Risk to all ages: 100 kids die of flu each year

NEW YORK (AP) — How bad is this flu season, exactly? Look to the children.

Twenty flu-related deaths have been reported in kids so far this winter, one of the worst tolls this early in the year since the government started keeping track in 2004.

But while such a tally is tragic, that does not mean this year will turn out to be unusually bad. Roughly 100 children die in an average flu season, and it's not yet clear the nation will reach that total.

The deaths this year have included a 6-year-old girl in Maine, a 15-year Michigan student who loved robotics, and 6-foot-4 Texas high school senior Max Schwolert, who grew sick in Wisconsin while visiting his grandparents for the holidays.

"He was kind of a gentle giant" whose death has had a huge impact on his hometown of Flower Mound, said Phil Schwolert, the Texas boy's uncle.

Health officials only started tracking pediatric flu deaths nine years ago, after media reports called attention to children's deaths. That was in 2003-04 when the primary flu germ was the same dangerous flu bug as the one dominating this year. It also was an earlier than normal flu season.

The government ultimately received reports of 153 flu-related deaths in children, from 40 states, and most of them had occurred by the beginning of January. But the reporting was scattershot. So in October 2004, the government started requiring all states to report flu-related deaths in kids.

Other things changed, most notably a broad expansion of who should get flu shots. During the terrible 2003-04 season, flu shots were only advised for children ages 6 months to 2 years.

That didn't help 4-year-old Amanda Kanowitz, who one day in late February 2004 came home from preschool with a cough and died less than three days later. Amanda was found dead in her bed that terrible Monday morning, by her mother.

"The worst day of our lives," said her father, Richard Kanowitz, a Manhattan attorney who went on to found a vaccine-promoting group called Families Fighting Flu.

The Centers for Disease Control and Prevention gradually expanded its flu shot guidance, and by 2008 all kids 6 months and older were urged to get the vaccine. As a result, the vaccination rate for kids grew from under 10 percent back then to around 40 percent today.

Flu vaccine is also much more plentiful. Roughly 130 million doses have been distributed this season, compared to 83 million back then. Public education seems to be better, too, Kanowitz observed.

The last unusually bad flu season for children, was 2009-10 — the year of the new swine flu, which hit young people especially hard. As of early January 2010, 236 flu-related deaths of kids had been reported since the previous August.

It's been difficult to compare the current flu season to those of other winters because this one started about a month earlier than usual.

Look at it this way: The nation is currently about five weeks into flu season, as measured by the first time flu case reports cross above a certain threshold. Two years ago, the nation wasn't five weeks into its flu season until early February, and at that point there were 30 pediatric flu deaths — or 10 more than have been reported at about the same point this year. That suggests that when the dust settles, this season may not be as bad as the one only two years ago.

But for some families, it will be remembered as the worst ever.

In Maine, 6-year-old Avery Lane — a first-grader in Benton who had recently received student-of-the-week honors — died in December following a case of the flu, according to press reports. She was Maine's first pediatric flu death in about two years, a Maine health official said.

In Michigan, 15-year-old Joshua Polehna died two weeks ago after suffering flu-like symptoms. The Lake Fenton High School student was the state's fourth pediatric flu death this year, according to published reports.

And in Texas, the town of Flower Mound mourned Schwolert, a healthy, lanky 17-year-old who loved to golf and taught Sunday school at the church where his father was a youth pastor.

Late last month, he and his family drove 16 hours to spend the holidays with his grandparents in Amery, Wis., a small town near the Minnesota state line. Max felt fluish on Christmas Eve, seemed better the next morning but grew worse that night. The family decided to postpone the drive home and took him to a local hospital. He was transferred to a medical center in St. Paul, Minn., where he died on Dec. 29.

He'd been accepted to Oklahoma State University before the Christmas trip. And an acceptance letter from the University of Minnesota arrived in Texas while Max was sick in Minnesota, his uncle said.

Nearly 1,400 people attended a memorial service for Max two weeks ago in Texas.

"He exuded care and love for other people," Phil Schwolert said.

"The bottom line is take care of your kids, be close to your kids," he said.

On average, an estimated 24,000 Americans die each flu season, according to the Centers for Disease Control and Prevention. People who are elderly and with certain chronic health conditions are generally at greatest risk from flu and its complications.

The current vaccine is about 60 percent effective, and is considered the best protection available. Max Schwolert had not been vaccinated, nor had the majority of the other pediatric deaths.

Even if kids are vaccinated, parents should be watchful for unusually severe symptoms, said Lyn Finelli of the CDC.

"If they have influenza-like illness and are lethargic, or not eating, or look punky — or if a parent's intuition is the kid doesn't look right and they're alarmed — they need to call the doctor and take them to the doctor," she advised.

___

CDC advice on kids: http://www.cdc.gov/flu/protect/children.htm

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A priest's confession, a man's relief

There is something about me that is happier when accompanied by a small boy.... Perhaps besides the sexual element, the child in me wants a playmate.

— Father Robert Van Handel

::

Damian Eckert turned on the computer in his in-laws' home office, a tiny, dim, book-strewn space. He left the door open so he could hear his 5-year-old daughter playing in the next room.

He pulled up a website and scanned it for Father Robert Van Handel, the priest who led the community boys choir he and his younger brother sang in when they were growing up in Santa Barbara. There he was — receding hairline, bulbous nose, gap-toothed smile.

Eckert opened a document: 27 pages that Van Handel wrote for a therapist years ago, his so-called sexual autobiography. It made Eckert's palms sweat and his back knot.

His in-laws poked their heads into the room: Are you OK? Yes, he reassured them.

