BioethicsTV: Legionnaires' Disease and the Cover-Up That Killed Flint Residents During the 'Flint Water Crisis'


Keisha Ray, PhD

Publish date

Tag(s): Legacy post
Topic(s): BioethicsTV Black Bioethics Cultural Environmental Ethics Justice Public Health

by Keisha Ray, Ph.D.

The story of Flint, Michigan’s water crisis, beginning in 2014 is a story that most people are familiar with. After changing how their water is supplied—Going from Detroit supplied water to water supplied from Flint river to the ultimate goal of pipelines bringing in water from Lake Huron—the water became contaminated. The yellow-ish brown, foul odor water brought in from Flint River had high levels of lead causing many people to not drink the water or use it for cooking, brushing teeth, or any other life activity that required water. Celebrities, professional athletes, and every day people all donated bottled water to Flint’s residents to help them with this crisis.

A just released PBS Frontline episode (season 37 episode 16) exposes a less well known story to come out of the Flint water crisis and that is the outbreak of legionnaires’ disease. Legionnaires’ disease is a severe type of pneumonia that people get from inhaling legionella bacteria. Since the state of Michigan did not require Flint to protect its pipes from corrosion, the corroded pipes that temporarily supplied Flint’s water from Flint River were a breeding ground for legionella bacteria. It is suspected that people breathed in the bacteria from water droplets. Although there is correlation between the changes to the water supply and the outbreak of the disease, officially the water supply could be named as a culprit for the outbreak because officials would not test the water. During the outbreak at least 90 people in Flint were diagnosed with legionnaires’ disease and at least 13 peoples’ deaths are attributed to the disease.

After watching the documentary about Flint’s water crisis and its legionnaires’ disease outbreak what is evident is that residents were infected with and/or died from the disease because the people who were making decisions about Flint’s water future were careless at all stages of the process. Even when state and city officials were made aware of the legionnaires’ disease outbreak officials ignored what was happening or completely denied that there was a problem.

By the summer of 2014 Flint started to see its first cases of legionnaires’ disease. By fall, 30 people were diagnosed. The county health department began an investigation into the outbreak and emails exchanged between officials show that some suspected that the change in water supply might be the culprit and were worried about the media getting notice of the outbreak. Janet Stout, Ph.D., a legionnaires’ disease expert says that a basic protocol—test the water, disinfect the water—is usually followed when legionnaires’ disease is suspected but it was not done in Flint. Because nothing was done to curb the outbreak, by the end of 2014, there were 40 confirmed cases of legionnaires’ disease and 3 deaths. By the end of the outbreak in 2015 there were 90 confirmed cases and 12 deaths.

During the outbreak residents were not told about the possible connection between the water supply and legionnaires’ disease. In fact, the residents did not know that there were any confirmed cases of the disease. The health department suggested that county officials draft a notice to send to medical providers in Flint but this notice was never sent because the person in charge wasn’t at work the day the letter was drafted. No medical personnel were alerted and county and state health department officials could not explain why.

One of the most egregious acts of carelessness with lives and frustrating parts of the documentary is when the Centers for Disease Control and Prevention (CDC) is mentioned. Officials in Flint reached out to expert Dr. Stout about the legionnaires’ cases and she says that she told them to contact the CDC. County health officials reached out to the CDC and told them that they had 47 cases of legionnaires’ disease and needed the CDC’s assistance. However, the state department officials also reached out to the CDC and said that they did not need assistance and that if and when they did they would be in contact, but they never did. The CDC did, however, call for an investigation. Had the CDC gotten involved the outbreak could have prevented more deaths and been a huge turning point in the outbreak.

Michigan governor Rick Synder claimed to not have known about the outbreak during this time, yet emails show that his aides and cabinet members knew about the outbreak as early as March 2015, making it’s difficult to believe that Synder did not know about the cases of legionnaires’ disease. Nonetheless, Synder ordered Flint to return to Detroit water supply and in 2016 he made a public, televised announcement about the legionnaires’ cases. He acknowledged that information about the outbreak had not been made available to the public but that the city, nor state can conclude that the change in water is the cause of the outbreak. However, this is only the case because when the initial cases of legionanires’ disease were brought to the attention of city and state officials, they refused to test the water. In Synder’s announcement he did not mention that the CDC called for an investigation.

There are many shocking parts of this documentary but another moment that stood out is when a team of 23 experts and scientists were hired to investigate the outbreak after it had been announced to the public. At first, the team members say that the state officials were very helpful, but eventually the state’s cooperation ended. When the team met with Nick Lyons, head of the Michigan health department to tell him that surveillance needed to be stepped up to prevent another possible outbreak of legionnaire’s disease or else more Flint residents would die, Dr. Shawn McElMuray, a team member (and others) claims that Lyons responded with “Well, they have to die of something.” Lyons, via his attorney claims that he did not make this statement.

