Thursday, August 13, 2009

News Clipping Archives

 

 

Maryland / Regional

Death of D.C.-area adult is Md.'s 6th linked to swine flu (Baltimore Sun)

State's pension obligations loom (Daily Record)

A MACo conference, sans tchotchkes (Daily Record)

Md. health care meeting packed but controlled (Daily Record)

Beating the heat during a sweltering week (The Gazette)

 

National / International

Child-Safe Eye Drops (Baltimore Sun)

Know Your Supplements (Baltimore Sun)

Daniel Radcliffe Says No To LGBT Suicide (Change.org)

Fairfax Schools Air CDC's Strategy for Swine Flu's Return (Washington Post)

Thousands Line Up for Promise of Free Health Care (New York Times)

 

Opinion

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Maryland / Regional

Death of D.C.-area adult is Md.'s 6th linked to swine flu

 

By Kelly Brewington

Baltimore Sun

Thursday, August 13, 2009

 

Maryland health officials reported a sixth death associated with swine flu Thursday. Officials would not release details about the death, except to say it was an adult from the Washington suburbs with an underlying medical condition.

 

As of last Friday, the Centers for Disease Control and Prevention reported 436 deaths and 6,506 hospitalizations nationwide associated with the virus, known as H1N1.

 

As infections continue to spread, the federal agency and state health departments have stopped recording confirmed flu cases that do not result in deaths or hospitalizations. State health officials urged people to use good hygiene, such as thorough hand washing, to limit the spread of the new flu and to take advantage of vaccines for both the seasonal flu and the H1N1 virus once they are available.

 

On Monday, researchers began testing an H1N1 vaccine adults at academic sites nationwide, including the University of Maryland's Center for Vaccine Development, in anticipation of what could be a mass vaccination campaign in October.

 

Copyright 2009 Baltimore Sun.

 

State's pension obligations loom

 

By Andy Rosen

Daily Record

Thursday, August 13, 2009

 

As Maryland struggles to battle its way out of the toughest economic times since the Great Depression, the clock is ticking on another fiscal problem that dwarfs the current budget crisis.

 

The day of reckoning is approaching when the state must meet its pension obligations — to teachers, state police officers, judges and thousands of other state workers — and the funding level for these obligations stood at about 79 percent, just below the minimum recommended level, last year.

 

The funding level is likely to fall even lower as the state closes the books on fiscal 2009, which ended June 30. Already, the State Retirement Agency has announced that it lost 20 percent of its assets under management, about $8.1 billion, last year because of investment losses.

 

The state’s long-term obligations don’t stop with its $50.2 billion in projected pension costs. Maryland also has committed to pay for health care and other benefits to retirees. As of last year, the state had put aside $100 million toward a total liability of $15.2 billion, leaving a gap larger than the state’s 2009 budget.

 

“It’s a big problem right now, and if we were a corporation, our stock would be in the toilet,” said Del. Murray D. Levy, D-Charles, an accountant who sits on the House Appropriations Committee and has served on several legislative panels studying fringe benefits.

 

“Corporations can go bankrupt, and the state cannot go bankrupt,” Levy added. “What will happen is the taxpayers will go bankrupt as we have to tax them to pay for health care for our employees.”

 

But it’s not likely that Gov. Martin O’Malley or the General Assembly will attempt a long-term fix when they come back to Annapolis next January. Instead, they probably will be working on more immediate problems with the state budget, which could face a shortfall of up to $1.5 billion next year.

 

O’Malley said Thursday that retirement costs are an issue not just for Maryland, but for other states, corporations and the federal government. However, he said the state’s primary objective is to navigate through the immediate fiscal crisis.

 

“Given the challenges of this big recession, those issues of the long-term stability of our pension system have kind of taken a back burner to the immediate task of closing your budget and balancing your budget as you see the revenues erode with the economy,” he said.

 

Maryland used to account for retiree health care costs annually as they came due, but a recent change in accounting standards has pushed governments to look at retiree benefits as a long-term expense and calculate future liability as it does pension costs.

 

Sen. Donald F. Munson, R-Washington, who is also part of legislative fringe benefit discussions, said the assumption that retiree obligations must be fully funded is somewhat misguided because the state will never have to pay out its entire obligation at once.

 

“I think it’s a phony issue to a large extent, because the state’s not going out of business,” Munson said. “The fact that the federal government is forcing us to look at this issue the way we are defies reality, in my opinion.”

