Flint’s Deadly Water

The water crisis in Flint, Michigan — one of the poorest cities in the U.S. — began in April 2014, when the state took over city management and decided to switch the city's water supply from treated Detroit Water and Sewerage Department water to water from the Flint River, a notoriously polluted waterway.

The state's takeover of Flint's city management was due to the city being near bankruptcy. For this reason, the influence of city council officials over decisions relating to Flint's water sourcing was limited.

As longtime Flint resident Rhonda Kelso told CNN in 2016,¹ "We thought it was a joke. People my age and older thought 'They're not going to do that.'" Indeed, supplying the city with water from a known polluted source seems neither rational nor reasonable nor even ethical. But it wasn't a joke.

This cost-cutting strategy was implemented to save $5 million — a temporary measure while a new pipeline was being built for the newly created Karegnondi Water Authority, which would supply fresh water from Lake Huron to the mid-Michigan area, including Flint.

Flint's Unprecedented Health Crisis

Problems became apparent almost immediately following the switch. Residents noticed their tap water had turned a dirty brown, and had an odd smell and taste.

In a March 2016 article,² CNN interviewed Flint resident LeeAnne Walters, whose twin boys developed strange rashes after the switch. One of them was also diagnosed with lead poisoning. Other people also suffered mysterious illnesses, including hair loss, nervous system disorders and cancer.

The featured PBS Frontline documentary, "Flint's Deadly Water," which initially aired September 10, 2019, reveals how this entirely preventable tragedy was allowed to occur, and how after five years, the public health ramifications are still ongoing, with no justice in sight.

In my view, Frontline has exceeded 60 Minutes in digging deep into serious issues. This is an absolutely brilliant piece of original investigative journalism that PBS committed significant resources to produce.

As highlighted in the documentary, aside from poisoning thousands of people with toxic lead, Flint's contaminated water supply also spawned one of the nation's largest outbreaks of Legionnaires' disease³ — a severe and potentially lethal form of pneumonia contracted from contaminated water — with cases being reported to this day.⁴

Frontline's investigation shows that, just as with the lead issue, state officials not only failed to take the appropriate action to prevent and stop the deadly outbreak, they interfered with and prevented a thorough investigation that could have saved lives.

As noted by Flint city councilman Eric Mays, who is interviewed in the film, Legionnaires' disease has been the real killer in this case, yet the death toll from Legionnaires' disease has gone largely unnoticed outside of Flint.

"That was the one [thing] I think they tried to hide the most," Mays says. "That's the one I still think they don't want people outside of Flint to know [about]"

Officially, 12 died and more than 90 were sickened by Legionella during the height of the outbreak in 2014 and 2015.⁵ The true death toll, however, is likely well over 100, as the Frontline documentary shows clear evidence of state manipulation of the statistics.

A review of death records shows 115 residents died from pneumonia during the peak of the outbreak, and Frontline hired two epidemiologists from Emory University who concluded there was a statistically significant issue in Flint. According to PBS:⁶

"Epidemiologists and infectious disease specialists told us that some of those people could have been Legionnaires' disease cases that were left undiagnosed, untreated and, ultimately, uncounted."

Legionnaires' Disease Cover-Up in Flint

As reported by Frontline, the outbreak of Legionnaires' disease began in June 2014, shortly after the city's switch to water from the Flint River. The Legionella bacterium is unique in that it lives and thrives in water. The disease is contracted not via human to human contact, but rather by the inhalation of contaminated water droplets or spray.

As noted by Janet Stout, Ph.D., a Legionnaires' disease specialist with Special Pathogens Laboratory in Pittsburg, if you control the bacteria in the water, you control the spread of the disease. In Flint's case, proactive remediation was never undertaken, thus allowing the outbreak to grow.

By mid-summer 2014, there were more than a dozen confirmed cases of Legionnaire's at Flint hospitals, yet residents of Flint remained unaware of the growing health crisis as no public announcement was made.

As noted in the film, it wasn't just one failure that led to the lead and Legionella problems in Flint. Basically, all safeguards that are typically in place failed, and officials at all levels of government failed to take appropriate action.

An old decommissioned water treatment plant was reopened to treat the Flint River water, but it was ill equipped to handle such highly polluted water. Hours before the switch took place, the plant foreman, Matt McFarland, urged his sister to warn everyone she knew and tell them not to drink the water, saying the plant wasn't ready and the water wasn't safe.

Within weeks, residents began complaining of foul-smelling and discolored water coming out of their tap. Some reported rashes. Yet the response they got was there wasn't anything to worry about and the water was safe for consumption.

Not only was the improperly treated water speeding up corrosion and causing lead to leach out of Flint's aging water pipes, it also quickly became a breeding ground for Legionella. As noted by Stout, when Legionnaires' disease outbreaks occur, standard procedure involves testing water supplies for Legionella, and then disinfecting the source of the bacteria.

Yet for some reason, this was not done in Flint, even though the fact that they had a large and growing outbreak on their hands was readily apparent, and the Flint River water was the prime suspect.

CDC Prevented From Doing Its Job

When Stout was contacted by county officials about the growing Legionnaires' problem, she told them to contact the Centers for Disease Control and Prevention. That's standard procedure. The CDC will perform the necessary testing so the outbreak can be properly remediated and contained. The problem, however, was that CDC protocols require an invitation from state officials.

