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State legislators indicated they will let the $1.4 billion State Center redevelopment in Baltimore City move forward, despite lingering concerns about the project’s finances and impact on Maryland’s ability to borrow money.

The Senate Budget and Taxation Committee voted unanimously, but with some conditions, to endorse the State Center project, which involves leasing 25 acres of land to a private development team. The House of Delegates’ Appropriations Committee indicated it will do the same but did not formally vote as its Senate counterparts did Thursday afternoon.

The project will now go to the state Board of Public Works for a scheduled June 3 vote. The board is led by Gov. Martin O’Malley, who supports the project and worked closely on it while he was mayor of Baltimore. Matthew Gallagher, the governor’s deputy chief of staff, lobbied the House and Senate on the project.

“We are at the cusp of a very important milestone,” Gallagher said. “The governor’s office is very supportive of this project and has been involved dating back to our time at the city,” Gallagher told the House during its hearing on the project.

In signing off on the proposal, the House and Senate legislators insisted on having more oversight in the redevelopment process. They also conditioned their approval on seeing input from the Maryland Stadium Authority, which is familiar with such large-scale development projects.

A private State Center LLC development team was selected in March 2006 to remake the state office complex off Martin Luther King Boulevard. As proposed, the developers would lease the land from the state, convert the complex into a $1.4 billion mixed-use development, and then lease a substantial portion of the project’s planned 2 million square feet of office space back to the state for use by its various agencies.

For the project to move forward, the Board of Public Works must approve a master development agreement setting the terms for State Center LLC. Once that happens, the developers will then design the first phase of the project and come back to the state with specific costs and lease terms. That process would continue through each of the development’s four phases, expected to take between 10 and 12 years to complete.

The first phase would focus on the project’s office space. When fully developed, the project is slated to include 1,200 residential rental and for-sale units, 2 million square feet of office space, 250,000 square feet of retail space and 7,000 parking spaces. Groundbreaking for the project’s first phase could begin in June 2010.

In the closing days of the General Assembly, some legislators in the House and Senate attempted to halt the project due to concerns they were being kept out of the planning process.

Their efforts failed, but the legislature’s budget committees passed a requirement the project be reviewed by state Treasurer Nancy Kopp.

The legislature asked Kopp to look specifically at an accounting provision of the project to determine if the state’s leasing of office space from the developers should be considered an operating lease or a capital lease.

If it were deemed a capital lease, that would mean the state would need to list it on its budget as an asset and a liability, and those costs would be added to the state’s overall debt affordability limit — its ability to borrow money to finance other capital projects.

In a May 15 report, Kopp wrote she couldn’t make a definitive determination because she didn’t have specific information about the proposed lease terms. Those terms won’t be determined until after the master development agreement is approved. But Kopp felt it should be considered a capital lease, and those costs could cause the state to exceed its debt service limits by 2018.

9 rabies cases seen in populated areas

Rabid raccoons reported in Ocean Pines, Ocean City, South Point

By Jenny Hopkinson

Salisbury Daily Times

Friday, May 29, 2009

OCEAN CITY -- The Worcester County Health Department has had nine confirmed cases of rabies in raccoons since May 1, bringing the to-date annual number to 12.

While rabid animals are nothing new in this rural county -- which averages about 100 cases each year -- what has officials worried is where these cases are being found.

"It's always here," said Janet Tull, rabies coordinator for the health department. "But our most recent cases have been in highly populated areas, so there is more of a chance that there is contact with domestic animals -- dogs and cats -- or even people."

A raccoon with the disease was found in South Point, another two in Ocean Pines and one in Ocean City. A fifth was even caught in the White Marlin Mall.

While there have been no cases reported of rabid raccoons attacking people so far this year, four dogs have had to be quarantined after skirmishes with the animals, and two more dogs -- both unvaccinated -- were euthanized.

Rabies is a virus that attacks the nervous system and is spread through contact with the saliva of an infected animal normally through bites, according to the Maryland Department of Health and Mental Hygiene. The disease in Worcester County is found most often in raccoons and foxes, although skunks, cats, bats and groundhogs -- among others -- are also known to carry rabies in Maryland.

A rabid animal can be recognized by changes in behavior -- wild animals may become more friendly, while domestic pets might become more aggressive. Infected creatures may stagger or drool and become active during unusual times of day.

The spread of rabies in wild animals is often hard to control, but people can take certain precautions to protect themselves and their pets from infection, Tull said.

"Make sure pets are vaccinated, report abnormal and aggressive behavior from rabies species -- raccoons, foxes and skunks," she said. "People need to check that their pets are current on the rabies vaccine."

Food that may attract creatures should not be left outside, and it is a bad idea to take wild animals as pets, Tull added.

If a vaccinated pet is bitten by a rabid animal, they can easily be treated with a series of booster shots by a veterinarian. The same is true if a person is infected.

Parents form social group for young adults with disabilities

Lake Linganore couple hopes group will spark friendships

By Katherine Mullen

Frederick County Gazette

Thursday, May 28, 2009

Tamar and Saul El-Or want their 19-year-old daughter to have a place where no one snickers or rolls their eyes at her because of her disabilities. They want her to have real friends who treat her as an equal.

At their Lake Linganore home last week, the El-Ors said their daughter - who has mild disabilities - was often bullied in high school, and has never had a true friend with whom she can talk or invite to their home.

"We would like her to meet other young adults where she can feel good about who she is and not to feel excluded," Saul El-Or said.

Finding no other opportunities in the community for this, the El-Ors are in the beginning stages of creating a parent-led social group for young adults with disabilities, either developmental or physical.

The response in the community has so far been encouraging, the El-Ors said, as more than 30 parents have e-mailed or called them to express interest in helping to start the group.

On May 21, the El-Ors and more than 20 parents met for the first time at the C. Burr Artz Library in Frederick to discuss organizational plans and ideas for the group.

One by one, parents spoke with emotion of their adult children's difficulty in making friends or losing the one friend they thought they had. All agreed the group is much needed.

The El-Ors hope the group will become a place where their daughter and her peers will feel comfortable to socialize, talk and engage in fun, instructor-led recreational activities based on their interests.

They are seeking a location for the group to meet every three weeks, and have yet to set another planning meeting.

Evelyn Rivera, a service coordinator for Service Coordination Inc., sees a need for such a group. Service Coordination is a private, nonprofit organization that helps adults and children with developmental disabilities access resources and services to fulfill life goals.

Part of the organization's work is to identify service gaps and try to make improvements in the system. "I think this group would fill the gap," Rivera said.

Susan Barnhill of the Mental Health Association of Frederick County also attended the first meeting and said that because young adults with disabilities are often socially isolated, "they end up going on the Internet, getting on chat rooms.

"They're at risk for being victimized because they don't know who's on the other end," Barnhill added.

If young adults without disabilities have trouble maintaining relationships after high school, "how are kids who are really challenged navigating it?" Barnhill noted.

Fundraiser to benefit Child Advocacy Center

Event to be held tonight at Perdue Stadium

By Sharahn D. Boykin

Salisbury Daily Times

Friday, May 29, 2009

SALISBURY -- While prosecutors and experts anticipate an increase in child abuse during tough economic conditions, funding for the Wicomico County Child Advocacy Center, like many nonprofits, is uncertain.

The center, made up of local law enforcement investigators, prosecutors and workers from the Department of Social Services and the Life Crisis Center, has received funding from the Wicomico County Partnership for Families and the state. However, this year state funding for the center that investigates reports of child abuse and neglect is not guaranteed. It needs $50,0000 to $60,000 to cover operations.

Members of the agency say they hope this year's fundraiser will help close the funding gap.

"Government does fund it, but government can't fund everything, especially in a county like this," said Michelle Hughes, executive director of the Life Crisis Center. "It costs money nobody has in his or her budget. These people really are keeping people's children safe."

Tonight, the center hosts its third annual Wicomico County Child Advocacy Center Night at Arthur W. Perdue Stadium. The Delmarva Shorebirds will wear special batting helmets with the CAC's colors during the game. The helmets, autographed by the players, will be added to the silent auction later in the evening.

The fundraiser also features a dunk tank before the game. For a small fee, individuals can take a shot at trying to dunk local notables such as Perdue Farms CEO Jim Perdue, First Shore Federal Savings and Loan President Marty Neat and Delegate Jim Mathias.

The CAC started as a pilot program nearly 10 years ago in response the death of 8-year-old Shamir Hudson, who was killed by his adoptive mother.

At the time, Wicomico County was reported to have the highest rate, more than double the state average, of child abuse in Maryland.

Over the years, the collaboration between agencies through the CAC led to quicker responses to reports of abuse and neglect and a spike in child abuse convictions.

"We're able to prosecute a lot of cases in Maryland that can't be prosecuted in other states," Wicomico County State's Attorney Davis Ruark said. "The mere fact that we are able to prosecute them at all and get a conviction speaks to the efficacy of the center."

Additional Facts

If you go

WHAT. Third annual Wicomico County Child Advocacy Center Night at Perdue Stadium

WHEN. Tonight at 6:05 p.m.

INFO. General admission, $6; Skybox, $40 (includes all you can eat buffet)

TICKETS. Contact the Life Crisis Center at 410-749-4357 (Credit cards accepted only at LCC); Wicomico County State's Attorney's Office; or First Shore Federal Savings and Loan -- downtown

Senior center to close Fridays

Urbana, Brunswick and Emmitsburg sites will cut back hours beginning in June to save money

By Sherry Greenfield

Frederick County Gazette

Thursday, May 28, 2009

The Frederick County Department of Aging has reached a compromise with Brunswick and Emmitsburg officials to close their towns' senior centers one day a week instead of the proposed two.

Starting next month, the Brunswick Senior Center will close on Tuesdays, but remain open Monday, Wednesday, Thursday and Friday. The Emmitsburg Senior Center will close on Mondays, but remain open Tuesday through Friday.

The Urbana Senior Center will also close on Fridays.

Rearranging hours will allow staff to serve the county's busier centers.

