We Don’t Know for Sure, and the Death Toll is Still Climbing
by Anne Polansky
Sr. Climate Policy Analyst
The 2018 hurricane season is now upon us, even while millions of people residing in hurricane alley – the large swath of ocean stretching from Africa to North America – are still recovering from the hyperactive, catastrophic 2017 hurricane season. Last year we saw Hurricanes Franklin, Gert, Harvey, Irma, Jose, Katia, Lee, Maria, Nate, and Ophelia – 10 hurricanes in all – swoop through the Atlantic and Caribbean Oceans, some wreaking a path of major destruction and devastation. Six of these were considered to be major hurricanes, reaching Category 3 and above. In addition, there were seven named tropical storms. 2017 was the fifth most active hurricane season in recorded history, and featured the highest total accumulated cyclone energy (ACE), or the cumulative wind energy for all hurricanes and storms over a season. To many, this is proof-positive of the deleterious effects of climate change: a warmer atmosphere and warmer waters pump energy and water into tropical storms, creating “hurricanes on steroids,” as the preeminent climate scientist Stephen Schneider would often quip. (See CSPW related posts on hurricanes as climate change impacts: for example, here, here, and here, also listed below.)
For Puerto Rico, Hurricanes Irma and Maria packed a harsh one-two punch that brought the island nation to its knees last September, wiping out the entire electricity grid, toppling buildings, downing trees, flooding large areas, and rendering parts of Puerto Rico uninhabitable. The island is still heavily crippled: many are still without power and the entire electricity grid is prone to crashing every few weeks; many lack potable water, sufficient food, and safe shelter. Hundreds of thousands have fled and are still fleeing to the U.S. mainland and elsewhere. Well over one thousand Puerto Ricans have lost their lives as the direct result of Hurricane Maria, and the true mortality rate is still climbing. Yet, we do not have in place methods for accurately counting the death toll following such disasters. Worse, we vastly underestimate the mortality rate by counting only those who die in the immediate aftermath of a natural disaster. This needs to change if we are to accurately assess the number of human lives lost following extreme weather events associated with climate change.
Hurricanes can be deadly, but hurricanes souped-up by climate change are much deadlier.
The way we measure the human mortality rate following a so-called “natural” disaster such as a major hurricane is fundamentally flawed. The number of fatalities that becomes the official death toll for any natural disaster typically includes only those who die as a direct result of, and immediately following, an extreme weather event – e.g. those who drown in floodwaters, suffer deadly blunt force trauma in collapsed buildings, are suddenly disconnected from life-support machines, or meet their demise in other ways directly attributable to the disaster. The official count thus excludes those who die in the following days, weeks, even months, from conditions directly related to the disaster – e.g. those who die of dehydration; those who succumb to infectious disease worsened by unsanitary conditions; those with serious illnesses who lack access to hospitals and medical care; those who die from heat exhaustion because there is no power for air conditioning; and so on.
About two-thirds of the island’s hospitals were put out of commission by Maria and it has taken time to rebuild and repair damage done by high winds and floodwaters. In the days and weeks following Maria, only 29 of the island’s 70 hospitals were intact enough to treat patients. Still today, some hospitals remain so badly damaged that they are operating at partial capacity. The Kaiser Family Foundation has published a comprehensive report on the overall damage done to Puerto Rico’s health care system, including its infrastructure. Six months following Maria, growing physical and mental health needs, together with frequent power outages, are presenting major challenges to the health care system compromised by the storm.
The official death count for Puerto Ricans who died as a result of Hurricane Maria stands at 64, but the true number is two orders of magnitude higher. Moreover, eight months out, the death toll is still climbing. A December 2017 New York Times analysis of daily mortalities on the island between September 20 and October 31 found that in the 42 days following Maria’s landfall, 1,052 more people than usual had died. This number is consistent with data collected and reported by the Center for Investigative Journalism, a Puerto Rico-based organization, and with a study conducted by Alexis Santos, director of graduate studies in applied demography at Pennsylvania State University. Santos studied the daily mortality data from the Puerto Rican government and found approximately one thousand more deaths than normally occur on the island in the month after Maria (see CNN news report). These findings are also consistent with numbers reported in the Journal of Health Affairs, which published a research study in April titled “In Puerto Rico, Counting Deaths And Making Deaths Count.”
Indeed, if we remain ignorant of the actual number of deaths caused by major hurricanes – hurricanes made more powerful and deadly as the result of higher-than-normal average global temperatures – we cannot begin to understand their full impact or to take the steps necessary to save lives. Prevention of mass casualties following major storms through improved preparedness must be paramount in public policymaking, else we can expect continued, and unnecessary, loss of life.
