Thursday, June 11, 2009

News Clipping Archives

 

Maryland / Regional

Worcester swine flu cases rise to six (Salisbury Daily Times)

Bethesda Doctor, Wife Charged in Drug Case (Washington Post)

Maryland Pharmacy Discount Program Launched (Progressive Grocer)

$2.5B spent, no alternative med cures (Daily Record)

 

National / International

Can Memory Loss Be Prevented? (New York Times)

WHO declares swine flu pandemic (Associated Press)

WHO Declaration of Swine Flu Pandemic Looks Imminent (ABC News)

 

Opinion

Big Breakthroughs for Single Payer Health Care (Baltimore News Network Commentary)

One Health Battle: Doctor vs. Doctor (New York Times Letter to the Editor)

 

 

Maryland / Regional

Worcester swine flu cases rise to six

 

By Jenny Hopkinson

Salisbury Daily Times

Thursday, June 11, 2009

 

SNOW HILL -- Three more Worcester County public schools students and another county resident have tested positive for the H1N1 virus -- otherwise known as swine flu -- bringing the total of confirmed cases up to six.

 

News of the four additional cases comes less than a week after the Worcester County Health Department announced that two residents -- one adult and a student at Ocean City Elementary School -- had contracted the virus.

 

In a letter released to parents Wednesday, Superintendent Jon Andes confirmed the four cases at "various schools in our system," which he later described as being in "four different locations" in a phone interview. School officials and the health department declined to name the schools affected by the new cases.

 

"Students diagnosed with the H1N1 flu are being treated by a physician and will return to school when cleared by their physician," Andes wrote in the letter.

 

For privacy reasons, the school system and the health department will not release any specific information on the cases. All 14 schools will remain open, Andes said; the last scheduled day of classes is Tuesday.

 

As of Wednesday, there were 137 confirmed cases of the virus in Maryland, found in 12 counties and Baltimore City, said David Paulson, a spokesman from the state Department of Health and Mental Hygiene. That number is up from 83 on Friday. The median age of those infected is 15 years old, he said, and there have been no reported deaths in Maryland from the disease.

 

Worcester County is one of two jurisdictions east of the Chesapeake Bay and the only on the Lower Shore to have confirmed occurrences of H1N1, Paulson said. Cecil County officials announced their first case in May.

 

While swine flu seems to be new to Worcester County, the number of confirmed cases across the state can be misleading, Paulson said. When the virus first appeared, everyone with flu-like symptoms was tested, but that is no longer a priority.

 

"Now because we know more about (the virus) -- it is a relatively mild form and acts a lot like regular seasonal flu -- we are certain we aren't testing every case of flu-like illness," he said. "It is entirely probable that every county in Maryland has seen H1N1, but those cases haven't been reported and tested."

 

The arrival of the flu in Worcester County comes as little surprise, said Debra Stevens, nursing program manager for the health department.

 

"It's in Maryland, so we knew eventually it would make it all across the rest of the state to the Shore," Stevens said.

 

Health officials have been following the disease since it appeared in April, and work with local organizations and medical providers and the state to coordinate procedures, testing and disperse information on preventative measures.

 

With more understanding of the virus, and drugs readily available to combat symptoms, the state and local health departments are treating potential cases and recommending standard precautions that would be used during flu season, Stevens said.

 

"There certainly could be cases that are not being confirmed, but that's normal for even seasonal flu," she said. "That is why it's so necessary for people to understand that respiratory and hand hygiene is really important."

 

At Atlantic General Hospital in Berlin, doctors and practitioners are telling people with any symptoms to stay home and rest, said spokeswoman Toni Keiser. If they do begin to feel worse, patients should call their primary care provider instead of heading to the emergency room, she said.

 

Paulson said it is likely the outbreak this spring will not be the last Maryland, or the rest of the country, sees of the virus. While the Centers for Disease Control and Prevention is working with pharmaceutical companies to develop a vaccine, those who contracted the disease this spring will most likely be immune to any strain that may reappear this winter, Paulson said. This theory may also explain why older people -- those aged 50 or more -- seem to have been less affected by the disease.

