How COVID-19 is Impacting the Fight Against Lead Poisoning

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Brian Lehrer: It's The Brian Lehrer Show on WNYC. Good morning again, everyone. According to the Centers for Disease Control and Prevention, nearly half a million children nationwide missed routine blood lead level tests in the first five months of 2020. Joining me now to talk about how New York City's focus on fighting the pandemic has slowed down the resources once used to prevent childhood lead poisoning and what can be done about it now is Christopher Werth, senior editor in WNYC's Narrative Unit. Hi, Christopher. Welcome back to the show.

Christopher Werth: Hey, Brian really good to be here.

Brian: The pandemic of course has appended so much of our lives and you report led screening is no exception. Why are kids falling through the cracks on this?

Christopher: I think the child well visits have dropped pretty considerably throughout the pandemic. Obviously, the biggest decreases were in those spring months when the whole city ground to a halt. The Department of Health in New York City has reported that in April saw the biggest decline of about 88% in kids showing up for those visits and getting lead screening. That's where that screening takes place. I've talked to a number of pediatricians who say they think that that has picked up quite a bit over the past few months, but certainly, those really bad spring months, we've left a lot of kids behind.

Brian: It's part of a larger picture of kids not getting their WellCare or other medical care in general so they and their parents can stay home?

Christopher: That's right. Kids were not showing up for those well-child visits. I think the last month that we have data for, that was down only about 6%, so much less, from what I'm hearing, there's a big backlog of kids that haven't been screened, tens of thousands of kids actually, if you compare the first six months of 2020 to the first six months of 2019.

Brian: Is there data to indicate kids are being exposed more to lead because they're spending so much more time at home during the pandemic?

Christopher: Yes, that's the big fear that I'm hearing from public health experts on this is that if they're in a bad apartment with a lead paint hazard, then they're going to spend more time in there obviously and their exposure will increase. When you look at the Department of Health’s data in New York City, it's hard to suss out whether or not we're actually seeing a trend here because as I say, the level of screening is down so considerably. According to the Department of Health, the rate of exposure, so number of kids per 1,000, is up. It's 12.2 for the first six months of 2020 whereas it was at about 11 in 2019. But again, it's hard to really read that data without more complete numbers.

Brian: That data does seem to suggest though that many more kids may be having more lead exposure if there's a little uptick in the measurement, but there's a lot less measurement being done. Listeners, wondering if there are any parents out there who haven't been able to get your child tested for lead this year or just have chosen not to because you're trying not to go to the doctor in general to not expose yourself to doctor's offices or to outside stuff generally.

Whether you routinely do it or are concerned about that in your home listeners, 646-435-7280. Or if you've had your child recently tested, how did it go or anything else you'd like to report? Is your landlord following-up in the ways they're supposed to, if you suspect lead in your home? 646-435-7280, 646-435-7280 or tweet @BrianLehrer for our Christopher Werth, who has done a lot of reporting on lead and public health.

Christopher, the Health Department is supposed to send inspectors to the homes of children anytime a child has a lead level at or above five micrograms I think the level is. If they find violations, the department then is supposed to force landlords to make repairs. What's the current status of that local law and is it being enforced during the pandemic?

Christopher: I have talked to people both within the Department of Health who aren’t authorized to speak and also people who are working directly with, for example, Department of Health nurse managers in these cases. What we've heard particularly from Montefiore Hospital, which runs one of the most robust lead prevention and treatment programs in the city is that certainly throughout the summer, those inspections really haven't been happening in the way that they're supposed to and really only the most acute cases. Kids, what you said, that the inspections are supposed to happen when a child tests at five micrograms and above.

Those inspections really were only happening with kids who were at 45 micrograms and above. That's where pediatricians are advised a hospital has a child and start chelation therapy, which is a therapy that can draw that lead out of the bloodstream. I'm told that the inspections have started to pick up a little bit starting in September, but still, certainly not at the five micrograms that's mandated in city law.

Brian: Are you saying that even kids who had 45 micrograms of lead in their blood, those homes were experiencing delays with inspections?

Christopher: It's hard to know for sure. We'd submitted a lot of questions to the Department of Health and we didn't really get many answers on the inspection side of this issue but I am told that those cases were prioritized. Whether there was a delay, it's hard to tell, but certainly, for those cases where a child has to be hospitalized, I'm told that there was a priority there for those kids. The kids under 45, they were not being prioritized for inspection.

