By Kelley Kauffman, MSN, APRN-CNP, PMHNP-BC, Center for Health Equity Engagement Education and Research
(Admin Note: This entry can be viewed as a sort of follow-up to a post from July 7th, 2020. While it is not necessary to read the previous entry, it does provide a good background for this one. If you are interested in learning more check it out here.)
Coronavirus related state-wide shutdowns have caused disruption in all sectors of American life. Unfortunately, that means that Cleveland, Ohio’s efforts to reduce childhood lead poisoning and increase lead testing in the city’s children have been negatively impacted, as well.
Not only are fewer children being tested, according to this Ideastream article, to see if they have been exposed to the toxin, but children have been spending more time in homes with potential lead hazards. Compared to previous years in Cleveland and across Ohio, tests for lead have decreased by nearly half, driven mainly by the closure of pediatrician’s offices and labs in March to all non-emergency visits due to the pandemic.
Testing children for lead is the main way to identify damaging lead hazards, as well as, to help parents recognize developmental delays or behavioral issues linked to lead exposure, which as discussed in my previous blog can cause irreversible damage to a child’s brain and set a child on a pathway to prison. Due to the pandemic-related drop in testing, fewer lead-exposed children will be identified and receive help from state-supported early intervention programs, which are now offered automatically when a child’s blood test shows exposure.
Furthermore, public health authorities won’t receive as many referrals to investigate potential lead hazards in homes which are also triggered by a high lead-level test. Delaying intervention could result in prolonged exposure for children to lead dust or paint chips and potentially worse developmental and/or behavioral outcomes.
Tests have started to pick back up in recent weeks as the state has begun phased reopening and parents have scheduled routine well-child visits. However, there is no plan in place to make up for the missed testing. Insurers, Caresource and UnitedHealthcare, are collaborating on ways to increase lead testing but past efforts, such as, programs that offered incentives for parents have been unsuccessful.
There is a concern that with the recent spikes in coronavirus cases, parents will once again avoid bringing their child to the doctor’s office or lab because of fears about the virus. However, Dr. Abdulla Ghori, vice chair of Pediatrics at MetroHealth Medical Center, states that in terms of risk, “coming to the hospital is better than going to the grocery store and certainly much safer than [attending] a birthday party.”
Not enough is known about the potential effects increased time at home related to coronavirus may have on lead levels in children, but it appears that levels are already up slightly over last year (approx. 0.5%). Pediatricians and Public Health experts are sounding the alarm to not ignore lead testing as health systems focus on getting children their necessary immunizations. Lead testing should be done in combination with these other well-child visit activities, not seen as an afterthought that could have potentially dangerous long-term consequences for Ohio’s children.