He continued to read.

::

For years, Eckert had been part of an effort to pry confidential files from clergy members at the now-closed St. Anthony's Seminary in Santa Barbara who'd been accused of molesting children. The battle over releasing thousands of once-secret pages went all the way to the California Supreme Court.

The day the files were made public last May, Eckert, 44, left the news conference and went to his in-laws' house. It was the nearest place to read the words of the priest he says abused him.

I asked my best friend once if he saw anything "special" in pictures of [naked] children. He said, 'No, not at all.' I began to realize that I was different.

The product of an alcoholic, volatile father who served in the military and a scared mother, Van Handel was the third of five children, Eckert read. The priest went to high school in the 1960s at St. Anthony's, a campus of sandstone facades and grand towers near Old Mission Santa Barbara run by the Franciscan religious order.

Years later, while attending graduate school in Berkeley, he started a boys choir at a local parish, despite his self-professed lack of musical skills. There, Van Handel wrote, he met one of his first victims.

He was 7 or 8. Light hair. Blue eyes. His parents were divorcing and grateful for the priest's interest in their son.

Always this was done under the cover of some "legitimate" touching. [The boy] never seemed to mind, and I wasn't about to stop on my own.

Around this time, Van Handel wrote, he implied to a Franciscan counselor that he was sexually attracted to boys. The counselor quickly changed the subject.

In 1975, at age 28, Van Handel returned to St. Anthony's as a teacher and founded the Santa Barbara Boys Choir.

The Eckert boys joined when Damian was about 10 and his brother, Bob, about 8. Choir members, dressed in the blazer-and-shorts style of English schoolboys, mainly sang Catholic hymns. Damian was a soprano, Bob an alto.

They felt at ease around Van Handel, a soft-spoken friar who eschewed his brown robe for striped shirts. He tsk-tsked boys who flubbed notes, but he also allowed them to play the seminary organ and swim at the school pool.

When Damian was about 11, he recalled, his parents told him they were splitting up. The next day at choir practice, he tried to sing. Instead, tears. He ran into the hallway. Van Handel followed. Everything will be OK, the priest promised.

As the weeks went by, he chatted with the boy in his office, strolled with him around the mission. Eventually, Damian said, Van Handel persuaded him to try on "special shorts" — extra-large, the priest wrote, so he could see up them. Other boys had worn them too.

[One boy] said he did not want to. I insisted. He started to cry and that snapped something in my head. For the first time I was seeing signs that he really did not like this.

Ashamed and confused, Damian told no one. But the priest unsettled Damian's father, Tom. One day, Van Handel tried to persuade Tom and the boys' mother to send Damian and Bob on a choir trip to England. Only years later could Tom put into words the way Van Handel eyed his sons: "like a man looking at a woman he wanted to have sex with."

Their mother signed off on the trip. After all, she reasoned, was there a more trustworthy chaperon than a priest?

::

By the time Damian was in his early 20s, he'd stopped praying daily and was prone to binge drinking and flashes of rage. One day, in response to some rumors, his father took him aside and asked if Van Handel had molested him.

No, Damian said.

You're lying, Tom thought. But he didn't press the issue. Bob denied being sexually abused, as well.

At a loss for what to do, Tom marched over to the seminary, he recalled in a deposition. He confronted Van Handel on the steps outside.

"I want to kill you," Tom said. "How could you wear the cloth and molest my boys?"

The priest didn't flinch. "You need to get divine intervention," he said. Then he walked away.

The Franciscans said they first learned of Van Handel's abuse in 1992 — five years after St. Anthony's closed — when the parents of one boy wrote a letter describing the dart games Van Handel played with their son. If the boy won, he got money. If the priest won, he gave the child what he called a "back rub."

A few months later, the same parents wrote to Cardinal Roger Mahony of the Archdiocese of Los Angeles, which includes Santa Barbara: "We challenge you as spiritual leader of this archdiocese, as shepherd of a wounded and wandering flock to address this horror, the destruction of our children's lives by sexual abuse by clergy."

Mahony reassured them in a letter that no priest could serve "unless we are morally certain that he will be able to minister properly."

Van Handel was sent for psychiatric treatment, Damian read. The Franciscans assembled a board of inquiry. The panel's conclusions, in 1993, were well-covered in the local media: St. Anthony's had been a cesspool of abuse, where 11 clergy members had molested at least 34 boys.

Van Handel was suspected of abusing up to 17.

When I realized that my case was becoming public, I decided that I needed to tell my parents about my sexual acting out.... My dad responded immediately that he was sure God would take care of everything and I was not to worry — they would keep me in their prayers. My mother was in stunned silence.

::

In 1994, Van Handel pleaded guilty to one count of lewd and lascivious behavior with a choirboy, who told authorities he was molested with the frequency of "taking a shower or putting on my shoes." The priest became state inmate No. J30982.

Damian had been contacted during the investigation. He wanted no part of it. Talking about Van Handel unleashed long-buried anguish. One night, he woke up, his face wet with tears, his wife shaken by what he'd been screaming:

"Why did you do this to me?"

I was interviewed and tested in every way possible, including medical examinations and a brain scan.... The psychiatrist emphasized the seriousness of the problem, which he diagnosed as pedophilia, same sex, non-exclusive.

Damian turned to the one person he felt he could confide in: Bob. "I'm remembering things," Damian told his brother.

Damian didn't realize that Bob had a secret too. One night on that long-ago trip to England, when Damian and Bob were bickering, Van Handel made Bob sleep in his room. Father Robert abused me too, Bob said.

Damian felt as if he'd been punched.

