Saturday, August 18, 2018

Puerto Rico gov’t sticks to its commissioned report on hurricane deaths

By on May 31, 2018

Editor’s note: This article originally appeared in the May 31 – June 6, 2018, issue of Caribbean Business.

The issue of deaths in Puerto Rico from Hurricane Maria took an unexpected turn this week after a new independent study, published by the prestigious New England Journal of Medicine, came to light, which sets the number of victims at 4,645, which is 70 times more than the 64 deaths reported by the local government.

The investigation–conducted by various departments from Harvard University, in collaboration with the Puerto Rico Science, Technology & Research Trust; the Psychology Department of Universidad Carlos Albizu; and Ponce Health Sciences University–reflects a dramatic increase compared to officials estimates. The findings were compiled and analyzed using three different methodologies: Sampling Framework, Household Survey and Statistical Analysis.

Harvard survey: Over 4,600 people died in Puerto Rico in aftermath of Hurricane Maria

One of the first high-ranking officials from the executive branch to react to this study was the director of the Puerto Rico Federal Affairs Administration (PRFAA), Carlos Mercader, who for the first time acknowledged in the name of the Government of Puerto Rico that they expected a higher number than those officially released.

“The Government of Puerto Rico welcomes the newly released Harvard University survey and we look forward to analyzing it. As the world knows, the magnitude of this tragic disaster caused by Hurricane Maria resulted in many fatalities. We have always expected the number to be higher than what was previously reported. That is why we commissioned George Washington University [GWU] to carry out a thorough study on the number of fatalities caused by Hurricane Maria, which will be released soon. Both studies will help us better prepare for future natural disasters and prevent lives from being lost.”

For his part, Gov. Ricardo Rosselló Nevares reacted hours after the report was released, stating: “We want the real numbers to come out. We had a protocol that really was subpar, and we recognize it.”

From right, Gov. Ricardo Rosselló and Public Safety Director Héctor Pesquera (Courtesy)

Rosselló Nevares made the comments during a press conference where details on the government’s readiness to handle disasters were given. The National Guard and Federal Emergency Management Agency (FEMA) took part, as well as the local security component headed by Héctor Pesquera.

It was Pesquera, after consulting with the governor in an aside, who issued a controversial declaration about the investigation by the third-best university in the world, as ranked by the 2018 QS World University Rankings.

“The study, although we have not seen it, the one from Harvard is based on a survey, not based on scientific data. The one from George Washington comes with a different methodology. At some given moment, I am sure George Washington will get in touch with them and will try to validate it, but a survey is not the same as a scientific base, which is what George Washington is carrying out,” said Pesquera, who serves as state coordinating officer during the emergency.

Pesquera’s declaration did not happen in a vacuum because, at the closing of this week’s edition of the newspaper, Judge Lauracelis Roques, of Puerto Rico’s Court of First Instance, had under her consideration whether to grant the Centro de Periodismo Investigativo (Center for Investigative Journalism, or CPI by its Spanish acronym) and CNN access to raw data compiled by the Health Department on deaths after Maria.

“One of the arguments being discussed at the trial was the balance of the public interest that the judge has to make when deciding if the information being solicited has some parts that may be confidential and if these, under any law or regulation, have priority over the public interest to know about the conditions under which people died after Hurricane Maria, said Carla Minet, executive director of CPI. “Now that we know once again that the release of information on how many people died and how they died has been postponed, from my perspective it gives urgency to the call that we are making for the information to be divulged now. We are at the door of a new hurricane season and continue to not know how to best prepare for a possible storm or emergency situation as terrible as the one we experienced.”

Status of GWU’s preliminary report a mystery?

What is the status of the GWU report and what information have researchers asked for to date to complete their independent study? Caribbean Business asked La Fortaleza press secretary Yennifer Álvarez Jaimes on on May 8.

