Photo: Mario Tama (Getty Images)

When President Donald Trump visited Puerto Rico this past fall after Hurricane Maria, he insisted the island territory should feel proud to have not lost thousands of lives as compared to “a real catastrophe like [Hurricane] Katrina.” On Tuesday, however, a study from the Harvard T.H. Chan School of Public Health claimed that the number of people killed by the storm is likely at least 70 times higher than the officially reported death toll.

In their report, the researchers said they contacted more than 3,000 Puerto Rican households, chosen at random, and “asked about displacement, infrastructure loss, and causes of death.” They then compared the results with the official mortality rates from the same time period during previous year, and determined a total of “4,645 excess deaths during this period.” The official death toll from Maria and its aftermath stands at 64.

“In our survey, interruption of medical care was the primary cause of sustained high mortality rates in the months after the hurricane,” the researchers claimed. (The U.S. government’s combined refusal and inability to adequately respond to the island’s basic health and infrastructure needs following the storm has been extensively documented.)

What’s more, the study’s authors added (emphasis mine):

This number is likely to be an underestimate because of survivor bias. The mortality rate remained high through the end of December 2017, and one third of the deaths were attributed to delayed or interrupted health care. Hurricane-related migration was substantial.

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To put that in context, the death toll from Hurricane Katrina, President Trump’s so-called “real catastrophe,” is believed to be “just” 1,833 people—less than half of those now estimated to have died in Puerto Rico.

At a press conference held in response to the study, Puerto Rican Governor Ricardo Rosselló acknowledged that the island’s official count was almost certainly an underestimate of the actual death toll:

We since the beginning have said that number would rise that that was the result of the protocol we had and it’s for that reason that we have invited [George Washington University] to conduct an independent study.

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He went on to describe Puerto Rico’s existing protocol as “sub-par.”