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https://www.nejm.org/doi/full/10.1056/NEJMsa1803972?query=featured_home

Mortality in Puerto Rico after Hurricane Maria

Our results indicate that the official death count of 64 is a
substantial underestimate of the true burden of mortality after
Hurricane Maria. Our estimate of 4645 excess deaths from September 20
through December 31, 2017, is likely to be conservative since
subsequent adjustments for survivor bias and household-size
distributions increase this estimate to more than 5000.