The Economist made an estimate [for Maria], and they thought it was more like 1,000. They were looking at death records [to compare deaths from September 2017 to September 2016]. Every day in September, you get a number that’s pretty consistent. And then you look at it for the day of Maria, and it’s hugely different. This is called all-cause mortality, because it doesn’t determine a particular cause. This is an anomaly above the baseline.
Harvard was interested in that, but they were also interested in the long run. This is always a question with disasters: When do you stop counting? The day after? The day after that? Many people, if they are displaced, particularly the elderly, will die days and weeks afterwards, for many reasons—[it’s] the trauma of displacement.
So Harvard kept tracking it. How long did above-average deaths keep occurring? That’s how they got a big number. And you just have to ask yourself, Is that fair? Is that reasonable? Two months afterwards, can you really seriously call it a disaster death? Well, in my opinion, yes. If you can say this death would not have happened were it not for the hurricane … even if it’s weeks or months later, I think it’s completely fair.
After Katrina, there was a lot of infant mortality. Poor women in Mississippi—who probably didn’t get very good health care anyway—when they were pregnant [during and after the storm] got no health care. So infant mortality rose for a while, and the reason was not [physically related to the hurricane itself]. It’s because people can’t get access to health care. It just goes on and on.
Here in New York, after Hurricane Sandy, one of the veterans’ hospitals had to close. People have done studies on the excess mortality associated with closing one hospital. It’s a cumulative thing. It wouldn’t have happened if it weren’t for Sandy. That’s the way to think about it.
Godfrey: So, thinking about the COVID-19 outbreak as a cumulative thing, what could increase the death count long after this pandemic is technically over?
Mutter: In Katrina, suicide rates increased in the weeks and months afterwards because unstable people were very distressed.
The indirect effect often results from confinement, such as we are asked to do now. In crowded settings, like refugee camps and the FEMA trailers that housed so many Katrina survivors, if couples are not getting on well, then that sort of confinement can cause friction, abuse, and even death.
Read: The coronavirus is a disaster for feminism
Displacement [when people are moved for safety reasons or to receive better care] is hard on older people with medical issues who need regular doctor visits. They are separated from their normal care providers and will not necessarily remember what the medications are that they need. They get stressed and can fail just from that. And just being displaced and not knowing when return might be possible, if at all, can cause deep depression among the elderly.
Addicts separated from dealers can become suicidal and, if they are able to find the drugs they want after a long time, can overdose.
With COVID-19, people are going to have to be removed from hospitals into different care situations [because of a] lack of hospital services. Almost certainly that care will be [worse] than hospital care.