Frederick County commissioners unanimously approved the closings on May 21 after asking Department of Aging officials to find a way to allow the Emmitsburg and Brunswick senior centers to close one day a week instead of two.

Commissioners wanted to appease the concerns of Emmitsburg and Brunswick leaders opposed to the closings.

"We sat down and took into consideration what you [commissioners] had proposed and the various suggestions that were presented, as well as the different ways we may accomplish what we are trying to do, which is to essentially add staff to the different programs where we really need them the most right now," said Carolyn True, director of the Department of Aging. "It still gives seniors that attend the senior centers, four days a week."

Brunswick and Emmitsburg leaders appreciate the compromise.

"I think this one is a better plan, and I am supportive of it," said Emmitsburg Mayor James Hoover.

Brunswick Mayor Carroll Jones agreed. "Carolyn and I spoke yesterday [May 20], and we're in support of the compromise and in support of the recommendations," Jones said. Though the senior centers serve as a place for older residents looking for friendship, activities and lunch, the centers in Brunswick, Emmitsburg and Urbana do not attract a large number of people.

The Brunswick center brings in eight to 10 people a day, while Emmitsburg averages 14. The Urbana Senior Center has a few.

In comparison, the Frederick Senior Center averages 100-125 people a day, said Linda McGinnes, the center's coordinator.

The cost to operate the county's five senior centers varies considerably, according to True.

In fiscal 2008, the most recent year for which figures are available, it cost the county $223,916 to run the Frederick Senior Center; $132,436 for Thurmont; $118,745 for Brunswick; $113,900 for Urbana; and $99,707 for Emmitsburg.

True said attendance fluctuates, so she could not provide a breakdown of how much each center cost per person.

At the May 14 meeting, the Department of Aging proposed closing the Brunswick center on Tuesdays and Fridays, the Emmitsburg Senior Center Mondays and Thursdays, and the Urbana Senior Center every other Friday. This would allow staff to move to other more active senior centers and provided additional staff to the Meals on Wheels home delivery meal program.

But Hoover and Jones voiced their concerns over closing the senior centers for two days, saying this would be a hardship for those who use them.

Commissioners asked that a compromise be reached before they would approve any changes. They were pleased Thursday that an agreement had been reached.

"I appreciate the efforts going into this and trying to resolve some of the concerns," Commissioner Kai J. Hagen (D) said.

Board President Jan H. Gardner (D) agreed. "I do think it's a good compromise," she said. "We do appreciate the participation."

BUGGED OUT - Bug infestation at shelter leads to new policy, homeless to march on City Hall

Officials: Homeless population grows 12% to 3,400 since 2007

By Stephen Janis

InvestivgativeVoice.com

Friday, May 29, 2009

Residents of a Baltimore homeless shelter fed up with a new policy that bans them from storing their belongings at the facility during the day while they are on the streets are planning a march on City Hall Friday morning to protest the policy.

Implemented two weeks ago by city officials concerned over a bed-bug infestation at the Guilford Avenue shelter, the policy has made it difficult for the city's homeless to look for work, said Leslie Doy, 45.

“You can’t go out looking for a job with a pile of clothes in your hand,” Doy said Thursday. “It’s unsanitary, other people may get sick.”

“To carry around all your clothes to look for a job, you can’t expect people to take you seriously.”

Doy, who has been homeless for five years due to a struggle with alcoholism, said that since the policy went into effect many of the homeless residents staying at the 24-hour facility, which houses 350 people, have lost clothes, identification, and personal keepsakes.

“If we don’t take our clothes away they get thrown away,” she said.

“They tell us not to try to get our stuff from the garbage cans, they’ll call the police,” she said.

“We should be able to keep our stuff there. They want us to be productive but we can’t be productive with our bags.”

“It’s embarrassing. They [employers] are not going to hire us; they’ll say this is a bum.”

To show their displeasure, Doy said she and fellow shelter mates plan to march on City Hall to request a meeting with Mayor Sheila Dixon early Friday morning.

“We want the policy to stop; we want the mayor to understand that this policy is making our life even more difficult."

But city homeless officials countered that the “no-belongings-left-behind policy is the result of a chronic bug infestation – including bed bugs – that has become a health hazard.

“We had such a bad bug problem that we had to set off bombs and clean and delouse everything," said Diane Glauber, president of Baltimore Homeless Services, the city agency tasked with coordinating homeless programs.

“It was really something we had to do for the health and safety of the residents.”

Among the bug infestations are notorious bed bugs, Glauber said. Bed bugs are extremely difficult to eradicate, often requiring the disposal of clothes and removal of furniture.

Glauber said homeless officials were sympathetic to the residents' desire to store belongings. Thus the proposed permanent homeless shelter that the city plans to build on the 600 block of Fallsway Road, just east of downtown, would be equipped with a storage facility.

“It will have places for people to lock their things up but right now the facility on Guilford just does not have the room,” she said.

Meanwhile, Glauber said the soon-to-be-released survey of the city’s homeless population shows a 12 percent increase over two years, adding to stress on an already taxed shelter system.

“Right now we have 3,400 homeless residents in Baltimore, so there is more demand in services.”

The good news, Glauber said, was $9 million in stimulus money designated for homeless prevention and emergency housing that the city will be spending soon.

“We’re going to work on programs for court-based eviction prevention, and getting people into permanent shelter."

Still, for the homeless Doy, who wants to get a job and be reunited with her four children – ages 13-26 – the new shelter, along with Mayor Sheila Dixon’s 10-year plan to end homelessness, is slow in coming.

“In 10 years I’ll be dead; we need help now.”

Del. bill would legalize pot

Senator introduces medical marijuana legislation

The News Journal

By Ginger Gibson

Salisbury Daily Times

Friday, May 29, 2009

DOVER -- Joe Scarborough has survived HIV for 17 years, during which he has also undergone treatment for an aggressive form of cancer. Between chemotherapy and HIV medication, Scarborough was in pain and sometimes couldn't eat.

"When (HIV) medications became available in 1996, the regimes were extremely harsh and very toxic," he said, and he was one of a multitude of patients who turned to marijuana to ease the constant pain and help him stick to the strict schedule for taking his medication -- something he credits for helping him live with the disease so many years.

Scarborough shared his story Wednesday as he stood beside Sen. Margaret Rose Henry as she introduced legislation she said is necessary to improve the quality of life for people suffering long-term health problems and chronic pain. Henry wants Delaware to become the 14th state to legalize marijuana for medicinal purposes.

Under Senate Bill 94, residents would be allowed to have up to 6 ounces of marijuana, considered a month's supply, Henry said, and would be issued identification cards to prevent them from being prosecuted for having that amount or less. The state would also license centers to grow and sell marijuana to be sold for medicinal purposes.

Nationwide, efforts like Henry's got a boost last week when the U.S. Supreme Court refused to hear a challenge to California's medical marijuana law, allowing the law to stand and the sale of medical marijuana to continue.

Henry said her proposal would not decriminalize marijuana or prevent people who sell or purchase it illegally from being prosecuted.

"The bill calls for setting up compassion centers or centers with the right to grow marijuana," Henry said. "You would not be able to go on the street corner and buy. We're not talking about heroin or the drugs we see on street corners."

The legislation is co-sponsored by Rep. Hazel Plant, D-Wilmington North, and also lists Sens. Karen Peterson, D-Stanton, Robert Venables, D-Laurel, and Liane Sorenson, R-Hockessin.

Joe Rogalsky, spokesman for Gov. Jack Markell, said the governor is still studying the issue of legalizing medical marijuana and does not yet have a position on the bill.

Maryland pollutes more than 150 countries

Greenpeace report highlights individual states' contribution to global warming

By Meredith Cohn

Baltimore Sun

Friday, May 29, 2009

Maryland emitted more cumulative global warming pollution between 1960 and 2005 than more than 150 other nations surveyed, according to a report released this week by Greenpeace. And that makes it one of the least-polluting states on a per-person basis.

The United States has long been considered the chief emitter, but months ahead of a global forum on the subject, the environmental organization was seeking to underscore the level by compiling Department of Energy statistics for individual states and comparing them with World Resource Institute data from 184 other countries.

Sixteen states emitted fewer gases per person than Maryland, Greenpeace's report shows. Vermont, Oregon and Idaho had the lowest contributions. Wyoming, West Virginia and North Dakota contributed the most per person.

Tracy Wax, Maryland field organizer for Greenpeace, said the group was trying to drum up attention ahead of the United Nations Climate Change Conference in Copenhagen in December. "If the United States won't take the lead, then why would China or India do anything?" she said during a news conference at the Herring Run Watershed Center on Belair Road, a newly certified "green" building by the U.S. Green Building Council.

Wax said the effects in Maryland already can be seen: Rising sea levels consume at least 260 acres of coastal land each year. She said Maryland's legislature and Gov. Martin O'Malley have taken steps to reduce emission in the state from cars and other sources, though the effects can't yet be determined. She urged Congress to follow suit.

Groups threaten to sue over Sparrows Point cleanup

Bay foundation, harbor organization see violations to '97 agreement

By Timothy B. Wheeler

Baltimore Sun

Friday, May 29, 2009

A pair of environmental groups is threatening to sue state and federal environmental agencies as well as the present and former owners of the Sparrows Point steel mill complex, accusing them of failing to clean up pollution of the industrial site and of the surrounding community, as they promised to do 12 years ago.

The Chesapeake Bay Foundation and Baltimore Harbor Waterkeeper contend that toxic waste from the steel-making complex is contaminating the soil and groundwater beneath the 3,100-acre peninsula and that cancer-causing metals and chemicals are seeping into Bear Creek and the Patapsco River, in violation of environmental laws and of the cleanup agreement signed in 1997. They also contend that the manufacturer is discharging harmful pollution directly into the water from its waste treatment plant and potentially endangering surrounding residents by releasing gritty particles into the air.

The groups say the pollution poses potential health risks for residents who live near the plant and who fish and crab in the waters around it. They say their concerns are heightened by a Virginia company's proposal to build a liquefied natural gas terminal on a portion of the old steel-making complex, which would require dredging contaminated sediments from the waters around it.