 

"People born after 1976 would have less resistance to a flu like this than older citizens who lived through the swine flu in 1976," he said. "It doesn't mean these people can't get it again, but they will be highly resistant to it."

 

Copyright 2009 Salisbury Daily Times.

 

Bethesda Doctor, Wife Charged in Drug Case

 

By Dan Morse

Washington Post

Thursday, June 11, 2009

 

A Bethesda physician who is the focus of an investigation into the distribution of prescription painkillers was charged with drug possession after a raid at his home turned up cocaine and traces of Ritalin on drug paraphernalia, authorities said yesterday.

 

The doctor, Eric C. Greenberg, was arrested last week as a result of the April 1 raid in the 9300 block of Old Georgetown Road, where he works and lives, according to charging documents. His wife, Jaquenette I. Fischman, was also arrested.

 

Greenberg's medical license has been suspended, and he has been charged with possession of a controlled substance and two counts of possession of drug paraphernalia. Fischman, 46, was charged with the same offenses.

 

Greenberg, 42, did not immediately respond to messages left at his office yesterday seeking comment. It was unclear whether he is represented by an attorney in the criminal case.

 

Last fall, pharmacists told authorities about suspicions that Greenberg was writing prescriptions for drug addicts, according to records filed at the Maryland Board of Physicians. A suspect in a Montgomery County drug case also told investigators that "all of his friends" who once got illicit prescriptions from a doctor whose license had been suspended were getting them instead from Greenberg, the records show.

 

On March 11, investigators with the Drug Enforcement Agency took trash from outside Greenberg's home, finding medical paraphernalia that allegedly contained cocaine. Investigators searching his home and office the following month noticed "fresh needle marks" on his arm and hands, according to the records.

 

About the same time, Prince George's County police charged two county employees in an investigation linked to Greenberg, according to the board records. Police said they found an estimated $6,000 worth of painkillers and other narcotics in the possession of the engineering inspectors while at work.

 

Ryan Hampton of Jessup was charged with possession with intent to distribute OxyContin and possession of Adderall. Court records show that the distribution charge was later dismissed. James Schmitz was charged with possession of Dilaudid and of Suboxone. A Prince George's spokesman said Hampton and Schmitz are no longer employed by the county.

 

On April 1, during the search of Greenberg's home and office, police found cocaine in a plastic bag in an upstairs office area, according to charging documents. The documents do not say what amount was found.

 

Police also found traces of cocaine and Ritalin on the inside of tubes and pen casings in an upstairs dining room, and they found cocaine residue on a glass dish in the master bedroom, according to charging documents.

 

In 2007, Greenberg was placed on probation by the Maryland Board of Physicians for prescribing medicine to a family member and for failing to maintain proper records on six patients.

 

Copyright 2009 Washington Post.

 

Maryland Pharmacy Discount Program Launched

 

Progressive Grocer

Thursday, June 11, 2009

 

The state of Maryland yesterday launched a new statewide discount drug card program called the Maryland Rx Card to help residents pay for prescription drugs, and named Safeway and Giant Food, LLC the preferred pharmacies for the program.

 

The Maryland Rx Card, which is free to all residents, will provide savings of up to 75 percent on prescription drugs (savings should average roughly 30 percent). The program has no restrictions to membership, no income requirements, no age limitations and no applications to fill out, and is accepted at more than 50,000 pharmacy locations across the country.

 

The card program was launched to help the uninsured and underinsured residents of Maryland afford their prescription medications. However, it can also be used by people who have health insurance coverage with no prescription benefits, which is common in many health savings accounts (HSA) and high deductible health plans. Additionally, people who have prescription coverage can use this program for non-formulary or noncovered medications.

 

Marylanders can download a free Maryland pharmacy discount card by visiting www.marylandrxcard.com, or by visiting any Giant or Safeway Pharmacy location.

 

Copyright 2009 Progressive Grocer.

 

$2.5B spent, no alternative med cures

 

Associated Press

Daily Record

Thursday, June 11, 2009

 

Ten years ago the government set out to test herbal and other alternative health remedies to find the ones that work. After spending $2.5 billion, the disappointing answer seems to be that almost none of them do.