“They continue to work on the report. In the end, the requested data will be informed. They have been in communication with the public agency and it is expected they will contact professional organizations linked to the response to the emergency. They have requested documents and interviews of government officials that have taken place,” Álvarez Jaimes said in a written statement six days before the contract was signed. It was not until May 1481 days after the independent investigation was announced to commission the study—that the agreement, obtained by Caribbean Business, was legally binding.

Preliminary report on Hurricane Maria deaths in Puerto Rico vanishes

On May 4, Caribbean Business filed a request for information with epidemiologist and study director Dr. Carlos Santos-Burgoa to review the progress of his investigation. It was not until May 22 that the petition was referred to the director of media relations at GWU’s Milken Institute, Kathleen Fackelmann, in Washington, D.C. Follow-up emails have yet to be answered.

These data, added to Pesquera’s evident lack of knowledge on basic issues, such as the widely accepted methodologies used by the scientific community, hurt the government’s credibility even more on this issue, at a time when they retain all available information, data they have had to share with GWU as well as with the Centers for Disease Control & Prevention (CDC), which requested to be given until November to submit its database codified according to its standards.

“The state wants to show that the process carried out by the CDC to codify and review the data submitted by the Department of Health prevents making public the preliminary information that is available,” said the CPI executive editor, insisting there is no legal impediment that justifies the delay in delivery of public documents requested by the courts.

Worried about the delay?

Last week, and given the additional time GWU was granted to submit the final report, Caribbean Business published the contract between the Forensic Sciences Bureau and the Washington-based university, questioning the silence regarding delivery of the preliminary report that became part of the agreement clauses.

“The preliminary report will be the first deliverable due date, and it will be on or before May 22, 2018. The maximum amount assigned to that task will be ONE HUNDRED AND TWENTY-FIVE THOUSAND DOLLARS ($125,000). After the delivery of the preliminary report, the Contractor will have sixty (60) days to complete and submit the final report, and the deliverable due date will be no later than July 23, 2018, provided an amendment to the contract is generated. The invoice of the service rendered as part of this task will be up to ONE HUNDRED EIGHTY THOUSAND THREE HUNDRED SIXTY-EIGHT DOLLARS ($180,368),” reads page 4 of the contract.

“These studies have various components. What we have asked [GWU] in advance is for the part regarding the resilience and readiness of public health. I prefer to have something well done to something that is inappropriate and may cost us in the next event,” Rosselló Nevares answered to questions from the press. It is interesting that not a single administration official has requested the preliminary report in the contract.

“The first report [according to the Jan. 4 executive order] never materialized. While Public Safety Secretary Héctor Pesquera told the media there was a working group and they were working on producing a report, this report never saw the light of day. As for the report commissioned to George Washington University, we do not know what its status is or the methodology being used,” Minet said, highlighting the great value of independent studies to support efforts by the government of Puerto Rico during the protocol-revision period to improve its response in coming emergencies.

“That is why it is extremely important that not only the GWU study that is in progress is carried out, but also that independent studies can be done by the press, the public health schools at universities in Puerto Rico, professionals and nonprofit entities that have the expertise and knowledge to take this raw data and analyze it. This analysis and the contrast with the official information is what will probably have a result with some degree of credibility among people, but if we do not have access to that data, we are blind,” the CPI’s director added.

In a statement Wednesday about Harvard University’s study, GWU’s Milken Institute said its study differs in that it “will use actual data about deaths – death certificate and other mortality data from September 2017 to the end of February 2018 – in order to estimate the excess deaths related to Hurricane Maria,” or “a more accurate way to assess mortality.”

It added that its study “is expected to provide a narrower range of uncertainty around the estimated excess deaths tied to Hurricane Maria.”

A final report for “the Phase I of the two-part study is expected out this summer,” the Milken Institute said.

George Washington University to lead study on Hurricane Maria deaths in Puerto Rico

Contradictions between gov’t, doctors emerge in Senate hearing over Hurricane Maria deaths

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