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In a pair of tweets casting doubt on the official estimate of nearly 3,000 deaths, the president clung to an outdated estimate, wrongly suggested that doubt over the figure emerged “a long time later” and inaccurately characterized the new figure as including all deaths on the island. (Qiu, 9/13)

“I’m flabbergasted,” said Irwin Redlener, director of Columbia University’s National Center for Disaster Preparedness, a think tank. “People need to understand we’re not just counting immediate fatalities. We have to understand what happens long-term with ongoing conditions.” (Shields, 9/13)

Public health experts have estimated that nearly 3,000 perished because of the effects of Maria. But Trump, whose efforts to help the island territory recover have been persistently criticized, was having none of that. He said just six to 18 people had been reported dead when he visited two weeks after the storm and suggested that many had been added later "if a person died for any reason, like old age." Trump's jarring comments, coming as the East Coast braced for a massive storm, offered fresh evidence of his resistance to criticism and his insistence on viewing large and small events through the prism of his own success or failure. (Lucey, Miller and LeMire, 9/14)

The researchers estimated the number of excess deaths by analyzing death certificates and other mortality data, and comparing the number of deaths during the designated period with past mortality patterns. They calculated the total number of deaths in the period was 22% higher than the number of fatalities that would have been expected, the researchers said. In analyzing Puerto Rico’s death-certification process, the study found that listed causes of death included cardiac arrest, respiratory failure and septicemia. But researchers concluded that such causes were sometimes misassigned, with physicians failing to link the deaths to the hurricane. (Ballhaus, 9/13)

Kaiser Health News: 4 Takeaways On Puerto Rico’s Death Toll, In The Wake Of Trump’s Tweet Storm 

Prior to the GWU study, other researchers and one newspaper released estimates that also garnered media attention. One study, published in the New England Journal of Medicine, put the number of excess deaths at 4,645 in the three months following the hurricane. A study by The New York Times used vital records from the government to calculate an excess of 1,052 deaths in the first 42 days after the disaster. (Heredia Rodriguez, 9/14)

Ever since the storm, Mr. Trump has pushed back against criticism that his administration was slow to respond to Puerto Rico, where the distribution of supplies, gas and food lagged and power outages lasted for months, particularly compared with a swift and efficient response to an earlier hurricane that hit Texas. It was six days after Hurricane Maria hit the island before Mr. Trump pledged to go there, even as he traveled to Texas four days after Hurricane Harvey made landfall. Full power was restored to homes only in August, nearly a year after the storm. Former Gov. Chris Christie of New Jersey, a Republican ally of Mr. Trump’s who was praised for his own leadership during Hurricane Sandy in 2012, said that Puerto Rico was an “extraordinary challenge” in part because the island’s infrastructure was in poor shape to begin with and that Mr. Trump resented being blamed for factors beyond his control. (Baker, 9/13)

Trump’s charge about the Puerto Rico storm — a humanitarian crisis that continues to affect life on the island a year later — baffled his advisers as well as officials at the Federal Emergency Management Agency, who have been working to prepare the Carolinas for Hurricane Florence, the potentially deadly storm forecast to make landfall Friday. Trump’s aides said they have tried to focus the president’s attention on Florence, noting that he has been engaged in daily disaster briefings and called governors, senators and other officials representing North Carolina and South Carolina. Officials have brought large, colored charts and graphs into the Oval Office to illustrate Florence’s dangerous path for Trump, who is a visual learner. And the president made a rare trip outside, to visit the staff of the National Security Council’s resilience office housed across the street in the Eisenhower Executive Office Building. (Rucker, Costa and Dawsey, 9/13)

Florida Republicans are angered by President Donald Trump advancing a conspiracy theory casting doubt on Hurricane Maria’s estimated death toll in Puerto Rico. Even Trump’s two top Florida allies, Gov. Rick Scott and GOP gubernatorial candidate Ron DeSantis, disagreed with his insensitive comments. (Caputo, 9/13)

Emails released Thursday by congressional Democrats show correspondence between first responders that appears to undermine the Trump administration’s public reporting of the human toll from Hurricane Maria last year. In one email, dated Sept. 29, 2017, a first responder — whose name has been redacted — describes “finding mass graves in mud slide areas,” and requests counseling support for federal first responders in the area. An unnamed Army National Guard general is included in the correspondence. (Wilhelm, 9/13)