Excess deaths and Hurricane María

We clarify the distinction between direct and indirect effects of disasters such as Hurricane María and use data from the Puerto Rico Vital Statistics System to estimate monthly excess deaths in the immediate aftermath of the hurricane which struck the island in September of 2017. We use a Bayesian linear regression model fitted to monthly data for 2010–16 to predict monthly death tallies for all months in 2017, finding large deviations of actual numbers above predicted ones in September and October of 2017 but much weaker evidence of excess mortality in November and December of 2017. These deviations translate into 910 excess deaths with a 95 percent uncertainty interval of 440 to 1,390. We also find little evidence of big pre-hurricane mortality spikes in 2017, suggesting that such large spikes do not just happen randomly and, therefore, the post-hurricane mortality spike can reasonably be attributed to the hurricane.