However, the numbers in all of these studies are approximations. The tragic truth is that we still do not know how many people died from Hurricane Maria (see, for example, a recent ABC News report and an April article in The Atlantic). Medical examiners tend to report the clinical cause of death, such as head trauma or drowning, and normally do not make reference to a hurricane on a death certificate.
An alarming piece posted on BuzzFeed reported that the Puerto Rican government has been permitting the bodies of those who died as a result of Hurricane Maria – and presumably other hurricanes – to be cremated without being included in the official hurricane death count. Funeral home directors report that they lack proper instruction and are generally unclear about how to classify hurricane-related deaths. San Juan Mayor Carmen Yulín Cruz expressed her frustration: “I asked for transparency regarding death toll,” she tweeted in November, adding, “Request for funeral homes to provide info=no credibility.”
The official death count also excludes those who decide to take their own lives by committing suicide, rather than suffer the difficult aftermath of a powerful hurricane. The suicide rate in Puerto Rico spiked after Hurricane Maria and was significantly higher in 2017 than in previous years. The mental health of many Puerto Ricans has been compromised as the result of multiple factors related to the storm: grief from losing loved ones; anxiety and stress associated with difficult living conditions; even PTSD following the sheer trauma of experiencing a hurricane as fierce and unforgiving as Maria.
In February, Puerto Rico Governor Ricardo Rosselló announced that the Milken Institute School of Public Health at George Washington University in Washington, DC, in partnership with several Puerto Rican institutions, would be conducting a full review of the death count following Maria (see announcement in GW Today). However, if a more accurate death count is not completed soon, we may never know the true number. The 2018 hurricane season has already begun, and should Puerto Rico be so unlucky as to be hit again with a major storm and suffer additional deaths, this will further complicate the gruesome task of counting those who continue to lose their lives as the result of Maria.
Artificially low death counts after major hurricanes amount to “alternative facts” and “fake news.”
During President Trump’s visit to Puerto Rico on October 3rd, he appeared to be congratulating Puerto Ricans for the low death toll – measured at 16 at the time – saying they should be “proud.” After callously tossing a roll of paper towels into a crowd gathered in a shelter, he downplayed the seriousness of Hurricane Maria by comparing the official two-digit death count so far to the nearly 2,000 deaths attributed to 2005’s Hurricane Katrina, calling Katrina “a real catastrophe.” The fact is that Maria now tops the list of worst natural disasters in Puerto Rico in recorded history. By Trump’s visit, 556 more people had died than in years past, according to the same New York Times analysis referred to previously.
“Sixteen people certified,” Mr. Trump said. “Sixteen people versus in the thousands. You can be very proud of all of your people and all of our people working together.”
A week later, on October 12, President Trump placed blame for the devastation following Maria on the Puerto Rican government for allowing its infrastructure to degrade. He also threatened to withdraw FEMA, Army Corps of Engineers, and other federal disaster assistance personnel from the island, arguing in a set of tweets that Congressional appropriations for Puerto Rico for emergency disaster relief had “thrown our budget a little out of whack.” Trump didn’t mention the large appropriations that also went to Texas and other states affected by hurricanes in 2017. By downplaying the tragedy, the U.S. government is able to rationalize offering less support to the Commonwealth of Puerto Rico, compared with support to states on the mainland.
Artificially low death counts lead to false impressions regarding the deadliness of extreme weather events, made deadlier as a result of global warming and climate change. If we want to be real about the hazards of failing to mitigate, adapt to, and prepare for climate change impacts, we need to know how many lives are lost as the direct result of these impacts.
Truth-Teller Carmen Yulín Cruz Soto, Mayor of San Juan, Blows the Whistle on the U.S Government
About a week after Maria made landfall, San Juan Mayor Carmen Yulín Cruz Soto made an impassioned plea to cut bureaucratic red tape in Washington and allow FEMA assistance to flow. “People are dying,” she pleaded. She is still pleading.
“We were dying, and they were killing us with their bureaucracy and their inefficiency,” the mayor of San Juan, Puerto Rico told her audience of several hundred at the National Press Club. It was April 18, and after grueling efforts had restored power to most of the island, the entire grid failed and all Puerto Ricans were without power – again. It had been 211 days since Hurricane Maria struck the island on September 20, and 225 days after Hurricane Irma made landfall there. Mayor Yulín had shed her jeans and work boots to get all dressed up and to travel to Washington, DC to accept the Ron Ridenhour Prize for Truth-Telling. Don’t be fooled by Mayor Yulín’s diminutive stature and unassuming manner: this remarkable woman can speak truth to power with the best of them.
