Puerto Ricos death toll in the aftermath of Hurricane Maria is estimated to be almost 5,000, according to a Harvard study published Tuesday . Data from this large-scale survey also revealed some sobering information about what life has been like for those trying to manage their health on the island in the wake of the storm.

The study, which surveyed 3,299 randomly chosen households in Puerto Rico over three weeks, found that from Sept. 20 to Dec. 31, 2017, at least 4,645 people died in connection to the storm. The governments death toll is 64.

Dr. Satchit Balsari, one of the researchers for the study, explained the importance of having an accurate death count not only because of its financial ramifications but also because it gives families a sense of closure. Its important to acknowledge what happened and why they lost their family members, he told reporters in a conference call on Tuesday.

Researchers calculated this new alarmingly high death toll and gathered facts about causes of death, displacement and infrastructure loss in the months after the storm. The information paints a distressing picture of the sort of challenges that millions of Puerto Ricans faced after Hurricane Irma and Hurricane Maria ravaged the island in September of last year.

The studys numbers aligned with previous media reports and analyses that the death toll was likely in the thousands. The researchers findings are dismaying but, unfortunately, are surprising only in their magnitude.