 

Shooting for 80 percent

Keith Brainard, research director for the National Association of State Retirement Administrators, said 80 percent is recognized as an appropriate funding level for pension funds.

 

“A funding level below 80 percent can become a cause for concern. The further you are below 100 percent funded, the more unfunded liability you have to pay for,” he said. “The bigger the unfunded liability, the bigger the contribution.”

 

Maryland is meeting its pension obligations and providing health benefits for its retirees at this point. For the last few years its funding level has been close to the 80 percent threshold cited by Brainard.

 

Dean Kenderdine, executive director of the Maryland State Retirement Agency, said the system will be able to meet its obligations for decades, and is set up to overcome the type of market difficulties that it encountered last year.

 

“The state retirement system is well-funded, although it is not fully funded, and it is positioned, by way of its investments, to remain well-funded,” he said.

 

Several things could happen to make the state’s fringe benefit obligations an immediate problem. First, the state could begin to pay out more than it takes in each year. That could prove a significant drain on state resources.

 

Also, the bond rating agencies that examine the state’s finances and help determine what Maryland pays to borrow money could decide that the state is too far behind in funding its pension obligations. The state is rated “AAA,” the highest ranking for public debt and a distinction shared by just seven states. A lower rating would cost the state millions in interest.

 

In response, the state would likely have to increase its own contributions, increase employee contributions, or both.

 

Before a bond sale completed last week, the three major rating houses reaffirmed the state’s top bond ratings, but they are watching the state’s retirement obligations. Standard & Poor’s noted that the pension fund “has experienced a reduced funded ratio annually in the past five years.”

 

House Speaker Michael E. Busch, D-Anne Arundel, said he thinks the state’s bond rating speaks to the state’s preparation to pay for retiree benefits.

 

“I do think that we’re pretty much well-positioned as the market goes up to create the solvency that we want for our pension system,” Busch said.

 

A change in the formula

In 2000, the state had more money in trust than it needed to cover its entire pension liability. But the legislature changed the formula for funding pensions in 2002, which allowed the funding ratio to drop in recent years. A benefit increase also passed in 2006.

 

The new formula covers the state’s two largest funds, the employees’ and teachers’ systems. It allows the state to pay for pensions at the same rate as the previous year, assuming that the obligations are funded between 90 percent and 110 percent, and gradually make up the difference if the fund falls below the threshold.

 

The state budgeted about $1.2 billion for pension payments this year, and since 2003, it would have paid approximately $745 million more if it had not adopted the new funding model.

 

Some influential voices are calling for the end of the current funding formula. The state retirement and pension system’s board of trustees has consistently opposed the method, instead calling for actual obligations to be funded each year.

 

State Treasurer Nancy K. Kopp, chairwoman of the board of trustees, said one of the flaws of the funding system is that it was instituted after a year where pensions were close to full funding, which kept the contribution relatively low.

 

“It make is much more difficult to maintain full funding, which is still everyone’s goal, when you’ve got a system that is artificially constraining you,” she said.

 

Lessons of history

Kopp was representing Montgomery County in the House of Delegates in 1979, when concerns over the affordability of future pensions led the state to restructure its obligations significantly. In the 1970s, the state’s obligations were only partially paid for in advance.

 

After studying the issue for several years and receiving a report that suggested the state’s annual commitments would balloon by more than 10 times within a half-century, lawmakers created new, fully-funded pension systems and in 1980, all new employees and teachers were required to join them.

 

The existing systems for state employees and teachers, the two largest funds, were closed to new members. The state planned at the time to fully fund all of the plans, new and old.

 

But the problems didn’t stop and costs continued to mount. By 1984, the state projected that its pension obligations would take up 10 percent of its general fund budget. That year, the state passed a bill that sought to limit cost growth for retirees that continued to receive benefits under the old system.

 

That year, the General Assembly gave allowed members of the old retirement systems to either move to the new system with its lesser benefits or stay in the old system with a cap on payouts or an annual increase in their own contributions.

 

The move was highly controversial politically and led to a challenge in federal court, where the state’s plan was upheld.

 

Kopp said it is difficult to compare today’s situation to that of the 1970s and 1980s, but it will be important to watch investment returns carefully in coming years. The more the state contributes now, she said, the more the money can be invested and grow.