 

Echinacea for colds. Ginkgo biloba for memory. Glucosamine and chondroitin for arthritis. Black cohosh for menopausal hot flashes. Saw palmetto for prostate problems. Shark cartilage for cancer. All proved no better than dummy pills in big studies funded by the National Center for Complementary and Alternative Medicine. The lone exception: ginger capsules may help chemotherapy nausea.

 

As for therapies, acupuncture has been shown to help certain conditions, and yoga, massage, meditation and other relaxation methods may relieve symptoms like pain, anxiety and fatigue.

 

However, the government also is funding studies of purported energy fields, distance healing and other approaches that have little if any biological plausibility or scientific evidence.

 

Taxpayers are bankrolling studies of whether pressing various spots on your head can help with weight loss, whether brain waves emitted from a special "master" can help break cocaine addiction, and whether wearing magnets can help the painful wrist problem, carpal tunnel syndrome.

 

The acupressure weight-loss technique won a $2 million grant even though a small trial of it on 60 people found no statistically significant benefit — only an encouraging trend that could have occurred by chance. The researcher says the pilot study was just to see if the technique was feasible.

 

"You expect scientific thinking" at a federal science agency, said R. Barker Bausell, author of "Snake Oil Science" and a research methods expert at the University of Maryland, one of the agency's top-funded research sites. "It's become politically correct to investigate nonsense."

 

Many scientists say that unconventional treatments hold promise and deserve serious study, but that the federal center needs to be more skeptical and selective.

 

"There's not all the money in the world and you have to choose" what most deserves tax support, said Barrie Cassileth, integrative medicine chief at Memorial Sloan-Kettering Cancer Center in New York.

 

"Many of the studies that have been funded I would not have funded because they seem irrational and foolish — studies on distant healing by prayer and energy healing, studies that are based on precepts and ideas that are contrary to what is known in terms of human physiology and disease," she said.

 

In an interview last year, shortly after becoming the federal center's new director, Dr. Josephine Briggs said it had a strong research record, and praised the many "big name" scientists who had sought its grants. She conceded there were no big wins from its first decade, other than a study that found acupuncture helped knee arthritis. That finding was called into question when a later, larger study found that sham treatment worked just as well.

 

"The initial studies were driven by some very strong enthusiasms, and now we're learning about how to layer evidence" and to do more basic science before testing a particular supplement in a large trial, said Briggs, who trained at Ivy League schools and has a respected scientific career.

 

"There are a lot of negative studies in conventional medicine," and the government's outlay is small compared to drug company spending, she added.

 

However, critics say that unlike private companies that face bottom-line pressure to abandon a drug that flops, the federal center is reluctant to admit a supplement may lack merit — despite a strategic plan pledging not to equivocate in the face of negative findings.

 

Echinacea is an example. After a large study by a top virologist found it didn't help colds, its fans said the wrong one of the plant's nine species had been tested. Federal officials agreed that more research was needed, even though they had approved the type used in the study.

 

"There's been a deliberate policy of never saying something doesn't work. It's as though you can only speak in one direction," and say a different version or dose might give different results, said Dr. Stephen Barrett, a retired physician who runs Quackwatch, a web site on medical scams.

 

Critics also say the federal center's research agenda is shaped by an advisory board loaded with alternative medicine practitioners. They account for at least nine of the board's 18 members, as required by its government charter. Many studies they approve for funding are done by alternative therapy providers; grants have gone to board members, too.

 

"It's the fox guarding the chicken coop," said Dr. Joseph Jacobs, who headed the Office of Alternative Medicine, a smaller federal agency that preceded the center's creation. "This is not science, it's ideology on the part of the advocates."

 

Briggs defended their involvement.

 

"If you're going to do a study on acupuncture, you're going to need acupuncture expertise," she said. These therapists "are very much believers in what they do," not unlike gastroenterologists doing a study of colonoscopy, and good study design can guard against bias, she said.

 

The center was handed a flawed mission, many scientists say.

 

Congress created it after several powerful members claimed health benefits from their own use of alternative medicine and persuaded others that this enormously popular field needed more study. The new center was given $50 million in 1999 (its budget was $122 million last year) and ordered to research unconventional therapies and nostrums that Americans were using to see which ones had merit.

