Texas officials have attributed three dozen more deaths to February’s winter storm, raising the death toll to 246.

The Department of State Health Services added 36 storm-related fatalities to its totals Friday, according to its final report released on New Year’s Eve. The toll from the historic winter storm — which knocked out power, water and heat to millions of Texans — in Dallas and Tarrant counties was 22 and 11, respectively.

Forty-two of the reported storm deaths, or nearly one-fifth of the total, occurred in North Texas. In addition to those reported in Dallas and Tarrant counties, Collin and Ellis counties each had two deaths, and Grayson, Hunt, Kaufman, Lamar and Parker counties each had one.

Another one-fifth of the state’s deaths, 43, occurred in Harris County, and 28 more were in Travis County.

The deaths occurred from Feb. 11 to June 4, and most were the result of hypothermia or cold-weather exposure, according to the report. Other causes included carbon-monoxide poisoning, exacerbation of preexisting conditions, falls, fire and traffic accidents.

The toll from the storm is more than double that caused by Hurricane Harvey in 2017.

People killed in the storm ranged in age from under 1 to 102, and the vast majority — more than 90% — were residents of Texas.

DSHS was notified of disaster-related deaths via forms submitted to the state by medical certifiers that specified the death was related to the disaster; flagged death records by medical certifiers; and news reports of disaster-related deaths that were then matched to death certificates.

While State Health Services has completed its mortality reports, experts and epidemiologists have said there may never be an accurate count of the fatalities and knowing whether some deaths were storm-related may remain impossible.

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