"We are concerned that there are clear impacts to the ecosystem," said Eliza Smith Steinmeier, director of the Baltimore Harbor Waterkeeper organization. "If you pull up a sample from the bottom of the river around the [Sparrows Point] peninsula, you will get a black, sludgelike substance that smells like petroleum." While she said she doesn't know what the bottom sediments contain, Steinmeier said she's sure that "it's something I would not want to crab out of."

The groups have scheduled a news conference today near the steel mill at Turner Station Park, where local residents often fish and crab, to detail their concerns. If the problems the groups list aren't resolved in 90 days, they say, they intend to ask a U.S. District Court judge to enforce the consent decree and fine the steel company for violations of pollution laws.

The environmental groups' action comes as some area residents are also organizing to file a class action lawsuit over pollution from the complex. They have long complained about pollution from the steel mill that has occupied Sparrows Point for more than a century, contending it has fouled the air, their yards and the waterways where they boat and fish. In the 1990s, the state Department of the Environment and the Environmental Protection Agency sued Bethlehem Steel Corp., then the mill's owner, and reached an agreement in 1997 to clean up contaminated soil and ground water.

The bay foundation and harbor group contend that although some cleanup has occurred, much of what was promised in the 1997 agreement has not been done. Bethlehem Steel went bankrupt in 2003, and since then the mill has changed hands repeatedly. Severstal North America Inc. acquired the facility last year.

Though Severstal is legally obligated to abide by the cleanup agreement, the groups contend that groundwater tainted with toxic metals, petroleum byproducts and solvents is seeping into Bear Creek and the Patapsco. Landfills containing hazardous wastes have been illegally expanded, they complain, and nothing has been done to stop rainfall from washing off the tainted site into the river. They also contend that the facility has been pumping high levels of chromium, zinc and other pollutants into the water, repeatedly violating its wastewater discharge permit.

Representatives for state and federal environmental agencies say that they have been overseeing cleanup of the Sparrows Point complex and that the new owner is continuing to do what's required. Dawn Stoltzfus, spokeswoman for MDE, said the state is seeking to update the cleanup agreement to set more specific deadlines for action and to improve communication with the surrounding residents, but the recent ownership turnover has complicated negotiations.

"The facts are that Severstal has been in compliance with the Consent Order, and there are no immediate public health threats," Stoltzfus said in an e-mail.

Bette Kovach, spokeswoman for Severstal, said company officials have not been notified of any legal action and would not comment until they had received it.

National / International

New Approach May Outflank AIDS Virus

Associated Press Science Writer

By Randolph E. Schmid

Baltimore Afro-American

Monday, May 18, 2009

(May 18, 2009) - WASHINGTON (AP) – Like a general whose direct attacks aren't working, scientists are now trying to outflank the HIV/AIDS virus.

Unsuccessful at developing vaccines that cause the body's natural immune system to battle the virus, researchers are testing inserting a gene into the muscle that can cause it to produce protective antibodies against HIV.

The new method worked in mice and now has proved successful in monkeys, too, they reported Sunday in the online edition of the journal Nature Medicine. The team is led by Dr. Philip R. Johnson of the Children's Hospital of Philadelphia.

That doesn't mean an AIDS vaccine for people is in the wings, Johnson said. Years of work may lie ahead before a product is ready for human use.

Nevertheless, the report was welcomed by Dr. Beatrice Hahn, an AIDS researcher the University of Alabama at Birmingham, who was not part of Johnson's team. "It basically shows there is light at the end of the tunnel,'' she said in a telephone interview.

"It shows thinking outside the box is a good idea and can yield results, and we need perhaps more of these nonconventional approaches,'' she added.

According to the International AIDS Vaccine Initiative, AIDS is one of the most devastating pandemics. More than 20 million people have died so far and about 33 million are living with HIV. The Center for Disease Control and Prevention last year estimated there are about 56,000 new HIV infections annually in the United States.

Most efforts at blocking AIDS have sought to stimulate the body's immune system to produce antibodies that fight the disease. This model has worked for diseases such as measles and smallpox. It hasn't done as well with HIV/AIDS; test vaccines have failed to produce a protective reaction.

So Johnson decided to try something different.

"We used a leapfrog strategy, bypassing the natural immune system response that was the target of all previous HIV and SIV vaccine candidates,'' Johnson said. HIV, or human immunodeficiency virus, causes AIDS in people. The closely related simian virus, or SIV, affects monkeys.

"Some years ago I came to the conclusion that HIV was different from other viruses for which we were trying to develop vaccines and we and might not ever be able to use traditional approaches,'' Johnson said in a telephone interview.

He said the researchers knew there were proteins that could neutralize the HIV virus, so they began thinking about whether they could use them to fight the disease.

In a decade-long effort, Johnson, K. Reed Clark of Nationwide Children's Hospital in Columbus, Ohio, and their team developed immunoadhesins, antibody-like proteins designed to attach to SIV and block it from infecting cells.

Then they needed a way to get the immunoadhesins into the cells.

The researchers selected the widely used adeno-associated virus as the carrier because it is an effective way to insert DNA into the cells of monkeys or humans. That virus was injected into muscles, where it carried the DNA of the immunoadhesins. The muscles then began producing the protective proteins.

Scientists first tested the idea in mice and then turned to monkeys because SIV is closely related to HIV and would be a good test model.

A month after administering the AAV, the nine treated monkeys were injected with SIV, as were six not treated in advance.

None of the immunized monkeys developed AIDS and only three showed any indication of SIV infection. Even a year later they had high concentrations of the protective antibodies in the blood.

All six unimmunized monkeys became infected; four died during the experiment.

The next step is moving toward human trials, Johnson said. He said he is working with the International AIDS Vaccine Initiative in hopes of getting tests in humans under way in the next few years.

The research was supported by the National Institute of Allergy and Infectious Diseases.

Eco-friendly shopping bags: Are they making you sick?

Canadian plastics group labels reusable shopping bags as a health risk

Tribune reporter

By Julie Deardorff

Baltimore Sun

Thursday, May 28, 2009

Your eco-friendly shopping bag could be making you sick, a study says. But before you switch back to plastic, you might want to consider the source.

An alarming 15-page paper, published on the Web site for Canada's Environment and Plastics Industry Council, concluded that reusable grocery bags are "a breeding ground for bacteria and pose a public health risk" because of high counts of yeast, molds and bacteria.

The potential hazards include "food poisoning ... bacterial boils, allergic reactions, triggering of asthma attacks, and ear infections," according to the paper. Plastic shopping bags, on the other hand, may be bad for the environment, but they're "more hygienic than reusables," EPIC said.

Droplets leaking from bloody meat can, indeed, transfer from one surface to another. And folded bags can create a moist environment that helps bacteria grow.

But if you start worrying about getting an ear infection from your shopping bag, you're being paranoid, said Harley Rotbart, a professor of microbiology and pediatric infectious diseases at the University of Colorado School of Medicine. He called the study "a classic middle-school science fair experiment where swabs are taken to random surfaces and, shockingly, germs are found on those surfaces."

The bottom line: "Germs are everywhere, and under certain circumstances, germs on surfaces can cause human infections," Rotbart said. "Common sense has to prevail. Disgusting reusable bags should be washed in hot water [and bleach]."

Don't forget to wash your hands.

'Tell somebody,' if you're thinking of suicide, says general

By Tom Watkins

CNN.com

Friday, May 29, 2009

FORT CAMPBELL, Kentucky (CNN) -- The 101st Airborne's senior commander in effect ordered his soldiers Wednesday not to commit suicide, a plea that came after 11 suicides since January 1, two of them in the past week.

"If you don't remember anything else I say in the next five or 10 minutes, remember this -- suicidal behavior in the 101st on Fort Campbell is bad," Brig. Gen. Stephen J. Townsend told his forces. "It's bad for soldiers, it's bad for families, bad for your units, bad for this division and our army and our country and it's got to stop now. Suicides on Fort Campbell have to stop now."

Fort Campbell's suicide rate, the highest in the Army, "is not a good statistic," he said in remarks to one of four divisions he addressed during the day.

After nearly one soldier per week committed suicide at the post between January and mid-March, the Army instituted a suicide prevention program that "seemed to be having good effects" until last week, when two more suicides occurred, he said.

"Suicide is a permanent solution to what is only a temporary problem," Townsend said. "Screaming Eagles don't quit. No matter how bad your problem seems today, trust me, it's not the end of the world. It will be better tomorrow. Don't take away your tomorrow."

He urged anyone feeling hopeless or suicidal to "tell somebody."

"You wouldn't hesitate to seek medical attention for a physical injury or wound; don't hesitate to seek medical attention for a psychological injury."

Townsend exhorted any soldier who suspects that a fellow soldier may be feeling suicidal to act -- first by asking how the soldier feels, then by escorting him or her to help.

"Do not wait," he said.

Soldiers can turn to their leaders, chaplains, medics, social workers, teammates, family and friends, he said.

"Don't let yourself, your buddies or your families down," he said, ending his comments by repeating, "This has got to stop, soldiers. It's got to stop now. Have a great week."

But Townsend's message -- called a Second Suicide Stand-Down event -- is likely to be ineffective, said Dr. Mark Kaplan, a professor of community health at Portland State University in Oregon, who has researched veterans' suicide and served last year on a Veterans Administration blue-ribbon panel on suicide risk.

"It sounds like an order," he told CNN in a telephone interview. "I'm not sure that a command like this is going to alter the course of somebody who is on a trajectory of self-harm."

He suggested the Army might want to adopt the U.S. Department of Veterans Affairs model.

"They're dealing with a comparable problem with a similar population," Kaplan said. "They have infused more sensitivity to their approach to suicide prevention as opposed to this. This is like any other order."

The military culture attaches a stigma to mental illness that needs to be reduced, he said. Soldiers who acknowledge they are considering suicide can suffer severe repercussions, such as losing opportunities for promotion and access to firearms, he said.