For example, in late September, when Acting Secretary of Homeland Security Elaine Duke had remarked, “I know it is really a good news story in terms of our ability to reach people and the limited number of deaths that have taken place in such a devastating hurricane,” Yulín shot back. “Dammit, this is not a good news story, this is a ‘people are dying’ story. It’s a life or death story.” Acting Sec. Duke was forced to clarify: “The end of my statement about good news was it was good news that the people of Puerto Rico, the many public servants of the U.S. and the government of Puerto Rico are working together,” she said. If anyone wonders whether Puerto Rico is viewed as a U.S. colony, consider how odd it would be to hear the same said about the recovery efforts in Texas or Florida. Federal-state-local government cooperation is something we can and should take for granted on the mainland.
The 3.5 million people who live in Puerto Ricans are U.S. citizens and have the right to be treated equally with all other U.S. citizens, yet, the island’s status as a U.S. territory has caused many to view Puerto Rico as a U.S. colony and to disregard the lives and livelihoods of Puerto Ricans; Puerto Ricans have become accustomed to such political subordination. “Maria has unmasked many truths, one is that Puerto Rico’s status, its colonial status, must change into a dignified relationship, one that sets us off on a path of mutual dignity and respect,” Mayor Yulín told the Ridenhour event attendees. At this point, however, it is difficult to see how that will happen.
“I’m not the same person I was on 20 September of last year. None of us are,” Cruz had remarked at a political summit in Baltimore, MD in March (See The Guardian, March 21, 2018). “We’ve all changed. We look at life with different eyes,” she said.
CSPW Posts on Hurricanes and Climate Change
- Hell and High Water: the Perils of Climate Denial Politics — South Carolina as a Case Example (October 2015)
- Floods, Fires, and Public Policy Failures: ExxonMobil Facilities are Among Those Being Slammed by Climate Change Impacts (July 2016)
- Exxon Mobil Has Been Silent About Climate Change Risks to Its Operations: Will Hurricane Harvey Change That? (September 2017)
CSPW Senior Climate Policy Analyst Anne Polansky has 30 years of experience in public policies relating to energy and the environment, with a strong focus on climate change and renewable energy. She is a former Professional Staff Member of the House Committee on Science, Space and Technology.
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I was at home cleaning my toilet – I do my own cleaning – when I got this call telling me that I was to receive the Ron Ridenhour award for truth-telling. And I thought, “this has got to be a joke.” And I remember saying, “Look, you know, I only did what I had to do.” I am the great granddaughter of a sugar cane plantation worker. My grandmother worked in a cafeteria at night in New York City so that my father could eat there during the day. So, I am two generations removed from extreme poverty. So, I thought, this isn’t special, you do what you have to do when the time calls for it. And then I remembered I was a politician. [Laughter]. And I thought well, maybe this is somewhat strange. And then I remembered I was five feet tall – and I was a woman – and I was a woman of color.
So, you see, sooner or later we all have a choice to make in life. We either tell the truth, no matter what the consequences, or we stand down and are quieted. With that silence we profoundly participate in a complicity for the absolution of reprehensible acts. That is precisely what I had to do. I had a choice: to tell the truth after two hurricanes – not one, two hurricanes – Irma and Maria, devastated the island nation of Puerto Rico. I raised my voice in an effort to bring attention to the humanitarian crisis brought upon by the neglect displayed by a man that does not get it. It isn’t that he can’t get it, it’s that he does not get it.
Playing along would have meant giving way to a false narrative, thus I told, for some, the inconvenient truth. We were dying, and they were killing us with the bureaucracy and their inefficiency. And so, the simple act of truth-telling brought me to you today.
While the American people opened their hearts and reminded us time and time again that we weren’t alone, that our lives mattered, that we weren’t going to be dismissed and forgotten, the President of the United States and the federal government failed the people of Puerto Rico, and people died because of that.
Faced by their inescapable inefficiency, the Trump Administration engaged in an attempt to cover up their failed efforts – someone so far as to call the Puerto Rican situation a good news story, in an attempt to change the narrative. There are actually some Pentagon Papers written, emails sent to a reporter whose name unfortunately now I forget, stating that the Mayor of Puerto Rico continues to be a damp on us trying to change the narrative, and stating that only the massacre in Las Vegas seemed to have changed the focus. The implication was that lives could be traded from one place to another, that deaths could be looked at as a way of covering up the inefficiency of the very people were supposed to be there to help.
