In hurricanes, more people die from indirect causes than the storms themselves

Not all who died in Hurricane Ian drowned in the storm surge or collapsed beneath falling trees.  

One Ian casualty, a man of 71, fell from his roof while installing shutters. Two elderly victims in Sarasota County, Fla., succumbed to failed oxygen machines after losing power. A Volusia County, Fla., man slipped into the canal behind his home while draining his pool.  

Storm trackers will probably label those cases “indirect” deaths: casualties that cannot be ascribed directly to the storm’s brutal assault but that would not have happened without it. 

A tally of recent U.S. hurricane deaths by The Hill finds that in the deadliest storms of the past 12 years, more people died of indirect than direct causes, by a margin of 371 to 324. The count includes nine cyclones since 2010, each of which claimed at least 20 lives in the United States. It does not include Ian, which has killed at least 100, mostly on Florida’s Gulf Coast.  

When Hurricane Ida stormed ashore in August 2021, seven people died in Jefferson Parish, La., part of greater New Orleans. One was a woman who drowned in her home. The other six died of indirect causes.  

“Conditions were deteriorating. It was hot, no electricity,” recalled Cynthia Lee Sheng, the parish president. “There was a fight for gas. A guy shot somebody else in a gas line. And then we had a hit-and-run on the street because the streets were dark.”  

Hurricane Katrina, 16 years earlier, had taught Sheng that the danger does not pass with the storm. Hurricanes plunge communities into chaos, leaving dystopian wastelands in their wake.  

“It’s the direct hit, but it’s also the breakdown of civilization for people post-storm, for vulnerable people,” she said. “It’s the breakdown of society. It’s the breakdown of community.” 

One 2016 report examined more than 1,400 indirect hurricane deaths across a half-century. Researchers found 468 fatalities from heart attacks, 264 from car crashes, 69 from carbon monoxide poisoning, 68 from electrocution, 49 from falls and 45 from fires, among other causes. 

The writers identified four common factors in such deaths: power problems, cardiovascular failure, evacuation and vehicular crashes. Misuse of generators alone killed scores of people. Dozens died of cardiac arrest before the storm even arrived, stricken while they nailed plywood over windows, helped neighbors hang shutters, piled sandbags or secured roofs. 

Some died as the result of miscalculations: They attempted too much or failed to accurately assess risks.  

“People seeing an inch or two or three of water on the road and thinking that’s fine,” said Martin Merzer, longtime hurricane reporter for the Miami Herald, now retired. “Well, that’s not fine. Three or four inches of water can wash your car off the road.” 

In recent meetings of meteorologists and storm chasers, leaders of the National Hurricane Center unveiled new data suggesting that most recent cyclone deaths can be traced to factors besides the obvious ones, storm surge, flooding and wind. 

Examining hurricane deaths from 2017 through 2021, the agency found indirect deaths surpassed direct ones, 299 to 271. Most indirect deaths involved people over 60.  

Researchers ascribed indirect casualties to several broad causes, including crashes (17 percent), carbon monoxide poisoning (16 percent), excessive heat (13 percent), electrocution (13 percent), and accidents during storm preparation or recovery (11 percent).  

When researchers looked at the 271 direct deaths, they found patterns “far different from the classic hurricane image of storm surge and wind claiming lives along and near the coast,” wrote Bob Henson, a meteorologist and writer, in the journal Yale Climate Connections. 

In the five years studied, only eight people died in the dreaded storm surge, the rise in sea level that swamps coastlines and prompts evacuation orders. That’s partly thanks to the hurricane center, which has “upped its surge-awareness efforts dramatically in recent years,” Henson wrote.  

The bigger killer in recent storms has been freshwater flooding, inundations that can claim lives hundreds of miles inland and far from the eye of the storm. Freshwater floods caused two-thirds of direct deaths from hurricanes between 2017 and 2021.  

“Usually, people living on the coast are smart enough to get out of the way,” Merzer said. “People living inland are not quite so sensitized to the dangers.” 

More than 100 people have died in the U.S. as a result of Hurricane Ian, with drowning being the leading cause. At least 50 perished in Lee County, Fla., home to Fort Myers Beach, where storm surge submerged stretches of coastline beneath perhaps 12 feet of sea. The press is questioning whether local officials waited too long to order evacuations, which hundreds of coastal residents then ignored.  

Many indirect hurricane deaths appear avoidable. Motorists who hydroplane on wet roadways or collide with fallen trees probably could have avoided driving under such dangerous conditions. Seniors who suffer heart attacks while cleaning storm-damaged properties might have asked neighbors for aid. But neighbors aren’t always available. 

“If you are a vulnerable person and you don’t have the help that you need, you cannot survive in a post-storm community,” Sheng said. 

After Hurricane Michael tore through Mexico Beach, Fla., in October 2018, the community marveled that only four people had died, all from drowning.  

“We were at ground zero,” recalled Al Cathey, the mayor. “Eighty percent of our structures were either severely damaged or destroyed.” 

And then, in the days and weeks after the storm, more people died: older residents, people who had lost everything “from baby shoes to prom pictures,” Cathey recalled. 

“When you have that kind of devastation in three and a half hours, I honestly believe that the shock factor of that can send people into cardiac arrest,” he said. “That look of despair, when you lose all, that’s a frightful thing.” 

After Katrina, in September and October 2005, Sheng watched the same tragedy play out in her parish.  

“That fall,” she said, “I was going to funeral after funeral after funeral for older people. We all thought, ‘It’s Katrina.’”