Hurricane Maria's death toll was far worse than officials said

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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.

The analysis, published in the New England Journal of Medicine, criticizes the Puerto Rican government's narrow accounting methods, calling its tally of just 64 deaths a "substantial underestimate". A new report says that estimate is off - by about 4,600.

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A Pennsylvania State University study put the number at 1,085. Harvard's independent review of the number of deaths in Puerto Rico will not be the last of its kind; in fact, George Washington University researchers were recently given the green light for a similar review.

For comparison, the death toll from 2005's Hurricane Katrina - the costliest hurricane in U.S. history - was far lower, and estimated at 1,833. Researchers surveyed households on the battered island in Maria's wake and found evidence of more than 4,600 "excess deaths" during the storm and the weeks that followed.

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"These numbers will serve as an important independent comparison to official statistics from death-registry data, which are now being re-evaluated, and underscore the inattention of the US government to the frail infrastructure of Puerto Rico", the research team wrote. FEMA eventually attributed 1,800 some deaths to that 2005 Gulf Coast storm. The CDC reportedly classifies deaths as attributable to the storm if they are caused by "forces related to the event, such as flying debris, or if they are caused by unsafe or unhealthy conditions resulting in injury, illness, or loss of necessary medical services".

The 2018 Atlantic hurricane season begins June 1.

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Researchers explained that the actual toll was more likely 5,740 when they accounted for deaths among people who had been living alone.

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