 

She said the state is likely to have more flexibility in its handling of retiree health care, because it does not have the same legal commitment to that as it does for pensions. Many expect the discussion of retiree health care costs to pick up after Congress completes its work on a proposed health system overhaul.

 

As the state looks at its ongoing budget issues, it should take a long look at the way it structures its pensions, said Ronald Wineholt, vice president of government affairs with the Maryland Chamber of Commerce.

 

He said Maryland should consider a switch to a defined contribution plan, in which the state commits to paying a certain amount into a retirement fund but does not guarantee the benefit. That’s the direction most private-sector employers are taking, he said.

 

“The state can’t really say it’s cutting to the bone” without adopting such a change, Wineholt said.

 

Copyright 2009 Daily Record.

 

A MACo conference, sans tchotchkes

 

By Andy Rosen

Daily Record

Thursday, August 13, 2009

 

OCEAN CITY — As local governments and private companies alike look to save money in a tough economy, some of the extras are missing that normally come along with the Maryland Association of Counties Summer Conference.

 

Still, those among the crowd at the annual political retreat said the networking opportunities among state and local officials are too important to pass up, particularly in a year that all levels of government are looking at severe cutbacks as tax revenues decline.

 

Some of the traditional receptions are missing, and some exhibition booths aren’t handing out free tchotchkes, but most of the crowd is still showing up.

 

Final attendance numbers were not available because registration for the four-day conference is still going on, but MACo Executive Director Michael Sanderson said he expected that attendance would be down about 10 percent from the approximately 2,000 people who came last year.

 

“I think this year is a little softer than last year,” he said. “No surprise in a tough economy.”

 

Still, local and state government agencies and private businesses packed the exhibition halls at Ocean City’s Roland E. Powell Convention Center, paying prices from $160 for small local government booths, to $2,200 for double-wide stalls for private companies.

 

Larry Markle, senior account manager at Millersville-based Micrographic Equipment Design Inc., sat at a regular-sized booth at the convention center and said he thought the company would easily recoup its estimated $1,500 in expenses for travel and exhibition.

 

“It’s a big part of our business, so we need to be in front of and in contact with the counties,” he said. “They’ve got to do more with less, and they’ve got to be more efficient.”

 

That is one of Markle’s selling points this year. One of the company’s major services involves working with federal, state and local governments to convert paper files into digital form and make them searchable. Markle said a medium-sized contract would run around $30,000.

 

The company has sometimes kept staff in Ocean City for two nights in the past, but they will only stay for one night this year. Otherwise, Markle said, the company is doing its MACo conference the way it has for about 20 years. He said he completed a sale Wednesday.

 

Sanderson, of MACo, said the company usually has to turn potential exhibitors away, so the organization did not have a problem filling the halls this year.

 

Baltimore Mayor Sheila Dixon said her office has sought to reduce expenses this year. Her staff numbered 10 last year, and she only brought four staff members this year. She was scheduled to host a reception Thursday night, but noted that the event was sponsored by businesses rather than taxpayers or campaign contributors.

 

Dixon said the conference is valuable, especially in a year where local governments are bracing to absorb millions in state spending cuts.

 

“We have to make sure that we [keep] in line with what’s going on in other jurisdictions,” Dixon said. “This year’s a tough time, so there’s a lot of discussion.”

 

Gov. Martin O’Malley, who has plans to bring up to $470 million in budget cuts to the Board of Public Works in two weeks, said local governments will have to feel a part of the crunch.

 

He said Thursday that the cuts would probably also include state worker furloughs, and his administration has been trying to find a fair way to do that in discussions with state worker unions.

 

O’Malley has asked his staff to mind their costs during the Ocean City retreat, and this week canceled a reception that his office has held each year at the Seacrets nightclub.

 

“While certainly we look for opportunities to reduce spending and reduce costs everywhere, I think that we should not short-circuit the sort of interactions, the sort of sharing of best practices, that happens here,” he said.

 

Copyright 2009 Daily Record.

 

Md. health care meeting packed but controlled

 

Associated Press

Daily Record

Thursday, August 13, 2009

 

U.S. Sen. Ben Cardin told an excitable, skeptical crowd in western Maryland on Wednesday that the federal government has a responsibility to provide affordable health care to all, and that duty need not add to the national debt.

 

Critics of health care reform often interrupted the Maryland Democrat, forcing him to compete with chants of, "Just say no!" near the end of the 70-minute session.

 

But Cardin also drew loud applause for saying he supports a Patients' Bill of Rights guaranteeing a process for appealing insurer decisions, and opposes age discrimination in access to care.

