How could the Ottoman force suffer such heavy losses?

How did the Ottoman army suffer such large losses without abandoning the siege earlier?

The published garrison totals may omit many Maltese civilians and household troops, making the defenders more numerous than the formal figures imply.

The siege lasted nearly four months, with Ottoman deaths from battle and disease reported in the tens of thousands. A formal garrison of only 6,100 or 8,600, spread among several positions, seems too small to explain that result without much wider local participation. The costly struggle for Fort St Elmo reinforces that suspicion because both sides lost large numbers before the rest of the island's defences had been reduced. Maltese civilians, household troops, and militia are therefore treated as missing parts of the manpower picture, while the published totals remain uncertain. Even an 8,000-strong relief force would leave the listed defenders substantially outnumbered by an Ottoman army put at 48,000. In this interpretation, pressure from Maltese civilians helps explain the attackers' urgency and withdrawal.