When Disaster Strikes: Unveiling the Truth Behind the Harlem Legionella Outbreak
Join HC3 host John Brocas and environmental health expert Dr. David Krause as they go beyond the headlines of the recent Harlem Legionella outbreak—an incident that’s shaken New York City to its core. Is this just another unavoidable crisis or a systemic failure hiding in plain sight?
In this gripping episode, we rip the lid off complacency, exposing why public health regulations failed to protect our most vulnerable—right in our hospitals, EMS stations, and even a public health laboratory under construction. Discover why official assurances may not be enough, how flawed oversight and construction missteps set the stage for tragedy, and why compliance does NOT always equal safety.
Dr. Krause shares firsthand insights into regulatory loopholes, the actual risks of cooling towers and municipal water, and how weak accountability puts entire communities at risk. Together, John and David unravel the “natural disaster” narrative, reveal the hidden dangers of under-reported cases and construction-related outbreaks, and call out the urgent need for transparency, independent testing, and proactive surveillance.
If you care about public health, transparency, and the safety of our cities, this is an episode you can’t miss. Listen now—and join the fight for real change before the next outbreak hits.
🎧 Tune in, get informed, and stay engaged with HC3. Your voice matters—especially when lives are on the line.
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Good morning.
Speaker A:Good evening, ladies and gentlemen, wherever you are in the Eastern United States or wherever you're actually listening to this, actually, this is Labor Weekend, and myself and Dr. David Krauss has jumped on here to cover something really important because as you know, if you've been listening to our discussions and some of our episodes, we, you know, we rely heavily on exposing potential issues to do with Legionella and pathogens and, you know, unknown pathogens and things like that.
Speaker A:And obviously, if you have been watching the news, you'll know that there has been a serious outbreak in Harlem area in New York.
Speaker A:But we're going to dive into some things today because there's assumptions abound, there is ignorance that has been played out.
Speaker A:There is lives being lost, and we just need to, we just need to jump into this.
Speaker A:David, good morning.
Speaker A:How are you, my friend?
Speaker B:Good morning.
Speaker B:I'm really glad to be here and to delve into some of the issues that are coming to light at this point.
Speaker A:You know, you sent me some articles we've been keeping on the news.
Speaker A:We've been watching this very closely.
Speaker A:And it seems to me, I mean, again, just before we came on here and discussed this, the irony that this is, is the Legionella is in a hospital now, an emergency medical, an emergency, an EMS station, and to make matters worse, worse, public health laboratory that is being constructed.
Speaker A:Now, whether people will say, well, you know, this thing happened.
Speaker A:And then we have assumptions where they say that everything was covered and they were compliant.
Speaker A:And this happens because it's natural.
Speaker A:But in reality, David, it may have a natural foundation, but this is not natural and this is dangerous.
Speaker B:Yes, of course, of course.
Speaker B:Well, you know, one, I'm, I'm a bit surprised because in my past experiences with dealing with outbreaks, it is again, the, the role of and responsibility of public health officials, typically at the state, county, in this instance, New York City, to investigate those outbreaks.
Speaker B:There has been, in my observation, a reluctance to look at or seriously consider government owned buildings being whether they, they're federal, state, county, local facilities.
Speaker B:So there's usually they're not even tested to begin with here.
Speaker B:I think the pressure and the, the epidemiology and the need really drove it.
Speaker B:They had indicated that, well, this is New York City.
Speaker B:We have the, the most rigorous cooling tower regulations.
Speaker B:We have requirements for registration, we have requirements for testing, and guess what?
Speaker B:All of that didn't make a difference.
Speaker B:So you can have regulations and in many instances, complying with the regulations, either on paper or in reality, does not manage the risk and does not ensure safety.
Speaker A:I want to talk a little bit about also, David, they have claimed it's come from two water cooling towers.
Speaker A:We've discussed this before, ladies and gentlemen.
Speaker A:You can go back and listen to some of our discussions.