 

"The objective is to make sure that we don't discriminate by age, ever, in our health care system," Cardin told an 11-year-old boy who asked if his grandfather's quality of care, if he got cancer, would be lower than for a younger person.

 

Still, the loudest cheers were for audience members who said they see the Democrat-led effort to provide universal health insurance as an ill-advised federal takeover of the medical system.

 

"This is really not about health care reform or insurance reform. It's a bill about government control," one man said to wild applause.

 

Another questioner got a standing ovation when she declared, "Your government has lost the faith and trust of the American people."

 

Some booed when Cardin responded that the Obama administration has started restoring trust in health care. He quickly calmed the crowd by pledging not to support any health care reform bill that would increase the federal deficit.

 

People lined up in warm, humid weather hours before the meeting at Hagerstown Community College. About 500 remained outside after the auditorium was filled, said campus security chief Henry Gautney.

 

The first in line was Carol Austin, 64, a Hagerstown antiques dealer who supports universal health care and said she showed up at 8 a.m. for the meeting.

 

"I think we drastically need health care reform," she said. "Providing for the general welfare is part of our Constitution, and I think health care for all is part of that."

 

The opposite view was expressed by most of the signs displayed outside.

 

"The Obama health plan sucks," read a sign stuck in the ground near the steps leading to the campus theater.

 

Many wore signs or T-shirts identifying themselves as members of an "angry mob."

 

Cardin told reporters before the meeting that those who portray the reform effort as a bid to legalize euthanasia and provide free health care for illegal immigrants are deliberately misleading the public, "and I don't think that furthers the debate."

 

He disagreed with Democratic House Speaker Nancy Pelosi's claim, along with House Majority Leader Steny Hoyer, D-Maryland, that the disruptions at town hall meetings are "un-American." But Cardin said unruly behavior is better suited for demonstrations.

 

"If people try to disrupt, that's not what you should be doing at a town hall meeting," he said.

 

Copyright 2009 Daily Record.

 

Beating the heat during a sweltering week

Monday region's hottest day this year

 

By Zoe Tillman and Rachael DeNale

The Gazette

Thursday, August 13, 2009

 

With temperatures this week among the region's hottest so far this year, many Prince George's County residents said they were heeding officials' advice to stay cool to avoid heat-related health problems.

 

AJ Keyes, a 12-year-old Laurel resident, spent Tuesday with his sister, Erin Keyes, 14, at the Laurel High School marching band practice where Erin is a member of the color guard. AJ said he plans to go to a pool in the next few days.

 

The siblings said they are trying to stay inside in the air conditioning and out of the heat, despite the outdoor band practice.

 

"[The heat] is a definite concern," said Kari Rea, a volunteer working with the color guard. She said the group takes breaks frequently and spends some time indoors so the students don't overheat.

 

"We try to keep them inside for the hottest part of the day," said band director Chuck Zimmerman.

 

Color guard member Chyne Okonkwo of Laurel said cold drinks and food, like ice cream and popsicles were the way to go to stay cool.

 

County officials encouraged senior citizens, young children and anyone with an illness to stay indoors to prevent heat stroke, dehydration or other heat-related complications. Those without air conditioning or fans were directed to air-conditioned cooling centers throughout the region.

 

Prince George's County runs cooling centers at the Camp Springs Activity Center, at 6420 Allentown Road, and the New Carrollton Nutrition Center, at 6016 Princess Garden Parkway in Lanham. The cooling centers are open from 8:30 a.m. to 5 p.m. Monday through Friday all summer.

 

Those without access to the centers were urged to drink water often and seek out air conditioning elsewhere.

 

"Find a movie, a mall, a library," said Jermoni Dowd, a county family services spokesman. "Stay out of any strenuous activities such as working out outside or even cutting the grass."

 

Residents can also take refuge at any of the county's air-conditioned community centers or one of the 10 open swimming pools, said Craig Kellstrom, a spokesman with the county department of parks and recreation.

 

If residents begin to feel overheated, dizzy or nauseous, they should call 911 or seek medical attention immediately, Kellstrom said.

 

Temperatures reached the high 90s on Monday but felt as hot as 105 degrees due to humidity. Despite the sweltering heat, National Weather Service forecaster Bryan Jackson said this summer has been mild compared with last year.

