"The results of our epidemiological study suggest that, tragically, Hurricane Maria led to a large number of excess deaths throughout the island", principal investigator for the report, Carlos Santos-Burgoa, said.
Researchers said they adjusted for various factors that could account for fluctuations in mortality, most notably the displacement of some 241,000 residents who fled the island in the immediate aftermath of the storm. That's a far bigger number than initially thought, and those affected tended to be the elderly and the poor.
Hurricane Maria was the most powerful storm to strike the Caribbean island in nearly a century.
It was the third major hurricane to hit the United States with lethal force in less than a month previous year, following Harvey in Texas and Irma in the Caribbean and Florida.
"Those interviewed said they did not receive information about how to certify deaths during, or in conditions created by, a disaster", according to the report.
San Juan Mayor Carmen Yulín Cruz, who tangled with President Trump over hurricane response after the storm, tweeted, "These deaths due partly to negligence". This is a people-are-dying story.
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It could have political implications, as Donald Trump had marvelled over the small number of fatalities compared with "a real catastrophe like Katrina" and was criticised for responding half-heartedly to the disaster.
A Harvard study published in May in the New England Journal of Medicine estimated the storm's death toll at 4,645, and said that figure is still "likely to be conservative".
"These numbers are only the latest to underscore that the federal response to the hurricanes was disastrously inadequate and, as a result, thousands of our fellow American citizens lost their lives", she said in a statement.
Santos-Burgoa said the high death toll, ranking Maria among the worst natural disasters in USA history, was evidence that "we lack a culture of preparedness".
Parsippany-based Acrow Bridge, an worldwide bridge engineering and supply company, announced it is finishing up the last two of 14 bridges ordered to aid in the reconstruction of Puerto Rico's transportation infrastructure. At the time, the New York Times reported that the Puerto Rican government said it would wait to update its official tally until after the George Washington University study was released.
Nearly 3,000 people died in the wake of Hurricane Maria, which battered Puerto Rico last September, the USA territory announced after a new study.
The official death toll from Maria has been a point of contention since the storm ripped through the middle of the island September 20, destroying homes and island infrastructure, displacing thousands and plunging the island into a blackout for months.
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