Speaker A:There's an assumption here, and the assumption is, and it almost seems like to me, in reading between the lines, it's like, you know, it happens.
Speaker A:Let's, you know, crap rolls down a hill.
Speaker A:These are the things that just this is a natural disaster, which we know it's not because the minute that we introduce man's needs or you know, changing the environment in some way or bringing water into systems that are built, it's no longer natural.
Speaker A:Why?
Speaker A:Where do you think this?
Speaker A:I just, I find it just not even plausible how they could come out and say publicly, hey, this happens, it's natural when people are dying.
Speaker B:Yeah, that's, it's a, it's a fallback position to say, well, there's nothing we could have done about it.
Speaker B:And it will be interesting to see as more and more information, historical information is brought to light as to whether something could have been done and what they were actually doing.
Speaker B:One of the biggest factors that I've always said with that's a problem, it's a fundamental flaw with the cooling tower regulations in New York City is that the entity, whether it's the owner or the cooling tower treatment company, cooling towers have to be treated with biological agents and anti corrosive agents on a regular basis, ongoing basis, continuously, in order to keep them from becoming, you know, either corroded entirely and dysfunctional or to, from growing bacteria to unhealthy and dangerous levels.
Speaker B:But the New York City regulations, as well as the absence of any regulations across the country, implicitly and strictly allows for the contractors who are responsible for maintaining those systems to collect samples that are used to validate the effectiveness of their own work.
Speaker B:And this creates a disincentive to effectively evaluate and monitor and detect contaminants and contaminant conditions early.
Speaker B:Essentially you're asking them to grade their own homework.
Speaker B:And we don't do this in any other type of environmental investigations where we're dealing with asbestos, lead, radon mold.
Speaker B:You can't grade your own homework and you cannot expect good outcomes when you allow this to happen.
Speaker A:They've also said, I noticed as well that they said, you know, the towers have been, as you mentioned, it has to be treated okay.
Speaker A:Now they're kind of holding their hands up and said, hey, we've remediated the problem.
Speaker A:It's Gone.
Speaker A:We've taken remediation steps.
Speaker A:Cooling towers have been treated and it's all good, but yet it's like the horses.
Speaker A:You know, we've opened the door, the horses bolt.
Speaker A:There's nothing you can do about it because it's already in the system.
Speaker A:Because now we have an outbreak within the emergency medical services unit in the hospital.
Speaker B:What they got there, they reported that they detected Legionella in the plumbing system.
Speaker B:They haven't reported any disease related to that.
Speaker B:However, it's not uncommon for us to miss that type of diagnosis.
Speaker B:The arrogance with which they say, oh, the cooling towers are disinfected, period.
Speaker B:They didn't say that the cooling towers have been disinfected, cleaned, put back into operation and tested, sampled and gotten results back to ensure that they do have non detects.
Speaker A:Yes, it's somewhat arrogant.
Speaker A:It's somewhat arrogant in the way that they've come across with this, you know.
Speaker B:The, the simply stating it has been done.
Speaker B:Show me.
Speaker B:Because I frequently see remediations fail to achieve what they need to achieve.
Speaker B:I frequently see them actually even increase the concentrations of bacteria.
Speaker B:So just publicly saying it's been taken care of, don't worry about it, is nonsense.
Speaker A:The public health lab that is being built, the laboratory that's being built, obviously that is.
Speaker A:I'm flabbergasted with that because even though it's under construction.
Speaker A:Let's talk a little bit about that because that's another.
Speaker A:Seems to be an excuse.
Speaker A:Well, because we're building it.
Speaker A:There's construction in, you know, we're, you know, making it possible for Legionella to colonize.
Speaker A:And this happens because it's natural.
Speaker B:Yeah.
Speaker B:Huge risk factors that are beyond the control of the, the building operators, owners or the people who have a water management plan have to be acknowledged and dealt with.