 

That is opposite how other National Institutes of Health agencies work, where scientific evidence or at least plausibility is required to justify studies, and treatments go into wide use after there is evidence they work — not before.

 

"There's very little basic science behind these things. Most of it begins with a tradition, or personal testimony and people's beliefs, even as a fad. And then pressure comes: 'It's being popular, it's being used, it should be studied.' It turns things upside down," said Dr. Edward Campion, a senior editor who reviews alternative medicine research submitted to the New England Journal of Medicine.

 

That reasoning was used to justify the $2 million weight-loss study, approved in 2007. It will test Tapas acupressure, devised by Tapas Fleming, a California acupuncturist. Use of her trademarked method requires employing people she certifies, and the study needs eight.

 

It involves pressing on specific points on the face and head — the inner corners of the eyes are two — while focusing on a problem. Dr. Charles Elder, a Kaiser Permanente physician who runs an herbal and ayurvedic medicine clinic in Portland, Ore., is testing whether it can prevent dieters from regaining lost weight.

 

Say a person comes home and is tempted by Twinkies on the table. The solution: Start acupressure "and say something like 'I have an uncontrollable Twinkie urge,'" Elder said. Then focus on an opposite thought, like "I'm in control of my eating."

 

In Chinese medicine, the pressure is said to release natural energy in a place in the body "responsible for transforming animal desire into higher thoughts," Elder said.

 

In a federally funded pilot study, 30 dieters who were taught acupressure regained only half a pound six months later, compared with over three pounds for a comparison group of 30 others. However, the study widely missed a key scientific standard for showing that results were not a statistical fluke.

 

The pilot trial was just to see if the technique was feasible, Elder said. The results were good enough for the federal center to grant $2.1 million for a bigger study in 500 people that is under way now.

 

Alternative medicine research also is complicated by the subjective nature of many of the things being studied. Pain, memory, cravings, anxiety and fatigue are symptoms that people tolerate and experience in widely different ways.

 

Take a question like, "Does yoga work for back pain?" said Margaret Chesney, a psychologist who is associate director of the federally funded Center for Integrative Medicine at the University of Maryland.

 

"What kind of yoga? What kind of back pain?" And what does it mean to "work" — to help someone avoid surgery, hold a job or need less medication?

 

Some things — the body meridians that acupuncturists say they follow, or energy forces that healers say they manipulate — cannot be measured, and many scientists question their existence.

 

Studying herbals is tough because they are not standardized as prescription drugs are required to be. One brand might contain a plant's flowers, another its seeds and another, stems and leaves, in varying amounts.

 

There are 150 makers of black cohosh "and probably no two are exactly the same, and probably some people are putting sawdust in capsules and selling it," said Norman Farnsworth, a federally funded herbal medicine researcher at the University of Illinois at Chicago.

 

Even after a careful study, "you know one thing more precise and firm about what that agent did in that population with that outcome measurement, but you don't necessarily know the whole gamut of its effectiveness," as the echinacea study showed, Briggs said.

 

The center posts information on supplements and treatments on its Web site, and has a phone line for the public to ask questions — even when the answer is that not enough is known to rule in or rule out benefit or harm.

 

"I hope we are building knowledge and at least an informed consumer," Briggs said.

 

Copyright 2009 Daily Record.

 

National / International

Can Memory Loss Be Prevented?

 

The New Old Age - Caring and Coping

 

By Anne Underwood

New York Times

Thursday, June 11, 2009

 

Brandon Thibodeaux for The New York Times Bob Branham, 78, at home with some of his quilting projects. He participates in a study designed to see whether acquiring new skills can stave off dementia.

 

At the age of 78, Bob Branham, a retired computer software developer in Dallas, Tex., took up quilting. It wasn’t his idea, actually. He’d never dreamed of piecing together his own Amish diamond coverlet or rummaging around Jo-Ann Fabrics in search of calico prints. But then he enrolled in a trial sponsored by the National Institute on Aging to assess whether learning a new skill can help preserve cognitive function in old age. By random assignment, he landed in the quilting group.