If the Army is serious about addressing the problem, it needs to address the stressors common to soldiers, including financial problems, marital problems, frequency of deployments, length of deployments, deployments to hostile environments, exposure to extreme stress and service-related injuries, he said.

The role of alcohol too must be addressed if the rate of suicide is to be lowered, he said. "More often than not, these are individuals who'll get liquored up, so to speak, and have access to a gun and die from a self-inflicted gunshot wound," Kaplan said.

Bill Lichtenstein, who serves on the board of the Rosalynn Carter Fellowships for Mental Health Journalism, the advisory council of the Center for the Advancement of Children's Mental Health at Columbia University, and on the advisory board of Families for Depression Awareness, was equally unimpressed with Townsend's tack.

"It's the equivalent of 'Just Say No' to prevent drug abuse,' " he told CNN in a telephone interview.

Screening techniques that involve a series of questions are available to identify people at risk for suicide, he said.

"Prominent among them, if not the most important question is: Have you made a plan for suicide? Using a simple battery of questions, you can suss out people who might be at risk, which is far more important than telling somebody, 'Don't take your life,' " Lichtenstein said.

The problem is not limited to Fort Campbell. The Army has reported 64 potential active-duty suicides this year; 35 have been confirmed as suicides, and 29 are pending determination of manner of death.

2008 Cable News Network.

FDA Group Issues Cautions on Acetaminophen Overdose

Commonly Used Pain Drug Poses Serious Danger in Certain Cases, FDA Says

By Dan Childs and Lauren Cox

ABC News Medical Unit

Friday, May 28, 2009

When Antonio Benedi of Springfield, Va., felt a case of the flu coming on one weekend in February 1993, he did what millions of others do -- he reached for a common over-the-counter pain medication.

"I was taking Tylenol like I was supposed to, by the label," he said.

A few days later the then 37-year-old Benedi was in a coma and in desperate need of a liver transplant.

Benedi, like hundreds of Americans each year, experienced acute liver failure as a result of taking acetaminophen, the most commonly used painkiller in the country today. Many of these cases are due to either intentional or unintentional overdose. Past research also suggests that combining the medication with alcoholic beverages increases the risk of liver damage.

But Benedi, who was formerly a special assistant to President George H.W. Bush, said that while he did take the medicine on a mostly empty stomach, he neither overdosed on acetaminophen, nor had an alcoholic beverage while he was taking the drug. He said he did occasionally enjoy a glass of wine, but never while taking acetaminophen.

"It's not the mixing of the two; I never misused anything," he said. "I took Tylenol as recommended for three days. By Monday night, my liver was failing. By the time I reached the hospital I was near death."

Today, Benedi, now 53, is still living with the transplanted liver he received 16 years ago. Three years ago he required a kidney transplant as well -- a result of the damage that his organs sustained from the anti-rejection drugs he had to take after his liver transplant. And now this transplanted kidney may be failing as well.

On Wednesday, a U.S. Food and Drug Administration working group released a report urging stronger warnings and stricter dose limits for drugs that, like Tylenol, contain acetaminophen -- and hence may pose an increased risk of liver injury to those who use them improperly.

Among other things, the recommendations call for moving the maximum adult daily dose for acetaminophen to no more than 3,250 milligrams from the current max of 4,000 milligrams per day. The recommendations would also limit the strength of immediate release versions of the drug and place greater controls on the use of acetaminophen in liquid formulations for children.

Limit Doses of Tylenol or Acetaminophen

McNeil Consumer Healthcare, a Johnson & Johnson subsidiary and the manufacturer of Tylenol, said in a statement Thursday that they fear the recommendations could have the effect of steering consumers away from an appropriate and safe drug.

"While we share the FDA's mutual goal of preventing and decreasing the misuse and overdose of acetaminophen, we have concerns that some of the FDA recommendations could discourage appropriate use and are not necessary to addressing the root causes of acetaminophen overdose," the statement reads.

Still, emergency room doctors are no strangers to acetaminophen overdoses. Dr. Richard O'Brien, a spokesman for the Dallas-headquartered American College of Emergency Physicians, said that such cases are very common is his emergency department -- and not all are intentional overdoses in which patients have tried to commit suicide.

"I do see an occasional overdose where people don't read the label of multiple products," he said. "The combination products where they're taking the equivalent of three times the dose, multiple times a day... acetaminophen is a liver toxin, and I have seen people die of liver failure from it."

Liver transplant specialists agreed. "People are frequently pushing the toxic dose limits by taking too much directly and by unknowingly consuming in other products in parallel," noted Dr. Dan Salomon, transplant biologist at the Scripps Research Institute in La Jolla, Calif.

Dr. Jeffrey Punch, chief of the Division of Transplantation at the University of Michigan Transplant Center in Ann Arbor, Mich., said he has seen patients in need of a liver after problems linked to acetaminophen, "especially patients that take over-the-counter acetaminophen as well as a narcotic drug like Vicodin that also includes large amounts of acetaminophen.

"It is made worse if they take too much acetaminophen along with alcohol and/or while fasting," he added.

Lingering Concerns Over Acetaminophen Overdose

The report is not the first time that concerns over the potential for acetaminophen overdose have surfaced. In 2002, Dr. Peter Lurie of the consumer advocacy group Public Citizen appeared before the FDA's Nonprescription Drugs Advisory Committee to relay concerns about unintentional overdoses associated with acetaminophen. In November 2005, a study in the journal Hepatology found that the majority of acute liver failure cases in the U.S. were due to acetaminophen poisoning. And more recent research has suggested that these cases may be on the rise.

Worse, O'Brien said, is that because many who take the medicine are already sick, they could be experiencing the side effects of acetaminophen poisoning without knowing it.

"That's the problem because some of the symptoms are like the flu: nausea, vomiting, and abdominal pain," he said. "It's usually fatal over a day or two."

But Punch said that even the new recommendations may not have a great impact on public health.

"I support the measures, but I don't think the change in maximum dosage will have much effect," he said.

Protecting Yourself From Acetaminophen Overdose

Punch said that if there is a take-home message for consumers, it would be the importance of paying attention to dosage recommendations for acetaminophen.

"It is found in cold medicines, in prescription pain relievers, and in [over-the-counter] pain relievers," he said. "People think that OTC drugs are benign, but they can be just as dangerous as prescription drugs if not taken correctly."

As for Benedi, a jury later found in his favor in an $8 million decision against Johnson & Johnson.

"I went through hell, and so did my family, watching me almost die," he said. "People should really be aware of the dangers of taking Tylenol when not eating properly and if they are used to having a beer or two over the weekends."

The Associated Press contributed to this report.

'Pulling Out' Method Gets New Respect

Study Says Withdrawal is 'Better Than Nothing,' But Women React in 'Sheer Disbelief'

By Susan Donaldson James

ABC News

Friday, May 28, 2009

When sex researcher Rachel K. Jones published a report that suggests the much-maligned withdrawal method of birth control was nearly as effective as condoms in preventing pregnancy, she was showered with criticism.

And it wasn't evangelicals who had taken virginity pledges who pulled out the big guns.

Those whom Jones said could benefit from this information -- couples in monogamous relationships who are not at risk for sexually transmitted diseases -- reacted in "sheer disbelief," she said.

"I don't know anybody who does the 'pull out' method, as we call it," said Lizzy Holmgren, a 23-year-old graduate student from Denver who has been a monogamous relationship for more than two years. "Most of us have had enough sex education courses to know that doesn't work very well."

The act of withdrawal -- the male pulling out before ejaculation -- is a long controversial method of birth control, one many sex education classes have condemned as risky.

But Jones' findings, based on several studies and data from the Guttmacher Institute , a nonprofit organization focused on sexual and reproductive health where she is a senior research associate, were just the opposite.

Her studies found that in perfect use -- meaning the man pulls out every time -- withdrawal has a 4 percent failure rate, as compared to condoms, which have a 2 percent failure rate.

"But nobody's perfect," said Jones, who published her commentary in the June issue of Contraception magazine.

In typical use, when used consistently and correctly, coitus interruptus and condoms have an 18 and 17 percent failure rate, respectively.

"Although withdrawal may not be as effective as some contraceptive methods, it is substantially more effective than nothing," said the report. "It is also convenient, requires no prior planning and there is no cost involved."

Jones noted that one persistent myth often cited as a drawback to withdrawal -- that there is mobile sperm in pre-ejaculate -- is actually contradicted by two studies cited by the National Institutes of Health.

"In two small studies there is no sperm in the fluid," she said. "If the guy has had sex in the last couple of hours is the only way it gets in pre-cum. But if you go to the bathroom, it flushes the sperm out."

"Withdrawal gets a bad rap," according to Jones, who urges sex educators and health professionals to discuss the method when teaching about birth control.

Withdrawal Rivals Condoms

Her research set off fireworks in the blogosphere as both women and men assailed the withdrawal method as "reproductive roulette."

On Jezebel.com, which reports on celebrity, sex and fashion for women, a blog on the study had nearly 14,000 pages views and 337 comments, out-performing its popular column, "Slutty Feminists."

"Yeah," wrote Macloserboy. "The very fact I'm even writing this is proof it doesn't work. Thanks dad, for sharing that piece of information in a drunken, bonding moment 30 years ago."

"Should we start dropping off products of failed withdrawal techniques at the local ATM?" asked fireflyinjuly.

"A co-worker of mine refers to this as the 'pull and pray' method," wrote one commenter, saintbernadette.

Even sex educators like Dr. Judy Kuriansky from Columbia University's Teachers College said that "very little could be worse."

"Teens will misuse the data and boys will use it as an excuse not to wear condoms," she told ABCNews.com. "It is also not good for monogamous couples, especially those who are religious and against abortion, who may have more unplanned pregnancies."

Jones, surprised by the thrust of her critics, responded with a letter she hoped would be widely published.

"I've grown used to promoters of abstinence only-until-marriage programs dismissing the effectiveness of contraception," said Jones. "However, I'm surprised to see such disparagement of withdrawal among a crowd that is presumably younger, more diverse and open-minded."