::

In prison, Van Handel made a handwritten plea to the Vatican, asking to be defrocked. Damian has yet to read it.

“I now realize that although I acted in good faith at the time,” the letter said, "I did not have a vocation to the priesthood and religious life." His request was granted.

Upon Van Handel's release in 1998, the Franciscans helped him financially, citing his decades of observing a vow of poverty. He eventually moved to a mountain town near Santa Cruz, where for years he rented a garage apartment deep in the redwoods. His longtime landlady, who declined to give her name, recently described him as a model tenant.

::

By the early 2000s, Damian had two children of his own. He'd tiptoed back to religion. The pastor at a local church prayed with him during his divorce in 2001 and reaffirmed his faith in the goodness of clergy. Even so, during services, Damian struggled to sing.

Damian tried to ignore the major news of 2002: the Catholic Church sex abuse scandal. But California lawmakers decided to lift the statute of limitations on child sex abuse claims for one year. That meant alleged victims could sue organizations that they said had failed to protect them from known molesters, even if the abuse had happened long ago.

In 2003, hundreds of people filed claims against Roman Catholic dioceses — including the Eckert brothers. Damian did so reluctantly, and only after speaking to a counselor. She'd asked him: What if someone molested your kids?

In recent years, a key part of clergy abuse cases has involved getting confidential files released. The Catholic Church is a meticulous record-keeper. When a letter accuses a priest of molestation, it's supposed to go into his file. So are reports from therapists — no matter how graphic.

The documents have repeatedly backed up the allegations of victims whom the church initially tarred as liars. The Roman Catholic Diocese of Orange made public 10,000 pages. The L.A. archdiocese is expected to release its own trove in the coming weeks.

In 2006, the Eckert brothers and 23 other plaintiffs settled with the Franciscans. (The L.A. archdiocese covered a portion of the $28 million.) The battle over releasing the files dragged on. A state Supreme Court decision in 2011 finally forced the order to hand over the papers of nine clergy members, including Van Handel.

::

The former priest is now 65. He recently moved out of state and could not be reached for comment. His former landlady said his health had deteriorated so rapidly in recent months that he'd made plans to move to a care facility. Already something of a loner, he'd also grown convinced that someone would hunt him down, she said.

His papers showed he once told a social worker that he was guilt-ridden, even suicidal, over what he'd done. He was also terrified that someone would make public those 27 confessional pages, which included his own secret:

One night when I was [a student at St. Anthony’s] I was sleeping alone in the school infirmary because I was running a fever.... I woke up in the night to find a priest sitting on my bed and ready to take my temperature, which he did. Then he took off the covers, lifted my pajama tops and lowered the bottoms. I tried to stop this, but he gently moved my hand out of the way.

::

Damian had rebuilt his life in recent years: getting remarried, having a third child, even singing again in a church play. He credited his renewed faith. So he scoured the priest's papers for one thing in particular: whether he too felt a close connection to God.

An hour passed. Then two.

"God is not here at all," Damian thought — and that was a relief.

He rejoined his wife, Katie.

"You all right?" she asked.

"Yeah. There's some heavy stuff in there."

The couple scooped up their daughter and drove home in silence.

A few days later, Damian spoke to a friend he'd met at a church retreat. He told him about reading the papers, and how they'd changed the way he pictured the former priest.

Damian started to cry.

For more than 30 years, Van Handel had been the monster who haunted his dreams.

Finally, the monster had lost his power.

ashley.powers@latimes.com

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Cubans Take Advantage of Day 1 of New Travel Rules

HAVANA — Cubans flocked to immigration offices and travel agencies on Monday, eager to take advantage of a lifting of government travel restrictions that have been in place since Fidel Castro was a dark-bearded firebrand in his 30s.

The new rules eliminate the expensive bureaucratic hurdles long faced by Cubans wishing to go overseas, many of whom know loved ones who lost everything when they emigrated or who left the island in the dead of night on rafts and powerboats.

As of Monday, most Cubans can head for the airport with only a passport, a plane ticket and a visa, if required, from the country they intend to visit.

“We have lived for decades in captivity,” said Marta Rodríguez, 65, a retired office manager who was waiting to pick up a tourist visa from the United States Interests Section in Havana. “It’s a positive move — one they should have taken 50 years ago.”

The reform is not expected to prompt a major exodus, because most countries use entrance visas to control the number of visiting Cubans, and international travel remains way beyond the means of most islanders, who earn state salaries of about $20 per month. There are, of course, Cubans who want to travel from the island and return.

The government says it will continue to limit travel for tens of thousands of Cubans who work in strategic sectors, such as military personnel and scientific workers, as well as those they deem a threat to national security.

How tightly, and for how long, the government will continue to control those sectors’ movements will only become apparent over time, Cubans and outside analysts said. In a development that could signal new government flexibility, Yoani Sanchez, a prominent blogger and activist who says she has been denied an exit visa by the Cuban government at least 19 times in the past, said on Monday that she was one of the first in line at the immigration office and submitted paperwork for a new passport without any problems.

Arturo López-Levy, a Cuban-born academic who left the island 10 years ago and lectures at the University of Denver, said the migration reform was not simply a maneuver to defuse political pressure but a structural shift in the relationship between the island and the diaspora that the government once rejected as traitorous “worms.”

“This is a real change in the way in which the government perceives the relationship between the Cuban population and the outside world,” he said.

At immigration offices, Cubans scrutinized posters clarifying the new rules, stood in line to get new passports and pressed around immigration officials in spearmint-colored uniforms seeking details of what paperwork was now required.

More police were on hand than usual outside immigration offices and near consular offices, particularly the small park near the United States Interests Section — known locally as “the place between life and death” — where Cubans wait each day for appointments with American consular officers.