 

When it comes to mental agility, we’re more likely to think of crosswords than cross-stitch. But neuroscientists suspect that learning a challenging new skill — a new language, a new musical instrument — may be even more effective than mental games at keeping the brain sharp. And quilting is more complicated than it may seem.

 

“It’s a very abstract task,” said Dr. Denise Park, a cognitive neuroscientist at the University of Texas at Dallas, who is leading the trial. “You have to picture what the pattern will look like, match fabrics, manipulate geometric forms, mentally rotate objects.”

 

In Mr. Branham’s case, he also had to learn to use a sewing machine. And while it’s too early to tell if quilting is sharpening his mind, he quickly found that he loved his new pastime. He spends as much as 40 hours a week piecing and stitching, both at home and at the social center that Dr. Park set up for the trial.

 

“I get ideas and pointers from the instructor and the other participants,” he said. “We have a real good time.”

 

Memory is among the least understood areas of neuroscience, and the sad truth is that there is no magic pill or potion at present that will prevent our parents’ minds from failing. But a panel of 30 experts from the United States and Europe recently issued a consensus statement on what we do know about maintaining brain fitness (which includes not only memory, but also reasoning, attention and speed of processing). The verdict was that three things are crucial: physical exercise, mental challenges and good health habits in general.

 

But wait! What about the supplements and software programs we’ve been stocking up on? “There’s a lot of snake oil out there,” warned Dr. Laura Carstensen, director of the Center on Longevity at Stanford University, who co-chaired the panel. In short, don’t count on supplements. (The rationale behind ginkgo biloba is plausible, but there is no scientific evidence it works.) Steer clear of anything that promises to prevent Alzheimer’s disease. (Such a claim would require approval from the Food and Drug Administration, and no product has it.) And look skeptically on software programs. (Most improve performance only on the games themselves, not mental function in general.)

Brandon Thibodeaux for The New York Times

 

Instead, Dr. Carstensen said, get moving. Exercise may sound like an impractical way to boost Mom’s cognition when her energy levels are dwindling. But multiple studies show it helps. In a study published in the Archives of Internal Medicine in 2001, women ages 65 and older who walked the most showed the least cognitive decline over an eight-year period — up to 30 percent less than their sedentary counterparts.

 

Another trial in the journal Nature by Dr. Arthur Kramer, a neuroscientist at the University of Illinois at Urbana-Champaign, found not just slower declines but actual improvements in working memory, attention and executive skills in older adults (average age 72) after six months of an aerobic exercise program — specifically, 45 minutes to an hour of walking, three times a week.

 

How could aerobic exercise possibly accomplish this? Among other things, it increases blood flow, encourages the formation of new synapses and reverses some of the age-related decline in brain volume. “If exercise were a pill, it would be the most expensive drug on the market,” said Dr. Carstensen.

 

Other good habits are important, too. As neuroscientists like to say, what’s good for the heart is good for the brain. That would include maintaining healthy blood sugar and blood pressure levels. A study last December in the Annals of Neurology showed that controlling blood sugar, even in non-diabetic adults, can help prevent deterioration in a part of the brain that’s necessary for memory formation. Another paper published in the Archives of Neurology in February by scientists at Columbia University found that eating a heart-healthy Mediterranean diet — rich in fish, vegetables, whole grains, fruits, legumes and unsaturated fats — lowered the risk of mild cognitive impairment over four and a half years by as much as 28 percent.

 

But even if Mom follows all the advice she herself used to propound — eat your vegetables, go outside and exercise — there is no substitute for mental challenges. The brain is a use-it-or-lose-it type of organ. Synaptic connections that aren’t firing will weaken.

 

The problem with most of our favorite approaches to staying sharp is that they are narrowly focused when what’s needed is global improvement. Crosswords are great for word retrieval. That’s clearly important. But not even The Times’s Sunday puzzle by Will Shortz will help you remember where you left your car keys. “If you want lots of improvement, you have to do mental cross-training,” said Dr. K. Warner Schaie, a professor of psychology at Pennsylvania State University.