"Perhaps because most of us have been told for so long that withdrawal doesn't work, we are unable to embrace scientific evidence that counters what we 'know,'" said Jones.

IUD and Hormones Most Effective

Despite the explosive reaction, statistics suggest that most women have used withdrawal.

According to the 2002 National Survey of Family Growth, 56 percent of all sexually experienced women rely on withdrawal at some time during their lives. About 82 percent have used the pill and 90 percent a condom.

The Women's Well-Being and Sexuality Study found that 21 percent of younger and more educated women were using withdrawal.

Dr. Melissa Gilliam, chief of family planning and contraceptive research at the University of Chicago, worries that sexually active teens might get confusing messages if withdrawal were promoted as an option.

"It clearly has a high failure rate," she told ABCNews.com. "It should only be used as a stop-gap measure or as emergency protection."

Jones notes that hormones and the IUD (intra-uterine device) are the most effective forms of birth control. But many women can't use these longer lasting methods, and many can't afford them.

Birth control pills are typically not covered by health insurance plans and can cost $20 to $50 a month. An IUD, which lasts for up to a decade, can cost several hundred dollars for insertion at a doctor's office.

Teens Need Sex Information

"My practice is in pediatric adolescence, and I prescribe at lot of birth control for medical and contraceptive reasons," said Gilliam, who sits on the board of the Guttmacher Institute. "But even with highly effective methods there are a lot of issues of adherence. The more complex the message the more confusing it's bound to be."

She recommends "belts and suspenders" or "double Dutch," meaning both a highly effective method like pills, an IUD, injections or implants, as well as condoms to protect from infections.

An estimated 25 percent of all teens have a sexually transmitted infection, according to the CDC.

"When you are dealing with those numbers and pregnancy, it's very different message than for monogamous older couples who already have lower rates of fertility," Gilliam said.

Jones agreed teens need comprehensive information on sex.

"Anecdotally, some are using [withdrawal], and we needed to know how effective it is or not," she said. "In certain situations, it's most effective."

"If you can't take hormones, it's better than nothing," Jones said. "It's a back-up method if you forget to take pills or there are no condoms around."

Men Can't Be Trusted to Pull Out

Many women say that a birth control method that relies on the will-power of a man is doomed to fail, a problem that could be particularly evident with teens.

Heather Corinna, the founder of ScarletTeen, a Web site that discusses "sex education for the real world," said younger men have "less awareness and control" over ejaculation.

"And if we're being really forthright, we also can safely say [withdrawal] is probably the most-sabotaged method by male partners," Corinna told Salon.com.

"In other words, it's the one male partners will most often agree to, then not comply with, either by talking a female partner into just letting them ejaculate, or by saying they did so on accident when it wasn't at all accidental," she said.

But Jones suggested it wasn't fair to say that men can't be counted on to act responsibly.

"Most interesting is the response that many men can't be trusted in the heat of the moment," she said. "Sometimes it seems men can't win for losing when it comes to sexual and reproductive health. We argue that contraceptive is a couples' issue, that women should not be solely responsible, yet we don't think men can handle the responsibility."

Sex Educators Use Scare Tactics

Megan Carpentier, who wrote the Jezebel blog, "Can We Stop Shaming Women Who Practice Withdrawal Now?" argued that although the method may not work for every couple, her reader reaction illustrates the "real lack of knowledge" women have about their bodies.

"We are told only that every 28 days you bleed and you could be fertile at any time," she said. "It's a scare tactic."

"Every method requires knowledge and responsibility," said Carpentier. "Most women aren't given enough information and are scared of their bodies."

The Guttmacher report, she said, lifted the stigma that surrounded a couple's choice to use withdrawal.

"There aren't only three methods to have responsible sex," said Carpentier.

One of her readers, EvieB agreed.

Unemployed without insurance, she said she'd had "horrible experiences" with hormones and condoms.

"The withdrawal method has worked very well for me, and I'm glad to see that there is research being done to show that it's not as ineffective as people might think," said EvieB. "And maybe now I won't be seen as completely responsible for using it."

State health plans offer lessons for Congress

A look at low-cost insurance coverage in Tennessee and Massachusetts

Associated Press

MSNBC.com

Friday, May 29, 2009

Laid off from her job in Massachusetts, Danielle Marks thought immediately about losing her health insurance. How could she afford the medication and physical therapy she needed to heal after shoulder surgery?

Valerie Nash, laid off in Tennessee, thought about her diabetes. Could she stock up enough test strips and insulin before her coverage expired?

The two women, both briefly uninsured, got covered again thanks to their home states' 3-year-old experiments in expanding health insurance coverage. And while both are mostly pleased with the coverage and low cost of their new state-backed plans, their futures hold plenty of doubt.

Congressional lawmakers can look north to Massachusetts and south to Tennessee for guidance as they craft a national plan to restrain costs and cover the nation's estimated 50 million uninsured.

In Massachusetts, nearly every resident has health insurance, but doctors are turning away new patients, costs to the state are climbing and thousands have paid tax penalties for being uninsured. In Tennessee, that state's much smaller program hasn't cramped the budget, but few people are buying the new insurance even though premiums are as cheap as a monthly cell phone bill.

"The belief that we should all have health insurance coverage is broadly held," said Alan Weil of the nonpartisan National Academy for State Health Policy. "But there are tremendous differences around the country in beliefs on how to achieve that goal."

Pared-down benefits

A Massachusetts-style requirement for individuals to obtain health insurance is likely to emerge as part of the health overhaul taking shape in Congress, although details remain unsettled. A variation of Tennessee's practice of charging higher premiums to smokers and those who are overweight also may emerge; some in Congress are discussing a lifestyle tax on alcohol and sugar-sweetened drinks to help finance the national plan.

In Plymouth, Mass., Marks and her husband, Tad, now pay just $78 a month for state-subsidized insurance that covers doctor visits, prescriptions and hospital stays. Because she's pregnant, Marks, who worked as an administrative assistant until her layoff, pays nothing for her checkups, medicine and vitamins.

But pared-down benefits may lie ahead in Massachusetts because throngs of the newly insured swelled costs of Commonwealth Care to $628 million last year.

And the demand for care is outstripping the number of doctors. One in five Massachusetts adults said a doctor's office or clinic told them they weren't taking new patients with their type of insurance, or they weren't accepting new patients at all, according to a new study published Thursday in the journal Health Affairs.

Massachusetts chose to cover virtually everyone. It set high standards for minimum health insurance and decided to deal with costs later. Soon a state commission expects to call for fundamental changes in the way doctors and hospitals are paid, a plan that amounts to putting them on a financial diet.

"Once you start down the moral path to universal coverage, you inevitably confront costs," said Jon Kingsdale, who directs the board that oversees the state's plan. He and others said Congress can learn the Massachusetts way: coverage first, then cost control.

"If you get everybody covered first, it's easier to deal with costs," Kingsdale said. "If you're going to hold the uninsured hostage to containing costs, you have more than doubled the height to get up this hill."

Tennessee, on the other hand, chose to get just a few more people bare-bones insurance at a budget price with limits on how much plans would pay for hospital stays.

‘Baby steps’ with coverage

In Chattanooga, Tenn., Nash, who had worked at a car dealership, and her husband, Larry, now pay $193 a month for their state-subsidized coverage, called CoverTN. Their doctor visits and generic drugs are covered, but the plan pays only $10,000 a year on hospital bills. A serious medical crisis could bankrupt them.

"My husband and I barely squeak by as it is now," Valerie Nash said. "It would be a devastating blow."

Compared to Massachusetts, Tennessee is similar in population size, but has more uninsured adults of working age and higher rates of diabetes, childhood obesity, low birth weight and smoking.

What set the stage for Tennessee's go-slow approach was the state's history with expanding health insurance during the 1990s, said Gov. Phil Bredesen.

A state program built around Medicaid, called TennCare, "got totally out of control. It was growing at 15 percent a year. Tennessee had the most expensive Medicaid program in the country," Bredesen said. "Our experience with trying to do universal coverage ended up being a disaster."

When Bredesen took office in 2003, he inherited soaring state health care spending. In 2005, he cut 170,000 adults from TennCare. He reduced benefits for thousands more.

His new initiative, CoverTN, takes "baby steps" toward covering more people. It targets workers at small businesses, the self-employed and the recently unemployed. The cost of monthly premiums is shared by the state, the individual and employers. No one is forced to participate.

Bredesen said the plan design reflects what uninsured Tennesseans want - primary care, not catastrophic care - in a trimmed-down package. Only eight people have exceeded the annual maximum for inpatient hospital costs since the program began.

"This is not the insurance for someone who's going to get into a motorcycle accident," Bredesen said.

The program costs less than anticipated and a fraction of Massachusetts' cost - $10.9 million last year, in part because only about 19,000 have signed up so far.

"I've dreamed about 100,000," Bredesen said. "I'm always amazed, however, when you actually charge someone for health insurance, how many fewer people are willing to sign up for it, than are willing to demand affordable health care."

Mostly it's the "young invincibles" who are staying away. Those are young adults who "don't feel like they're going to get sick," said Laurie Lee, who directs CoverTN and other state health benefits programs. "We've been surprised by that," she said. Older people with chronic conditions are signing up.

Massachusetts officials boast of adding 432,000 to the insured population; 187,000 of those got insurance through their employers or individual purchase. A state survey last year found fewer than 4 percent of working age adults remained uninsured.

Tennessee's uninsured rate for working-age adults probably is not much lower than it was before CoverTN, roughly 20 percent. New census data on the uninsured comes out later this year.

"We learn from Massachusetts that a bold objective matters. If it can be sustained, that's terrific," said Weil, who's lived in both states and said the plans reflect the states' different political cultures. "It would be nice if you had a southern state that had achieved universal coverage and did it in a different way, but we don't have that."

Massachusetts

Population: 6.5 million

Law signed: April 2006

Additional people covered: 432,000.

Cost to state: $628 million in fiscal year 2008, about 42 percent of that reimbursed by the federal government.

How it works: Uninsured adults must pay tax penalties if the state says they can afford insurance. Employers with more than 10 workers must offer insurance or pay penalties of $295 per worker.