 

This season's moderate temperatures likely made Monday feel even worse, he said. The high temperatures were expected to come down to the 80s or low 90s by mid-week, he added.

 

Carol McCreadie, an employee at the Laurel Chuck E. Cheese, said she has seen an increase of patrons this week, probably to take advantage of the air conditioning.

 

However, she wasn't complaining about the warm temperatures.

 

McCreadie, a native of England who moved to the U.S. in June 2008, said Tuesday she was enjoying the heat and hasn't gotten sick of it yet.

 

But McCreadie conceded that the heat feels "like an oven."

 

"It's the humidity that gets you hot," she said. "It's a very, very sticky heat."

 

Copyright 2009 The Gazette.

 

National / International

Child-Safe Eye Drops

Which drops to choose?

 

HealthKey.com

Baltimore Sun

Tuesday, August 11, 2009

 

-- When your little one's eyes are red and itchy, try some natural remedies. Splash clean, cold water on the eyes. Be sure there is no chlorine in the eye bath. A cool, wet washcloth over the eyes can help ease the irritation.

 

-- There are eye drops and oral medications available to treat eye allergies in children. Artificial tears are extremely safe and can be used at any age.

 

-- Also extremely safe are homeopathic drops such as Similan's Active Response Formula. These stimulate they eye's natural ability to fight dryness and clear redness. There's no stinging or worries about the rebound effect or interactions with other medications.

 

-- Some eye drops, such as antihistamines and antihistamines/mast cell stabilizers, can be used in children who are 3 years and older. Any treatment should be discussed with your child's physician. Red, itchy eyes may be a sign of allergies or it may be symptoms of an infection or virus such as "pink eye." Find out what the problem is before you treat it with drops or medications.

 

Copyright © 2009, Today's Health Source.

 

Know Your Supplements

Weight-loss aids can have strong side effects.

 

Tribune Newspapers

By Melissa Healy

Baltimore Sun

Thursday, August 13, 2009

 

The recent recall of a popular weight-loss supplement comes when Americans are more desperate than ever to lose weight -- and possibly more curious about what's in the supplements to which they turn for help.

 

In May, the Food and Drug Administration warned consumers to stop using Hydroxycut, a line of herbal dietary supplements marketed as an aid to weight loss, body sculpting and athletic performance. So far, the agency has not identified which of the many ingredients in Hydroxycut products, or its dosage, may have caused dangerous side effects. Since many of the ingredients in the formulations are found widely in other dietary supplements, the culprit -- if there is one -- may still be on the market. The following are among weight-loss ingredients most frequently used in these formulas.

 

Caffeine

Seldom acknowledged on the labels of dietary supplements promoted for weight loss, caffeine is almost uniformly their key ingredient. Its sources are many and extremely varied: green tea extract (or Camellia sinensis), guarana, yerba mate and kola nut, to name a few. In studies, high doses of caffeine have been shown to decrease appetite, but the effect doesn't last long.

 

Antioxidants

Glutathione, green tea extracts and, more recently, the Brazilian açai berry are among the many sources of antioxidants marketed in supplements as an aid to weight loss. In test tubes, antioxidants called flavenoids and phenolic acids have been found to cut the production of triglycerides in mouse fat cells. But their weight-loss properties in humans haven't been rigorously tested.

 

Bitter orange

After the FDA banned the sale of ephedra and other products containing ephedrine in 2004, marketers of dietary supplements for weight loss widely proclaimed extracts from the peel of bitter orange (Citrus aurantium) "the next ephedra."

 

Bitter orange (also called Seville orange and sour orange) is touted as an energy-enhancing fat burner, as was ephedrine. There is evidence that, like ephedrine, it may cause slightly more weight loss than diet and exercise alone. And the active ingredients in bitter orange extract -- synephrine and octopamine -- are related to ephedrine.

 

Hydroxycitric acid

The ingredient from which the Hydroxycut name was originally drawn is a derivative of the Malabar tamarind, or Garcinia cambogia. Used in traditional medicine to treat high cholesterol, it is touted as an agent that interferes with fat metabolism and possibly suppresses appetite.

 

Conjugated Linoleic Acid

Frequently included in products that promise to help dieters transform fat into lean muscle mass, CLA is a polyunsaturated fat found naturally in milk and meat, and is derived from the oil of sunflower (Helianthus annuus) and safflower (Carthamus tinctorius) seeds. One product that touts its power -- Phosphacore -- says that Carthamus tinctorius "may work to safely break up and flush away unhealthy adipose [fat] cells."

