Nearly 90 per cent of the island was without electricity more than three weeks later and hundreds of thousands of people struggled to access food and water.
The situation was declared a humanitarian crisis and Mexico later offered aid after the response of the US government was condemned by island residents and officials.
Mexico, which suffered its own devastating earthquake in September, offered to send clean water and mosquito repellent to the island following Donald Trump’s visit, during which he compared the disaster with “a real catastrophe” like Hurricane Katrina in 2005.
It was thought at the time that the death toll was much lower.
During an appearance on CNN’s “The Lead with Jake Tapper” Ms Yulín Cruz pointed out that there had been 911 cremations on the island in the past month – twice as many as in a normal month.
She said: “It appears, for whatever reason, that the death toll is much higher than what has been reported. What we do know for sure is that people are being catalogued as dying…natural deaths”.
Bringing aid to Puerto Rico
Show all 20
Bringing aid to Puerto Rico
1/20
Crew chief Kenney shelters under the blade of an HH-60 Blackhawk helicopter from 101st Airborne Division's "Dustoff" unit preparing to take off during recovery efforts following Hurricane Maria, in Isla Grande, Puerto Rico, October 6, 2017
Reuters/Lucas Jackson
2/20
An HH-60 Blackhawk helicopter from 101st Airborne Division's "Dustoff" unit takes off behind Crew Chief Alexander Blake and his fellow soldiers during recovery efforts following Hurricane Maria, in Morovis, October 5, 2017
Reuters/Lucas Jackson
3/20
Crew member Bynum stands in tropical rain as a HH-60 Blackhawk helicopter from 101st Airborne Division's "Dustoff" unit prepares to take off during recovery efforts following Hurricane Maria, in Isla Grande, October 6, 2017
Reuters/Lucas Jackson
4/20
UH-60 Blackhawk helicopter pilot Chris Greenway receives a hug from a woman thanking him for water as he works with the First Armored Division's Combat Aviation Brigade during recovery efforts following Hurricane Maria, in Verde de Comerio, October 7, 2017
Reuters/Lucas Jackson
5/20
A man carries a case of water away from an HH-60 Blackhawk helicopter after soldiers working with 101st Airborne Division's "Dustoff" unit dropped off relief supplies during recovery efforts following Hurricane Maria, in Jayuya, October 5, 2017
Reuters/Lucas Jackson
6/20
Crew chief Alexander Blake from 101st Airborne Division's "Dustoff" unit loads water into a helicopter during recovery efforts following Hurricane Maria, in Isla Grande, October 5, 2017
Reuters/Lucas Jackson
7/20
Residents wait for soldiers in UH-60 Blackhawk helicopters from the First Armored Division's Combat Aviation Brigade to deliver food and water during recovery efforts following Hurricane Maria, in San Lorenzo
Reuters
8/20
An HH-60 Blackhawk helicopter from 101st Airborne Division's "Dustoff" unit lands in a field to avoid lightning during recovery efforts following Hurricane Maria, in Manati, October 5, 2017
Reuters/Lucas Jackson
9/20
Residents hold their hands aloft to signal that they need water as UH-60 Blackhawk helicopters from the First Armored Division's Combat Aviation Brigade fly past during recovery efforts following Hurricane Maria, near Ciales, October 7, 2017
Reuters/Lucas Jackson
10/20
Tropical rain splashes on a runway as HH-60 Blackhawk helicopters from 101st Airborne Division's "Dustoff" unit wait for weather to clear during recovery efforts following Hurricane Maria, in Isla Grande, October 6, 2017
Reuters/Lucas Jackson
11/20
Pilot Eldwin Bocanegra Torres speaks with residents isolated by landslides in the mountains after unloading water and food from a helicopter during recovery efforts following Hurricane Maria, near Utuado, October 10, 2017
Reuters/Lucas Jackson
12/20
Residents stand in front of wind-damaged trees as they wait for soldiers in UH-60 Blackhawk helicopters from the First Armored Division's Combat Aviation Brigade to deliver food and water during recovery efforts following Hurricane Maria, in San Lorenzo, October 7, 2017