The Obama administration was watching the developments with interest. “We will see if this is implemented in a very open way and if it means that all Cubans can travel,” said Roberta S. Jacobson, assistant secretary of state for Western Hemisphere affairs, according to The Associated Press.

Despite multiple reports in recent weeks by official Cuban news media, many Cubans seemed unclear about how the new law would work: whether it applied to them, whether they needed a new passport or a special stamp (they do not), how it would work for minors.

Under the old system, most Cubans who applied for an exit permit to travel received it — if they could provide the authorities with an invitation letter from someone in the country they intended to visit — all at a cost of nearly $400.

Caridad Reyes Risse, 69, a retiree who was in line at a downtown travel agency to buy a ticket to visit her daughter in the United States, said she had waited until Monday to avoid that $400 expense.

“The question now is, ‘Will I get a ticket?’ ” she said, gesturing to the gaggles of Cubans that spilled out of the tiny agency.

Ramona María Moreno, 61, a restaurant worker, said that even though most Cubans who sought permission in the past received it, the change had psychological importance.

“It’s the idea you can go,” said Ms. Moreno, who was at an immigration office looking for a list of countries that admit Cubans without a visa. “It’s a freedom that we have never had.”

She acknowledged there were still barriers to travel. “I have no money,” she said with a chuckle.

The news last week that the government would allow members of its jealously guarded medical corps to travel has prompted excitement among doctors who for decades have had to go through a lengthy process to get permission, if they got it at all.

“Everyone is waiting to see what happens,” said Niurka, 45, a doctor who would like to join her family in Miami. Requesting that her last name not be published to avoid riling the authorities, she said she did not believe the tight restrictions on medical professionals would be lifted overnight.

“Still, it gives me hope,” she said.

However the government chose to carry out the new regulations, they signified a new era in Cuba’s relationship with its diaspora and the wider world, said Ms. Rodríguez, the retiree.

“They have realized the island needs to open up to the world,” she said “They can’t go back on this now.”

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Bachelor Sean Lowe: My Girl Must Love Dogs

For any of the 25 women looking to win over this season's Bachelor, Sean Lowe, here's a tip straight from the source: "The girl I'm dating must be into my dogs," he tells PEOPLE.

The proud pet parent to two pooches, a boxer named Lola and a chocolate Labrador named Ellie, Lowe says, "For so long it's just been me and my two dogs, and I'm certainly not going to replace them with any woman."

Having had both animals for the past six years, the hunk has developed a special bond with the duo – though he admits his quest for love has forced him to make some changes.

"For many years, my dogs would sleep in the bed with me," he says. "I'm a big guy and I've got two good-sized dogs, so it's a full bed. Then I just realized one day, 'Alright, if I get married and a woman's going to join me in the bed, there's not going to be enough room.' I had to break the dogs of the habit of sleeping in the bed."

Luckily for Lowe, the pair have taken to their new accommodations easily.

"They're very intelligent dogs; they pick up on things really quickly," he says. "They learn pretty fast."

To hear more from Sean Lowe – including how his dogs help him navigate the dating world – check out the video above.

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Hospitals crack down on workers refusing flu shots

CHICAGO (AP) — Patients can refuse a flu shot. Should doctors and nurses have that right, too? That is the thorny question surfacing as U.S. hospitals increasingly crack down on employees who won't get flu shots, with some workers losing their jobs over their refusal.

"Where does it say that I am no longer a patient if I'm a nurse," wondered Carrie Calhoun, a longtime critical care nurse in suburban Chicago who was fired last month after she refused a flu shot.

Hospitals' get-tougher measures coincide with an earlier-than-usual flu season hitting harder than in recent mild seasons. Flu is widespread in most states, and at least 20 children have died.

Most doctors and nurses do get flu shots. But in the past two months, at least 15 nurses and other hospital staffers in four states have been fired for refusing, and several others have resigned, according to affected workers, hospital authorities and published reports.

In Rhode Island, one of three states with tough penalties behind a mandatory vaccine policy for health care workers, more than 1,000 workers recently signed a petition opposing the policy, according to a labor union that has filed suit to end the regulation.

Why would people whose job is to protect sick patients refuse a flu shot? The reasons vary: allergies to flu vaccine, which are rare; religious objections; and skepticism about whether vaccinating health workers will prevent flu in patients.

Dr. Carolyn Bridges, associate director for adult immunization at the federal Centers for Disease Control and Prevention, says the strongest evidence is from studies in nursing homes, linking flu vaccination among health care workers with fewer patient deaths from all causes.

"We would all like to see stronger data," she said. But other evidence shows flu vaccination "significantly decreases" flu cases, she said. "It should work the same in a health care worker versus somebody out in the community."

Cancer nurse Joyce Gingerich is among the skeptics and says her decision to avoid the shot is mostly "a personal thing." She's among seven employees at IU Health Goshen Hospital in northern Indiana who were recently fired for refusing flu shots. Gingerich said she gets other vaccinations but thinks it should be a choice. She opposes "the injustice of being forced to put something in my body."

Medical ethicist Art Caplan says health care workers' ethical obligation to protect patients trumps their individual rights.

"If you don't want to do it, you shouldn't work in that environment," said Caplan, medical ethics chief at New York University's Langone Medical Center. "Patients should demand that their health care provider gets flu shots — and they should ask them."

For some people, flu causes only mild symptoms. But it can also lead to pneumonia, and there are thousands of hospitalizations and deaths each year. The number of deaths has varied in recent decades from about 3,000 to 49,000.