 

Cortisol blockers

Tinctures of golden root (Rhodiola rosea) or other herbs, such as rose root, are marketed as weight-loss aids on the argument that stress -- which causes the release of the hormone cortisol -- can lead to weight gain and, particularly, to the accumulation of belly fat. There is no evidence that blocking cortisol causes weight loss, or that herbal remedies lower cortisol levels.

 

Chitosan

The chemically cleansed product of grinding up the shells of shrimps, crabs and lobsters, chitosan is a powder that has been used in the water-purification industry for years: Sprinkled on top of holding tanks, it binds to lipids, or fats. Fats and oils can thus be skimmed off easily. This has led to the claim that supplements containing chitosan have "fat magnet" qualities, absorbing dietary fat before it can be absorbed into the gut and flushing it away.

 

But three human clinical trials found no difference in weight or serum cholesterol levels between subjects taking chitosan supplements and those taking a placebo. Chitosan could be dangerous to anyone with shellfish allergies.

 

Hoodia

A succulent plant native to the Kalahari Desert in Africa, hoodia (Hoodia gordonii) is chewed and eaten by San Bushmen to reduce their hunger and thirst during long hunts. In a 2004 study published in Brain Research, scientists injected p57, thought to be the active ingredient in hoodia, into a region of rats' brains thought to govern appetite. They found reduced activity there.

 

Copyright © 2009, Chicago Tribune.

 

Copyright 2009 Baltimore Sun.

 

Daniel Radcliffe Says No To LGBT Suicide

 

San Fransico Lesbian Gay Bisexual Transgender

By Michael A. Jones

Change.org

Monday, August 10, 2009

 

When it comes to celebrity support for LGBT rights, Daniel Radcliffe is giving everyone a run for their money.  "http://gayrights.change.org/blog/view/daniel_radcliffe_loathes_homophobia" Two weeks ago Radcliffe gave an interview to the UK's Attitude magazine, where he talked about how much he loathed homophobia, and the people that foster it.  Now he's giving a major donation to one of our favorite organizations, http://www.thetrevorproject.org/" The Trevor Project, to combat suicide among LGBT youth.  Talk about putting your money where your mouth is.

 

"http://www.thetrevorproject.org/Documents/DanielRadcliffe.pdf" The Trevor Project announced today that Radcliffe would be joining its circle of major donors, to help support the organizations work among LGBT youth.  Trevor works on a number of different issues, from combating violence against LGBT youth to fostering education programs that spotlight issues facing LGBT youth.  They are perhaps most famous for their Trevor Helpline, a 24-hour suicide hotline for LGBT youth.  That Help Line provides an invaluable service for LGBT populations, and the organization has said that call volume to the suicide hotline is up more than 300 percent since last year.  Wow.

 

Maybe that's one reason why Radcliffe wants to support the organization so badly.  There's perhaps never been a more critical time to deal with the issue of LGBT suicide, especially among young people. "http://www.thetrevorproject.org/Documents/DanielRadcliffe.pdf" Here's what Radcliffe said in announcing the donation:

 

It's extremely distressing to consider that in 2009 suicide is a top three killer of young people, and it's truly devastating to learn that LGBTQ youth are up to four times more likely to attempt suicide than their heterosexual peers. I deeply hope my support can raise the organization's visibility so even more despondent youth become aware of The Trevor Helpline's highly trained counselors and Trevor’s many other resources. It's vitally important that young people understand they are not alone and, perhaps even more important, that their young lives have real value.

 

LGBT lives have real value.  What a message for the most famous 20-year-old in the world to proclaim loudly.  For more information on The Trevor Project, "http://www.thetrevorproject.org/" check them out here.

 

Copyright 2009 The SF LGBT Community Center.

 

Fairfax Schools Air CDC's Strategy for Swine Flu's Return

 

By Nelson Hernandez

Washington Post

Wednesday, August 12, 2009

 

The expected resurgence of swine flu this fall could lead some public schools to become mass inoculation clinics. Infected students could be forced to wear surgical masks and put in isolation rooms before being sent home.

 

But school officials predict that the wave of school closings that caused much angst in the spring is unlikely to be repeated.

 

"School closures aren't really on the table," said Fred Ellis, director of safety and security for Fairfax County public schools. Unless the virus, known as H1N1, mutates to become more severe, health officials said, they will try to keep schools open and prevent the spread of the virus through other means.