Speaker B:So you know, if you look on, you know, look at the maps, photographs of that area, there's been construction going on, on that block, on that hospital constantly, not just that 10 story building.
Speaker B:And the, the irony is that it is, is intended to be the public health laboratory that probably will be running samples from Legionella in the future.
Speaker B:But you know, that can happen with any, any construction, any long term construction can cause the disruption in the, in the water mains that increase the levels of Legionella.
Speaker B:You also got, you know, there was one study that looked at numerous outbreaks and they, they concluded that 35% over a third of outbreaks that they had, they had evaluated at the CDC were caused by or had a major contributing factor due to external Disruptive factors such as construction and I've seen this in so many instances as well.
Speaker B:So when you have nearby construction that is impacting your water mains, that is a huge factor you have to take into into place and increased surveillance has to occur or you can be, you know, receive a nasty surprise like this.
Speaker B:The other thing is the massive rains that happened July 15th.
Speaker B:The New York City experienced record level rainfall in one two hour, one in a single one hour period they received two inches of rain.
Speaker B:What that does, these open top cooling towers, they're exposed to the atmosphere and they get overflowed, they overflow due to excessive rainfall.
Speaker B:That rainfall dilutes the disinfectant chemicals that are in the water.
Speaker B:Once that happens, it allows for the rapid amplification of bacteria, amoeba and introduced bacteria from the make up fill water from the municipal water systems.
Speaker B:So it's kind of a one, two punch.
Speaker B:So these factors are not discussed, warned, published, talked about in public health and you know, they're entirely foreseeable.
Speaker B:I think cooling tower operators recognize it but often they're, they're, they're limited in what they can do or recommend or because it takes time and money to manage those issues.
Speaker B:The other big factor here is New York City was holding on to data for two weeks, 10 to 14 days after they had those, had collected those samples.
Speaker B:The average onset of time between exposure and symptoms is easily is five to six days.
Speaker A:So I was going to say it's about a week before it to develop.
Speaker B:And it can be two days, it can be up to 14 days.
Speaker B:But the average, the median time is five days.
Speaker B:So if that's the case, if you look at the distribution curve, the EPI curve on cases, that means if they had positive results on July 25, they would have had that they collected on July 25.
Speaker B:If they had gotten those results, that they had positive culture results for Legionella And Ammophila on July 27, they could have, and they should have taken action rather than waiting until well into August to make any statements or requirements for I think was August 7th that they required them to actually disinfect the towers.
Speaker B:30 additional people contracted Legionnaires disease during that period which may, you know, one, two or three deaths may have occurred from that.
Speaker A:So we, and the numbers are continually going up.
Speaker A:David?
Speaker B:Well, they're reported to be going down.
Speaker B:But understand who's reporting them.
Speaker B:The New York.
Speaker A:They are, yeah.
Speaker B:Involved in this.
Speaker B:They are, they're both, they are the, they're the investigator, they're the judge, they're the laboratory, they're the.
Speaker B:Yeah.
Speaker B:And they're going to be the jury on this.
Speaker B:They, we have to recognize they are in an impossible conflict of interest and they need to step aside and open up their books and their processes to allow transparency.
Speaker B:Otherwise anything they say is going to be seen as self serving.
Speaker A:It seems to me that it's pretty much self serving at the moment.
Speaker A:I want to jump back a little bit as well to the construction side of things because that seems to be an important issue.
Speaker A:And from what I'm seeing is that there doesn't seem to be any guidelines in construction because it is, it is a massive threat.
Speaker A:This is how it gets introduced during construction phases, sediment in the water, etc.
Speaker A:But I mean, there doesn't seem to be any guidelines or testing.
Speaker A:The construction companies don't do it.
Speaker B:That's the problem.
Speaker B:They do.
Speaker B:There are guidelines.
Speaker B:The Facilities Guidelines Institute, which is updated every few years, it is the, I'll say, the bible for constructing hospitals.
Speaker B:But if you're doing a building next to the hospital, it doesn't apply.