Strengths: High standards for what qualifies as minimum health insurance coverage. Low-income residents now more likely to get preventive care. Employers still offer benefits, haven't been "crowded out" by the state-subsidized plan.

Weaknesses: Rising health care costs may force future cuts to benefits. One in five adults say they were told by a doctor's office no new patients being accepted.

Advice for Congress: "Insurance is a grudge buy. Nobody goes down to the brokers on Saturday to see how fast this baby will go from zero to 60 and smell the new leather." — Jon Kingsdale, executive director, Commonwealth Health Insurance Connector Authority, Massachusetts.

Tennessee

Population: 6.2 million

Law signed: June 2006

Additional people covered: 19,000

Cost to state: $10.9 million in fiscal year 2008. No federal dollars.

How it works: Plan targets workers at small businesses, the self-employed and recently unemployed adults. The cost of monthly premiums is shared by the state, the individual and employers.

Strengths: No one is forced to participate. People who want coverage get the basics like doctor visits, prescriptions and lab tests at affordable rates.

Weaknesses: Covers only generic drugs, except for brand-name insulin. Annual limits on inpatient hospital visits leave people vulnerable to high bills when they most need help. Hospitals potentially lose money when people in plan hit annual maximums.

Advice for Congress: "There's nothing wrong with crossing the river a stone at a time. You don't have to make a flying leap for the far bank." — Gov. Phil Bredesen of Tennessee.

The Many Hidden Costs of High-Deductible Health Insurance

Patient Money

By Walecia Konrad

New York Times

Friday, May 29, 2009

Is your medical insurance bad for your health? If you have a high-deductible plan, the answer may be yes.

The investment firm Fidelity recently surveyed employees at various companies who had opted for a high-deductible health plan linked to a health savings account. About half of those workers said they or a family member had chosen not to seek medical care for minor ailments as many as four times in the last year to avoid paying the out-of-pocket expenses.

As any doctor will tell you, small health problems left untreated can become big problems, warns Kathleen Stoll, director of health policy at the health care advocacy group Families USA. “This is just one of the many high-deductible pitfalls consumers need to watch out for,” Ms. Stoll said.

High-deductible health plans are essentially insurance policies that charge lower monthly premiums than traditional plans because the consumer is responsible for paying the first $1,000 to $5,000 or more in medical bills before the insurance kicks in. The plans, sometimes called catastrophic insurance, are often used in conjunction with a health savings account.

With these accounts, earnings on savings are allowed to accumulate tax free and roll over year to year, as long as the money is ultimately used to pay for medical expenses. To qualify for one of these tax-sheltered savings accounts, an insurance plan must have a deductible of at least $2,300 for families and $1,150 for individuals.

A person can put up to $3,000 annually in these accounts, or $5,950 for a family.

People who can best take advantage of this tax break are those who can afford to contribute the maximum but do not spend it all on health care. The idea is that the money accumulates over the years, providing a cushion down the road when health problems or the need for long-term care arise.

To encourage employees to choose a high-deductible option, many employers put money into employees’ accounts or match part of the workers’ contributions. High deductibles, though, can pose problems for people who cannot afford the out-of-pocket costs associated with the plans. For a low-income family earning $25,000 a year, for example, the out-of-pocket costs of a high-deductible plan would eat up an estimated 15 percent of the annual household budget, according to a Kaiser Family Foundation report.

What’s more, low-income families don’t benefit from the tax breaks associated with health savings accounts the way middle- and high-income earners do.

Even if you can afford the costs, the loopholes that insurers often weave into these plans to reduce premiums can mean that even after your deductible is met, you may not have the coverage you need to handle a serious illness or accident.

“For most people, a high-deductible plan is basically a bet against yourself,” said Ms. Stoll. “You’re betting that you won’t get sick and you won’t have an accident. But isn’t that exactly what insurance is supposed to be? A bet that something might happen, and if it does you’ll be protected?”

Whether you are considering a high-deductible policy because you are healthy and don’t think you need much coverage or you want the tax-sheltered savings account or you simply cannot afford anything else, you need to carefully consider the following.

WHY IS THE PREMIUM SO LOW? It is not always simply because the deductible is high. There may be other cost-reducing limitations on the plan as well. If the premium looks too good to be true, look for one of these lurking loopholes:

A cap on lifetime coverage. It is hard to even estimate what you will need over your lifetime in health care coverage. But when you are looking at this number, keep in mind that the average hospital charge for an appendectomy is $22,000, and the average charge for a hip replacement is $40,000. You do not want a lifetime coverage cap that is going to be exhausted quickly by one or two long hospital stays or by extended outpatient care for a chronic illness.

A cap on doctor visits. Some severely restrictive plans will cover only a handful of doctor visits a year after the deductible is met. Others charge a big co-payment for every doctor visit. Still others will not even start to cover doctors’ visits unless they occur after a hospitalization — which, as Gary Claxton, a vice president at the Kaiser Family Foundation, points out, is basically a hospital-only policy.

A cap on hospitalization costs. Again, consider those hospital costs. Is the policy you are considering going to get you through? Mr. Claxton has seen policies that so severely restrict hospitalization that they will not pay for the first day you are admitted. “That’s the day when you’re most likely to have the most costs,” he said. “Think of it: You’re admitted to the E.R., you have surgery and you spend the night in the I.C.U., and none of it is covered.”

Other high out-of-pocket costs. Just because you have met your deductible doesn’t mean you are done spending money. High co-payments of 20 percent or more on doctors’ visits, prescription drugs and hospitalizations can add up quickly. With some of these policies, Mr. Claxton says, you will pay an extraordinary amount in out-of-pocket costs, sometimes as much as $10,000.

LEARN MORE Consumers need to read the policies carefully. “But it’s not easy to know what is adequate coverage and what isn’t,” Mr. Claxton said. “I’ve been in this business for years, and I still wouldn’t know what, say, a reasonable cap on physical therapy for a stroke victim would be, or what a cap on radiation services would mean for a cancer patient.”

If you use a Web site like ehealthinsurance.com, you can find out more about each price quoted by clicking on “plan details” and reading carefully, looking for the categories listed above. If you do not find the specifics you need, call the insurer’s customer service department and ask.

In addition to researching and comparing policies on the Internet and by phone, Ms. Stoll suggests enlisting the help of a well-recommended insurance broker or agent who specializes in high-deductible plans, to help you wade through the really fine print. If you are comparing plans offered by your employer, your benefits department will be able to answer questions and provide copies of the policies.

DON’T OVER-APPLY Your goal is to apply only for the policy you think you are most likely to get. The drawbacks to being turned down are too great to submit applications to many insurers, hoping for the best deal.

The prices you see on the Internet or hear quoted by an agent are not necessarily the premium you will pay. To get that number, the insurance company needs to know your age, weight and other personal details and look at your medical history — a process known as underwriting.

If you are turned down for a policy for any reason, that information can be shared among insurers and be used to deny you future coverage. The more policies you apply for, the more likely you are to be turned down by at least one of them, and the more likely you are to have the damaging information in your files. Avoiding this trap is good advice, says Ms. Stoll, whether you are applying for high-deductible or traditional health insurance.

IS THERE A SAVINGS PLAN? High-deductible plans that can be linked to a health savings account must adhere to federal regulations that include limits on out-of-pocket costs and the amount of the deductible. It is usually clear on most insurance Web sites whether a plan is eligible for linking to a savings account. If you have any doubts, call the insurance company’s customer service department and ask.

PREVENTIVE CARE Because people with high deductible plans are less likely to seek routine preventive treatment — risking costly problems later on — some insurers have included basics like an annual physical and certain preventive prescription drugs.

These plans often come with slightly higher premiums, though. So you will need to calculate whether the extra coverage is cheaper than what you would pay out of pocket for preventive care.

Many women put pregnancy plans on hold in shaky economy

By Anne Harding

CNN.com

Friday, May 29, 2009

Diana Adam, 35, and her husband wanted to have a second child this year. The timing just seemed right. She had a job as a software engineer at a big market research company near San Francisco, California, and it had good benefits -- including paid maternity leave. He was looking for a faculty position after finishing his Ph.D. in sociology but had a steady job as a lecturer at a state university. Their first child, a boy, was three.

But that was before the economic meltdown. Since then, her husband's hours were cut at work and may dry up completely in the fall. At least half of the faculty positions he's applied for were cut due to hiring freezes. Adam herself survived a round of layoffs at her job, but still doesn't feel completely secure. "Right now we are postponing [a pregnancy] to definitely next year at the earliest," Adam said.

Adam and her family are not alone. Nearly one in five married women ages 18 to 44 say the shaky economy has affected their plans to increase the size of their family, according to a survey released in May by the American College of Obstetricians and Gynecologists (ACOG). Nearly one in 10 say that they put off a planned pregnancy because of the bad economy.

Meanwhile, urologists have noticed a spike in men seeking vasectomies, and Planned Parenthood clinics report that more women are calling to ask for help paying for their birth control. Organizations that help low-income women pay for abortions say they're getting more calls, too. Health.com: Birth control is safer than ever

"There is no doubt that the economy is directly affecting the women in our community," said Jenifer Vick, the director of development and communications at Planned Parenthood of East Central Iowa in Cedar Rapids.

Women cutting back on routine health checks

ACOG's poll found that 17 percent of married women said the economy had "affected their plans to increase the size of their family," and 20 percent said they were more concerned than they were last year about having an unplanned pregnancy. While about one-third of women said they were paying more attention to their contraceptive use for this reason, 14 percent had put off getting their annual well-woman checkup, and 15 percent were cutting back on some of their medications or just not taking them anymore. The online survey was conducted between March 25 and April 1, 2009, and included 1,031 women ages 18 to 44.