A survey by CDC researchers found that in 2011, more than 400 U.S. hospitals required flu vaccinations for their employees and 29 hospitals fired unvaccinated employees.

At Calhoun's hospital, Alexian Brothers Medical Center in Elk Grove Village, Ill., unvaccinated workers granted exemptions must wear masks and tell patients, "I'm wearing the mask for your safety," Calhoun says. She says that's discriminatory and may make patients want to avoid "the dirty nurse" with the mask.

The hospital justified its vaccination policy in an email, citing the CDC's warning that this year's flu outbreak was "expected to be among the worst in a decade" and noted that Illinois has already been hit especially hard. The mandatory vaccine policy "is consistent with our health system's mission to provide the safest environment possible."

The government recommends flu shots for nearly everyone, starting at age 6 months. Vaccination rates among the general public are generally lower than among health care workers.

According to the most recent federal data, about 63 percent of U.S. health care workers had flu shots as of November. That's up from previous years, but the government wants 90 percent coverage of health care workers by 2020.

The highest rate, about 88 percent, was among pharmacists, followed by doctors at 84 percent, and nurses, 82 percent. Fewer than half of nursing assistants and aides are vaccinated, Bridges said.

Some hospitals have achieved 90 percent but many fall short. A government health advisory panel has urged those below 90 percent to consider a mandatory program.

Also, the accreditation body over hospitals requires them to offer flu vaccines to workers, and those failing to do that and improve vaccination rates could lose accreditation.

Starting this year, the government's Centers for Medicare & Medicaid Services is requiring hospitals to report employees' flu vaccination rates as a means to boost the rates, the CDC's Bridges said. Eventually the data will be posted on the agency's "Hospital Compare" website.

Several leading doctor groups support mandatory flu shots for workers. And the American Medical Association in November endorsed mandatory shots for those with direct patient contact in nursing homes; elderly patients are particularly vulnerable to flu-related complications. The American Nurses Association supports mandates if they're adopted at the state level and affect all hospitals, but also says exceptions should be allowed for medical or religious reasons.

Mandates for vaccinating health care workers against other diseases, including measles, mumps and hepatitis, are widely accepted. But some workers have less faith that flu shots work — partly because there are several types of flu virus that often differ each season and manufacturers must reformulate vaccines to try and match the circulating strains.

While not 100 percent effective, this year's vaccine is a good match, the CDC's Bridges said.

Several states have laws or regulations requiring flu vaccination for health care workers but only three — Arkansas, Maine and Rhode Island — spell out penalties for those who refuse, according to Alexandra Stewart, a George Washington University expert in immunization policy and co-author of a study appearing this month in the journal Vaccine.

Rhode Island's regulation, enacted in December, may be the toughest and is being challenged in court by a health workers union. The rule allows exemptions for religious or medical reasons, but requires unvaccinated workers in contact with patients to wear face masks during flu season. Employees who refuse the masks can be fined $100 and may face a complaint or reprimand for unprofessional conduct that could result in losing their professional license.

Some Rhode Island hospitals post signs announcing that workers wearing masks have not received flu shots. Opponents say the masks violate their health privacy.

"We really strongly support the goal of increasing vaccination rates among health care workers and among the population as a whole," but it should be voluntary, said SEIU Healthcare Employees Union spokesman Chas Walker.

Supporters of health care worker mandates note that to protect public health, courts have endorsed forced vaccination laws affecting the general population during disease outbreaks, and have upheld vaccination requirements for schoolchildren.

Cases involving flu vaccine mandates for health workers have had less success. A 2009 New York state regulation mandating health care worker vaccinations for swine flu and seasonal flu was challenged in court but was later rescinded because of a vaccine shortage. And labor unions have challenged individual hospital mandates enacted without collective bargaining; an appeals court upheld that argument in 2007 in a widely cited case involving Virginia Mason Hospital in Seattle.

Calhoun, the Illinois nurse, says she is unsure of her options.

"Most of the hospitals in my area are all implementing these policies," she said. "This conflict could end the career I have dedicated myself to."

__

Online:

R.I. union lawsuit against mandatory vaccines: http://www.seiu1199ne.org/files/2013/01/FluLawsuitRI.pdf

CDC: http://www.cdc.gov

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AP Medical Writer Lindsey Tanner can be reached at http://www.twitter.com/LindseyTanner

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Villaraigosa speaks in D.C., urging immigration overhaul

WASHINGTON — Los Angeles Mayor Antonio Villaraigosa delivered a high-profile speech in the nation's capital Monday in support of overhauling immigration laws but sidestepped questions about his future once his mayoral term ends.

"I'm focused on the job I've got and want to finish as strong as I can," he told a National Press Club audience. When asked whether he would serve in the Obama administration after his term ends June 30, he said, "When I'm asked, I'll answer the question.

"The sun may be setting on my administration, but I'm not riding off into the sunset just yet," Villaraigosa said. He is due to return to Washington at the end of the week for a news conference with other mayors calling for tougher gun laws.

On Monday, Villaraigosa called for comprehensive immigration legislation that includes a path to citizenship for the 11 million people who are in the United States unlawfully. Illegal immigrants would have to undergo background checks, show English language skills and American civics knowledge and pay back taxes before they could be processed for legal status under his proposal. The overhaul, he said, should include an effective employment verification system and "smart enforcement."

"We've created an immigration system that is long on enforcement but short on opportunity ... a system that happily capitalizes on the labor of millions of undocumented men and women but then refuses to extend them the basic rights and privileges that most of us take for granted," he said.

"The goal of our immigration enforcement policy should be to remove real threats to our borders and inside our country," Villaraigosa said. "We should deport serious offenders. We should not deport people whose most serious crime is a lack of papers."