Reuters/Lucas Jackson
13/20
The contents of a home are seen from the air during recovery efforts following Hurricane Maria near Utuado, October 10, 2017
Reuters/Lucas Jackson
14/20
Thomas looks out of the window of an HH-60 Blackhawk helicopter from 101st Airborne Division's "Dustoff" unit, loaded with relief supplies, during recovery efforts following Hurricane Maria in Isla Grande, October 6, 2017
Reuters/Lucas Jackson
15/20
A message written on the rooftop is seen from the air during recovery efforts following Hurricane Maria near Humacao, October 10, 2017
Reuters/Lucas Jackson
16/20
A HH-60 Blackhawk helicopter from 101st Airborne Division's "Dustoff" unit lands in a field during recovery efforts following Hurricane Maria in San Sebastian, October 6, 2017
Reuters/Lucas Jackson
17/20
Sergeant First Class Eladio Tirado, who is from Puerto Rico, looks for a landing spot for a UH-60 Blackhawk helicopter from the First Armored Division's Combat Aviation Brigade, during recovery efforts following Hurricane Maria near Ciales, October 7, 2017
Reuters/Lucas Jackson
18/20
Boys carry water away from an HH-60 Blackhawk helicopter after soldiers working with the U.S. Army's 101st Airborne Division's "Dustoff" unit dropped off relief supplies during recovery efforts following Hurricane Maria, in Jayuya, October 5, 2017
Reuters/Lucas Jackson
19/20
Sergeant First Class Eladio Tirado from the First Armored Division's Combat Aviation Brigade, who is from Puerto Rico, speaks with residents as he helps during recovery efforts following Hurricane Maria, in San Lorenzo, October 7, 2017
Reuters/Lucas Jackson
20/20
Residents peek through a fence at helicopters from 101st Airborne Division's "Dustoff" unit that had parked in a locked field during recovery efforts following Hurricane Maria, in Lares, October 6, 2017
Reuters/Lucas Jackson
1/20
Crew chief Kenney shelters under the blade of an HH-60 Blackhawk helicopter from 101st Airborne Division's "Dustoff" unit preparing to take off during recovery efforts following Hurricane Maria, in Isla Grande, Puerto Rico, October 6, 2017
Reuters/Lucas Jackson
2/20
An HH-60 Blackhawk helicopter from 101st Airborne Division's "Dustoff" unit takes off behind Crew Chief Alexander Blake and his fellow soldiers during recovery efforts following Hurricane Maria, in Morovis, October 5, 2017
Reuters/Lucas Jackson
3/20
Crew member Bynum stands in tropical rain as a HH-60 Blackhawk helicopter from 101st Airborne Division's "Dustoff" unit prepares to take off during recovery efforts following Hurricane Maria, in Isla Grande, October 6, 2017
Reuters/Lucas Jackson
4/20
UH-60 Blackhawk helicopter pilot Chris Greenway receives a hug from a woman thanking him for water as he works with the First Armored Division's Combat Aviation Brigade during recovery efforts following Hurricane Maria, in Verde de Comerio, October 7, 2017
Reuters/Lucas Jackson
5/20
A man carries a case of water away from an HH-60 Blackhawk helicopter after soldiers working with 101st Airborne Division's "Dustoff" unit dropped off relief supplies during recovery efforts following Hurricane Maria, in Jayuya, October 5, 2017
Reuters/Lucas Jackson
6/20
Crew chief Alexander Blake from 101st Airborne Division's "Dustoff" unit loads water into a helicopter during recovery efforts following Hurricane Maria, in Isla Grande, October 5, 2017
Reuters/Lucas Jackson
7/20
Residents wait for soldiers in UH-60 Blackhawk helicopters from the First Armored Division's Combat Aviation Brigade to deliver food and water during recovery efforts following Hurricane Maria, in San Lorenzo
Reuters
8/20
An HH-60 Blackhawk helicopter from 101st Airborne Division's "Dustoff" unit lands in a field to avoid lightning during recovery efforts following Hurricane Maria, in Manati, October 5, 2017
Reuters/Lucas Jackson
9/20