The results are particularly distressing, said Dr. Iffath Abbasi Hoskins, because most women of reproductive age rely on their ob-gyn for primary care as well as their reproductive health. Hoskins said the physician group commissioned the survey from the Gallup Organization because patients were telling its members that economic pressures were affecting their choices about family planning and health care. Health.com: Have your best gyno visit ever

"The downturn in the economy is having unintended consequences, and these consequences are affecting the most personal and intimate areas of a woman's life," said Hoskins, who is vice president of ACOG and chairs the department of obstetrics and gynecology at Lutheran Medical Center in Brooklyn.

A March report suggests that vasectomy rates are increasing as well. Urologists at the Cornell Institute for Reproductive Medicine in New York City and their colleagues reported that consultations for vasectomies were up 48 percent to 75 percent compared to recent years and months.

Last fall, Planned Parenthood of East Central Iowa qualified five or six women weekly for a state program that offers free birth control, annual Pap smears, and other reproductive health-care services to those who meet the income guidelines. Now, according to Vick, the clinic is qualifying five or six women every day, while 10 to 20 women call daily looking for help paying for health care and contraceptives. Health.com: Do pregnancy and bipolar disorder mix?

"Just this week, there was a woman who came in saying that her company has decided to cut their expenses by raising the deductible on their insurance plans. She said she can't afford the $500 deductible. Our clinic staff is seeing how they can help her access the contraceptives she needs," Vick said. "Some women are coming in saying that they are in fear of losing their job/health insurance and that they want to know what we can do to help if this does happen. These women know we're here and don't know where else to go."

More women seeking financial help

Toni Bond Leonard, who runs the Illinois Reproductive Justice Fund, which helps women pay for abortions, said more women are looking for help, while the fund's donors are having to cut back on their support. When women call the Chicago-based fund, Leonard said, they are asked whether they can pay some of the cost. Callers used to say they could contribute $50 to $100. A first-trimester abortion costs $365, on average, in the Chicago area, Leonard said.

"Now women call and they have nothing," she said. The fund typically asks a woman to try to raise some money on her own, and then call back, Leonard added. "Women aren't calling back because they just can't raise anything."

While hard numbers are difficult to come by (the most recent U.S. data on abortion rates are from 2005), the Boston-based National Network of Abortion Funds says most of its 102 member funds reported a 50 percent to 100 percent increase in call volume over the past several months. Call volume to the National Network's offices, which refer women to local funds and the network's national case manager, has tripled. Health.com: 6 Rules for a healthy postpartum slim down

"In the Network offices, since the first of the year, the increased desperation has been notable," the NNAF said in a March press release. "It is now common for staff to pick up the phone to hear sobbing and gasping women who have tried everything they can think of to raise enough money for an abortion, are still coming up short, and are at the breaking point emotionally."

Will the poor economy lead to a "baby bust"?

The rates of reproduction have fluctuated with the economy in the past, according to the Population Reference Bureau. In fact, senior demographer Carl Haub wrote on the Population Reference Bureau's blog that the U.S. has seen two big "baby busts": once during the Great Depression, and a second time in the recession-ridden, oil embargo--plagued 1970s.

The total fertility rate, or the average number of children born to a woman during her lifetime, fell to 2.1 by 1936, and declined to an "all-time low" of 1.7 in the 1970s, according to statistics from the bureau. Total fertility eventually rebounded and has held steady at 2.0 to 2.1 for the past several years, Haub wrote, but it's too early to tell what the impact of the current slowdown may have on birth rates. Health.com: Post-pregnancy workout tips

Meanwhile, Diana Adam and her husband are planning to hold off on adding to their family until he lines up some steady work. It doesn't have to be full-time, Adam says, but it does need to be dependable. Last year the family could plan on him teaching a couple of classes each semester, and one during the summer session. "We knew what we could expect; now it's more about, 'Let's see,'" Adam says. "It's all a last-minute decision, and you can't plan anything on this."

Adam said she hopes the wait won't be too long, because having a baby closer to 40 "gets me nervous a little bit."

"I don't want to delay too much," she said. "You never know how long it actually takes sometimes to get pregnant."

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Warning Signs That Flu Is Serious

By Denise Grady

New York Times

Friday, May 29, 2009

How do you know when swine flu has turned serious? Today, doctors from the Centers for Disease Control and Prevention explained what flu warning signs warrant urgent medical attention.

Dr. Anne Schuchat, the C.D.C.’s interim deputy director for science and public health, said that in the United States, 507 people have been hospitalized because of swine flu. She noted that people over 55 account for only 1 percent of cases, and 62 percent of the people getting sick are from 5 to 24 years old.

In children, warning signs to seek medical attention include:

* Fast or troubled breathing.

* Skin turning bluish or gray.

* Persistent or severe vomiting.

* Not drinking enough fluids.

* Being unusually hard to wake up or not interacting.

* Being so irritable that the child doesn’t want to be held

* Flu-like symptoms improve but then return with fever and worse cough

In adults, serious warning signs include:

* Difficulty breathing or shortness of breath.

* Pain or pressure in the chest or abdomen.

* Persistent vomiting.

* Sudden dizziness.

* Confusion.

* Flu-like symptoms improve but then return with fever and worse cough

Dr. Schuchat said that so far, the “attack rate” of this new strain of flu — the proportion of people in the community who get sick — seems to be from 7 to 10 percent. About 20 percent of people who are exposed to a sick household member catch the virus. These figures are similar to the usual strain of seasonal flu.

As Flu Retreats, Scientists Brace for Its Return

The H1N1 Virus, Strains of Which Have Circulated for Decades, Could Come Back in a More Virulent Form

By Betsy McKay

Wall Street Journal

Friday, May 29, 2009

Over the next several months, the new H1N1 flu virus is likely to continue to spread around the world, reaching into the southern hemisphere along with winter, then possibly staging a resurgence in the northern hemisphere come fall.

Hundreds of thousands of people could fall sick, and some will die. Public health officials will scramble to minimize the damage, as governments and drug makers continue to invest millions of dollars in a potential vaccine.

Yet the public, after an initial spasm of fear and concern, has turned its attention away from a strain that seems less serious than first advertised. The complacency is increasing the challenge for health officials who are trying to track and limit the spread of a disease that can still make people seriously ill even if it isn't deadly for most.

As of Wednesday, the virus had sickened at least 13,398 people in 48 countries from Argentina to the U.S., and 95 people have died, according to the World Health Organization. In the U.S., 7,927 probable and confirmed cases in 47 states and the District of Columbia have been reported to the Centers for Disease Control and Prevention, with at least 11 dead. Officials believe thousands more -- at least 100,000 in the U.S. -- have had the virus, but weren't tested or sick enough to visit a doctor.

"We need to stay ready," CDC respiratory diseases official Anne Schuchat said this week.

Infections seem to be slowing in many parts of the U.S., according to the CDC. It hasn't spread in most other countries as widely as it has in Mexico and the U.S. Many of those who have died had other health problems, such as asthma or heart disease. Unlike the viruses that created the most recent three flu pandemics, this one isn't entirely new.

Introduced into the human population by the 1918 pandemic, the H1N1 virus circulated widely in various forms until 1957, when it was replaced in another pandemic by a new strain known as H2N2. The H1N1 virus re-emerged in 1977 and has circulated ever since, changing slightly every year. But it differs from the new H1N1 virus, which is made up of swine viruses, and hasn't circulated in humans until now.

Already, there are signs that people over 60 years old with exposure to H1N1 viruses that circulated decades ago may have some immunity. And other mild H1N1 viruses haven't mutated to become more virulent, says Peter Palese, chairman of the department of microbiology at the Mount Sinai School of Medicine in New York, calling this new form of H1N1 a "mellow virus."

It "may be less likely to be a killer virus or a virus which is highly virulent," says Dr. Palese.

But that doesn't mean it can't make people seriously ill or isn't worth combating, pandemic flu scientists say. Flu viruses are notoriously unpredictable. It's not clear whether this virus will peter out or return next fall. If it does return, officials can't predict whether it will cause the same mild disease, or mutate into a more virulent bug that could strike with a vengeance -- like the dreaded 1918 pandemic virus that resurfaced and killed 50 million people, by some estimates.

"That really terrible experience of 1918 is in our minds. But I can't tell you whether this virus will cause a lot of disease, some disease or no disease here in the northern hemisphere next season," Dr. Schuchat said.

Flu viruses regularly mutate or change by swapping genes with other flu viruses to outsmart the immune systems of their human hosts. Such changes, which ensure a virus's survival, make it possible to catch the flu from one year to the next. They can also make a mild virus like the current H1N1 strain more virulent. CDC scientists are examining potential changes to the new H1N1 strain to see if any might create a virus that would cause more severe disease, says Dan Jernigan, deputy director of the agency's influenza division.

"There are a lot of other conditions out there that have killed many more people in the last three weeks than this has," says Michael Osterholm, director of the Center for Infectious Disease Research and Policy at the University of Minnesota. "But this is not about what's happening now. It's about what could happen."

In New York City, the health department announced Tuesday that two more people with swine flu had died, bringing the total to four. Of particular concern to health officials is that the disease is striking mostly younger people. The virus is making its way through New York schools at an energetic pace after more than a month, with five more closing Wednesday.

Age matters. About 64% of U.S. H1N1 infections have been in people ages 5 to 24, while just 1% are over age 65, the age group that normally gets hit hardest by the flu. Some are developing severe disease: about 37% of those hospitalized with H1N1 have been between ages 19 and 49, according to a CDC analysis of a portion of U.S. patients. Pregnant women and people with chronic health conditions have been at risk.

A similar pattern was seen in the 1918 pandemic, in which death rates were highest among young adults. That may be due at least partly to the fact that people over age 60 may have some immunity to the new virus, from exposure to older H1N1 viruses that are more similar to the new swine flu than the other recent H1N1 varieties, according to the CDC.

Unsure of the course the disease will take, officials are preparing for the worst. Over the next eight to 10 weeks, CDC and WHO officials plan to track the spread of the disease in the southern hemisphere, where winter and flu season are setting in. They are watching to see if the virus mutates as it mixes with other circulating seasonal flu viruses, becoming more virulent or resistant to antiviral drugs such as Tamiflu. Last winter, one variety of H1N1 developed such a resistance while the more recent version hasn't so far.