He dismissed the notion that it may be too difficult for Congress to tackle the politically hot issue of immigration as it gears up for fights over gun laws and federal spending.

"Washington should be able to walk and chew gum at the same time," he said.

Villaraigosa said he would be speaking to the U.S. Conference of Mayors soon, seeking its support in pressuring Congress to pass comprehensive immigration legislation.

Urging Republicans to support an overhaul of immigration laws, he brought up GOP presidential nominee Mitt Romney's poor showing among Latino voters, attributing it to the "vitriolic nature of the immigration debate."

"If the Republicans don't go to the center — they continue to be, you know, dominated by the far right — you're going to see them lose more and more," he said.

Villaraigosa also pitched his immigration-overhaul idea as financially smart.

"This doesn't just make moral sense, it makes economic sense," he said. "If we legalize the 11 million undocumented immigrants here in the United States, we'd give an infusion to our economy of $1.5 trillion, a shot in the arm over the next decade. The federal government would see $4.5 billion in more tax revenue in just three years."

Acknowledging the difficulty of the issue, Villaraigosa recalled a massive 2006 immigration rally outside Los Angeles City Hall during which "many on my staff said, 'Don't go out there; don't do it; you've been in office less than a year; your job is to fix potholes; leave immigration to the feds.'

"But when 1 million people march to your front step, they deserve a welcome," he said. "No human being is illegal.... We must enshrine this principle into the heart and soul of the country's immigration policy."

Kristen Williamson of the Federation for American Immigration Reform said the mayor's presentation was nothing new: He "merely reiterated the same tired calls for more immigration from the open borders lobby. His plan to extend amnesty to illegal aliens, continue chain migration and invite more unskilled immigration benefits immigrants while harming American workers and undermining the rule of law.''

richard.simon@latimes.com

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Egyptian Court Overturns Mubarak’s Conviction

Mohamed Abd El Ghany/Reuters

Supporters of Hosni Mubarak celebrated on Sunday outside a High Court in Cairo.

CAIRO — An Egyptian appeals court on Sunday threw out the guilty verdict and life sentence against former President Hosni Mubarak on charges that he allowed the killing of protesters. The court ordered a new trial, which would once again send the ailing autocrat rolling on a stretcher into the steel defendant’s cage in an Egyptian criminal court.

Whether this was a victory or a setback for Mr. Mubarak was confused and contested. Both the prosecution and the defense had appealed the verdict, one side seeking a stronger verdict and the other an acquittal. Lawyers for the Islamist party allied with President Mohamed Morsi argued that a new trial with new evidence could yield a death penalty.

But other Egyptians reacted to the decision with exasperated sighs, seeing a parable of the country’s fitful progress in its struggle to break free of its autocratic past.

“Oh my God, we went back to square one, back to the early days of the revolution two years ago, when people were first calling for a Mubarak trial,” said Emad Shahin, a political scientist at the American University of Cairo.

Mr. Mubarak’s unending case, he said, reflects Egypt’s unfinished revolution, in which a leader of the old Islamist opposition has come to preside uneasily over the largely still intact institutions of Mr. Mubarak’s former government, including the courts and the police.

“You are fighting Mubarak with his laws and his men,” Mr. Shahin said.

With a parliamentary election set for April, the new trial appeared certain to revive the calls for justice and revenge that once animated the uprising against Mr. Mubarak. Among Mr. Morsi’s Islamist supporters, the renewed attention to the case played into their depiction of an epic struggle between Egypt’s newly elected leaders and the vestiges of the old state.

“God’s will was for the trial to be redone under Morsi, with the availability of new evidence and new defendants,” Essam el-Erian, a senior leader of President Morsi’s Freedom and Justice Party, said in a statement.

Mr. Mubarak, 84, spent Sunday night in a military hospital, where he has been transferred repeatedly from his prison cell because of a host of reported health problems, some resulting from falls in the prison bathroom. At one point last year, the official Egyptian state news agency erroneously reported that he was “clinically dead” from a stroke. His first trial was conducted under the rule of the generals who seized power at his ouster, and have since ceded authority to Mr. Morsi.

More than 800 civilian demonstrators were killed, many of them by police and security forces, during the three weeks of mostly nonviolent protests that ended Mr. Mubarak’s rule. When the transitional government pursued charges against Mr. Mubarak and his circle, human rights lawyers faulted the prosecutors for relying on the same police force accused of killing the protesters to collect evidence against itself. And during Mr. Mubarak’s trial, many accused the prosecutors of failing to make good use of the evidence they did gather.

The guilty verdict was considered ripe for appeal from the moment it was issued, because the judge who handed it down said at the time that he had seen no evidence to back up a conviction. Instead, the judge reasoned that Mr. Mubarak and his Interior Ministry bore responsibility for the deaths of the protesters by virtue of their positions; he acquitted a half-dozen subordinate Interior Ministry officials who were charged in the same case.

Under Egyptian law, the ruling on Sunday effectively rewinds the court proceedings to the original indictment of Mr. Mubarak in 2011. When the case is assigned to a new court, the judge will have broad latitude and can send the case back to prosecutors for further investigation and new evidence, or even amend the charges.

Evidently anticipating Sunday’s ruling, Egyptian prosecutors recently had begun a new case against Mr. Mubarak, accusing him of taking payoffs from the state news organization Al Ahram in the form of $1 million in gifts over the last six years of his rule. The prosecutors issued an order on Saturday that would allow them to go on detaining Mr. Mubarak for questioning in that matter even if the court threw out his conviction in the protesters’ deaths.

