Almost six months after a deadly tornado struck Tuscaloosa last April, the city’s fatality list is still increasing.

On Sept. 29, Mayor Walt Maddox’s office officially added Samuel Brasfield’s name to the list of those killed by the tornado, bringing the total to 52 deaths citywide.

“Based on evidence from prior disasters, we expect that as the weeks pass, the number of deaths that could be attributed to the storm may increase,” Maddox said in a press release.

Brad Fisher, director of communications at Druid City Hospital, said the number was likely rising because there were a number of elderly residents transferred from nursing home to nursing home, and their condition declined.

“[Their] health was so fragile that the move caused health to decline and they passed,” Fisher said.

Fisher referenced the La Rocca nursing home in Alberta, which was destroyed in the tornado. Although the building itself is no longer standing, all of its residents survived the storm and had to be moved to other nursing homes, according to The Tuscaloosa News. In the weeks following the tornado, however, as many as 10 residents died, the article said.

John Brook, co-incident commander for the city, said the storm’s mental and physical impact on the elderly had a different effect than on others.

“Many elderly were impacted by the storm,” Brook said. “Many didn’t sustain injuries but were impacted. In the months since, we’ve been contacted by their family members, who explain how the storm affected their loved ones, and if they want their name to be included on the list, we include them.”

Brook said the city is adding names to the April 27 death toll simply because it seems the right and human thing to do.

“There’s no federal funding increase and no death benefits,” Brook said. “But as we look back, they were affected by the storm, and we want to honor their lives.”

Following the addition of the fifty-first name to the fatalities list, Maddox said he was not surprised the list was still growing.

“One of the things we learned early in this process is that, unfortunately, one of the most affected parts of the population is seniors,” Maddox said. “And when something like the storm complicates a preexisting condition, sometimes that leads to their passing and adds to the death toll.”