 

"We really want people to get sick and tired, as I know you already are, of hand-washing and coughing etiquette," Ellis told about 200 Fairfax principals who had gathered for a back-to-school briefing Tuesday. A school might still be closed if there aren't enough healthy teachers and staff members to run the school or bus drivers to transport students, Ellis said.

 

The session at Luther Jackson Middle School, in the Falls Church area, offered a window into the preparations underway across the country as school officials pore over the latest guidance from the Centers for Disease Control and Prevention in the weeks before classes resume.

 

In the spring, when little was known about how deadly the disease might be, the CDC's advice frustrated some health officials, school principals and parents. Initially, a school could be closed for a week or more because of a single confirmed case of swine flu, and it seemed that the entire school year could crash to a halt. But that directive quickly changed because the virus's effects appeared to be fairly mild.

 

The CDC's latest advice gives local school systems more flexibility in dealing with the illness and on closing schools.

 

Students and staff members who are sick should stay home and should not return to school until at least 24 hours after the fever has broken, the CDC says.

 

Under CDC guidelines, sick students who do go to school would be asked to wear a surgical mask and sent to a quarantine room to be watched over by an adult also wearing a mask. The students would remain quarantined until their parents picked them up.

 

There could be more changes to the guidelines, particularly after a vaccine begins to be administered to the public en masse.

 

At the University of Maryland School of Medicine in Baltimore, 66 adult volunteers have received the first of two doses of an H1N1 vaccine. The university is one of 10 sites for national clinical trials of the vaccine, which started Monday.

 

The goal of the clinical trials is to determine how strong a dose is required to protect different age groups. To that end, researchers will test for antibodies in the volunteers' blood to assess their immunity.

 

Once testing is complete, the vaccine is to be given to states and local governments and administered to millions of Americans, starting with vulnerable populations such as children and young adults, pregnant women and people with weak immune systems. But there is no timeline or firm idea of how the vaccinations will be administered.

 

"Right now, we cannot stand here and tell you what the vaccination plan is going to look like," Ellis said. "We have no idea."

 

One option discussed would use schools as mass inoculation clinics. But Ellis also said Fairfax County's plan for dealing with the virus is "flexible and fluid," one of several remarks that drew laughs.

 

The H1N1 vaccine will not be a substitute for seasonal flu vaccine, and health officials recommended that their employees and everyone else get both.

 

Seasonal flu shots will be free for all school employees.

 

At Tuesday's briefing, Fairfax principals wrote out questions on blue index cards for health and school officials to answer. There were queries about the vaccine's effects (it should be as safe as a seasonal flu shot); about how to clean rooms in schools (with standard cleaning products, because antibacterial soap isn't any more effective against a virus); and about who will pay for cleaning products (the school system).

 

As they left the meeting, the principals seemed ready to face what will come.

 

"I think people are much more comfortable at this point in time," said Theresa West, principal of McNair Elementary School in Herndon. "Last spring, nobody knew what was happening. There was fear, getting in planes and everything else. Information, it helps people be calm."

 

Staff writer Rachel Saslow contributed to this report.

 

Copyright 2009 Washington Post.

 

Thousands Line Up for Promise of Free Health Care

 

By Jennifer Steinhauer

New York Times

Thursday, August 13, 2009

 

INGLEWOOD, Calif. — They came for new teeth mostly, but also for blood pressure checks, mammograms, immunizations and acupuncture for pain. Neighboring South Los Angeles is a place where health care is scarce, and so when it was offered nearby, word got around.

 

For the second day in a row, thousands of people lined up on Wednesday — starting after midnight and snaking into the early hours — for free dental, medical and vision services, courtesy of a nonprofit group that more typically provides mobile health care for the rural poor.

 

Like a giant MASH unit, the floor of the Forum, the arena where Madonna once played four sold-out shows, housed aisle upon aisle of dental chairs, where drilling, cleaning and extracting took place in the open. A few cushions were duct-taped to a folding table in a coat closet, an examining room where Dr. Eugene Taw, a volunteer, saw patients.

 

When Remote Area Medical, the Tennessee-based organization running the event, decided to try its hand at large urban medical services, its principals thought Los Angeles would be a good place to start. But they were far from prepared for the outpouring of need. Set up for eight days of care, the group was already overwhelmed on the first day after allowing 1,500 people through the door, nearly 500 of whom had still not been served by day’s end and had to return in the wee hours Wednesday morning.

