Asays the death toll from Hurricane Maria last year is dramatically larger than reported. The study, published in the New England Journal of Medicine, estimates more than 4,600 people died on the island. The official government death toll is just 64.
Researchers randomly knocked on doors and asked if anyone died there. There were more questions -- but that's how it started. It took six weeks and $50,000 from Harvard to come up with a number that is stunning, reports CBS News' David Begnaud.
, who himself is a scientist, seemed blindsided by the Harvard study. His government wasn't involved and he didn't know it was being released.
"We welcome all studies," Rosselló said at a press conference Tuesday. "We want the real number to come out. We had a protocol that really was subpar and we recognize it."
The government protocol is for doctors to tell the government if a death was caused by Hurricane Maria. Families have to petition the government to investigate if they disagree with a doctor's opinion.
The Harvard study surveyed more than 3,000 homes across the island and found the mortality rate rose 62 percent in the three months after Hurricane Maria compared to that period the year before. Researchers concluded the final death count could be as high as 8,500.
"One third of our deaths were reported because lack of medical treatment," said Domingo Marques, who was a lead author of the study.
During his visit to Puerto Rico last October, President Trump hailed the low death toll, which at the time was 16. He compared it to Hurricane Katrina. In light of the Harvard report, a White House spokesperson said the people of Puerto Rico deserve nothing less than transparency and accountability.
"The negligence that allowed those lives to be lost, needs to be accounted for," San Juan mayor Carmen Yulín Cruz said.
Cruz has blasted Mr. Trump for being tone deaf and slow to respond. When asked to evaluate her own response she said, "I know I didn't get to everyone… We did the best we could, but that wasn't' good enough. That wasn't good enough."
Why this story is more than just a shocking number? For every death that is certified by a government official to be related to Hurricane Maria, family members are eligible to have the federal government help pay for funeral expenses. The numbers matter.