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Comment & Response
March 12, 2019

Excess Deaths After Hurricane Maria in Puerto Rico

Author Affiliations
  • 1School of Public Health, University of Maryland, College Park
  • 2School of Medicine, University of Connecticut, Farmington
JAMA. 2019;321(10):1005. doi:10.1001/jama.2018.20861

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.