Brian: Let's take a phone-- [crosstalk] Go ahead and finish the thought. Go ahead.

Christopher: No, I was just going to say, I think with the resumption, I'm told that this is happening for inspectors on a voluntary basis. Understandably, the inspectors at the Health Department may not want to go into homes and certainly at the peak of the pandemic in the spring, wouldn't have and it could be on the other side where the families don't want an inspector coming into their home during this period of time.

Brian: Let's take a phone call. Stephanie in Brooklyn, you’re on WNYC. Hi, Stephanie.

Stephanie: Hi, oh my gosh my heart's racing. I listen to you all the time. My son is one-and-a-half and he tested positive for lead at the beginning of the pandemic for his one-year wellness visit and his rate was 14. An interesting thing about the pandemic is that we ended up needing to vacate our apartment and going up to my mother-in-law's house where there was no lead exposure. Because we were quarantined in a place without lead, his levels ended up going down significantly over the summer but now we're back here and we have to address the lead.

The city inspectors have been really helpful. They’ve been coming. We have a private inspector come and a city inspector and our landlords have also been really great about it. It's a big expense, a very big deal. We have to remove all the doorframes, all the windows replaced, sheet rock all the walls. We've been very fortunate that our landlords have been really amenable to it and supportive, but I can imagine that without a supportive landlord, this would be a really, really difficult process.

Brian: Christopher, anything you want to say to Stephanie or ask her?

Christopher: Stephanie, when exactly was there a long delay between the time that your child was tested and when the inspector showed up at your apartment?

Stephanie: Let's see. We played phone tag. They called right away, within two weeks I think of getting the announcement. First, we got a call from a case manager from a nurse and the nurse has been monitoring his lead levels for every test. We get him tested once a month. The nurse then was speaking with the inspector and the inspector actually didn't come because we were out of town for quite a while but they did reach out within two weeks. I think if we had been in town, they would have come probably within the month.

Christopher: When exactly did your child test positive?

Stephanie: In June.

Christopher: In June, okay. I think Stephanie's experience, I think that's great. I have also on the flip side of that, I have a story in Gothamist now about this. I talked to a parent who in a similar situation, child tested just right before the lockdown happened with an elevated blood lead level and then had a very hard time getting an inspector to her home to follow up actually and with a very reluctant landlord. I think there are two very different experiences that can happen.

Brian: Interesting. Of course, we hear from you, Stephanie, how much it can really turn your life upside down for a while to do the kind- -of remediation that needs to be done.

Stephanie: Yes, and now we will be leaving our apartment and we don't actually know where we're going yet. [chuckles] That's supposed to happen in about a week. With COVID levels rising, we're not sure where to go safely.

Brian: Christopher is the city supposed to help with that?

Christopher: The city, I think that they can help with some relocation and there's some options, but on the whole, I am not completely sure how relocation would work.

Brian: All right. Why are Health Department officials not showing up as much for home inspections? Sorry, folks, that's my phone in the background, just ignore it. I told them never to call me here. Is it that they're working on COVID-19 related issues? Or is the issue that they don't want to risk spreading the virus by going into homes? Or what would you say?

Christopher: It's unclear as to whether that point, and I should follow up on Stephanie's, on that last question that you asked. I do know that other families who've experienced this issue, the landlord is required to cover the cost of some relocation either in a hotel room or Airbnb.

Brian: That's good to know for any parent who might experience that situation and frankly, any parent who might be reluctant to discover the truth of that situation in your home, because of the way it might disrupt or the expenses that it might cause while you get remediated. Sometimes people don't want to look difficult things in the eye because of the shorter-term problems that they might cause. As we continue with our Christopher Werth, who's reporting on the nearly 500,000 children nationwide who missed routine blood lead level tests in the first five months of 2020, and with a particular focus on New York City.

Anyone else have a story or a question at 646-435-7280. 646-435-7280, and Louis in Brooklyn, you're on WNYC. Hi, Louis.

Louis: Hey, Brian. Thanks for taking my call. I live in a building where the landlord has had multiple lead violations. It seems that every time that they do the repairs, they hire the same company to do the repairs and the same company to do the test after they do their repairs. Even though the company approves-- does the test afterwards, the city comes back and finds more violation. Is there any way for a tenant to hire their own contractor to do the lead repairs and hire their own company to do the test afterwards? Because I've had repairs in my apartment multiple times, seven over a year. That seems a little bit excessive for me. Thank you.

