Lead testing is down 39 percent in 2020, including a 27 percent decline in the number of children tested. (File photo by Jabril Faraj) The pandemic, officials say, has led to a decrease in the number of lead tests conducted this year in Milwaukee, a major concern in a city whose Health Department has been criticized for its handling of the public health crisis. Marivel Montejano, director of home environmental health for the City of Milwaukee Health Department, said comparing 2019 data to 2020 data through September shows a 39 percent decline in lead tests performed and a 27 percent decline in the number of children tested. The reason for the drop: a coronavirus pandemic that has kept parents and children out of clinics for regular and follow-up visits and hindered the ability for health care and lead assessment workers to get into homes to conduct vital risk-reduction work. About 9.2 percent of Milwaukee children under the age of 5 who were tested in 2018 had blood lead levels of more than 5 micrograms per deciliter. Do you have feedback on Milwaukee NNS's reporting? Take our survey to let us know how we're doing! The Centers for Disease Control and Prevention, or CDC, recommends interventions for any children with lead exposure levels of 5 micrograms per deciliter or higher to minimize the risk of lifelong health, learning and behavior problems. Fueling more concerns are the rising number of children spending more time at home due to virtual schooling and other factors, and that older homes and buildings are primary sources of lead exposure. Montejano said the pandemic forced changes in protocol “to ensure both the safety of staff going into families’ homes and the families themselves.” Those changes included a pre-visit telephone screening for COVID-19 symptoms or possible exposure and referrals to local coronavirus testing sites. Home visits, if necessary, are planned based on recommended COVID-19 timeframes, she said. During the pandemic, the city’s home environmental health division continued to respond to and investigate all cases in which lead levels were high, she added. In extreme cases where children had blood levels of 20 micrograms per deciliter or higher, the families receive clinical case management services along with physical and neurological developmental screenings by public health nurse case managers. An environmental investigation by certified lead risk assessors is completed for the home in those cases, and education on how to minimize future exposure and a Healthy Homes Kit is provided, Montejano said. COVID-19 has also caused disruptions for the Sixteenth Street Community Health Centers’ Lead Outreach Program. “When March and COVID presented itself, it put the whole lead program on hold in terms of doing home visits,” said Marcos De La Cruz, clinical director of the organization’s lead program. COVID-19 “threw everybody for a loop.” Pre-pandemic, he said, outreach workers conducted door-to-door visits, in-home lead testing and lead abatement work in addition to follow-up lead testing and other services for children who tested with high exposure levels. “Because there is no medication for children with elevated levels, the education provided to parents focuses on proper nutrition and removing risks,” De La Cruz said. “Not being able to see patients in person made things difficult.” Although it was no longer able to conduct in-home visits, the clinic did follow up with children who tested with elevated levels of lead, and it conducted visual assessments of homes via Zoom when possible, he said. The center was able to continue to conduct lead tests on children during their six-, 12- and 18-month checkups, and during their annual checkups for kids ages 2 to 5, so the staff was able to capture a big group of patients, he said. Sixteenth Street has been working since September to bring a backlog of children who need retests or other services back to the clinic. A decision to resume in-home visits will be made once the positive rate of COVID-19 cases goes down. “There’s nothing set in stone for the near future, but we’re ready when we are able to,” De La Cruz said. The decrease in lead screenings is a major concern for U.S. Rep. Gwen Moore, a Milwaukee native. She said her office recently requested information on lead testing for the state. “They confirmed that preliminary data indicated that tests for children under 6 were down, especially in the early part of this year,” Moore said. Moore joined other members in Congress who sent a letter to Robert R. Redfield, director of the CDC, that requested additional federal funds and resources be allocated to address the COVID-19-related challenges to lead testing. Locally, Ald.