 

In short, engage in many types of mental activity. Do crosswords, Sudoku, acrostics, play bridge, read books, join clubs, get into debates, volunteer — anything to keep the mind alive and engaged in new and interesting tasks. If the activity includes social interaction, so much the better. Or take up a new hobby, a new language or a new instrument that will challenge the brain in entirely different ways, preferably for years. “One problem with aging is that you develop expertise in a few things and do them over and over,” said Dr. Carstensen. “Proficiency is good, but it’s probably not growing new synapses.”

 

Mr. Branham, on the other hand, seems to be sprouting plenty of neural connections. He’s now completed two full-sized quilts — one a sampler with various patterns, the other a split rail design with stars in the four corners. He’d even like to launch a small business selling his patchwork place mats and table runners. When friends at church ask him why he signed up for such a study, and why on earth he agreed to start quilting, he has a ready answer. “Studies need participants,” he says. “And you should sign up, too.”

 

Copyright 2009 The New York Times Company.

 

WHO declares swine flu pandemic

Declaration marks first global flu epidemic in 41 years

 

By Maria Cheng

The Associated Press

Thursday, June 11, 2009

 

GENEVA - The World Health Organization told its member nations it was declaring a swine flu pandemic Thursday -- the first global flu epidemic in 41 years -- as infections climbed in the United States, Europe, Australia, South America and elsewhere.

 

In a statement sent to member countries, WHO said it decided to raise the pandemic warning level from phase 5 to 6 -- its highest alert -- after holding an emergency meeting on swine flu with its experts.

 

The long-awaited pandemic decision is scientific confirmation that a new flu virus has emerged and is quickly circling the globe. It will trigger drugmakers to speed up production of a swine flu vaccine and prompt governments to devote more money toward efforts to contain the virus.

 

"At this early stage, the pandemic can be characterized globally as being moderate in severity," WHO said in the statement, urging nations not to close borders or restrict travel and trade. "(We) remain in close dialogue with influenza vaccine manufacturers."

 

On Wednesday, WHO said 74 countries had reported nearly 27,737 cases of swine flu, including 141 deaths.

 

The agency has stressed that most cases are mild and require no treatment, but the fear is that a rash of new infections could overwhelm hospitals and health authorities -- especially in poorer countries.

 

Still, about half of the people who have died from swine flu were previously young and healthy -- people who are not usually susceptible to flu.

 

Swine flu is also continuing to spread during the start of summer in the northern hemisphere. Normally, flu viruses disappear with warm weather, but swine flu is proving to be resilient.

 

The last pandemic -- the Hong Kong flu of 1968 -- killed about 1 million people. Ordinary flu kills about 250,000 to 500,000 people each year.

 

Many health experts say WHO's pandemic declaration could have come weeks earlier but the agency became bogged down by politics. In May, several countries urged WHO not to declare a pandemic, fearing it would cause social and economic turmoil.

 

"This is WHO finally catching up with the facts," said Michael Osterholm, a flu expert at the University of Minnesota who has advised the U.S. government on pandemic preparations.

 

Despite WHO's hopes, raising the epidemic alert to the highest level will almost certainly spark some panic about spread of swine flu.

 

Fear has already gripped Argentina, where thousands of people worried about swine flu flooded into hospitals this week, bringing emergency health services in the capital of Buenos Aires to the brink of collapse. Last month, a bus arriving in Argentina from Chile was stoned by people who thought a passenger on it had swine flu. Chile has the most swine flu cases in South America.

 

In Hong Kong on Thursday, the government ordered all kindergartens and primary schools closed for two weeks after a dozen students tested positive for swine flu -- a move that some flu experts would consider an overreaction.

 

In the United States, where there have been more than 13,000 cases and at least 27 deaths from swine flu, officials at the U.S. Centers for Disease Control and Prevention said the move would not change how the U.S. tackled swine flu.

 

"Our actions in the past month have been as if there was a pandemic in this country," Glen Nowak, a CDC spokesman, said Thursday.

 

The U.S. government has already taken steps like increasing availability of flu-fighting medicines and authorizing $1 billion for the development of a new vaccine against the novel virus. In addition, new cases seem to be declining in many parts of the country, U.S. health officials say, as North America moves out of its traditional winter flu season.

