“We’re afraid that the kids who are being missed are probably the kids at higher risk,” Dr. Courtney said. Some states reported that the dip in lead screenings was especially pronounced among children who were on Medicaid, he added.
For lead-poisoned children, the consequences could be devastating. Although there is no way to reverse lead poisoning, nutritional supplements and educational services can help mitigate the harms. Children who miss their lead screenings may not receive these essential interventions.
Moreover, in many cases, it takes an elevated blood lead level to trigger lead removal or remediation efforts. “If you don’t test, you don’t find,” said Dr. Morri Markowitz, director of the lead poisoning treatment and prevention program at the Children’s Hospital at Montefiore, in New York City. “If you don’t find, you don’t intervene, and the kid continues to be exposed, continues potentially to be ingesting lead.” He added: “And then it can progress, and by the time you check, things will have gotten worse.”
Even as lead testing rates were falling last spring, the amount of time that children were spending in their homes, where lead exposure is most likely, was rising. The pandemic, and the financial hardships that accompanied it, may also have prompted some families and property owners to postpone essential building repairs and maintenance tasks.
“I’m very concerned that we potentially may have more children who have been exposed if they’ve been in homes with peeling, chipping paint,” said Dr. Joneigh Khaldun, the chief medical executive for the state of Michigan and chief deputy director for health in the Michigan Department of Health and Human Services. “We just don’t even know it.”
Widespread building closures have created other risks. Although paint is the most common cause of childhood lead poisoning, lead pipes also pose a threat. The longer that water sits stagnant in such pipes, the more lead leaches into it; schools and day care centers that shut down last year could find their water dangerously contaminated when they reopen.
“There’s likely to be high lead levels in some taps,” said Jennifer Hoponick Redmon, a senior environmental health scientist at RTI International, a nonprofit research organization based in North Carolina. “Water needs to be flushed at schools and child care centers — and really, all places that are closed — before people start using the water again for drinking and cooking.”