There are a number of different institutions who try to quantify death tolls and other damages after natural disasters. The definitions and methodology differs between estimates and numbers vary depending on which method you choose. For example, if somebody is injured badly during a hurricane and die months later in hospital from their injuries, should this be included in the toll? A special article in the New England Journal of Medicine study, *[Mortality in Puerto Rico after Hurricane Maria](https://www.nejm.org/doi/full/10.1056/NEJMsa1803972?query=featured_home)* was published in July. They used a survey methodology to make an estimate of the death toll. They did not count the deaths recorded by medical services, but surveyed over 3,000 people in Puerto Rico about damage and deaths. From the answers they calculated that the death toll was 4645 with a 95% confidence interval of 793 - 8498. > From the survey data, we estimated a mortality rate of 14.3 deaths (95% confidence interval [CI], 9.8 to 18.9) per 1000 persons from September 20 through December 31, 2017. This rate yielded a total of 4645 excess deaths during this period (95% CI, 793 to 8498), equivalent to a 62% increase in the mortality rate as compared with the same period in 2016. However, this number is likely to be an underestimate because of survivor bias. The mortality rate remained high through the end of December 2017, and one third of the deaths were attributed to delayed or interrupted health care. Hurricane-related migration was substantial. According to these numbers, a death toll of 3,000 people is likely not an exaggeration. To answer your question: Donald Trump's statement is most likely not accurate.