Speaker A:Oh, okay, right, okay.
Speaker A:So the guidelines cover the hospital side, but any outbuildings or any other, such as a laboratory or something.
Speaker B:Exactly.
Speaker B:They're not covered by that.
Speaker B:And the hospital isn't required to take any actions during that period to deal with income, you know, with disruptions in its water mains and water service.
Speaker B:The other thing is New York City has been hyper focused on outbreaks and disease caused by cooling towers.
Speaker B:If you look at the rules and regulations you would, you would look at and assume that's the only way anybody can ever contract Legionnaires disease is from a cooling tower.
Speaker B:And we know that's not the case.
Speaker B:We just, we've had.
Speaker B:In the past 10 years, I've probably dealt with a dozen different outbreaks in legal matters related to plumbing systems, municipal water systems in apartments and hotels.
Speaker B:So this is, you know, a recurring, frequently recurring event.
Speaker B:Yet in this instance they are acting as if the cooling towers are entirely separate, not connected, not served by the same water system.
Speaker B:And the truth is, yeah, the water system that is used to supply water to those cooling towers in thousands of gallons a day is also the water that goes into the EMS station.
Speaker B:Yeah, the, as well as the, across the street at the, at the 65 plus Alma wrangle, you mentioned that, which is a, a high threat across the street.
Speaker B:I mean they require people to be 65 or older.
Speaker B:So they inherently by definition have a high risk.
Speaker A:And there, and there's probably people in that community that are immune compromised by definition.
Speaker B:They are.
Speaker B:Absolutely.
Speaker B:They fall into the high risk population.
Speaker B:So those people are and have been, and many of them may already have contracted it.
Speaker B:Public health doesn't release the names and addresses of the individuals who contract disease, but they try to, they try.
Speaker A:Let's just remind people that might, who may just be jumping and haven't listened to a lot of, you know, let's just remind people that how the, the path of infection actually happens.
Speaker A:Because a lot of people may not understand this because we've got it coming from the municipal water supply.
Speaker A:But how do these elderly people, immune compromised people and even people working in the area, how do they get the Legionella?
Speaker A:How do they contract it?
Speaker A:What's the path to contraction?
Speaker B:Well, all right, so we say for decades it's been stated that Legionella is an opportunistic pathogen that, that attacks people with compromised immune systems.
Speaker B:Now those individuals would have a higher risk, but it's not that much higher.
Speaker B:In an outbreak such as this, we have construction workers who contracted Legionnaires disease.
Speaker B:Yeah, Very healthy working population.
Speaker B:The pathway of exposure is via inhalation of fine water droplets, inhalable water droplets that contain the bacteria.
Speaker B:In a broad widespread outbreak such as this, we're dealing with, you know, community wide impacts.
Speaker B:And it does have the signature, the pattern of an, of a cooling tower outbreak.
Speaker B:But it's, it's not just cooling towers.
Speaker B:Any water system that has become colonized or seeded and began to grow and amplify this bacteria and then allows it to aerosolize has to be considered a possible risk.
Speaker B:So while the cooling towers may be the, the main source where it spews this, this fine mist out into the city streets, it's not the only source.
Speaker B:And treating it as such really does a disservice.
Speaker A:I, you know, one of the things that I find remarkable is how public health will brush under the carpet the potential threats of exposure.
Speaker A:It seems they might have a guideline out there, but they brush under the carpet the potential threats, especially to our elderly communities or veteran communities, this community that is right next to the hospital.
Speaker A:And at the end of the day, we have to look at who's to blame for this outbreak.
Speaker A:And you might not be able to answer that, but really there has to be, there has to be a foundation.
Speaker A:Look, this is your responsibility.
Speaker A:You're to blame.
Speaker A:You're brushing this under the carpet.
Speaker A:You're making wild assumptions and we're not getting to the root of the cause here.
Speaker B:Well, you know, that's been a tough One that's been a tough one in my view of the world.
