Puerto Rico Orders Review and Recount of Hurricane Deaths

The Times’s review, based on daily mortality data from Puerto Rico’s vital statistics bureau, found that 1,052 more people than usual had died across the island in the 42 days after Maria struck. The analysis compared daily figures for 2017 with an average of figures for the corresponding days in 2015 and 2016.

Puerto Rico’s Center for Investigative Journalism reached a similar estimate, that 1,065 more people than usual had died in September and October. CNN compiled figures from half the island’s funeral homes to report that funeral directors believed that 499 more deaths than the official count were tied to the hurricane.

Methods for counting storm deaths vary by state and locality. In some places, officials include only direct deaths, such as people who drown in storm floodwaters. Puerto Rico’s method is not that restrictive; the medical examiner includes some deaths indirectly caused by a storm, such as suicides.

The leading causes of death on the island in September were diabetes and Alzheimer’s disease, Puerto Rican government data show. But there was a sharp spike — by 50 percent — in the number of recorded deaths from sepsis, a complication of severe infection that can be tied to delayed medical care or poor living conditions.

Mr. Rosselló had previously said that his government would look into questionably attributed deaths reported by the news media. On Monday he said he welcomed the outside reviews of the death toll, but he cautioned that the government could not adjust its official mortality count based on “statistical analysis.”

“Every life is more than a number, and every death must have a name and vital information attached to it, as well as an accurate accounting of the facts related to their passing,” he said.

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Reviewing the circumstances surrounding each death will require interviewing family members and doctors who signed death certificates to find out if, for example, the heart attack listed as the cause might have been brought on by stress related to the hurricane or might have been fatal because an ambulance could not get through debris-blocked streets to help in time.

For weeks after the storm, top leaders of Puerto Rico’s government insisted that its count of the dead was accurate and not significantly low. On Sept. 29, nine days after Maria made landfall, Héctor M. Pesquera, Puerto Rico’s public safety secretary, said he did not think the count would rise by much. Four days later, President Trump visited the island and remarked that the death toll — which officially stood at 16 at the time — was much lower than the 1,833 people who died in 2005 because of Hurricane Katrina.

Mr. Pesquera has repeatedly said that Puerto Rico hewed to the Centers for Disease Control and Prevention’s protocols for counting storm-related deaths, and has urged families to share information with the authorities about any deaths that may be linked to the storm.

“We always expected that the number of hurricane-related deaths would increase as we received more factual information — not hearsay — and this review will ensure we are correctly counting everybody,” Mr. Rosselló said on Monday.

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Trump’s national security strategy emphasizes economic competitiveness

WASHINGTON — The national security strategy that President Trump released Monday puts economic issues — trade, energy independence and even tax reform — on an equal footing with more traditional military issues like nuclear defense. 

The result is a doctrine that attempts to balance competing objectives: Emphasizing political and economic competition with countries like Russia and China while also enlisting their help with security challenges like North Korea’s nuclear program.

Trump will outline his foreign policy vision in a speech Monday afternoon. Many of the themes are familiar: Putting America first, ending unfair trade deals, building a border wall and making allies pay their fare share of defense.

But in forging those individual policies into a single coherent strategy, Trump sees a world in which the United States creates a better world simply by acting in its own economic self interests.

“Today, the international community has the best chance since the rise of the nation-state in the seventeenth century to build a world where great powers compete in peace instead of continually prepare for war,” Trump says in the preamble to the 68-page document.

The national security strategy is a report, required by Congress, in which each administration sets to lay out its foreign policy doctrines in broad terms. It was in similar documents that President George W. Bush described his policy of preemptive defense against regimes with weapons of mass destruction, and President Barack Obama coined the term “strategic patience.” 

For Trump, the buzzword is “principled realism.” 

That means an emphasis on national interests and sovereignty as the drivers of foreign policy. Or, as Trump has put it, “America first.”

It’s a strategy that puts more emphasis on the business climate than on climate change, a key focus of Obama’s last national security strategy document. In fact, Trump’s strategy says the United States will counter “an anti-growth energy agenda that is detrimental to U.S. economic and energy security interests.”

The strategy places an emphasis on cyber-security even as it reduces intelligence that Russia interfered in the 2016 presidential election to a single and vague sentence: ”Through modernized forms of subversive tactics, Russia interferes in the domestic political affairs of countries around the world.”

Trump describes Russia and China as “revisionist powers” intent on changing the global status quo by illegitimately seizing territory — Russia through its occupation of Crimea and China through its island-building in the South China Sea. China’s unique economic and military clout makes it what Trump will call a “strategic competitor,” aides said.

But that doesn’t mean that the United States shouldn’t cooperate with them when their interests align, Trump argues. Just Sunday, Trump received the personal thanks of Russian President Vladimir Putin after the CIA gave the Russian security service information about a planned terrorist attack in St. Petersburg. 

In other areas, Trump attempts to expand the concept of national security as encompassing fair trade, tax reform and deregulation. 

The strategy promotes the idea of “national security innovation base“ — a term coined by Trump trade adviser Peter Navarro to describe the technology and other intellectual property that gives the United States a strategic and economic advantage in the world.

Under the Goldwater-Nichols Defense Department Reorganization Act of 1986, the president is required by law to submit a report on national security strategy to Congress every year. But previous presidents have treated the report with varying degrees of importance — President Barack Obama, for example, submitted the report only twice, in 2010 and 2015. 

By submitting the report his first year in office — and giving a speech to announce it — Trump is signalling that he’s personally invested in the strategy, aides said.

The strategy will be the first of a number of reports the Trump administration will roll out over the next few months on defense strategy, counter-terrorism, biodefense, nuclear posture and missile defense, aides said.

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