The CDC has shipped kits to influenza laboratories in more than 100 countries to allow them to test for the new H1N1 virus. Among the questions that agency scientists plan to monitor are whether many people are hospitalized for long periods with pneumonia, whether the virus causes secondary bacterial pneumonia, and who is affected most -- children or adults, primarily healthy people or those with underlying diseases, Dr. Schuchat said.

U.S. and global officials are also pushing ahead to prepare a vaccine against the H1N1 virus, even though they haven't decided whether or not to go ahead with mass production of shots. The U.S. government said last week it's setting aside $1 billion for clinical studies and the production of two bulk ingredients to be placed in a federal stockpile in case vaccine production goes ahead.

Alessandro Vespignani, a professor of informatics at Indiana University who has modeled scenarios for the spread of H1N1 flu, predicts a second wave would strike more than the hundreds of thousands of people he expects to be hit by the first wave. "It's good we had the first wave," he said. "It gives us time to understand more about the disease."

Printed in The Wall Street Journal, page A10

Caught in China's Aggressive Swine Flu Net

Quarantine Measures Keep Cases Down but Virtually Imprison Healthy Travelers

By Ariana Eunjung Cha

Washington Post

Friday, May 29, 2009

BEIJING, May 28 -- In ordinary times, Miguel Gomez's temperature of 98.9 degrees Fahrenheit, a mere 0.3 degrees above the benchmark for normal, would hardly be cause for alarm. But to the Chinese medical officials who boarded his flight last week to search for passengers with signs of swine flu, it was enough to deem him a public health threat.

Gomez, a 29-year-old Alexandria native, was separated from his wife, ordered to put on a mask and rushed by ambulance to a quarantine facility near the airport.

"I was feeling a little scared," Gomez recalled, "mainly because I had no way of contacting anyone."

Although he was eventually found to be free of any serious illness, including swine flu, Gomez spent three days confined in an infectious disease ward. He did not see a single uncovered human face his entire stay.

Doctors and nurses in head-to-toe biohazard suits sampled his blood, swabbed his throat and came into his room every few hours to test his temperature. Anonymous hands pushed meals through a small hole. Receptionists wearing masks passed messages to him by rapping on his only window, which faced inside the facility so he could be observed around the clock.

While the spread of swine flu seems to have slowed for the time being, and other countries have relaxed previous restrictions on public gatherings and travel, China has become increasingly vigilant -- throwing several thousand foreigners and Chinese nationals into quarantine facilities for having little more than a cough, runny nose or slight temperature and having been in contact with someone with a suspected case of swine flu.

Some public health experts say its aggressive measures to deal with a possible pandemic -- devised after China's slow and secretive response to the deadly SARS virus in 2003 was blamed for spreading the respiratory disease -- should serve as a model for other countries. Statistically speaking, China's efforts have been an amazing success this time around. Of a total of 13,400 confirmed infections worldwide, only 14 have been in China, though nearly a fifth of the world's population lives within its borders.

From a public relations standpoint, however, China's medical checks and quarantine procedures have been a disaster.

Mexico has accused China of unfairly targeting Mexican nationals with no symptoms, even those who had not been to Mexico in months. The situation has been so tense that Mexico chartered a plane this month to bring some of its citizens home. In the Chinese territory of Hong Kong, an entire hotel, the Metropark, was quarantined -- at great expense to the hotel and at great inconvenience to the approximately 240 guests, some of whom blogged about the resulting boredom and heavy drinking -- after one person staying there was found to have swine flu.

This week, 21 students and three teachers from the private Barrie School in Silver Spring have been quarantined on two floors of a four-star hotel in Kaili, a city in the southwestern province of Guizhou. A fellow passenger on the group's flight from the United States had a fever, but the high school students are symptom-free. The teenagers, who arrived in China on May 22, have been told they will be able to leave the hotel Friday -- giving them just one day for sightseeing before their flight home on Sunday.

"It's not what they expected, but they're having an adventure," said Debbie Silverman of Silver Spring, mother of a 16-year-old on the Barrie trip. "They're learning how not every place is like the United States, that's for sure."

Chinese officials deny that particular nationalities are being singled out for scrutiny and say all those under quarantine are being treated well. The measures are not "discriminatory in nature," said Chinese Foreign Ministry spokesman Ma Zhaoxu. "The issue is purely a matter of public health."

In Beijing, more than 650 people have been quarantined since the scare began in April. Many of them were identified at the city's international airport, where masked technicians inspect each passenger and check for fever with a thermal forehead scanner that emits a beam of light.

Those unlucky enough to have flulike symptoms are taken to a quarantine building, decorated with posters about SARS, or severe acute respiratory syndrome, at Beijing's modern Ditan Hospital. For the time it takes to get the results of a test for swine flu -- two or three days -- this is their home.

Each patient is given a single room, painted light blue, with a bed, sink, shower, telephone and TV. Patients get three meals a day -- their choice of Chinese cuisine (mostly chicken and rice) or Western cooking (chicken and rice prepared a different way). Many of the medical professionals speak English and are very kind, patients said.

That doesn't mean that those in quarantine are not begging to get out.

Shinjo, a 32-year-old housewife from Japan who came to China with her husband for a quick three-day holiday, complained by phone from her room that even if she were released immediately, it would leave her only one day to enjoy her vacation. Jaime Freile, 23, a Spaniard who came to China on Sunday for business, said the doctors refused to believe that he had a slight fever because of a tooth infection, not swine flu.

"I protested to them and said I wanted to go home," Freile said. "I agree that the government should take this situation seriously, but in this case they failed."

Rafeal Hughley, a 25-year-old American who works as a computer systems specialist for the U.S. government, also tried to reason with his doctors, explaining that he had been stationed in South Korea for the past few months and that it was extremely unlikely he had contracted swine flu there, since South Korea has had only a single confirmed case.

"There was nowhere for me to catch it," he remembers telling the men and women who spoke to him from behind masks. "They say they know what I mean, but they still have to keep me. I think it's just the panic -- everybody is so scared."

Gomez, a manager at a retail store, arrived last Friday with his wife to celebrate their first wedding anniversary. After flying from New York and spending a few days in Hong Kong, he acknowledged, he felt tired but thought he was in good health. He was surprised when technicians singled him out and pulled him off the plane while other passengers glared.

With a temperature of 98.9 degrees Fahrenheit, Gomez was a borderline case. Doctors often consider temperatures of up to 100.4 degrees normal, given that body temperatures vary by individual and may fluctuate by one to two degrees during the course of a day because of physical activity, strong emotions or other factors.

At Ditan Hospital, Gomez was placed in a room on the fifth floor and told he could use the phone as much as he wanted or watch TV, though all the channels were in Chinese. Attendants took his temperature every few hours, and it was consistently normal. But Gomez said he understood the Chinese government's aggressive response.

"I knew how they were freaking out about swine flu here, so having a fever, I was not terribly surprised that something like this went on," he said. "I was annoyed it took as long as it did, but I can't say I was completely unexpecting."

Besides, he added, "I was definitely happy I was treated nicely."

On his second day in isolation, however, he became restless. He missed his wife, and she missed him. She had come to the hospital to bring him some snacks, so he walked out of his room, which was unlocked, to find a window from which he could wave to her. The nurses shooed him back into his room.

"It's really weird to interact with people who are completely covered. It's strange not to see anybody's face," he said. "Being in there so long, I was freaking out a little. What if I do have swine flu? . . . I'm never going to get to see my wife, my family, my friends again. That was the worst."

About noon Monday, three days after he checked in to the hospital, Gomez was finally cleared to leave the ward. A hospital official asked him to sign papers acknowledging that he had been treated well and gave him a survey to fill out. Most of the questions, he said, seemed to apply to his mental well-being, such as having to answer yes or no to the statement "I feel lonely in here."

Then the hospital gave him a surprise parting gift: a get-well card and two bottles of hand sanitizer.

Staff writer Alan Cooperman in Washington and researchers Liu Liu and Zhang Jie in Beijing contributed to this report.

Worried About Flu, China Confines U.S. Students

By Doug Donovan

New York Times

Friday, May 29, 2009

BALTIMORE — When 21 students from a private school in Silver Spring, Md., arrived in the Chinese city of Kaili last Friday, they enjoyed a weekend of exploring the regional province of Guizhou.

But that is when the good times ended.

At lunch on Monday, Chinese officials quarantined the group to their rooms in the Heaven Sent Dragon hotel, Mike Kennedy, interim head of the school, the Barrie School, said Thursday.

Chinese officials were worried that the students had been exposed to swine flu on their flight from San Francisco to Hong Kong. A passenger on the flight had fallen ill and gotten off the plane with a fever, Mr. Kennedy said.

“Our kids were on the plane and only several seats away” from the sick passenger, he said.

The students, who paid more than $3,000 each to participate in the school trip, have been confined to their rooms ever since, but have been permitted to open their doors. They have been sitting in their doorways and talking with one another, Mr. Kennedy said. They are expected to be released from the quarantine on Friday.

Chinese officials have worked hard to make the quarantine as pleasant as possible, Mr. Kennedy said, adding that a cultural minister had delivered fruit and flowers and provided a choir to sing to the students. Most people suspected of swine, or H1N1, flu in China are quarantined for two weeks in hospitals, he said.

“They’re being as nice as they can be,” Mr. Kennedy said, though he added that the students were “bored and frustrated.”

A spokeswoman for Senator Benjamin L. Cardin, Democrat of Maryland, said his office had put Mr. Kennedy in touch earlier this week with State Department officials who were following the case. Mr. Kennedy said it was unclear why the quarantine had continued, even though officials had informed him that the sick passenger did not have swine flu.

After their expected release, the students will have only Saturday for more touring before their flight departs on Sunday.

Mr. Kennedy said the Barrie School organized “extended study weeks” every spring. Students travel to places in the United States and to countries all over the world.

On its Web site, the school, which is just outside Washington, says it has a curriculum that “encourages students to develop their own individual interests and talents through hands-on experiential learning.”

Opinion

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