Brian: Thank you. Christopher, can you help Louis?

Christopher: In terms of doing repairs, I'm sure that's something that you would have to clear with your landlord anyway. Certainly, that would be a personal decision that you could take if you're curious as to how well that remediation work was carried out at the end of it. Certainly, you can hire your own environmental testing companies to come in and do an analysis and take samples and tell you what the lead dust levels for example are or whether or not there's remaining lead paint surfaces. Go ahead.

Brian: I was just going to ask you if parents have access to any tools like lead testing kits for pipes that could help them determine whether or not to make a complaint themselves?

Christopher: For pipes, do you mean water?

Brian: Pipes or I guess I'm thinking about water pipes, but it's really a general question. It could be for lead-based paint on the walls, anything to do your own tests if inspections aren't being done by the city.

Christopher: For water, you can call 311 and request a free lead testing kit. They'll send it out to you. You fill up two bottles of water. One is a first sample first draw in the morning and then the other is after you flush it for about a minute or so. You send that back and you can get a lead test that way. For lead paint, there are lead paint testing kits that you can buy at a hardware store or order. Those are color tests. You break open a little swab and you wipe it on the paint and it will give you a pretty clear indication as to whether or not there's lead in the paint.

The way that the city determines what constitutes lead paint or not is based off of an XRF analysis, which is another level of testing, which is much harder to do, but there are certainly companies that will come in and do it. In the Health Department, if you're concerned about lead paint in your home and you have some deteriorating paint conditions, and you live in an old building, you can certainly call 311 again. Part of the Healthy Homes Program has built into it a process whereby that tenants can get their apartments tested.

Brian: Yes, that's good information, especially in the context of your reporting that the Department of Housing Preservation and Development in the city has seen a nearly 60% drop in the number of lead paint violations issued between late March and the end of October compared to the same period last year. In other words, if inspections and enforcement seem to be down in the pandemic, it's good for parents to have some of their own tools. You report that-- Well, actually, let's take another call. Kim and Hastings on Hudson, you're on WNYC. Hi, Kim.

Kim: Hi, thanks for taking my call. One of my twins just hit high for lead 20 years ago. We live in an old house in Westchester and my pediatrician said, "Go home, do what you can and will retest in three months." In three months, I think the number was that it's changed, which okay now, what’s not? They think what was at nine, and I painted, I vacuumed and mopped. I got them walking and I cut the number down. My pediatrician didn't call anyone and the number went down and everything was fine.

Then I started with tearing out doorframes and drywall. It’s one of the worst things you can do, especially if you have to live here. It's not [unintelligible 00:17:08] to keep the best way.

Brian: Kim, thank you for that. There is a line. There's sometimes a fine line between kicking up lead that might be more safely behind the paint and digging around in the name of your child's health in a way that might actually expose your kid to more at least in the short run. How should people navigate that?

Christopher: Westchester is obviously governed by different set of laws in New York City. In New York City, Local Law 1, which is a piece of legislation that was passed in 2004, and is largely attributed for that, you had a big decline in blood lead levels in New York City. It has preventative measures built into it. One of those is based around those like doorframes and windows, which are considered high friction surfaces. If you have lead paint on those surfaces and you have a door closing or a window opening, it produces a lot of lead dust, which is actually the primary route of exposure when it comes to lead paint, particularly in New York City.

It's not necessarily about a kid getting their hands on some lead paint chips, although that certainly happens. Certainly, abatement where you're taking out the doorframes that have lead paint or removing the doors and replacing them if they have lead paint and certainly windows. Those are all seen as very good things to do but you're right, when it comes to walls. I think the EPA guidelines are based around stabilization rather than absolute removal.

Brian: Listeners, let this conversation be a reminder. One of the things that's falling through the cracks, both for individual families and as our Christopher Werth reports, for the city is checking on lead paint levels in homes and in your children falling through the cracks during the pandemic, as people try to stay away from doctors, try to stay away from in-home visits of any kind. Don't let it fall through the cracks.

As we leave it with Christopher Werth, senior editor in WNYC's Narrative Unit. His latest report on Gothamist is titled Declined, Delayed, Defunded? How The Pandemic Has Thrown A Wrench Into The City's Lead Poisoning Prevention Laws. Thanks for revealing it, Christopher.

Christopher: Thanks Brian.

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