Eight days after Hurricane Maria made landfall, nearly half the population still does not have access to potable water and huge numbers of people are struggling to get access to fuel to power generators, according to the Federal Emergency Management Agency. Nearly the entire island remains in the dark after the power grid was knocked offline.
The dire situation has led to rising frustration on the island and in Washington, where local officials, disaster relief experts and members of Congress, including Republican Sen. Marco Rubio, aired open criticism or at least calls for a course-correction on Thursday.
But top Trump administration officials expressed nothing short of full confidence.
"I am very satisfied," acting Homeland Security Secretary Elaine Duke told reporters outside the White House. "I know it's a hard storm to recover from but the amount of progress that's been made, and I really would appreciate any support that we get. I know it is really a good news story in terms of our ability to reach people and the limited number of deaths that have taken place in such a devastating hurricane."
Tom Bossert, the White House homeland security adviser, expressed full confidence that the response effort is appropriately led and resourced and unfolding at a good pace.
"What I will tell you is that we are mobilizing and marshaling the resources of the United States of America in a way that is absolutely professional, fast, and adequate to meet the needs," Bossert said alongside Duke.
"This is textbook and it's been done well," Bossert added later from the White House podium.
Bossert did acknowledge the administration has moved to "augment and change our business model in the field," but sought to downplay some of the changes taking place -- like the deployment of a 3-star general to take charge of land, sea and air efforts.
He rejected the suggestion that the administration has made any mistakes and assured reporters the White House was firmly grounded in reality.
"There's no disconnect," Bossert assured a reporter who asked about the desperate scenes unfolding across the island.
'Good news story'
Still, Duke's suggestion that the federal response was a "good news story" struck some as tone deaf and reflected the perils of the Trump administration's attempts to reassure Americans that the federal government is responding appropriately to the unfolding crisis.
Asked to clarify her comment that the government's response to the storm is a "good news story," Duke pointed to effective coordination between federal and local authorities and said there is "unification of command."
"It's good news that we have a unification of command where the governor, the federal response, and the people are all united toward saving lives and giving things to the people they need," Duke said.
Duke struck a remarkably different tone than FEMA Administrator Brock Long, who said earlier Thursday on CNN that he is "not satisfied" with the federal response.
"I'm not satisfied because the fact is that we will not be satisfied until we stabilize the situation," Long said.
The island's power grid is not expected to come back online for months and government officials are still working to clear roads and put shipping ports and airports back into operation to distribute resources across the island.
Many hospitals on the island are only now coming back online, with 44 of Puerto Rico's 69 hospitals now operational, according to FEMA. Fewer than half were operational on Wednesday as limited access to fuel shut down power generators that allowed hospitals to remain up and running.
The devastation in Puerto Rico has presented federal responders with enormous challenges, with much of the country's infrastructure wrecked or significantly disrupted.
At least 10,000 containers of supplies
-- including food, water and medicine -- were sitting Thursday at the San Juan port, waiting to be deployed throughout the US territory.
Only 20% of truck drivers reported back for work in the wake of Hurricane Maria and diesel fuel shortages and blocked roads have also hampered the distribution of supplies.
Duke said the federal response is focusing first on restoring power to hospitals before moving to gas stations.
'Very difficult situation'
President Donald Trump did not publicly address the situation in Puerto Rico on Thursday, but acknowledged a day earlier the difficulties of bringing quick relief to the island, calling it "a very difficult situation."
"That place was just destroyed. That's not a question of, gee, let's dry up the water, let's do this or that. I mean, that place was flattened. That is a really tough situation," Trump told reporters on the South Lawn of the White House.
Trump took to Twitter on Thursday evening to praise the relief effort and criticize media coverage.
"FEMA & First Responders are doing a GREAT job in Puerto Rico," Trump tweeted. "Massive food & water delivered. Docks & electric grid dead. Locals trying.... ...really hard to help but many have lost their homes. Military is now on site and I will be there Tuesday. Wish press would treat fairly!"
Both Duke and Bossert emphasized that federal officials have been on the island since the storm hit and are working around the clock to rebuild the island and assist in recovery efforts.
"I think we had more workforce in Puerto Rico than we did for any other storm in history. It's been an unprecedented storm, it's been an unprecedented response, and the President and I have absolutely 100% confidence in what Sec. Duke, and Brock Long, and the men and women of Puerto Rico are doing. We're going to get through this," Bossert said.
"I understand the coverage in some cases is giving the appearance that we're not moving fast enough. I think that there's kind of two responses I'd have to that. First, there's an understandable degree of devastation on the island and for anybody that needs food and water, power, lifesaving needs and commodities, health care, there's nothing that can help fast enough," he said.