Residents hold their hands aloft to signal that they need water as UH-60 Blackhawk helicopters from the First Armored Division's Combat Aviation Brigade fly past during recovery efforts following Hurricane Maria, near Ciales, October 7, 2017
Reuters/Lucas Jackson
10/20
Tropical rain splashes on a runway as HH-60 Blackhawk helicopters from 101st Airborne Division's "Dustoff" unit wait for weather to clear during recovery efforts following Hurricane Maria, in Isla Grande, October 6, 2017
Reuters/Lucas Jackson
11/20
Pilot Eldwin Bocanegra Torres speaks with residents isolated by landslides in the mountains after unloading water and food from a helicopter during recovery efforts following Hurricane Maria, near Utuado, October 10, 2017
Reuters/Lucas Jackson
12/20
Residents stand in front of wind-damaged trees as they wait for soldiers in UH-60 Blackhawk helicopters from the First Armored Division's Combat Aviation Brigade to deliver food and water during recovery efforts following Hurricane Maria, in San Lorenzo, October 7, 2017
Reuters/Lucas Jackson
13/20
The contents of a home are seen from the air during recovery efforts following Hurricane Maria near Utuado, October 10, 2017
Reuters/Lucas Jackson
14/20
Thomas looks out of the window of an HH-60 Blackhawk helicopter from 101st Airborne Division's "Dustoff" unit, loaded with relief supplies, during recovery efforts following Hurricane Maria in Isla Grande, October 6, 2017
Reuters/Lucas Jackson
15/20
A message written on the rooftop is seen from the air during recovery efforts following Hurricane Maria near Humacao, October 10, 2017
Reuters/Lucas Jackson
16/20
A HH-60 Blackhawk helicopter from 101st Airborne Division's "Dustoff" unit lands in a field during recovery efforts following Hurricane Maria in San Sebastian, October 6, 2017
Reuters/Lucas Jackson
17/20
Sergeant First Class Eladio Tirado, who is from Puerto Rico, looks for a landing spot for a UH-60 Blackhawk helicopter from the First Armored Division's Combat Aviation Brigade, during recovery efforts following Hurricane Maria near Ciales, October 7, 2017
Reuters/Lucas Jackson
18/20
Boys carry water away from an HH-60 Blackhawk helicopter after soldiers working with the U.S. Army's 101st Airborne Division's "Dustoff" unit dropped off relief supplies during recovery efforts following Hurricane Maria, in Jayuya, October 5, 2017
Reuters/Lucas Jackson
19/20
Sergeant First Class Eladio Tirado from the First Armored Division's Combat Aviation Brigade, who is from Puerto Rico, speaks with residents as he helps during recovery efforts following Hurricane Maria, in San Lorenzo, October 7, 2017
Reuters/Lucas Jackson
20/20
Residents peek through a fence at helicopters from 101st Airborne Division's "Dustoff" unit that had parked in a locked field during recovery efforts following Hurricane Maria, in Lares, October 6, 2017
Reuters/Lucas Jackson
She explained that some of the deaths relating to the hurricane were being reported as “natural causes” because the storm was the secondary factor in their death.
For example, some people reportedly suffocated after their respirators stopped due to the power cut.
A spokesman for the Department of Public Safety told BuzzFeed News that these classifications were made by reviewing records rather than an autopsy by the medical examiner.
The bodies were cremated before the medical examiner could determine whether they should have been included in the official death toll.
Accurate information about the figure is particularly important in the US because if a person dies in a natural disaster, their family has the right to claim federal aid.
The Democrats have called on the Department of Homeland Security to provide accurate death counts for the string of hurricanes which hit the US’ overseas territories and the states of Texas and Florida, the Hill reported.
A group of senators wrote to acting Homeland Security Secretary Elaine Duke, saying: “We urge you to provide all necessary resources to confirm that storm-related deaths are being counted correctly”.
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