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While officials in Puerto Rico placed the official death toll from last year's Hurricane Maria at 64, researchers from Harvard believe the death toll was actually in the thousands. According to Harvard's study, there were an estimated 4,645 deaths directly or indirectly tied to the hurricane, which struck the island in September. Harvard estimated a mortality rate of 14.3 deaths per 1.000 people from September 20 through December 31, 2017 in Puerto Rico. Harvard said in its study that it believes its estimate is rather conservative due to a "survivor bias."Harvard conducted the study by performing a random survey of 3,299 households in Puerto Rico. "In our survey, interruption of medical care was the primary cause of sustained high mortality rates in the months after the hurricane, a finding consistent with the widely reported disruption of health systems," the study says. "Growing numbers of persons have chronic diseases and use sophisticated pharmaceutical and mechanical support that is dependent on electricity. Chronically ill patients are particularly vulnerable to disruptions in basic utilities, which highlights the need for these patients, their communities, and their providers to have contingency plans during and after disasters."Part of why there the death toll might have been underreported is due to how hurricane-related deaths are counted. In order to have a death counted as storm related, bodies had looked at by a medical examiner, which required a body to be transported to San Juan, or the medical examiner to travel to remote locations. With a lack of electricity and blocked roads, some bodies were likely buried before the government could count fatalities. Maria is considered the third-costliest hurricane in US history.  1816

When exploring mortgage options, it’s likely you’ll hear about Federal Housing Administration and conventional loans. Let’s see, FHA loans are for first-time home buyers and conventional mortgages are for more established buyers — is that it?Not necessarily.Actually, the differences between FHA loans and conventional mortgages have narrowed in the past few years. Since 1934, loans guaranteed by the FHAn have been a go-to option for first-time home buyers because they feature low down payments and relaxed credit requirements.But conventional loans — which are not insured by a government agency like the FHA, the Department of Veterans Affairs or the U.S. Department of Agriculture — have gotten more competitive lately.Both types of loans have their advantages. Here are the factors to consider when deciding between an FHA and a conventional mortgage. 886

WESTMINSTER, Colo. — A family's lifeline was stolen right in front of their home on Tuesday morning. Someone took off in their 2004 Toyota Highlander with something even more valuable inside — an electric wheelchair. "She goes 'let me just go get the car; I'll be right back,' " said Candace Trujillo.Trujillo's mom drives her to work every morning because she's unable to drive herself. She has brittle bone disease and uses a wheelchair to get around. "I was born with 26 fractures," Trujillo said.Doctors didn't expect her to live past age 2. She's now 28 years old and works five days a week. The morning started off just like any other. Trujillo woke up at 3 a.m. to start getting ready for her job in customer service. She usually leaves the house around 5 a.m. Her mom will pull the car up, load the wheelchair and then help her into the car. On this cold morning, she left the car running and it was gone 10 minutes later."It also had my wheelchair on there, which are my legs. I can't go anywhere without those," said Trujillo.The ,000 power wheelchair was recovered three hours after the vehicle was stolen. It was abandoned approximately 15 minutes from their home."It's just been going on and on in my head all day, I just don't understand why," said Trujillo.The car is still missing, and without it, Trujillo has no idea how she's going to get to work."It's really awful. I don't even know how to describe it," she said. "I'm at a loss of words because the car is everything to us right now. We don't have one." 1581

White House comms director Alyssa Farah says a document claiming ending the pandemic was an administration accomplishment was “poorly worded.” She says President Trump does not believe the pandemic is over. “The intent was to say that it is our goal to end the virus.”— Kaitlan Collins (@kaitlancollins) October 28, 2020 328

When you're facing a medical emergency, you trust your life to the doctors at in the emergency room. Those doctors sometimes have just seconds to make life or death decisions. Four in Your Corner is giving you an inside look as to what it's like to be an ER doctor."I love the pace of things and it takes a certain person to be an ER doctor," Dr. Keith Burley, who works in Cape Coral Hospital's emergency room, said/ "Emergency medicine is a true team sport. It takes the whole department to really resuscitate someone who is very sick.""Say someone comes in in cardiac arrest. They come in right through our trauma bay doors. They're dropped into one of our resuscitation rooms. Our team organizes very quickly. Everyone knows their jobs," Dr. Burley said.\In cases like this, techs will be running IVs; nurses will be hooking up defibrillation pads. Pharmacists will be running drugs. Staff will be trying to find out a patient's name. Dr. Burley said it's all about balancing quickness with efficiency while making sure patients are safe during triage."It's very important we triage effectively, making sure we point out and pick up the really sick people early on so we dedicate most of our resources to those sick people," Dr. Burley said. "We do need to triage because we have limited resources we need to effectively implement."Dr. Burley said when he sees a patient, he's trained to think worst case-scenario first."So someone coming in with a headache, we think, could this be a stroke? Could this be a subarachnoid hemorrhage? Could this be something else going on? Before we think it's just a headache," he said.Dr. Burley has known he's wanted to be a doctor since he was four years old after he was in a life-changing, dangerous situation."Like a good Canadian, I was tobogganing down a hill. We were going down the hill and my brother bailed. We continued to go down the hill and I hit a tree with my head," he said.He had a fractured skull and lost hearing in his left ear."I was seen by ER doctors, trauma doctors, a pediatric neurologist, had multiple MRIs," he said. "From that point on, as a young child, I always wanted to be a doctor."He said one of his most bizarre cases was just hours before Hurricane Irma hit. A dog was brought into the ER with it's eye hanging out."I'm not a veterinarian and I don't pretend to be one. I have a dog but it's a little out of my realm," Dr. Burley said. "We placed a pressured dressing and one of the staff members was able to call around to get a vet to see that dog just before the storm."For that dog and family, it was a happy ending, but Dr. Burley said the hardest part about emergency medicine are the days he deals with death and dying."It takes a certain person to deal with death and dying every day and then come back. It's a resiliency characteristic that all the ER staff have," Dr. Burley said.Whether their patients survive or not, the doctors have to learn to compartmentalize -- going from patient to patient until the end of their eight to 10 hour shift."We'll see a pediatric drowning, and then the next case we'll see someone with an eyeball injury, or someone with a simple laceration, and we have to give that patient the same amount of attention we gave the other patient and reset," he said."It's a privilege to be in a discipline where you get to see someone on their worst day of their entire life, and if you can make that a little better, you've done your job," he said.Dr. Burley said to unwind, he spends a lot of time at the beach and kite surfing. 3562

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