Mayy El Sheikh contributed reporting.

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HTC seeks Myanmar edge with local font phones

YANGON (Reuters) – Peter Chou, CEO of Taiwan smartphone company HTC Corp, will on Monday launch what he hopes will be a major boost to both a backward tech sector in Myanmar, his country of birth, and to his company’s share of one of the few untapped mobile markets: a phone that locals can use out of the box.

Until now, Chou says, Myanmarese users of mobile phones and computers must install fonts in their own language, a process that is cumbersome, often invalidates the device’s warranty and has, he says, slowed innovation and the embrace of technology.

HTC has instead teamed up with a local distributor and a software developer to customize Google’s Android operating system so its devices display local fonts and sport a dedicated and, Chou says, intuitive, Myanmar language onscreen keyboard.

“You don’t have to spend two months to learn how to type it,” Chou said in an interview ahead of the launch. “You just type it. We want to give people here a computing device they don’t have to learn. They just try it, they just use it, they just get it.”

Myanmar IT experts say that while the country’s alphabet is no more complex than some other Asian scripts, a failure to agree how to apply an international standard for language symbols called Unicode to existing versions of the computer font has made it difficult to bake the language into software.

As a result, web pages and apps will often be unreadable.

BIG CHALLENGES, LITTLE PENETRATION

The issue of fonts may seem a basic one, but reflects the challenges Myanmar faces in catching up with its neighbors as it sheds decades of military control over politics and the economy. Myanmar has one of the lowest mobile penetration rates in the world, with only 3 percent of the population owning a phone in 2011, according to the World Bank. In neighboring Bangladesh, 56 percent of people have a mobile phone.

When IT enthusiasts met last year for a conference on the future of technology called Barcamp Yangon, much of the discussion revolved around such basic issues, participants said. With at least two competing types of font software available, disagreements remain.

The problem is worse on smartphones, says Soe Ngwe Ya, general manager of KMD, HTC’s distribution partner for the new phones. In order to install such fonts on mobile devices users must first “root” the phone, effectively bypassing the manufacturer’s controls on customizing the phone’s operating system. That often invalidates any warranty. “It’s a major issue,” he says.

HTC also hopes it can claw back some ground from its biggest competitor in Android phones, Samsung Electronics, which has established a first mover advantage in Myanmar.

Samsung has at least two distributors for its handsets and its advertisements are visible around the capital. Soe says KMD will act as HTC’s distributor, open a flagship store and service HTC users.

Chou, who was born in Myanmar but left to work and study in Taiwan more than 30 years ago, says that at least for now the Myanmar fonts and keyboard will only be available on HTC devices. He denied that this undermined his claims of contributing to his homeland.

“While sometimes you can be idealistic,” he said, “the first thing you have to show the people is something to get excited about.”

(Editing by Ian Geoghegan)

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Flu more widespread in US; eases off in some areas

NEW YORK (AP) — Flu is now widespread in all but three states as the nation grapples with an earlier-than-normal season. But there was one bit of good news Friday: The number of hard-hit areas declined.

The flu season in the U.S. got under way a month early, in December, driven by a strain that tends to make people sicker. That led to worries that it might be a bad season, following one of the mildest flu seasons in recent memory.

The latest numbers do show that the flu surpassed an "epidemic" threshold last week. That is based on deaths from pneumonia and influenza in 122 U.S. cities. However, it's not unusual — the epidemic level varies at different times of the year, and it was breached earlier this flu season, in October and November.

And there's a hint that the flu season may already have peaked in some spots, like in the South. Still, officials there and elsewhere are bracing for more sickness

In Ohio, administrators at Miami University are anxious that a bug that hit employees will spread to students when they return to the Oxford campus next week.

"Everybody's been sick. It's miserable," said Ritter Hoy, a spokeswoman for the 17,000-student school.

Despite the early start, health officials say it's not too late to get a flu shot. The vaccine is considered a good — though not perfect — protection against getting really sick from the flu.

Flu was widespread in 47 states last week, up from 41 the week before, the Centers for Disease Control and Prevention said on Friday. The only states without widespread flu were California, Mississippi and Hawaii.

The number of hard-hit states fell to 24 from 29, where larger numbers of people were treated for flu-like illness. Now off that list: Florida, Arkansas and South Carolina in the South, the first region hit this flu season.

Recent flu reports included holiday weeks when some doctor's offices were closed, so it will probably take a couple more weeks to get a better picture, CDC officials said Friday. Experts say so far say the season looks moderate.

"Only time will tell how moderate or severe this flu season will be," CDC Director Dr. Thomas Frieden said Friday in a teleconference with reporters.

The government doesn't keep a running tally of adult deaths from the flu, but estimates that it kills about 24,000 people in an average year. Nationally, 20 children have died from the flu this season.

Flu vaccinations are recommended for everyone 6 months or older. Since the swine flu epidemic in 2009, vaccination rates have increased in the U.S., but more than half of Americans haven't gotten this year's vaccine.

Nearly 130 million doses of flu vaccine were distributed this year, and at least 112 million have been used. Vaccine is still available, but supplies may have run low in some locations, officials said.

To find a shot, "you may have to call a couple places," said Dr. Patricia Quinlisk, who tracks the flu in Iowa.

In midtown Manhattan, Hyrmete Sciuto got a flu shot Friday at a drugstore. She skipped it in recent years, but news reports about the flu this week worried her.

During her commute from Edgewater, N.J., by ferry and bus, "I have people coughing in my face," she said. "I didn't want to risk it this year."

