To the Editor Drs Santos-Lozada and Howard1 estimated 1139 excess deaths in Puerto Rico from Hurricane Maria, which made landfall on September 20, 2017. They found that the observed death toll for September through November 2017 fell outside the 95% CIs of the mean death counts.
Given the destructive effect of Hurricane Maria, it is understandable that these months would be outliers from the historical patterns observed on the island. However, we have concerns that their method might be flawed and their estimation inaccurate.
Cruz-Cano R, Mead EL. Excess Deaths After Hurricane Maria in Puerto Rico. JAMA. 2019;321(10):1005. doi:10.1001/jama.2018.20861
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