The Middletown Press (Middletown, CT)
City: Virus shutdown delayed identification of lead cases
20 more New Haven children being monitored for exposure
NEW HAVEN — The city is now monitoring 27 children for elevated levels of lead, with 20 of those cases found to date in 2020 brought to the attention of health officials in the last five weeks.
There was an interruption of reports on young children who may have elevated lead blood levels, as pediatric offices were closed, just as the coronavirus pandemic disrupted schools and businesses, according to health officials.
New Haven Health Director Maritza Bond said from March 15 when the city closed down to allow people to shelter in place to avoid contracting COVID-19, until the first week
in June, no new lead cases were reported to the city’s Department of Health.
“There was a delay in routine children’s care,” Bond said, one component of the closures among health care practices. “They were not getting the blood work. If there was no blood work being drawn, no positive (lead) cases were being reported.”
Bond said her lead inspectors are now back in the field continuing to follow the seven cases that occurred from January until mid-March, as well as the 20 that have been brought to the department’s attention in the last five weeks.
“We are now caught up with initial inspections,” Bond said.
Each individual case could be anywhere on the spectrum, as cases progress through an initial assessment of the child, to dust wipes and testing of flaking lead paint or other sources of the poison in the home, with abatement orders issued to the landlords where necessary.
All 27 children are being monitored at this time, the director said, plus cases from 2019 that have not been closed out.
Before June, they were contacting the parents on the earlier cases and conducting interviews over the phone, which they typically would have done in person.
Bond said the staff now has Microsoft Surface laptops they can use to enter data, as well as responses to questionnaires and epidemiological information, rather than using paper records.
“I pretty much brought them all to the 21st century when I started (as city health director),” Bond said.
Pediatricians report to the state any elevated blood levels over 20 micrograms of lead per deciliter of blood, or two levels of 15 micrograms within three months.
There is a separate special trigger where New Haven is notified when any child under age 6 has a blood lead level of 5 micrograms or higher.
It is the strictest measure in the state, a marker it had for years until the local Health Department in 2018 during Mayor Toni Harp’s administration decided, in order to save money, to use the state lead level before conducting an inspection, which could mean waiting for a child to get sicker before an intervention.
Experts have determined that there is no safe level of lead in children, which can cause neurological deficits.
The city lost six lawsuits brought by the New Haven Legal Assistance Association over the changes, which the courts consistently ruled violated the city’s ordinance.
A lawsuit filed last year said that, looking at the most recently available statistics from the state Department of Public Health, there were 314 lead poisoned children in New Haven; 281 of those children are poisoned at elevated blood lead levels of between 5 micrograms and 15 micrograms.
The use of lead paint has been outlawed since 1978 but lead dust or chipping lead paint has been found in some of the city’s older housing stock.
The initial version of a subsequent updated city ordinance also generated a fight when it gave too much discretion to the Health Department to decide when to conduct an inspection, which then proceeded on a tight timeline to an abatement order.
The final revised ordinance approved by the alders in December made the rules clear that inspections had to take place once a poisoned child was identified at the 5 microgram level.
Bond said she has had ongoing meetings with corporation counsel and a representative of the New Haven Legal Assistance Association on her effort to update protocols that enact the new ordinance.
The director said she plans to call a meeting of the Lead Advisory Task Force in the near future.
Bond said when she came onboard she reviewed the notification system that was in place, and how the city was managing the surveillance system monitored by the state.
She said there was one individual assigned to monitor cases, but she changed that to each inspector monitoring cases by census tracks.
Bond said the backlog was not cases that had not been dealt with, but rather old cases that had to be signed off and closed.
The director said there were no standardized procedures in place, but that has been put into practice.
“We got everyone on board to follow the same standard protocol. The staff was then ensured they had the proper training from the state, for example, to utilize the surveillance system,” Bond said.
There is now an official memo describing the steps for the overall process.
For example, if no lead is found in the home of a child with elevated blood levels, the next step is to determine where the child spends time, whether that is at a daycare or a babysitter’s home, which will then be inspected.
If a parent were to refuse to allow an inspection, Bond said an administrative warrant would be sought.
She said orders to abate a home are either hand delivered or sent by certified mail. The city works with the homeowner on a management plan to make sure the surfaces remain intact.
Bond said the land records in the city clerk office will include the lead order and management plans for all to see.
For federally subsidized housing, lead abatement is the responsibility of the Housing Authority, but Bond has to sign off that it has been completed.
The director said she has four active lead inspectors and two more she expects to hire shortly, to bring the total to the six.
The city was down to only three lead inspectors last year, having lost the opportunity to apply for millions in federal lead abatement funds in 2018. Bond said they now have access to almost $6 million in federal funds to help homeowners with lead abatement.
The city and New Haven Legal Assistance Association have been meeting to settle the last suit brought against the Health Department. The court has asked the parties to file an update on the status of the case by July 31.