Speaker B:There's two aspects to this.
Speaker B:There's the authority and there's the responsibility.
Speaker B:Who has the authority to investigate?
Speaker B:Who has the authority to implement rules and laws, regulations to prevent.
Speaker B:Who has the authority to stop work or to manage treat the water systems.
Speaker B:That authority is predominantly vested in the public health agency, New York City public health, the state public health agency and the Centers for Disease Control and Prevention.
Speaker B:They're the investigators.
Speaker B:They have the authority to give those investigations, but their, their authority to issue rules, regulations, requirements, you know, enforceable items.
Speaker B:At the federal level.
Speaker B:It is strictly, it's guidance.
Speaker B:It's a good recommendation and some of the recommendations are flat out wrong.
Speaker B:So there has been a.
Speaker A:And I find that, I find that so ignorant that it's.
Speaker A:The way that it's passed over is just a guideline, it's a recommendation.
Speaker A:You don't necessarily have to take action upon it, but we would rather you did.
Speaker A:And then look what happens.
Speaker B:Well, that's how public health has operated in this country for a long time.
Speaker B:Very few.
Speaker B:So wrong.
Speaker B:So wrong.
Speaker B:Well, yes, well.
Speaker B:And then we have outbreaks like this that show that that system is far from perfect and still allows for massive numbers of people to become ill and die to preventable disease.
Speaker B:The responsibility ultimately lies on the persons who own and operate those buildings.
Speaker B:And that may or may not be appropriate.
Speaker B:But in our legal system, that's where it ultimately lies.
Speaker B:They may not know about this risk.
Speaker B:They may, there, there's no requirement that they perform these risk risk assessments.
Speaker B:There's been efforts to implement them, but it hasn't happened.
Speaker B:And, and frankly with the, the water management plans, the way they're laid out under ASHRAE188, they're not a, they're not 100% effective.
Speaker B:There's no guarantee that they work and they've never been demonstrated to actually reduce the risk of Legionnaires disease in large populations.
Speaker B:So it seems like a good idea, but it hasn't proven worthwhile.
Speaker B: was published in: Speaker B:The number of outbreaks since then has continued to rise.
Speaker B:So if it was working, then we should see a diminution in outbreaks and cases.
Speaker B:And we haven't seen.
Speaker A:But we're not, we're actually seeing an increase in actual.
Speaker A:Ladies and gentlemen, we've actually did some.
Speaker A:And I'll link it below.
Speaker A:We've done a few other episodes which you can go and listen to or watch where we actually go into the reasons of why these are increasing.
Speaker A:It's very interesting.
Speaker A:And you can actually start to see that pattern and this pattern coming full circle.
Speaker B:Yeah.
Speaker B:A separate study that CDC did on 14 separate outbreaks.
Speaker B:This was published.
Speaker B:We can provide a link to that article.
Speaker B:And one of the aspects that they didn't bring to the attention of the reader or call out in their conclusions was that these facilities were just as likely to have a water management plan as not.
Speaker B:Meaning that if you had a water management plan or if you didn't have a water management plan, you would the same number of cases, the same number on each side of that had outbreaks.
Speaker B:So are they protective?
Speaker B:Is it just a flip of the coin?
Speaker B:Are the water management plans missing some key critical aspects?
Speaker B:Such as.
Speaker A:That's what I was going to ask.
Speaker A:That's what I was going to jump into.
Speaker A:Because you can have a water management plan, but that water management plan may not be enough.
Speaker A:I mean, it may not cover.
Speaker B:Oh my gosh.
Speaker B:I just, I've been retained on another case recently in which a facility had a five page water management plan.
Speaker B:Two of those pages were simply a plan to create a plan.
Speaker B:It was the most infantile, ridiculous plan I've ever seen.
Speaker B:It was ludicrous and yet it survived for seven years without being called out.
Speaker B:Crazy.
