monday, finds a far higher estimate for the actual death toll, 4,645, than the official estimate of just 64.

Context: The death toll from this study means that Hurricane Maria killed more people than Hurricane Katrina did in 2005. That storm killed at least 1,833. It also eclipses the death toll on the day of the September 11, 2001 terrorist attacks, which killed 2,977.

Details:

  • The study found that the post-hurricane mortality rate was 14.3 deaths per 1,000 persons, which was a 62 percent increase from the pre-storm mortality rate during the same period in 2016.
  • Researchers say their estimated death toll is "likely to be an underestimate."
  • The study, by a group of Harvard University researchers as well as experts in Puerto Rico and elsewhere, found that the death toll from the Category 4 storm was actually 70 times higher than the official estimate.
  • The study's findings are consistent with other recent investigations that have found that storm deaths were far higher than the official count.

The big picture: The biggest factors leading to the higher death toll were disrupted medical services, including access to medication and medical facilities, the study found.

The government of Puerto Rico has requested an independent review of death-registry data to arrive at a more accurate official count of storm-related deaths, but the timing of this is unknown.

How they did it: Researchers surveyed 3,299 randomly chosen households across Puerto Rico to arrive at an independent mortality rate for all causes after the hurricane. They calculated excess deaths by comparing post-hurricane mortality rates with the same period the year before, when there was no major storm. According to the study, the death toll may have exceeded 5,000.

Between the lines: Public health experts remain deeply skeptical of the low death count in Puerto Rico from the most intense hurricane to hit that island in more than 80 years. This new study is the latest to dramatically increase the number of deaths, but it's unclear when the official count will be changed.

Go deeper: Thirty years of Atlantic hurricanes

Go deeper

Off the Rails

Episode 4: Trump turns on Barr

Photo illustration: Eniola Odetunde/Axios. Photos: Drew Angerer, Pool/Getty Images

Beginning on election night 2020 and continuing through his final days in office, Donald Trump unraveled and dragged America with him, to the point that his followers sacked the U.S. Capitol with two weeks left in his term. Axios takes you inside the collapse of a president with a special series.

Episode 4: Trump torches what is arguably the most consequential relationship in his Cabinet.

Attorney General Bill Barr stood behind a chair in the private dining room next to the Oval Office, looming over Donald Trump. The president sat at the head of the table. It was Dec. 1, nearly a month after the election, and Barr had some sharp advice to get off his chest. The president's theories about a stolen election, Barr told Trump, were "bullshit."

In photos: Protests outside fortified capitols draw only small groups

Armed members of the far-right extremist group the Boogaloo Bois near the Michigan Capitol Building in Lansing on Jan. 17. About 20 protesters showed up, AP notes. Photo: Seth Herald/AFP via Getty Images

Small groups of protesters gathered outside fortified statehouses across the U.S. over the weekend ahead of President-elect Joe Biden's inauguration Wednesday.

The big picture: Some protests attracted armed members of far-right extremist groups but there were no reports of clashes, as had been feared. The National Guard and law enforcement outnumbered demonstrators, as security was heightened around the U.S. to avoid a repeat of the Jan. 6 U.S. Capitol riots, per AP.

Felix Salmon, author of Capital
8 hours ago - World

China's economy grows 6.5% in Q4 as country rebounds from coronavirus

A technician installs and checks service robots to be be used for food and medicine delivery in Jiaxing, Zhejiang Province, China, on Sunday. Photo: Hu Xuejun/VCG via Getty Images

China's economy grew at a 6.5% pace in the final quarter of 2020, the national statistics bureau announced Monday local time, topping off a year in which it grew in three of four quarters and by 2.3% in total.

Why it matters: No other major economy managed positive growth in 2020. Although the COVID-19 pandemic was first detected in China, the country got the virus under control and became one of the main positive drivers of the global economy even as the rest of the world was largely under lockdown.

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