The dire situation, and the reluctance of President Donald Trump to publicly embrace complications in the relief effort, are also raising questions about why the response to Maria seems more sluggish than the government efforts following monster storms that hit Florida and Texas over the last month.
The President himself, who did not appear in public Thursday, took to Twitter to rebut rising criticism of his government's response, saying "massive" amounts of food and water had been delivered while noting his planned visit next week.
And he resorted to a familiar tactic when under fire -- slamming the media.
"Wish press would treat fairly!" he wrote.
Trump returned to Twitter on Friday morning to defend his administration's response after Puerto Rico's governor appeared on CNN: "Puerto Rico Governor Ricardo Rossello just stated: "The Administration and the President, every time we've spoken, they've delivered......" Following up with a second tweet Trump went on: "... The fact is that Puerto Rico has been destroyed by two hurricanes. Big decisions will have to be made as to the cost of its rebuilding!"
Part of the problem is the way the administration is talking about Puerto Rico.
On Tuesday, Trump repeatedly boasted during a news conference that his team was doing a "great job" and said how "nicely" he had been treated by the island's governor, who he said had praised the administration's work.
Three days later, even as harrowing scenes emerged from the territory, Trump's acting Homeland Security Secretary Elaine Duke described the federal response to the disaster as "a good news story."
The comments did not yet appear to match the notoriety of former President George W. Bush's comment to his FEMA director Michael Brown that he was doing a "heck of a job" during Hurricane Katrina.
But the unfortunate assessments could come back to haunt the administration if the situation in Puerto Rico deteriorates further.
San Juan Mayor Carmen Yulin Cruz rejected Duke's assessment.
"Maybe from where she's standing it's a good news story," she said on "New Day."
"When you are drinking from a creek it's not a good news story. When you don't have food for a baby, it's not a good news story."
And they are already conflicting with the emerging reality of life on the US territory, where nearly half the population remains without drinking water, hospitals struggle to stay open, food is scarce and 97% of people have no power. CNN reporters on Thursday related poignant stories of life after Maria, including that of one woman suffering from diabetes and an infection who was rushed to hospital by one of the network's crews.
Such coverage is prompting some Trump critics to suggest more must be done.
"Where is the cavalry?" asked Democratic Sen. Bill Nelson on Twitter.
No one is saying that responding to a disaster of such magnitude is easy.
Federal Emergency Management officials are exhausted after dealing with their third massive Hurricane in a few weeks after Harvey hit Texas and Irma barreled across Florida. Puerto Rico is less developed and wealthy than those states, and the logistical challenges of helping an offshore island with mountainous terrain are immense. The territory also lacks the network of NGOs and private sector groups that helped out when storms hit the US mainland.
The White House said Thursday that 10,000 federal relief workers and more than 7,000 troops were on the island in an operation that in many ways has more in common with US efforts to mitigate natural disasters in Haiti than storms on the US mainland.
Yet there are mounting questions about whether the administration did enough to prepare for the storm, and whether actions it has taken since have been sufficient. And the repeated explanation by top officials of how hard things are is starting to wear thin.
"The island setting presents logistical hurdles that do not exist on the mainland, where trucks from around the country can converge on disaster areas," said White House press secretary Sarah Sanders on Thursday, using a formulation repeatedly voiced by officials in recent days.
As criticism of the White House effort grows, several emerging political threats are evident. The increasing contrast between the situation on the island being portrayed in news reports and the White House is beginning to set up a credibility gap that is casting doubt on the administration's statements on the crisis.
There's also a sense that officials are struggling to catch up with the quickly worsening narrative on the ground, and in the absence of a high-profile supremo to run the operation, or at least to speak about it publicly, the political messaging about the storm has been inconsistent.
Whereas Duke referred to a "good news" story on Thursday, FEMA Administrator Brock Long declared that he was "not satisfied" with the situation in an interview with CNN's Kate Bolduan.
The government's response left retired Gen. Russel Honoré, who turned around the botched response to Katrina in 2005, fuming.
"I don't know what the hell is going on!" he said on CNN, calling for the military to surge air traffic controllers onto the island to open airports, transportation specialists to clear roads and the deployment of many more troops, ships and helicopters.
"Puerto Rico is bigger than Katrina," he said.
Business as usual
If the government effort continues to appear outpaced by the scale of the disaster, there will inevitably be scrutiny of the man on whose desk the buck stops -- Trump.
The President has yet to formally address Puerto Rico in a standalone speech. He has however mentioned the disaster during several encounters with the press and during other engagements.
On Monday, he denied that his feud with the NFL, that he stokes every day, had distracted him from the worsening situation on the island.
But the President has still gone about his normal business, including a trip to Indiana on Wednesday to promote his top political priority, tax reform.
His only remarks on the situation on Thursday were on Twitter, and did not exactly drip with empathy for the victims.
"The electric power grid in Puerto Rico is totally shot. Large numbers of generators are now on Island. Food and water on site," he wrote in one post.
Still, the administration acted like it knows it had a perception problem on Thursday.
The President issued a waiver of the Jones Act
, which requires cargo shipped between US ports to be carried on American flagged vessels, to facilitate the delivery of aid.
The Pentagon meanwhile named three-star Gen. Jeffrey Buchanan to lead the military operation in Puerto Rico.
And the White House deployed the President's top homeland security adviser, Tom Bossert, who won good reviews of his performance during Irma and Harvey, to brief White House reporters.
Even so, some of his answers seemed defensive.
Asked by CNN's Jeff Zeleny why it had taken eight days to name Buchanan, Bossert answered: "It didn't require a three-star general eight days ago."
He also defended the timing of the Jones Act waiver, saying "that was not too late. It was not even too early."
Bossert also later defended Duke in an appearance on CNN, saying her remarks had been meant to highlight the selfless work of federal workers during the disaster.
In another CNN interview on Friday Bossert mounted a strong defense of the administration's effort but conceded there were logistical problems to be surmounted.
"I don't accept that we're doing anything short of everything we can do," Bossert said on "New Day".