Flint death toll from Legionnaires’ disease worsened by state and federal inaction

By James Brewer
25 February 2016

Health experts warned of the danger of Legionnaires’ disease in Flint, Michigan and the possible link to the change in the city’s water source as early as October 2014, yet their efforts to investigate the situation was blocked by high-placed officials in state and federal agencies. To this day, according to a recent Detroit News report, the city’s water has not been tested for the Legionella bacteria.

On April 25, 2014, the city of Flint switched its water source to the highly polluted Flint River after more than 40 years using the treated water from Lake Huron supplied by the Detroit Water and Sewerage Department (DWSD).

Within two months of the switch, the number of Legionnaires’ disease cases in Genesee County, where Flint is located, sharply jumped. During the summer months of 2014, 34 cases of the disease were reported, whereas the previous summer, only five were recorded. Legionnaires’ disease is more prevalent in the summer season, as the bacteria that produces it is more likely to grow in warm weather.

Arrows indicate city of Flint switches to Flint River water in April 2014 and back to Lake Huron water in October 2015. Red bars correspond to a second cluster of cases in summer 2015. Note that monthly case values are approximated for May/June 2015 and August/September 2015. [Source: flintwaterstudy.org]

Infectious disease epidemiologist Shannon Johnson with the Michigan Department of Community Health (DCH) wrote a concerned email on October 13, 2014 to Susan Bohm, an epidemiologist with the state’s Department of Health and Human Services (DHHS) saying the switch of the water source was a likely cause of the spike. Johnson also proposed a coordinated effort to test the water.

Johnson’s email stated, “The current hypothesis is that the source of the outbreak may be the Flint municipal water … I let Shurooq [Genesee County epidemiologist Shurooq Hasan] know that we could assist with and facilitate environmental testing, whether it be through our lab or DEQ [the state Department of Environmental Quality]. The LHD [Local Health Department] is meeting with the water dept. this week so she said she would let me know what their plan is. …McLaren [Hospital] conducted environmental testing on their system and found low levels of legionella bacteria and have since hyper‐chlorinated their water to disinfect the system. McLaren receives its water from the Flint municipal system.”

After Bohm discussed this on the phone with her superior, Liane Shekter-Smith, the DHHS Chief of the Office of Drinking Water and Municipal Assistance, she related the conversation to DHHS colleagues in an email with a subject line “Genesee County Legionnaires’ Disease Cluster.” It said, “What she did share with me was interesting—that there have been numerous complaints about the Flint water, that the governor’s office had been involved, and that any announcement by public health about the quality of the water would certainly inflame the situation.”

Johnson’s email should have provoked immediate multi-agency action to investigate the source of the disease and issue a public warning of the health danger posed by the outbreak of a lethal disease. Instead, Michigan officials responsible for the safety of drinking water were more concerned with concealing the possible dangers from the public and prevented the eruption of social opposition.

Authorities, all the way up to the office of Governor Rick Snyder, were aware of the anger and the demands of the population of Flint to return to the DWSD water source. Almost immediately after the switch, residents complained of smelly, discolored water coming from their taps. The city issued several boil-water alerts due to the appearance of coliform bacteria, then carcinogenic trihalomethanes as a result of over-chlorination in the attempt to treat for bacteria. Throughout this period, agency appointees at the highest levels, both state and federal, marched in lockstep to block revelations that Flint River water was unsafe.

Shenkter-Smith was one of several lower-level officials who have been fired or were forced to resign as a result of the exposure of the Flint water catastrophe. They have essentially been fall guys, however, to protect top officials from both parties in the Snyder administration, Obama’s Environmental Protection Agency (EPA) and the city of Flint.

In January 2015, warnings were mailed to residents about high levels of trihalomethanes in the water, yet still claiming the water was “safe to drink.” Various state agencies were sending emails to the DEQ, concerned about Flint’s water quality. Early in February 2015, Genesee County Health Department Environmental Health Supervisor James Henry, who had been attempting to obtain the collaboration of the DEQ on the Legionnaires crisis, informed the department that because he had not received a response to his inquiries about Flint water distribution, he had taken the highly unusual step of sending Freedom of Information Act requests by email and letter to the department.

In response to his continued efforts, DEQ Lansing Supervisor Stephen Busch, after months of obfuscation, chided Henry that “conclusions that legionella is coming from the public water system without the presentation of any substantiating evidence from your epidemiologic investigation appears premature and prejudice (sic) toward that end.”

DEQ spokesman Brad Wurfel went one step further in an internal email, “Essentially, Jim Henry with Genesee County Health is putting up the flare. He’s made the leap formally in his email that the uptick in cases is directly attributable to the river as a drinking water source—this is beyond irresponsible.”

Both Busch and Wurfel are no longer with the agency, along with DEQ Director Dan Wyant.

In June 2015, Jim Collins, director of the DHHS communicable disease division, issued a report declaring that the Legionnaires’ “outbreak is over.” Summarizing 45 cases of the disease from June 6, 2014 through March 9, 2015, the report said, “The last reported case occurred in March 2015. The lack of clinical Legionella isolates precludes our ability to link cases to an environmental source.” Henry responded that there were two more cases earlier that week. By the time the switch was made back to DWSD water in October 2015, 87 cases and nine resulting deaths were recorded.

The New York Times interviewed two surviving victims of the outbreak. Tim Monahan, 58 was one of the earliest to contract the disease. He is now “stunned and furious” about the response of authorities to the outbreak. He told the Times, “What gets me is how fast the state has just denied—‘We can’t prove it’s the water.’ I think they’re so afraid of tying nine deaths to this. The whole thing is just such a ridiculous tragedy.”

The disease left Connie Taylor, 62, with kidney failure, requiring dialysis three times a week. She left the hospital in September without being told she had Legionnaires’ disease. She told the Times, “It just took me right down. They called my family in from out of town. And then my kidneys failed. This was something I didn’t have to go through and it’s changed my life tremendously.”

The root cause of the public health disaster in Flint was the criminally irresponsible actions of officials from both big business parties, which have overseen the destruction of basic infrastructure while handing over trillions to Wall Street and the Pentagon war machine. The decision to separate Flint from its source of safe drinking water was bound up with efforts by the Snyder administration, with the backing of the Obama administration, to force cash-starved municipalities to privatize services in order to pay off wealthy bondholders.

The same officials who approved and allowed the switch to Flint River water, both Republican and Democrat, were responsible for monitoring water quality issues during the many resulting health dangers. The indifference and hostility of these officials towards the public is not a personal matter. On the contrary, it sums up the criminality of the entire corporate-controlled political establishment.

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