Speaker B:And then they, they started actually seeing increased number of results, positive sample results for the pathogenic form of Legionella and they did nothing about it.
Speaker A:There's no, Correct me if I'm wrong, David, but there's no legal requirement for anywhere to have a water management plan, is there?
Speaker B:The only, I'd say pseudo legal requirement is for hospitals and.
Speaker A:Right.
Speaker B:Skilled nursing facilities to have a water management plan.
Speaker A:But you're saying, you're saying a pseudo legal requirement.
Speaker A:So it's not tight then.
Speaker B:It's, it's not based on a law.
Speaker B: edicaid services published in: Speaker B:And that's it, that's the entirety of it.
Speaker B:They, they, they reference a requirement to have a, you know, to avoid healthcare acquired infections.
Speaker B:They point to Legionella.
Speaker B:They say you should do it in consideration of, of ASHRAE 188.
Speaker B:And then they call out specifically, this requirement is not telling you you have to actually collect samples for Legionella, which is basically saying, don't look.
Speaker B:And if this facility that I'm referring to had not looked, even on a minimal basis, which was an inadequate amount of samples, they still wouldn't know.
Speaker A:Looking at this case, David, looking at what has happened, the proliferation of, of the disease within, you know, within Harlem from the medical center, the construction, what is the potential consequences both legally and at a local level within this case now, because we've had so many deaths, there's been so many people that have contracted it, where are we going to go with this?
Speaker A:What's the potential here?
Speaker B:Well, I doubt anything is going to happen in the short term that benefits this.
Speaker B:New York City is probably going to make some changes to its rules, but I don't see that they're necessarily reaching out to experts.
Speaker B:They've been fairly insular in their approach.
Speaker B:Those rules will probably, from what I've seen that are being proposed, will just create, build more on a flawed foundation.
Speaker B:They're still not preventing the treatment companies from taking their own validation samples.
Speaker B:They're still not requiring third party validation.
Speaker B:One of the things you got to realize here is that the reporting system for Legionnaire's disease as a, you know, when a person contracts Legionnaires, requires that both the laboratory that detects a positive result and the physician or hospital or clinic that report, you know, that diagnoses that patient, both have to report that condition and that finding to the state health office or to the county health department, which then reports it to the state.
Speaker B:We don't have that requirement for the environmental testing.
Speaker B:If you did, if you had a requirement that that third party investigator had to report it not just to the building owner, but also to the state or the county health department and that the laboratory that diagnosed it had to report it directly, you can bypass the nonsense that does happen where those data sometimes just find their way into the circular file and never make their to the light of day.
Speaker B:There's no requirement that anybody has to report anything.
Speaker B:And so a report that I may publish and give to the client, I can assure you, isn't being sent up to the state.
Speaker A:So, you know, should it, should it be.
Speaker B:The rest of it is just, you know, lipstick on a pig.
Speaker A:Should it be a requirement as well for construction companies to get into the habit of having to have regular testing when they're doing anything to do with health care or any, any major construction for that matter?
Speaker B:You know, that right now that just depends upon the contract in place.
Speaker B:So there's no rules or requirements on it either way.
Speaker B:The, the plumbing systems, you know, we've had brand new hospitals have outbreaks due to Legionella growing in there plumbing system during construction cooling towers, they're a odd piece.
Speaker B:They come online and they may or may not be operating for most of that construction period.
Speaker B:So, you know, whether there's a, there's right now there's not any requirement and should there have been.
Speaker B:I think there was a big gap in the regulatory and unless it was spelled out in the contract for that facility to, to pick up water, you know, as soon as you have water in this system, you've got to start testing and monitoring and treating and ensuring that it's, it's safe.
Speaker B:Right now it's, it's a big gap in the protection of health and safety both to the, you know, for the contractors and for the community.
Speaker A:How far can this spread, David?
Speaker A:How far can this case in Harlem?
Speaker A:Because obviously we have a, an at risk community that's in the local area.