The vaccine is no guarantee, though, that you won't get sick. On Friday, CDC officials said a recent study of more than 1,100 people has concluded the current flu vaccine is 62 percent effective. That means the average vaccinated person is 62 percent less likely to get a case of flu that sends them to the doctor, compared to people who don't get the vaccine. That's in line with other years.

The vaccine is reformulated annually, and this year's is a good match to the viruses going around.

The flu's early arrival coincided with spikes in flu-like illnesses caused by other bugs, including a new norovirus that causes vomiting and diarrhea, or what is commonly known as "stomach flu." Those illnesses likely are part of the heavy traffic in hospital and clinic waiting rooms, CDC officials said.

Europeans also are suffering an early flu season, though a milder strain predominates there. China, Japan, the West Bank, the Gaza Strip, Algeria and the Republic of Congo have also reported increasing flu.

Flu usually peaks in midwinter. Symptoms can include fever, cough, runny nose, head and body aches and fatigue. Some people also suffer vomiting and diarrhea, and some develop pneumonia or other severe complications.

Most people with flu have a mild illness. But people with severe symptoms should see a doctor. They may be given antiviral drugs or other medications to ease symptoms.

Some shortages have been reported for children's liquid Tamiflu, a prescription medicine used to treat flu. But health officials say adult Tamiflu pills are available, and pharmacists can convert those to doses for children.

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Associated Press writers Dan Sewell in Cincinnati, Catherine Lucey in Des Moines, and Malcolm Ritter in New York contributed to this report.

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Online:

CDC flu: http://www.cdc.gov/flu/index.htm

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California's debt still a heavy cloud over state's future

SACRAMENTO — Gov. Jerry Brown proclaimed last week that California, which now has enough cash to pay its day-to-day bills, can no longer be described by naysayers as a "failed state."

But even though it appears to be free of the deficit that dogged the Capitol in recent years, the state is no model of financial health.

Sacramento is legally obligated to pay many billions of dollars withheld from schools, local governments and healthcare providers as lawmakers struggled repeatedly to balance the books. It owes Wall Street more per resident than almost every other state. And it has accumulated a crushing load of debt for retiree pensions and healthcare, now totaling more than taxpayers spend each year on all state programs combined.

The budget Brown proposed Thursday addresses only a small portion of the overall debt, which stems from the same types of bills that drove cities like Vallejo, Stockton and San Bernardino into bankruptcy. The state is likely to find its debt consuming an ever larger share of money meant for the basic needs of government.

"Every year we fail to acknowledge or fix these things, it just makes the cost bigger," said Joe Nation, a former Democratic assemblyman who teaches public policy at Stanford University.

When he released his budget plan, Brown vowed to knock down the state's "wall of debt." He presented a timeline for repaying nearly $28 billion the state owes to government programs that it raided for cash or deprived of funds over the years, as well as some bonds sold to balance the budget.

Payments of $4.2 billion would be made in the budget year that begins in July. Subsequent payments, growing to as much as $7.3 billion a year, would continue into 2017.

At that point, Brown says, $4.3 billion in debt would remain, mostly for delayed payments to healthcare providers and money owed to municipalities and schools for implementing state mandates.

"By paying down the debt, we've put ourselves in a stronger position when things go bad, as they inevitably do," Brown said.

But numerous reports by state agencies, think tanks and academics have shown the wall of debt to be many stories higher than $28 billion — hundreds of billions of dollars over the next few decades. Brown's repayment plan does not significantly reduce the sizable debt to Wall Street or account for promises the state has made to its current and future retirees but is not setting enough money aside to cover.

"If we just ignore these longer-term pressures, we're going to be back in the soup soon," said Mike Genest, who was budget director for Gov. Arnold Schwarzenegger.

State officials must grapple with a major shortfall in the retirement fund for teachers. Fund officials have warned that Sacramento needs to immediately start contributing about $3 billion annually to keep the pension system solvent.

Sacramento could kick the bill to school districts, requiring them to start paying more pension costs from their own budgets. But the money needed now to stabilize the fund is enough to wipe out the $2.7-billion budget boost the governor is proposing for schools after many years of cuts.

"That is a demand that will have to be met," said David Crane, who advised Schwarzenegger on pensions and the economy. "Even if there is an increase in funding for schools, the districts may have to use that — and more — to meet that demand."

So far, lawmakers have taken no action to fill the gap. They have opted, for now, to let it grow. (The changes legislators made in public pensions last year do not fix the problem.)

They have taken the same approach with the escalating cost of retiree healthcare.

State employees on the payroll 10 years or more are guaranteed insurance coverage for life — a benefit bestowed decades ago, before the cost of medical care exploded. Now, the state is facing a bill of $62.1 billion for those employees over the next 30 years, according to state projections. Sacramento has set no money aside to cover the payments, and the tab grows each year.

Brown proposed that lawmakers confront that cost last year. Lawmakers balked and excluded his plan to limit the number of state workers eligible for retiree healthcare.

The cost of closing the gaps in California's major public pension funds would be considerable. The State Budget Crisis Task Force, a bipartisan think tank based in New York, reported in September that every Californian would have to contribute $3,635 to cover the shortfalls. Paying for retiree healthcare might add a couple of thousand dollars to that tab.

The state's borrowing from Wall Street in recent years also comes at a cost. According to the state treasurer's office, it will cost $2,559 per Californian to pay that back. Texas, by contrast, has taken on just $588 of debt per resident.

Genest said California undeniably has made major strides since the darkest budget days of recent years. "We've finally got through the worst of it," he said.

But the mess is far from cleaned up, he cautioned: "We can't jump for joy."

evan.halper@latimes.com

chris.megerian@latimes.com

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