The team of scientists were also prohibited from speaking with people diagnosed with legionnaires’ disease and from entering their homes. The team also couldn’t test residents’ water filters. The state officials seemed the most resistant to the team’s request to examine patients whose deaths were attributed to pneumonia to determine if the deaths were actually due to legionnaires’ disease. Lyons claimed this was all in an effort to make sure money was being used wisely but it’s hard not to see this an instance of putting money before residents’ lives and trying to hide the corruption that lead to so many deaths. Ultimately, the team of scientists found legionella bacteria in residents’ water filters even though they claimed that a top aide for Gov. Synder threatened and attempted to silence them after they revealed their findings.

The Frontline investigators did their own investigation and examined death records of people who died during the 2014-2015 outbreak and found that there were 115 deaths attributed to pneumonia during the legionnaires’ disease outbreak, which is 3 times more than prior years. State health department officials attributed the spike in pneumonia to influenza despite independent researchers saying otherwise. So the official count for people who died because of legionnaires’ disease during the outbreak is only 12 people.

After the Michigan attorney general announced that a team would begin a criminal investigation to determine if laws were broken during the Flint water crisis special prosecutor Todd Flood’s investigation found misconduct and negligence and efforts from the government to cover up the water crisis.

By July 2016 Flood had charged 9 state and local officials for crimes related to the Flint water crisis and legionnaires’ disease outbreak. By 2017 the governor’s cabinet, including Lyon, who was charged with involuntary manslaughter were brought to trial for their involvement in the Flint water crisis. Their criminal charges specifically stemmed from their actions related to the legionnaires’ disease outbreak and for preventing the scientist team’s investigation into the outbreak. After political changes and a new governor, prosecutor Flood and his team were replaced and all charges against the officials were dropped.

The failures of city and state officials in Flint, Michigan are no more apparent in the documentary than when the story of Jasmine McBride is told. McBride is the youngest victim of the legionnaires’ outbreak. At 26 she was diagnosed with legionnaires’ disease (on the same day of her diagnosis the person in the next hospital bed was also diagnosed with legionnaires’ disease). After 3 months in the hospital McBride had to relearn how to eat, talk, and walk. “It was just like being reborn all over again,” she said of her recovery. Legionnaires’ disease had weakened her heart and lungs and damaged her kidneys. By 2018 she needed a kidney transplant but was not healthy enough to receive one. McBride also had a chronic skin infection that her weakened immune system couldn’t fight. Seeing her frail body, skin covered in lesions, her difficulty breathing and talking is heartbreaking. She’s in high spirits in the film but is obviously suffering. The documentary ends with Jasmine McBride’s funeral in 2019. She died of cardiac arrest attributed to complications from legionnaires’ disease. The documentary also notes that 20 people who had initially survived legionnaries’ disease during the outbreak eventually died soon after the outbreak.

Before ending, the documentary also tells the story of Marcus Wilson who died in 2014 after a diagnosis of pneumonia but was never tested for legionnaires’ disease. The story of McBride and Wilson are even more heartbreaking because they are just two of the many people in Flint who were failed by the Michigan government. The government was careless with residents’ lives beginning when it switched the water supply, using a water treatment plant that had not been in use for 50 years. The government was careless with residents’ lives when they did not test the water supply for legionella bacteria once cases of legionnaires’ disease started appearing in the city. Hospitals and clinics, nor residents were informed of the outbreak. And the government continued to be careless with people’s lives during its concerted cover-up of their misconduct.

In regards to my overall reflections on the documentary, as I watched I kept thinking about the Flint population. Flint has a 41% poverty rate and is 53% black. Given medicine and public health’s continuous disregard for black lives it’s difficult not to wonder how the Flint water crisis and the legionnaires’ disease outbreak would have been different had the population of Flint not been mostly poor, black people. Race is political. Existing in a black body is political. Black bodies are unfairly policed, legislated, incarcerated, and subjected to environmental harm and social ills often times for someone else’s political gain. If the residents of Flint weren’t poor and black there would have been more concern for human life, there would have been more public outrage for how these people were treated, and I think someone would have been held criminally responsible for these people’s sickness and deaths. But none of this happened and as history tells us, it’s likely because residents were poor and black. What happened in Flint is an example of the ways politics play out on the bodies of black people. Examining the disregard for black lives at every stage of the water crisis, which still continues to this day, and the legionnaires’ disease outbreak we see people’s egos and wallets being put before black lives.




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