Speaker A:We have the construction going on, the water towers.
Speaker A:Obviously they've been treated, but it's already gone in the water supply.
Speaker A:How far can we see this case spread?
Speaker B:Well, this, I mean, the public health department, New York City Public Health has deemed it to be over.
Speaker B:They declared it done.
Speaker B:They're done.
Speaker B:There's additional cases up in the Bronx.
Speaker B:There's additional, you know, and I can assure you during this outbreak there were probably cases outside of Harlem that were going, that were being reported that were excluded from the five zip codes.
Speaker B:So, you know, the, putting that hard boundary around it and a beginning and end date, that is what public health agencies and epidemiologists do.
Speaker B:So they're going to declare, is that.
Speaker A:Really a good move?
Speaker A:I mean, can you really just say it's over when you don't really have.
Speaker A:To me, you don't really have the empirical evidence that it's over because it's still potentially.
Speaker B:Well, according to, you know, the epidemiologists at New York City Public Health feel that they have the evidence to, to do that.
Speaker B:They've stopped perceiving additional cases.
Speaker B:The irony is that they're going to say, well, it's because of the actions we took.
Speaker B:It's because of, we stepped in and did this.
Speaker B:And you know what, whether they stepped in or not, the outbreak would have ended.
Speaker B:Yeah, saw that in Flint, Michigan.
Speaker B: , you know, yeah, they had in: Speaker B:It, it spiked, it peaked, it did its thing and it went away.
Speaker B:And that's what happens everywhere.
Speaker B:I've always said that I think 90% of the time, public health intervention is at the end of it anyway because of the lag between exposure and onset of symptoms, the lag between diagnosis and Reporting the lag between samples, collection and analysis.
Speaker B:I mean, you've got six to eight weeks in there sometimes.
Speaker B:And so a lot of the times I think they're just patting themselves on the back that, hey, look what we did.
Speaker B:And it was going to happen that way anyway.
Speaker B:It's like, yeah, getting the, getting the flu, you're going to, you're either going to recover or you're going to die.
Speaker B:Most of the medicines you take for it, they didn't, they did not stop the flu.
Speaker A:Yeah, it's like putting a plaster on something, you know, temporary plaster on it, and then claiming, hey, they, you know, we put the plaster on.
Speaker A:So we did, we did the job right.
Speaker A:And that's, that's the main.
Speaker B:So, you know, surveillance and prevention are the things that need to, need to happen this point.
Speaker A:And that's what I was going to ask you.
Speaker A:We've had a lot of cases, we've talked about this many times before, you and I, but it still seems that we're at this stalemate because it doesn't seem that anything really is changing yet.
Speaker A:We're still getting increased exposures, we're having increased outbreaks, but nothing seems to be changing.
Speaker A:Yes, I mean, we're moving forward in HC3, doing education and trying to move forward on that side of things, but nothing at the state level, nothing at the federal level, nothing even at a local level is changing.
Speaker B:It does not have priority.
Speaker B:The bodies have not stacked up high enough for it to reach national priority.
Speaker B:The US EPA still refuses to add Legionella pneumophila to the list of contaminants in public water systems that it has to test for and report.
Speaker B:You know, municipal water systems are blind to whether they are an ongoing source of Legionella to its users.
Speaker B:The users don't understand the risk that they're at.
Speaker B:There's no requirement to do a risk assessment, though there are some recommendations, and frankly, there's no test.
Speaker B:There's no certification and credential to ensure that those who do the risk assessment are qualified, competent, educated, certified in doing this.
Speaker B:And until you, you put all those pieces together, even if you require testing, if you don't require the testing be done in an effective, safe, reliable manner, that's, that's, that's repeatable.
Speaker B: ionella samples as we were in: Speaker B:Two weeks, 10 to 14 days before you get results.
Speaker B:And you cannot go down this nonsense of testing for both Live and dead and then trying to unbake that cake after you've said we found Legionella, but oh, by the way, 90% of it was dead.
