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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