County officials requested help from the CDC to rein in the outbreak, but the state refused to issue the prerequisite invitation. Instead, Frontline shows an email response that reads, "if there are areas where we would like to request CDC's assistance, we'll get in touch."

Even when the CDC persisted in recommending a full investigation, as Flint was now ground zero for one of the largest outbreaks of Legionnaires' in years, state officials refused to take them up on the offer. Making matters worse, the county health department also failed to notify the medical community about the outbreak.

It wasn't until the end of 2015, when the high lead levels became front-page news, that state officials had to face the fact that the water switch was having serious consequences.

Still, the cover-up continued. As the lead crisis grew, then-governor Rick Snyder ordered a switch back to Detroit water, but it took several more months before the Legionnaires' outbreak was publicly admitted. Even then, Snyder didn't admit the link between the outbreak and Flint River water.

Legionella Contamination Finally Admitted

January 13, 2016, Snyder and two top state health officials held a televised press conference in which Snyder announced there had been a spike in Legionnaires' disease during 2014 and 2015. For many, including Ron Fonger, a reporter with The Flint Journal who had been writing about Flint water for a year, the news came as a complete surprise.

Snyder did not, however, admit that the outbreak had anything to do with the switch to Flint River water. Michigan health and human services director Nick Lyon said: "The DHHS cannot conclude that this increase is related to the water switch due to lack of clinical isolates during the time period."

As noted by Stout, to make that determination, you actually have to test the water — and they didn't. Lyon also said, "This is part of our effort to be transparent and share information as quickly as we can."

Meanwhile, the Legionnaires' disease had been ongoing — unaddressed and unannounced — for two years. So much for transparency and timely notice. Also not mentioned was the fact that the CDC had pushed for a full investigation eight months earlier, and had been rebuffed.

Soon after that press conference, state Attorney General Bill Schuette launched a criminal investigation to determine whether laws had been broken.⁷ Todd Flood was appointed special counsel for the investigation.

In the summer of 2016, infectious disease experts Shawn McElmurry, Ph.D., from Wayne State University, and Dr. Marcus Zervos from Henry Ford Hospital, met with Lyon and other top health officials, calling for stepped up surveillance for Legionella.

Lyon was told that if he did not take appropriate measures, people could die. According to McElmurry and Zervos, Lyon's chilling response was, "Well, they have to die of something."⁸ For the record, even though the allegations were published by numerous news outlets including The Washington Post,⁹ Lyon declined to personally comment on the men's claims, and his attorney denied that he'd said it.

The Criminal Investigation

By the end of July 2016, the state's attorney investigation had led to claims being filed against nine state and local officials on a variety of charges, including conspiracy, misconduct, neglect of duty and tampering with evidence relating to the lead and Legionnaires' outbreak.

In June 2017, Lyon and Dr. Eden Wells, Michigan's chief medical executive, were charged with involuntary manslaughter for their roles in the Flint water crisis.¹⁰ In particular, their failure to alert the public to the danger posed by the Legionella contamination, and their participation in the cover-up of the outbreak.

The state's defense hinged on an unsubstantiated allegation that the outbreak originated not in the Flint River water, but in McLaren Flint Hospital, where about 60% of the cases had been reported.

This did not hold water, as at least 30% of the victims had no link to McLaren or any other hospital. What's more, were it true that the state knew about an outbreak in a hospital, they would have been required to address it, and they didn't.

The initial trial found all the defendants guilty and required them to go to trial. Sadly, that trial never occurred as a new governor came in, who assigned an attorney general early in 2019, who promptly dismissed the case against all the guilty government cronies.

Justice Delayed Is Justice Forgotten

McElmurry's team eventually published the findings of their investigation in PNAS in February 2018, concluding that, indeed, the Legionella outbreak was caused by the change in the water supply, combined with failures at the water treatment plant.¹¹

The state health department rejected the paper, going so far as to question the expertise of the team. The state published its own paper, laying the blame on McLaren Hospital.

Dana Nessel was sworn in as the new attorney general for Michigan in January 2019.¹² She quickly ousted Flood and his investigative team and appointed new prosecutors for the case who subsequently dropped all charges against Lyon, Wells and several other officials.¹³ Flint residents were outraged.

Despite the fact that two judges had decided there was enough evidence to have the health officials stand trial, the new prosecutors claimed Flood's investigation was "fundamentally flawed" and had to be redone from scratch, as it had "failed to collect all available evidence."

In an interview with Frontline, solicitor general Fadwa Hammoud points out that the charges were dismissed without prejudice, "which means these charges could be brought up again." Still, that's small consolation for the residents of Flint, many of whom are starting to give up on justice ever being served.

As noted by one of the investigators on Flood's team, "justice delayed will be justice forgotten." And while justice rests, clusters of Legionnaires' continue to pop up in Flint.¹⁴ Between January 1, 2019, and August 30, 2019, there were 16 confirmed cases.¹⁵

Kudos to Frontline for exposing a massive injustice in Flint that killed and harmed people and let responsible state officials off the hook. There is clear damage here that is going unpunished.

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