Image via AP. Trump throwing a paper towel roll into the crowd on his October 3rd visit to Puerto Rico.

On Friday night, San Juan mayor Carmen Cruz told CNN’s Jake Tapper that the death toll in Puerto Rico may be as high as 500, rather than the official count of 54. She reports that there have been 911 cremations in the past month after Hurricane Maria, which is about double the norm. (This is not counting the death toll in the US Virgin Islands).

An accurate death toll is critical because Trump has all but stamped “mission accomplished” on the crisis; earlier this month, he said that FEMA can’t hang around forever and has since kinda dropped the subject altogether. The Hill notes that on October 19th, Democratic senators including Elizabeth Warren, Cory Booker, and Bernie Sanders signed a letter urging the Department of Homeland Security to correct its official count “because President Trump seems to be using the number of fatalities to determine the quality of the disaster response.”

They refer to his statement that Maria was not “a real catastrophe like Katrina” because, he said, only 16 people had died.

That was his October 3rd trip, in which he spent an estimated four hours on the island. He has not been back since.

Even now, recovery funding doesn’t seem to be reaching people. It’s generally agreed that the majority of Puerto Rico remains without power, though estimates vacillate wildly–Puerto Rico’s official recovery site claims 40% has been restored, while a local energy employee estimated to CNN that as little as 5% of the island had access to power. There is “no reliable government information,” CNN reports. Not only that, but power restoration has been stalled by a scandal involving a shady $300 million contract with a power company Whitefish Energy, which was cancelled after raising several federal investigations. As of October 31st, FEMA estimated that a quarter of the island lacked access to drinking water.

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And today, Axios has reported that FEMA has only paid Puerto Rico $121,000 in National Flood Insurance because, for most Puerto Rican property owners, flood insurance is too expensive. By comparison, Texans affected by Hurricane Harvey have received $2.8 billion.

On Wednesday, Republicans swiftly postponed a hearing in which Mayor Cruz was set to testify on the state of hurricane recovery. So she gave her own testimony to the press. She claims that the federal government has been “killing the people” because “it’s been taking the money to pay the debt.”

“It really is 10 out of 100,” she added, referring to Trump’s “10 out of 10" self-rating for his response to Puerto Rico. “President Trump lives in an alternate reality. While we are feeding our people, he is in Mar-a-Lago playing golf,” she said.

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He has made at least four trips to his golf resorts since his Puerto Rico visit.