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Hurricane Maria made landfall in Puerto Rico on Sept 20, 2017, as a high-end category 4 hurricane, only weeks after the island had been affected by another hurricane. Puerto Rico experienced severe weather associated with the hurricane, including storm surges and flash flooding. The hurricane severely affected basic infrastructure such as electricity and water for several months, initially leading to a complete collapse of the power grid, affecting all 3· 4 million inhabitants. Early reporting on the death toll of the hurricane by the government and media was confusing and contradictory, and led to several law suits. Ultimately, Carlos Santos-Burgoa and colleagues were tasked with determining the actual death toll of the hurricane, which they now report in The Lancet Planetary Health. 1 Beyond political reasons, some of the initial controversy can certainly be attributed to the methodological difficulties of determining …