 

The enormous response to the free care was a stark corollary to the hundreds of Americans who have filled town-hall-style meetings throughout the country, angrily expressing their fear of the Obama administration’s proposed changes to the nation’s health care system. The bleachers of patients also reflected the state’s high unemployment, recent reduction in its Medicaid services for the poor and high deductibles and co-payments that have come to define many employer-sponsored insurance programs.

 

Many of those here said they lacked insurance, but many others said they had coverage but not enough to meet all their needs — or that they could afford. Some said they were well aware of the larger national health care debate, and were eager for changes.

 

“I am on point with the news,” said Elizabeth Harraway, 50, who is unemployed and came for dental care. “I think the president’s ideas are awesome, and I believe opening up health care is going to work."

 

Stan Brock, Remote Area Medical’s founder and among the many khaki-wearing volunteers in the arena, said his organization’s intent was not to become part of the health care debate, but to do what it had done for nearly 25 years: offer charity to people in need. Still, the group attracted attention last month when President Obama visited Bristol, Va., just days after it held a health care event in nearby Wise, Va.

 

“My position on the Obama plan is that I am delighted to see so much focus on the health care issue," Mr. Brock said. “There is incredible focus on what we do, but that is not my doing."

 

In the past, Remote Area Medical has also provided services in mid-sized American cities, including New Orleans after Hurricane Katrina, but had never tried an operation in such a large metropolitan area. Mr. Brock said the considerable logistics were made possible with the help of Don Manelli, a film producer, but he said he was disappointed in the dearth of volunteers among local providers — specifically dentists and optometrists — which made it hard to provide services for all comers.

 

Ana Maria Garcia, who works for Orange County, has health insurance that covers her husband and 3 ½-year-old daughter, but her dental deductibles are too high for them all to get care, she said.

 

Ms. Garcia’s husband, Jorge, who was laid off from his custodial job last October, arrived from their home — a 90-minute drive away — at 4 p.m. on Tuesday to get the family’s spot in line.

 

But the Garcias’ number never came up, so they slept in their car for a few hours and lined up again early Wednesday morning, awaiting a chance to get root canals and cleanings that Ms. Garcia figured were worth thousands of dollars. They made a friend in the bleachers outside, who gave the family some coffee and hot biscuits for breakfast.

 

“Regardless if you are employed or not,” Ms. Garcia said, “everything in California is expensive, and so I can empathize with everyone here. Looking at this crowd, I think this is what people fear health care is going to be with reform. But to me it also shows the need.”

 

Last month, the state dropped its dental and vision coverage for MediCal enrollees, and has since capped enrollment in the state’s health insurance program for children of the working poor. Thousands of people across the state lost their coverage in the middle of complex, multimonth procedures and have found themselves at a loss.

 

Sammie Edwards, a retired welder, was in the middle of getting dentures made when his care ran out, he said. A friend at a food bank clued him into the free clinic. “A lot of older people are caught in the midst of this,” Mr. Edwards said.

 

Begun in 1985 as a mobile health clinic serving undeveloped countries and later rural America, Remote Area Medical provides various medical services through units to people who are largely unable to gain access to health care. Officials from the organization said they believed that this week’s event in Los Angeles constituted the largest free health care event in the country, with the arena and all supplies and services provided free to the group. Other expenses were covered by the group’s fund-raising.

 

On Tuesday, volunteers provided 1,448 services to about 600 patients, including 95 tooth extractions, 470 fillings, 140 pairs of eyeglasses, 96 Pap smears and 93 tuberculosis tests, the organizers said. Hundreds of volunteer doctors, dentists, optometrists, nurses and others are expected to serve 8,000 patients by the end of the eight days.

 

For those willing to endure the long waits, the arena was like a magical medical kingdom, where everything was possible once a person got through the door. Mike Bettis, who runs security for a nightclub in Hollywood, and his fiancée, Lourie Alexander, who cleans homes, said they usually went on Craigslist, exchanging a home cleaning for a dermatology appointment.

 

By Wednesday, the couple had gotten between them dentures (him); a breast exam, Pap smear and general physical (her); and acupuncture (both).

 

“What I liked about it was that everyone was so sweet,” Ms. Alexander said. “You know when you haven’t seen a doctor in so many years you have a lot of questions.”

 

Copyright 2009 New York Times.

 

Opinion

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