Hurricane Maria claimed the lives of 4,645 people in Puerto Rico a year ago and not the 64 long pegged by the island's Government as the official death toll, according to a survey of thousands of residents by a research team led by Harvard University.
The Harvard University-led study was based on a survey of 3300 households that was compared with official figures to determine how many excess deaths took place up to the end of past year.
The official death toll has been questioned for months.
The death toll according to Puerto Rico's official government is 64.
The estimate accounts for direct causes of death due to the hurricane, such as bodily injury or drowning, as well as indirect causes of death: One third of all deaths caused by Maria could be attributed to "delayed or interrupted health care" as well as lack of access to food, water, and other necessities, the study said.
"Our results indicate that the official death count of 64 is a substantial underestimate of the true burden of mortality after Hurricane Maria", the researchers wrote. The Puerto Rican government has commissioned an external review of its death-registry data by researchers at George Washington University; while it was originally scheduled to be released in May, it is now expected sometime this summer.
The government of Puerto Rico stopped publicly sharing its data on hurricane deaths in December 2017.
Maria, a major hurricane with winds of about 240 kilometres per hour, caused an estimated $US90 billion ($120 billion) in damage to an island already struggling economically, and many residents have subsequently left. In October, when the official death count in Puerto Rico was still sixteen, President Trump visited Puerto Rico, threw paper towels into a crowd of people in need of federal aid, and spoke of the low official death count with pride.
Gathering data on Puerto Rico's death counts has been a contentious and hard task.