Who decides that a death was caused by Hurricane Florence? And why does it matter?
Gov.
The lag time illustrates how difficult it can be to fully account for the number of deaths caused by a natural disaster as large and widespread as a hurricane. That they were added to the list at all shows how important that full accounting is.
The death toll is an important way of measuring the magnitude of a storm like Florence; at each one of his daily briefings after the hurricane, Cooper always provided the latest number. But emergency managers say the most meaningful information is how those people died.
"That then starts to place emphasis on how you might prevent deaths in the future," said
"We'll make mistakes," Landry said. "We just don't want to make the same ones."
Hurricane Florence provided a good example of the wisdom learned from how people died in past storms. During Hurricane Floyd in 1999, nearly half of the 51 people thought to have died in the storm in
With Florence, whenever Cooper or other state officials spoke about the storm, they admonished people not to drive on flooded roads and to heed signs and barriers. (The
More deadly?
Hurricane
The guidelines say those deaths break down into two categories: Direct and indirect. If someone drowns or is hit by a fallen tree, that's considered a direct result of the storm.
Indirect deaths occur because of unsafe or unhealthy conditions at any phase of the disaster, including preparation and cleanup. These may not initially be seen as related to the storm and may take longer to count. There's also an element of judgment and making connections that some may not see initially.
"If you're killed in the storm itself or in a way that's directly connected to preparation or recovery efforts, that makes it clear that it's related to the storm," Frankenberg said. "But if your heart condition is aggravated by worry about the storm, that's harder to attribute."
Among the indirect deaths blamed on Hurricane Florence is an 81-year-old man who fell and struck his head while packing to evacuate his home in
The final decision about whether someone's death was caused by the storm rests with the
"The death of someone who fell and struck their head while packing for reasons other than an evacuation would not be considered a storm-related death," the medical examiner's office wrote. "But for the storm, the death likely would not have occurred at that time, place and for that cause."
Reports of suspected storm-related deaths come in to the Chief Medical Examiners Office from either county medical examiners or from the
Delays are understandable, according to the medical examiners office. Death investigations can take time, particularly when an autopsy is needed.
"And when the circumstances and cause of death is not apparent, it could take days or weeks to make a final determination," the medical examiners office wrote. "Medical providers may not realize a death is storm-related. This is especially true in indirectly related deaths."
Some or all of those indirect deaths may not have even been counted in past storms. None of the 51 deaths attributed to Hurricane Floyd occurred during cleanup after the storm, like the two men added to the list for Hurricane Florence last week. The medical examiners office says it's possible that the broader definition of a storm-related death in the federal government's guidelines could help explain the higher toll from Hurricane Florence compared to Matthew.
Final number?
The medical examiners office says there's no cut-off point for determining a storm's death toll; on Monday, a death that had occurred
But in reality the numbers usually don't change after a month or two. Indirect deaths that may result from long-term problems, such as lack of power or access to medications or health care or the cumulative effect of exposure to mold or other toxins after a storm, often go uncounted.
Researchers at
The researchers looked at death rates in
Their number of 2,975 was well above the Puerto Rican government's official toll of 64, a number that was criticized for months as too low. Trump tweeted that the estimate of nearly 3,000 deaths was ginned up by
Frankenberg, the director of the Carolina Population Center, says the excess mortality number alone may not provide specific lessons for preventing deaths in future storms; for that, you'd need to dig deeper into death certificates and other data to learn how people died and what factors may have contributed.
But she said such studies can be helpful in realizing a storm's true impact.
"It could be routinely done," she said. "And my guess is that somebody will do it for
For people whose deaths are officially linked to Hurricane Florence, their families could qualify for help with burial expenses from the
But there's really no financial benefit to state or local governments for having a higher death toll, Wade said.
The NC deaths blamed on Hurricane Florence
The deaths of 40 people have been blamed on Hurricane Florence in
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