For two years, a FRONTLINE team in Flint has been working to uncover the true toll of the city’s water crisis.

For the documentary Flint’s Deadly Water, they examined internal state emails and documents, conducted exclusive interviews, and undertook a sweeping analysis of every death in the county across a seven-year period.

What they found reveals how a public health disaster that’s become known for the lead poisoning of thousands of children also spawned one of the largest outbreaks of Legionnaires’ disease in U.S. history.

Here are eight key takeaways from the groundbreaking investigation:

1. Approximately 70 deaths during Flint’s water crisis may have gone uncounted.

An independent statistical analysis of death records found that there were approximately 70 more pneumonia deaths in Genesee County than normal during the water crisis — and that they coincided with an outbreak of Legionnaires’ disease, a severe form of pneumonia caused by a waterborne pathogen. Independent epidemiologists told FRONTLINE that it was likely the extra pneumonia deaths may actually have been undiagnosed cases of Legionnaires’ disease.

2. At least 20 confirmed Legionnaires’ patients who initially survived their diagnosis later died of causes commonly linked to the disease.

Those patients included Jassmine McBride, the outbreak’s youngest known victim, who died early in 2019 at age 31. “She was the story of Flint,” Marcus Zervos, her doctor, told FRONTLINE.

3. The public wasn’t notified about the deadly outbreak of Legionnaires’ disease for more than a year — and neither were most medical professionals.

In Feb. 2015, FRONTLINE found, county officials drafted an alert to medical providers at the suggestion of the state. It was never sent, according to internal emails, because the person in charge wasn’t there that day. Instead, just 15 people were notified by email. “It’s totally unacceptable,” Dr. Lawrence Reynolds, the former chief executive of Mott Children’s Health Center in Flint, told FRONTLINE. “There was no notification sent to the medical society … I’m trying not to be profane, but that’s utter rubbish.” The outbreak was finally announced by then-Gov. Rick Snyder and top health officials in January 2016, once the cases had subsided.

4. Officials rebuffed advice from the CDC to test the water.

Emails obtained by FRONTLINE show that the county health department reached out to the CDC in early 2015, saying they needed help. State health officials, however, told the CDC they didn’t need its help, and if they did, they’d get in touch. The CDC persisted, cautioning that this was one of the largest outbreaks in years and recommending a full investigation. Eight months later, once the outbreak was announced, top health officials said they couldn’t conclude that it was related to the water switch — in part because the water hadn’t been tested.

5. Members of a scientific team say the state repeatedly tried to impede their efforts to identify the source of the Legionnaires’ outbreak.

In 2016, the state convened a team of doctors, scientists, engineers and other experts to research the cause of the outbreak. But members told FRONTLINE it took months for the state to officially authorize them to begin working. Additionally, they told FRONTLINE that they were barred from contacting Legionnaires’ patients, investigating pneumonia deaths and testing water filters for legionella bacteria for months. At one point, when members met with state health director Nick Lyon to urge him to step up Legionnaires’ surveillance or risk more people dying, Lyon responded, “They’ll have to die of something,” according to three members on the panel. Lyon declined to be interviewed by FRONTLINE. In a letter, his attorney said, “Director Lyon did not make that crass remark.” He said the team’s work was one of Lyon’s top priorities, and blamed any delays on the scientists.

6. The day after members of the team warned at a public meeting in 2016 that they were finding legionella bacteria in residents’ water filters, the team leader said an aide to the governor threatened funding for his university.

Shawn McElmurry, an engineering professor at Wayne State University who had been asked to lead the team, said that he received a call from a top aide to Michigan’s governor. McElmurry says that the aide, Rich Baird, “basically said that he didn’t want to take away funding from the university if I wasn’t able to get on message.” He told FRONTLINE, “I viewed that as just a threat to me and my team, about the work we were doing, that we needed to better align our results with what their position was … That there were no more problems with the water in Flint at that time.” In an email, Baird told FRONTLINE that he never tried to influence or pressure the panel “to do anything except abide by the terms and conditions of their contract,” and that they failed to stay within the “scope and parameters” of the project.

7. Before Flint’s water supply was changed, the operations supervisor at the city’s water plant warned that “people are gonna die.”

Matt McFarland tried to sound the alarm that the water wasn’t safe, his sister, Tonja Petrella, revealed exclusively to FRONTLINE. “I remember specifically, the day before they actually flipped the switch, he called me and he said, ‘Tonja, contact everyone that you know in Flint, anybody you care about, and tell them, do not drink the water,’” Petrella said. Petrella said that McFarland cautioned, “It’s not safe. We’re not ready,” and finally warned: “People are gonna die.” McFarland, who passed away in 2016, told his sister that he had also expressed his concerns to his supervisors.

8. It’s still unclear whether anyone will ever be held accountable.

While still serving as the state’s health director, Nick Lyon would eventually be charged with involuntary manslaughter for failing to alert the public and allegedly covering up the Legionnaires’ outbreak. Prosecutors also accused him of interfering with Shawn McElmurry’s investigation. Through his attorney, Lyon has maintained that he did nothing wrong. Earlier this year, the new attorney general, Dana Nessel, fired the special counsel and appointed a new prosecution team, which dropped all charges against him, the state’s number two health official Dr. Eden Wells, and others. Fadwa Hammoud, Michigan’s solicitor general and the new lead prosecutor, said the investigation was “fundamentally flawed” and that the previous team had failed to collect all available evidence. “If we know the investigation was not complete, you just simply cannot proceed,” she said, and added: “We are interested in justice, no matter how hard that is.” Meanwhile, until all of Flint’s corroded pipes are replaced, residents have been advised not to use the water.

Stream Flint’s Deadly Water for the full story. The documentary is available at PBS.org/frontline, on demand, and on the PBS Video App.

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