By Tom Travis
“We are in a new normal,” the City of Flint’s newly-appointed Health Advisor to the Mayor, Dr. Lawrence Reynolds, asserted in a wide-ranging phone interview Sunday.
As numbers on the coronavirus pandemic skyrocket, both nationally and in the state and Genesee County, “All the assumptions under which we operated in the past should be tested, questioned or thrown out the window and reconstructed,” he said.
As of Sunday night, March 29, the state reported 5,486 cases and 132 deaths; in Genesee County, the numbers were 127 cases and 5 deaths.
Reynolds, a pediatrician for 41 years. has been deeply involved in health and health advocacy, especially for underserved parts of the Flint community, for most of his career. He was president and CEO of the Mott Children’s Health Center, founding board member of the Hamilton Family Health Center, president of the Genesee County Medical Society, and many other initiatives.
During the Flint water crisis, he was a member of then-Gov. Rick Snyder’s Flint Water Advisory Task Force and the Flint Water Interagency Coordinating Committee, becoming a bitter critic of state administrators. He was a vocal supporter of Mona Hanna-Attisha’s data and their implications for Flint children. He also is an at-large director of the Greater Flint Health Coalition.
At 67, Reynolds said he was “attempting to be a retired grandfather with three grandsons,” but Neeley had some other ideas. The two already had been intensely connected during the water crisis.
“Mayor Neeley was my state representative, who when contacted by the Health Coalition , went to the county offices with State Senator Jim Ananich and insisted the county must declare an emergency in September 2015,” he said.
And now Reynolds has hit the ground running at yet another time of challenge, joining the city’s administration team on the exact day in March the mayor shut down City Hall because of the coronavirus.
He said his new job will largely be communicating and coordinating with the Genesee County Health Department (GCHD) and the county’s Emergency Operations Center.
Reynolds, who lives in Flint’s 9th Ward, said a strength he brings to his new role is his many longtime ties to the local medical community and in the professional medical community throughout Genesee County and beyond. And because he lives in the city, he said he feels “tied to the community” and will bring those relationships to his position.
“We don’t know how bad it is”
Asked how long the pandemic might last, Reynolds replied, “We don’t know how bad it is right now. So first of all we have to find out exactly what our situation is in Genesee County, the State of Michigan and in this country.
“Once we can figure that out, then we can see, are things improving or worsening, and use that information to guide our activities to shorten the duration of this pandemic if possible.”
“Until we get a complete picture of what’s going on, until we can reorganize our public health, hospitals, and community based health services, we will be challenged. Until we stop putting stock market ups and downs as our criteria for success ,we’re looking in the wrong direction,” he warned.
Testing needed on those with symptoms
Asked if he is a proponent of testing every single individual, he said, “I’m a proponent of identifying contacts and people who have been infected and testing based on symptoms. By identifying their contacts and testing them then once we address those priorities we develop a system of testing.”
However, he warned, “Even if the test exists, a way to deploy the test effectively does not exist. So we have to prioritize who gets tested first. That’s why we tell people don’t go to the emergency room for testing, instead call your provider or your clinic’s office to get instructions if you think you have symptoms of the virus.”
Genesee County Commissioners warned seven years ago
Reynolds recalled that seven years ago the Genesee County Medical Society and the Greater Flint Health Coalition went to the Genesee County Commissioners and told them that if they did not adequately budget the Genesee County Health Department, when something happens the GCHD would be neither adequately staffed nor prepared.
Reynolds recalled a recent timeline of public health crises in Genesee county by saying, “Then came the lead crisis, then came the hepatitis A outbreak and now this pandemic.” Reynolds pointed out that while Genesee County has twice the population of Saginaw County, the Saginaw County Health Department’s budget is twice as large.
Reynolds stated the County Commissioners’ response seven years ago was “a polite nod,” but no action. Reynolds said it’s not too different than how the federal government has responded–with a lack of planning and anticipation, he stated.
State’s past austerity practices creating big problems now
Reynolds warned that part of the problem is due to austerity practices of the previous [State] administration and legislature and in ending revenue sharing years ago.
But also a problem has been not responding when health issues come up and not seeing the connection between the health of the community and most policies. He contended previous administrations have not looked at the state’s needs from a health perspective so they were slow to respond. He said it appears Gov. Whitmer is replacing what was previously weakened.
Flint budget pending, recovery from water crisis still in process
Reynolds reminded that The City of Flint is five months into a new mayoral administration and is still recovering from a lead crisis with the water and the legionaries crisis and ongoing fiscal crisis precipitated by the emergency managers.
“We have a shrinking tax base that presents challenges for fixing problems, and also it hinders the city being able to attract experienced people–this is all a challenge,” he said.
Affordable Care Act a bright spot
There are some good things to look at in all of this, Reynolds said. For example, “Imagine what Michigan would look like without the Affordable Care Act and the Healthy Michigan Plan. It’s not perfect, but it’s definitely better than what we had before.”
Reynolds digressed saying, “Our hospital systems are not connected. When you look at what has happened with the legionaries disease, if it happens in one hospital it’s not necessarily communicated in another hospital. The hospitals were constrained by the state health dept and it created all kinds of obstacles and delays. Fortunately, he said this is significantly less today.
Over the weekend, Gov. Whitmer signed an executive order mandating water service to be restored to all Michigan residents.
The City of Flint in this case was ahead of the governor, Reynolds pointed out.
Because the City of Flint has experience in dealing with public health crises, Reynolds noted, Mayor Neeley “had the courage” to push for all Flint residents to be reconnected to water service beginning on March 12 when he declared a city-wide state of emergency.