I didn’t know about Ron Ridenhour either. But, I did what every person in this room does a couple of times a day, I googled. I read his letter and I couldn’t believe the similarities from 1969 to 2018. In this letter, Mr. Ridenhour states after hearing this account, I couldn’t quite accept it. So, after seeing the pain in people’s eyes; after seeing the women that had to hold onto a rope to go from one side of the river to another just to get a nebulizer so that their children would not die of an asthma attack; seeing the hunger and the thirst of elderly people who were waving from outside their homes just asking for somebody to help. I had never seen poverty like that before. I’d seen it here [pointing to her head], but I’d never felt it here [placing her hand over her heart].
I had a grandmother that, as small as she was, she had a huge heart. She sheltered me from that; she went to school at NYU and Columbia University and made sure that education gave me a future. So, if there are teachers here, never give up the fight, never. My grandmother taught me that, because I was small, I had to run a little faster, hit a little harder, speak a little louder – and louder I spoke.
After seeing all of that, I couldn’t quite accept it. So, I did what I had to do in the hopes that somebody would hear us and somebody would help us, and the suffering and violation of our human rights would end. I have to thank the AFL-CIO and the 327 – I know exactly the amount – of workers: machinists, electricians, plumbers, doctors, medics, and teamsters. And no, that was not a Che Guevara cap I was wearing, it was an International Association of Machinists’ cap, which I will wear forever in the honor of men and women who left their homes just to tell us that our lives mattered.
I am often asked why I believe this happened. You see, it is difficult to understand that a country that can put a man on the moon 238,900 miles away cannot fathom the logistics to take help, to help men, women, and children, one thousand miles from its coast, because, as it was said, the logistical challenges were unsurmountable. Well, maybe from Mara Lago golf course they were unsurmountable. [Applause]
So, the neglect and the deaths that followed will forever be etched in all of our memories. For you can kill with a weapon as was done in Mỹ Lai, or you can kill with neglect. For, inaction produced by neglect and injustice can also be considered an act of aggression.
Perhaps it was too easy for President Trump and his Administration to disregard our lives because we are a territory, a colony of the United States. But we know better. The American people have not forsaken us, and they have done what some in the federal government have been unable to do. They have helped us understand that we no longer have to consent to be treated like less.
Maria has unmasked many truths, one is that Puerto Rico’s status, its colonial status, must change into a dignified relationship, one that sets us off on a path of mutual dignity and respect.
Don’t let the lights in San Juan fool you. Just today, again, the entire island Puerto Rico is without power, and it’s going to take about three days to get the power back on.
Last week, again, two days, the entire island was without power, and so it has come to pass every so many weeks.
And it always seems to be the same line, the line that supposedly was replaced by Whitefish Corporation. There is something fishy there, right?
So, I humbly accept this recognition on behalf of the thousands of Puerto Ricans that still have no electricity, seven months after Maria. On behalf of the parents, teachers, and children who today are taking to the streets to defend their communities by protesting against the closing of their schools, as their local government shows disregard for a public education. More than 300 schools are going to be closed and communities are going to be ripped apart.
I accept it on behalf of university students who are fighting to keep campuses open, and their tuition affordable as the fiscal control board tells us that we have to close half of the university campuses in Puerto Rico. On behalf of the elderly who will soon see their pensions reduced, as part of a long list of austerity measures imposed on us by a fiscal control board that, without a doubt, is evidence of Puerto Rico’s political subordination, and whose existence must come to an end.
Also, I accept this award on behalf of the close to 500,000 Puerto Ricans who had to leave Puerto Rico just to survive. Families have been ripped apart because conditions at home are not what they should be.
And it makes you mad.
I am more comfortable in tactical boots and jeans and a T-shirt, but I got all dressed up today just to ask you to help us and continue repeating the voices of help because people are still dying.
People cannot plug themselves to their respirators because the amount of diesel that it takes and the money that it takes to get them running just is not enough. We don’t have enough. It’s not like what the President said, that we want things to be done for us, we want to be able to do things for ourselves.
We are so grateful for so many in this room who have hugged me and said “I went down to Puerto Rico” on this day and that day. We are so grateful for the teachers and the unions and the AFL-CIO workers. But we still need your help.
We must continue to be unapologetic and relentless in telling the truth and asserting our right to be treated, all of our rights, to be treated with dignity. But most of all, I must continue to tell the truth, no matter what they say, no matter who says it, no matter the color of the house where they live in.
Because you see the truth is we don’t even know how many people have died. We have to honor the lives of the roughly more than one thousand Puerto Ricans who died as the result of a botched effort, at the hands of an administration that is mostly concerned about the narrative and the political implications.
I ask you to help me further the message. The political subordination and financial domination which allowed this injustice and neglect to occur must come to an end. I humbly ask you to help us further our endeavor. I am committed to continue to tell the truth in order to save lives, because after all, my grandmother taught me that you never start a fight, but you never, never, never leave one unfinished.
Thank you very much.