In October 2017 KWR conducted a scoping mission for the State of Michigan in the US to get a clear idea of the status of the multidisciplinary project, ‘Enhanced Disease Surveillance and Environmental Monitoring in Flint, Michigan’, which was being executed by the Flint Area Community Health and Environment Partnership (FACHEP). KWR was also asked to determine whether it could become an independent oversight party for the research project.
In 2014 and 2015 two outbreaks of Legionnaires’ disease occurred in the City of Flint, Michigan, which coincided with a change in the city’s source for drinking water production and treatment. The FACHEP research team, made up of university researchers and other experts, was commissioned to study the possible connection between the disease outbreaks and the water source switch.
External oversight role for KWR
The State of Michigan, through the Michigan Department of Health and Human Services (MDHHS), called on KWR because of a growing dispute between themselves and the FACHEP team. Specifically, KWR was asked to examine the project’s overall structure and management, research approaches and methodologies, preliminary results, the issues of dispute between MDHHS and FACHEP, and to present proposals about a possible KWR oversight role on the part of MDHHS.
Legionnaires’ disease connected to water source change?
The results of KWR’s scoping mission are laid down in the report, ‘Assessment of the study on Enhanced Disease Surveillance and Environmental Monitoring in Flint, Michigan’. Its main conclusion is that, despite all the good intentions underlying the establishment of FACHEP, the major problem is that there is no trust between the client and the contractor, and that the circumstances around the project (legal issues, constant attention from public and media) stand in the way of developing a climate where sound, unbiased and responsible research is promoted. The result is a project where the roles of research, communications, project management and project oversight are completely unclear, and where there are different views, both based on scientific data, with regard to the relationship between the outbreaks of Legionnaires’ disease and the change in the Flint water source.
The report also recommended that the possibilities of overcoming the trust problem be further explored, and that an agreement be reached to establish an independent review of both the scientific research and the public health communications. Lastly, besides the independent review, KWR said that it would be prepared and willing to conduct the project oversight on behalf of MDHHS, on the condition that the above-mentioned issues be addressed in the negotiations for the contract’s extension.
Follow-up: KWR’s second mission to Flint
On the basis of KWR’s analysis, the State of Michigan offered to extend the contract with FACHEP and assign an extra budget for it, on the condition that KWR conduct the oversight. FACHEP turned down the State’s offer, however, and shortly thereafter published two articles and issued a press release. In response, MDHHS issued its own press release, in which it criticised one of the articles and added perspective to the other article. MDHHS also makes reference to KWR’s scoping report which it has made available to the public.
KWR is currently working on the first phase of the State’s commission. This includes an investigation into the causes of the Legionella outbreak that occurred in Genesee County.