Harvard researchers unveiled a study which provided new insight on mortality in Puerto Rico following Hurricane Maria, a study which, among other occurrences, estimated a total of 4,645 deaths as a result of the storm. The estimate, as noted by researchers, is imprecise, but the figure will likely prove an effective starting point in the quest to fully gage the storm’s impact.

While a number of deaths were directly caused by Maria, thousands may have died as a result of poor conditions in the months following the hurricane. The Harvard study found that, on average, households went 84 days without electricity, 68 days without water, and 41 days without cell phone coverage. In addition, many homes remained without electricity and water at the time of the survey.

On top of a shortage of clean water and electricity, island hospitals sat in dire straits, unable to deal with a sudden influx of patients, and pharmacies remained low on medications. These along with similar factors, played a role in interrupted medical responses and an uptick in poor health, both of which led to increased death. One third of deaths, according to the study, were due to delayed or interrupted medical care.

The estimated number of deaths, 4,645, is actually the midpoint of a range of estimates from 793 to 8,498 (including a midpoint is standard for this type of study). To find these numbers, researchers surveyed a random sample of 3,299 households and found that of these, 38 people had died right after the storm hit. Responses were used to determine a mortality rate, which was then compared to that of the previous year.

The study is noteworthy due to the sheer magnitude of its death toll estimate. The figure stands over 70 times higher than the official toll of 64 and more than 4 times higher than previous estimates from other sources.

One reason for the discrepancy is simply a matter of time frame, as the Harvard study was conducted months after others. Additionally, the study utilized a different method to obtain its estimate. The New York Times, for example, compared the number of deaths per day in September and October of 2017, to the two preceding years, concluding with up to 1,052 excess deaths. Puerto Rico’s Center for Investigative Reporting, Pennsylvania State University and the University of Puerto Rico-Mayaguez, following similar methods, also estimated around 1,000 deaths.

The official hurricane death toll lies at 64, a number disputed by many (including the government of Puerto Rico itself). The figure is based on the amount of deaths medical examiners have identified as to be directly connected to the storm, an inaccurate method of measuring fatalities directly or indirectly caused by the hurricane.

In December, Puerto Rico’s government pledged to review the death toll and commissioned a study from George Washington University. The study is expected to be available at some point during the summer, and may fuel further discussion on the full effects of Hurricane Maria on Puerto Rico.

Regardless of the exact number of casualties incurred by Hurricane Maria, it's clear that far too many preventable deaths resulted. By understanding mortality following Hurricane Maria, the effects of delayed responses and poor infrastructure can be measured, allowing those on the island, and elsewhere, to stand better prepared for similar situations.