Thread by @jdsutter

This is grossly misleading. The best estimate is that 3,000 died b/c of Maria. That many if not most of those deaths occurred well after the storm is an indictment of federal/local response. Thousands were without power FOR MONTHS. People died w/o access to basic services. /1

https://twitter.com/realdonaldtrump/status/1040217897703026689

CDC guidelines say “indirect” hurricane deaths are still hurricane related deaths. This includes people who died because of lack of medical services, power, counseling etc. Medical examiners apply the “but for” test. But for the hurricane would this person be living? /2

We’ve met with MANY families of people who died in the aftermath of Maria. We surveyed 112 funeral homes across PR. We sued for records that highlighted hurricane deaths the government hasn’t recognized. All evidence suggests there were thousands of deaths /3

The most generous possible read of the Trump tweet is that he fundamentally misunderstands the types of deaths that count as hurricane related. Even that falls apart when you know many deaths were unreported by officials. Total chaos/lack of comms early on. /4

The 2,975 figure comes from at George Washington U study that measures the “excess deaths” that occurred in the months after Maria - compared to the usual number of deaths in PR. It’s a statistical measure. But good for the overall picture. Academics approve /5

Other academics have come up with similar estimates btw. Some higher. Some lower. All +1,000. /6

Please ask questions about this if you have them. I’m boarding a flight to PR now but will try to answer. /7

Instead of ranting about it I’m going to post a bunch of the CNN investigative stories about the death toll, in chronological order. I started investigating this in October 2017. /8

In Oct last year Trump praised Puerto Rico for having a relatively low death toll. Then 16. Later that day after Trump left the island the toll jumped to 34. That -combined with anecdotes of underreporting of deaths- pushed me to start digging into this issue /9

.@cristianmarroyo and I went around to every funeral home in one town - Arecibo - at a time when roads/phones were still pretty awful. We published a story on Oct 27, showing funeral homes there believed about 25 in that one town died b/c of Maria. Govt count there: one. /10

Here's a link to that piece from Arecibo in Oct. It's memorable now in part because a PR official told me it was "horseshit" that anyone would insinuate the death toll was being politically manipulated. cnn.com/2017/10/27/us/… /11

That mismatch between what funeral homes in Arecibo told us and the official PR gov't number for that town led me to pitch an island-wide survey of funeral homes, thinking they would be the only ones who had the data at that point - again with few phones working etc. /12

I teamed up with @leylasantiago @KhushbuOShea @McKennaEwen @cristianmarroyo and several other local journalists to survey as many funeral homes across PR as possible. We reached 112 of them. In Nov. we published the results of that survey. cnn.com/2017/11/20/hea… /13

Funeral homes told us - based on their records - they'd identified 499 deaths they considered hurricane-related. That wasn't meant as an exact number - just the best approximation possible at a time with few comms/no records access etc. That was about half of funeral homes. /14

More impt than the survey were the stories we started to uncover. I met the family of Pilar Guzman Rios in Corozal. She kept three parrots on her back patio, taught them to chant the Rosary and sing "La Cucaracha." When she got sick, "even the cats prayed for Pilar." /15

Pilar's death was like many in the appx 3,000 that occurred b/c of Maria. No power to refrigerate insulin. No power for the breathing machine she needed to survive. Ambulance didn't come. Again, per CDC, these are storm deaths. Caused by lack of vital services... b/c Maria. /16

Another person you should meet from that Nov. story: Quintín Vidal Rolón. He was 89. Known for his white hat and beat-up Ford. He built homes. Always in concrete, b/c that was safer. He cleared debris from his street after Maria hit. Again, at age 89. Incredible human. /17

Quintín died in a lantern fire. Oct 20. On month later. Power hadn't been restored. He wouldn't have been using that lantern if not for Maria.

This is what relatives found of his home. /18

From that Nov 2017 story. /19

At the time of our Nov 2017 investigation, Puerto Rico had reported only 55 deaths. That didn't mean only 55 hurricane deaths had occurred. It meant that that's what had been reported. Funeral homes said otherwise. /20

The PR government's response to that story was almost instant. Officials implored funeral homes to turn over info about the deaths.

cnn.com/2017/11/21/hea… /21

Academics/NYT started conducting studies of "excess death" to get a better approximation of how many people died, especially from indirect causes.

nytimes.com/interactive/20…

cnn.com/2017/11/29/hea…

/22

In December, Puerto Rico Gov @ricardorossello ordered a review of the death toll from the storm, citing news reports that had raised questions. /23

In Feb @ricardorossello announced GWU would conduct the analysis on behalf of the government. But with independence/academic rigor. cnn.com/2018/02/22/us/… This later results in the 2,975 estimate. /24

One of the hardest stories I've reported published in March. People were STILL DYING in PR because of the conditions brought about by the hurricane and the slow response of the government. "We are the forgotten people." That statement haunts me. cnn.com/2018/03/15/pol… /25

Here's a chart that shows why PR was different.
Y-axis = MILLIONS of people without power.
X-axis = number of days after these various storms.
You can see power restored so. much. faster. in florida/texas.
It's hard to argue logistics/distance account for all of this. /26

Fast fwd to spring/early summer. The government of Puerto Rico fights me/@CNN and @cpipr in court over mortality records. We'd sued for access. A judge agrees with us. PR tries to stall the release. But, eventually, they are forced to give them over. cnn.com/2018/06/12/pol… /27

In those records: some ppl whose deaths were labeled "victim of cataclysmic storm" were unaccounted. We also uncovered w/ @cpipr an apparent "epidemic" of waterborne illness that had been downplayed.

cnn.com/2018/07/03/hea…

cnn.com/2018/06/16/hea… /28

Meanwhile, academics just kept producing massive estimates -- all in the thousands -- on the death toll. The official count from PR still was 64, despite a preponderance of statistical evidence that it was higher.. /29

cnn.com/2018/08/02/hea…

cnn.com/2018/05/29/us/…

PR declined to comment much about Maria deaths until the GWU study they commissioned came out in August, after considerable delays. That study estimated 2,975 people died in the storm. It's the PR govt's official death toll. cnn.com/2018/08/28/hea… /30

Now the big Q is not whether 3K ppl died -- all evidence suggests that is ballpark correct, Trump's tweet notwithstanding -- but who exactly those individuals were. Why the official toll was so low for so long. Why it jumped after Trump's visit. And who's to blame for deaths. /31

We keep pushing to get more info about individuals b/c:
1. Their stories matter.
2. They shouldn't be forgotten.
3. Families need deaths to be documented as storm-related in order to get FEMA to pay for some of their funeral/burial costs. /32

FEMA has paid funeral benefits for only 247 cases as of Sept 5.
They've gotten 3,005 applications for that assistance.
Again, these are ppl claiming deaths were Maria-related.

cnn.com/2018/09/11/hea… /33

Will end this thread here for now.

In closing: These stories matter. This context matters. "Indirect" hurricane deaths ARE hurricane deaths, per CDC. And deaths were wildly underreported.

Plus: Grappling with this actual reality could help prevent future storm deaths. /34