The death toll attributed to last month’s severe winter storm in Texas nearly doubled Thursday. The Texas Department of State Health Services said that the number of deaths, initially 57, was in actuality 111 and is still expected to rise as state investigators continue their work. The majority of the fatalities were from hypothermia, but lack of access to medical care, traffic accidents, and fires also played a part. Carbon monoxide poisoning, often caused by sitting in a car in a closed garage, was also a culprit. Dallas County Chief Medical Examiner Jeffrey Barnard told The Dallas Morning News, “We’ll probably never have a really accurate number.” Millions lost power, heat, and water for days on end during the storm, leading to dire and unsanitary conditions across the state.