9 Investigates Hurricane Maria's death toll

ORLANDO, Fla. — Eight months after Hurricane Maria ravaged the Caribbean island of Puerto Rico, the storm's death toll remains a mystery.

The official count stands at 64, but various groups said the true number could be in the thousands.

An independent review won't be released this month as was previously expected.

Days after the storm, Channel 9 anchor Nancy Alvarez traveled to the island and asked how many people died because of the storm.

"Sixteen, now 17, but the devastation is big," Gov. Ricardo Rosselló said at the time. "We expect that number to go up."

Nearby, Ilda Ruiz was suffering.

"Three times, they told me she's gonna die," said Oscar Reyes, who spent 41 years with Ilda in both Orlando and Puerto Rico.

Ruiz had Alzheimer's disease. Reyes looked forward to his daily visits with her at a nursing home.

"She was doing good, and after the hurricane, she went back and back and back," Reyes said.

After the storm hit, Ruiz contracted pneumonia and developed bedsores that cut her skin to the bone. She fought hard, but died three months later.

After the storm, Ponce Mayor María Meléndez told Channel 9 that deaths in her city had nothing to do with the hurricane.

Eight months later, experts are revisiting that claim.

A team from George Washington University is reviewing all deaths from September through February.

Ana Cruz, of the city of Orlando's Hispanic Office for Local Assistance, said the agency has assisted thousands of evacuees, many of whom told stories of deaths, including suicides.

"They're so desperate about what's happening on the island," Cruz said.

The Centers for Disease Control and Prevention issued a 14-page guide on how to categorize deaths after a natural disaster.

"Direct deaths" are considered those caused by structural collapses or flying debris, and "indirect deaths" are those tied to unsafe or unhealthy conditions, according to the guide.

The guide said both types could be categorized as disaster-related, even if the death occurred months after the natural disaster.

A GWU spokesman described the process of reviewing the deaths as complicated and said regular blackouts on the island have slowed the team's progress.

The first phase of the review included interviews with medical examiners, doctors and city officials. A second phase will focus on interviews with the relatives of people who died during the storm.

The report is expected to be completed by summer.

Cruz said an accurate count is crucial.

"This is going to teach us a lesson of how bad a disaster can be if you don't act quickly enough," she said.

Reyes said he doesn't need a report. He blames the storm for Ruiz's death.

Cox Media Group