 

Still, Osterholm said the declaration was a wake-up call for the world.

 

"I think a lot of people think we're done with swine flu, but you can't fall asleep at the wheel," he said. "We don't know what's going to happen in the next 6 to 12 months."

 

 

Medical Writer Maria Cheng reported from London. Mike Stobbe in Atlanta, Jill Lawless in London, Dikky Sinn in Hong Kong, Vincente L. Panetta in Buenos Aires and Bradley S. Klapper in Geneva also contributed to this report.

 

Copyright 2009 The Associated Press.

 

WHO Declaration of Swine Flu Pandemic Looks Imminent

H1N1's Swift Spread in Australia May Meet Criteria for Full Alert, Agency Says.

 

HealthDay Reporter

By Steven Reinberg

ABC News

Wednesday, June 10, 2009

 

TUESDAY, June 9 (HealthDay News) -- A surge in cases of H1N1 swine flu in Australia may tip the balance and cause the World Health Organization to soon declare the first flu pandemic since 1968, agency officials said Tuesday.

 

Cases in Australia rose by more than 1,000 on Monday, with most occurring in the southern state of Victoria. Rapid spread of the virus in a region beyond North America has been considered a key factor in labeling the outbreak a pandemic.

 

We are getting really very close to knowing that we are in a pandemic situation," WHO influenza chief Keiji Fukuda said in Geneva.

 

He said the agency was concerned about the possible "adverse effects" of moving the alert from its current status of phase 5 to the highest level, phase 6, indicating a full pandemic, the Associated Press reported. Fukuda cited concerns over possible panic among the public or inappropriate steps taken by governments.

 

However, "on the surface of it, I think we are in phase 6," said Margaret Chan, the WHO's director-general. According to Chan, it is crucial to verify that H1N1 has become established beyond North America before a pandemic is declared.

 

She said WHO was planning a conference call Wednesday with governments to verify various reports. "Once I get indisputable evidence, I will make the announcement," she said.

 

According to the latest WHO data, there are now 25,288 reported cases of swine flu infection across 73 countries, including 139 deaths. That includes 13,217 cases and 27 deaths reported as of last Friday in the United States by officials at the U.S. Centers for Disease Control and Prevention.

 

While the vast majority of infections and deaths have occurred in Mexico (the source of the outbreak) and the United States, person-to-person transmission in now being reported in Australia and Chile, as well as Great Britain, Spain and Japan, according to published reports.

 

But Fukuda also expressed concern Tuesday about reports of unusually large numbers of severe cases among Canada's Inuit population, according to AP.

 

The vast majority of swine flu cases globally have remained mild, but some of the deaths have occurred in otherwise healthy people, the WHO noted. "Approximately half the people who have died from this H1N1 infection have previously been healthy people," Fukuda said.

 

He called that "one of the observations which has given us the most concern."

 

Since the outbreak started in April, health officials in the United States have also said that infections have been mild for the most part, and most patients recover fairly quickly. Testing has found that the H1N1 virus remains susceptible to two common antiviral drugs, Tamiflu and Relenza.

 

During the next few months, CDC scientists will be looking to see if the swine flu virus mutates or becomes resistant to antiviral medications, or is more easily spread among people.

 

U.S. health officials have said there's no way to tell now if the H1N1 virus will be more virulent when -- and if -- it returns to the Northern Hemisphere with the approach of winter.

 

A vaccine for the swine flu virus could be ready by October, if research and testing proceed on pace this summer. Candidate viruses have been shipped to vaccine manufacturers, agency officials said.

 

It's still not clear whether such a vaccine is needed. Any decision to move forward would be based on several factors, including the severity and spread of the virus and whether there's a safe and effective vaccine, the CDC has said.

 

Copyright 2009 ABC News.

 

Opinion

Big Breakthroughs for Single Payer Health Care

Less than a month after 13 single payer advocates were arrested protesting the exclusion of single payer health care, it is at the table in both Houses, making progress while the multi-payer pro-insurance reform is faltering.

 

By Kevin Zeese

Baltimore News Network Commentary

Wednesday, 10 June 2009

 

Single payer pays for itself, while multi-payer will add to the deficit.

