On September 20, 2017, Hurricane Maria made landfall in Puerto Rico, leaving widespread destruction in its path. The official death count for Puerto Rico after Hurricane Maria was 64 excess deaths, but that controversial death toll has been debated by a number of academic and independent researcher journalists. With the loss of electrical power and telecommunication systems for much of the island, it was unclear how many deaths in Puerto Rico were an immediate result of Hurricane Maria's destruction as opposed to the access to care conditions that prolonged. Santos-Burgoa et al. applied a time-series analysis of the Puerto Rico Vital Statistics data to estimate the death count over time. To consider how many people died as opposed to emigrated away from Puerto Rico, two counterfactual assumptions were used, a Census-based scenario and a Displacement-based scenario for expected population change. Under the Census scenario and the Displacement scenario, the estimated death counts in Puerto Rico was approximately 1200 deaths and 3000 deaths, respectively, where the Displacement scenario was acclaimed as the preferred model.

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Santos-Burgoa C, Sandberg J, Suárez E, Goldman-Hawes A, Zeger S, Garcia-Meza A, Pérez CM, Estrada-Merly N, Colón-Ramos U, Nazario CM, Andrade E. Differential and persistent risk of excess mortality from Hurricane Maria in Puerto Rico: a time-series analysis. The Lancet Planetary Health. 2018 Nov 1;2(11):e478-88. http://dx.doi.org/10.1016/S2542-5196(18)30209-2