The government-provided death toll stands at just 64, but experts say an accurate count was complicated by the power outages and widespread devastation wreaked by the storm, which caused $90 billion in damage and is ranked as the third costliest cyclone in the United States since 1900.
Earlier independent investigations had put the true toll at closer to 1,000. But the latest estimate, compiled by researchers at Harvard University, came back far higher - at 4,645 deaths from the day of the storm, September 20, until December 31, 2017.
For comparison, the death toll from 2005’s Hurricane Katrina - the costliest hurricane in US history - was far lower, estimated at 1,833.
Most deaths after Hurricane Maria hit Puerto Rico are blamed on interruptions in medical care due to power outages and blocked or washed out roads, said the report published in the New England Journal of Medicine.
“Approximately one-third of post-hurricane deaths were reported by household members as being caused by delayed or prevented access to medical care,” said the report.
Researchers went door-to-door at 3,299 homes randomly selected from across the US territory, home to some 3.3 million people.
Survey-takers used criteria from the US Centers for Disease Control and Prevention to determine if a person’s death could be blamed on the hurricane.