“How can you have two of the largest population centers in southeastern Michigan, Detroit and Flint, with people not having access to clean water so that they can do the basic necessity of washing hands, washing bedding, cleaning eating utensils with soap and water?”
No plans for make-shift hospitals – but the funding is there
EVM asked Reynolds if he knew of any plans to have a make-shift hospital set up in the area. Reynolds said he knew of no plans. But he waits to hear from the county’s Emergency Operations Center.
Federal action has released funds to Michigan to pay for these types of make-shift hospitals if needed. Reynolds said he believes Detroit would be the initial place for such a site and was sure that the Genesee County Emergency Operations Center has sites in mind if the need should arise.
A “typical day” in Reynolds’ “new normal”
Describing his typical day, Reynolds said he first scans the State and County websites to see any new developments and reviews new statistics updated overnight. Reynolds described the daily scene as an “ever evolving situation.” He said that he then scans medical journals viewing recent research and looking for “any kernel of information that may be useful.”
Next Reynolds said that he is in conversation with those who were involved in the lead crisis, environmental engineers, mechanical engineers, metallurgists, infectious disease specialists. We all call each other and Reynolds said, “they help me with questions that I have and they share observations they have.”
Reynolds said every day he talks with Billie Mitchel, the city’s public health manager, Brian Larkin, the chief of staff, and Mayor Neeley. “So once I gather information I can offer an opinion.”
Reynolds said these days he spends “98 percent of the time at home” and does most of his work there. Reynolds said that he was never located in City Hall due to the fact that he was appointed to this position on the day that City Hall was closed to the public.
He goes into City Hall once or twice in a week and more if needed. Reynolds said, “we wear out emailing, texting and phone calling” to communicate effectively with all involved.
Reynolds said his “new normal” involves learning every day more and more about the virus.
“We can’t say, with a reasonable degree of certainty anymore, that this is a seasonal virus and that it will go away. We can’t say with certainty what we said in the beginning about this virus being serious just for seniors. Now we’re seeing younger generations being affected by the virus. We have to work every day to get new information for this virus,” he said.
Many struggles around testing issues
Reynolds stated, “We didn’t even have a widely distributed test for COVID-19. Then we have a shortage of supplies in order to do the test–like having the correct swab for the test and having quick turn around time for results, and then a reporting system set up and making sure that all these things got out to doctor’s offices and clinics. And we’re still struggling to do that.”
Reynolds stated, “I’ll share with you this story of one large practice in Genesee County that was doing testing following the guidelines for people who had symptoms or had come in contact with someone that had COVID-19. Consequently their staff had to be put on quarantine and they had to close one office.
“It’s a challenge to get the test, and we really don’t have enough tests completed to come to any conclusions. We are like flying blind without surveillance. We really don’t have any idea how things are, getting better or worse. Although we’re getting an idea as more cases are identified.
Contrary to what’s being said on the news this morning it’s not wise to reopen schools and public places if we don’t know where the hot spots are.
Reynolds on Fauci: listen to this “wise person”
“Teaching by a wise person is a subversive activity,” Reynolds said, “and Dr. Fauci has been inspiring. You see how he walks the balance between achieving a level of cooperation from the President while calmly putting out the correct facts.
“He has taught me patience just by watching him on the television and listening to his words. If someone were to ask me, ‘well if I can’t talk to anybody else or listen to anybody else who should I listen to and in what order?’ I would tell them, our State health department and our County Health Department and listen to what Dr. Fauci has to say.”
EVM asked Reynolds what in his life has best prepared him for this moment of being a Public Health Adviser for the City of Flint.
Reynolds replied, “I’d like to thank Wayne State University because I was a political science major as well as a pre-med student. Next I’d like to thank the National Health Service which is part of the US Bureau of Primary Care, they provided me with a scholarship to finish medical school and an opportunity to serve in the public health clinics in Detroit.”
Reynolds continued, “I’d like to thank the city of Detroit because they trained me as an emergency medical technician. And then most of my career has been inside federally qualified health centers and non-profits like the Mott Children’s Health Center. And working as a medical clinical director of Hamilton Community Health Center, and working with the local medical communities. All these things have been part of preparing me for this job.”
Reynolds said, “What happened, how I got to this point is not by accident, but it was by opportunities provided by our city, state and federal government. ”
“I’m a community health person more than a public health person”
Reynolds is a graduate of the Howard University College of Medicine which, he pointed out, was open in the freedmen camps outside of the District of Columbia after the civil war. A brief history of this can be read here.
“So I have a long tradition of being involved in community health,” he said.
I have to say I’m more of a “community” health person, not so much a “public” health person. I get my information from public health, I get my information from professionals but most of my career was spent trying to figure out how to apply that to community health.
“Look out for each other”
EVM finally asked Reynolds, if he had a megaphone and could speak to all of the city of Flint right now, what would be the number one thing he would say. He responded,
“Look out for each other. Even if you’re just shouting across the yard or calling people on the telephone. Avoid unnecessary traveling and outings, use social distancing, wash your hands with soap and water, and if it’s not available, use a commercially based alcohol based sanitizer.
Lastly, he said, “Listen to credible sources.”
Reynolds said the most credible resource is the Centers for Disease Control (CDC) which transmits all their information to State and County Health Departments. Reynolds warns residents to not base your actions on anecdotal information you may hear from the internet or friends and family.
EVM Assistant Editor and Staff Writer Tom Travis can be reached at firstname.lastname@example.org.