 

When we started our campaign one month ago to put single payer national health insurance on the table, we were ignored.

 

When we stood up and demanded that single payer be part of the debate, we were arrested.

 

Today, single payer is breaking through, while the multi-payer pro-health insurance reform is faltering.

 

Here’s the news: single payer national health insurance will be at the table in the Senate, with a witness participating in a hearing on Thursday, June 11. And, on Wednesday, June 10 a hearing was being held on single payer in the House of Representatives.

 

The Senate Committee on Health, Education and Pensions has invited Margaret Flowers, M.D., of Physicians for National Health Policy to testify on June 11 at 3:00 PM in a hearing on health care reform. Flowers was one of the "Baucus 13" (I was another) who were arrested three weeks ago for protesting the exclusion of single payer from Senate Finance Committee hearings.

 

Also, on Wednesday, June 10, the Health, Employment, Labor, and Pensions Subcommittee of the House Education & Labor Committee held a hearing titled “Examining the Single Payer Health Care Option."

 

Single payer, in short, is making advances while the multi-payer pro-insurance industry reform bill is faltering. Here's why:

 

    * There are deep divisions over how to pay for the reform with the very unpopular taxing of health benefits now being considered. This was something President Obama opposed during the 2008 campaign. Paying for single payer is much easier, as the waste, fraud, abuse and bureaucracy of the health insurance industry—totaling $400 billion annually—would be applied to providing health care. Single payer pays for itself, while multi-payer will add to the deficit.

 

    * Mandating that people buy insurance or face fines—another provision President Obama opposed during the campaign—is gaining popularity among pro-insurance company legislators. And, the mandates would provide subsidies to the poor so they can purchase insurance (of course, this is also a subsidy to the health insurance industry). The working class, which cannot afford to purchase insurance, will feel the burden of this requirement. Under single payer, people are provided health care without these costs, which is one reason it is the most popular reform among voters.

 

    * The Public Insurance Option is opposed by Republicans and the insurance industry. While several schemes have been reported to make the public choice option ineffective, it is causing deep divisions. Single payer is the most popular health care reform among voters, doctors, nurses and economists because it provides all Americans with choice of doctors and providers.

 

    * The business community is questioning the pro-insurance reforms because they will include mandates on business, requiring them to pay for health insurance. At this critical time, business needs relief, not burdens. Single payer will provide businesses with economic relief by reducing the costs of health care and leveling the playing field among all businesses and allowing them to compete internationally with other countries with single payer systems.

 

In an effort to save the faltering pro-insurance reforms, President Obama announced his administration would be getting directly involved in health care negotiations with Congress. And, he has announced town hall meetings throughout the U.S.

 

President Obama will find that at all of these town hall meetings single payer will be the most popular reform among Americans. He needs to listen to voters. When Obama was in the Illinois Senate he said he supported single payer, but that before Americans got it they needed to win back the House, Senate and Presidency. Well, all three are now in Democratic Party control. It is time for President Obama to advocate for the people and push for single payer. The multi-payer system, as favored by the insurance industry, is the root cause of the problems in health care in the U.S..

 

Copyright © 2009 The Baltimore News Network. All rights reserved.

 

One Health Battle: Doctor vs. Doctor

 

New York Times Letter to the Editor

Friday, June 12, 2009

 

To the Editor:

 

Re “Doctors’ Group Opposes Public Health Insurance Plan” (news article, June 11):

 

The American Medical Association has done it again, coming out on the wrong side of history regarding health care in the United States.

 

Whether whipping up fears of “socialized medicine” or more sophisticated expressions like “government control of health care,” the A.M.A. has opposed every progressive change in health care financing, including Medicare, which we now take for granted.

 

But most doctors do not belong to the A.M.A., and the A.M.A. does not speak for many of us who believe that the United States should join all other Western countries in providing universal health care.

 

Jay V. Solnick

Davis, Calif., June 11, 2009

 

The writer, a medical doctor, is a professor in the departments of medicine and microbiology and immunology, University of California, Davis.

 

Copyright 2009 New York Times.

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