Speaker B:New test methods are available.
Speaker B:New test procedures do allow for shorter and shorter time periods.
Speaker B:So that has to happen.
Speaker B:And a requirement that we test from the point of the municipal water system, test in the high risk buildings, test in the high risk community exposures.
Speaker B:And further research needs to happen in order to understand the litany of sources that people are exposed to and how to control them.
Speaker B:So we have a long way to go.
Speaker A:We do have a long way.
Speaker A:But what's exciting, and this is something, and I don't want to jump into it too much here because it's another discussion that you, myself and probably Robert is going to talk about because we do have more tests and we have got breakthroughs that we are working on.
Speaker A:And that's another discussion that we're going to have.
Speaker A:So make sure, guys, that you keep watching and connect with us because we've got big announcements coming up.
Speaker A:But what would you say to what would you like to see from not only construction companies that are involved in this and healthcare organizations and companies, what would you urge them, David, before we finish off, what would you say to them now to be more proactive than reactive?
Speaker A:What can they do?
Speaker B:I think the one thing that has been said from the, the New York City Public Health Agency in their recent press release is that they deemed that the facilities at the Harlem Hospital and the adjacent construction of the New York Public Health Lab were in full compliance.
Speaker B:They were not out of compliance.
Speaker B:So that clearly is a clarion call in a very bright light that compliance with the rules does not manage risk.
Speaker B:The second thing is we've got to start treating surveillance of environmental sources of disease with the same or more seriousness as we do surveillance of diagnosed disease in patients.
Speaker B:We know diagnosis of patient Legionnaires disease is probably in the 10 to 15% effectiveness in that you're only capturing 10 to 15% of the actual number of cases.
Speaker B:If we can do better than that on the environmental source front, and we can do that in a fashion that allows us to sample before it makes people ill, now have the chance to start really managing risk.
Speaker B:And then the whole surveillance and reporting requirements, moving that into an electronic version, a requirement for testing and reporting, not just a convenience of testing and separating the testing from the treatment so that you have a third party verifying those results who's not disincentivized or putting themselves at risk if they report bad results.
Speaker A:David, I want you to, if you had a chance now, before we finish here, what message would you directly send to the New York Public Health Department?
Speaker B:Reconsider your entire program and look to make changes regarding surveillance of environmental sources, certainly for cooling towers.
Speaker B:But you have to look at the municipal water system and the belief that Legionella gets into these cooling towers in some fantastical fashion that is outside of the water that is supplied to it has to stop.
Speaker B:You have to acknowledge that water contains, albeit low levels.
Speaker B:Hopefully it is the source of the bacterium that then grows when the conditions within the man made systems allow.
Speaker B:So understanding where it's coming from can help people understand the magnitude of risk that they're actually at.
Speaker A:David, thank you for being with me again today.
Speaker A:I think this was really important.
Speaker A:Ladies and gentlemen, as we've said many times, connect with us if you've got any questions.
Speaker A:If you're worried, if you are an operator, a construction company and you're potentially worried that you're getting into a project, then please reach out to us@hc3fl.com, connect with David and he'll be able to help you through that.
Speaker A:But be aware, ladies and gentlemen, that this shouldn't be swept under the rug.
Speaker A:And the more that we become proactive, the more that corporation, the more that we have a bigger educational voice out there as well to educate the public not only at leadership level, but at local level that perhaps maybe we'll get some of these changes.
Speaker A:Make sure you connect with us, make sure you catch up with all the other discussions.
Speaker A:We've got plenty more discussions coming up and the next one we're going to be talking about a very important breakthrough in regionality testing.
Speaker A:So David, thank you for joining me this morning.
Speaker A:Thank you ladies and gentlemen.
Speaker A:Have a great holiday weekend.
Speaker A:If you're listening to this afterwards, then we hope you've had a great holiday weekend and we will be back in touch with you all again very soon.
Speaker B:God, God bless.