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."

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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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Beijing Air Pollution Off the Charts

Alexander F. Yuan/Associated Press

Fashionably masked women on Saturday outside an amusement park in Beijing. The World Health Organization has standards that judge an air-quality score above 500 to be more than 20 times the level of particulate matter in the air deemed safe.

BEIJING — One Friday more than two years ago, an air-quality monitoring device atop the United States Embassy in Beijing recorded data so horrifying that someone in the embassy called the level of pollution “Crazy Bad” in an infamous Twitter post. That day the Air Quality Index, which uses standards set by the United States Environmental Protection Agency, had crept above 500, which was supposed to be the top of the scale.

So what phrase is appropriate to describe Saturday’s jaw-dropping reading of 755 at 8 p.m., when all of Beijing looked like an airport smokers’ lounge? Though an embassy spokesman said he did not immediately have comparative data, Beijing residents who follow the Twitter feed said the Saturday numbers appeared to be the highest recorded since the embassy began its monitoring system in 2008.

The embassy’s @BeijingAir Twitter feed said the level of toxicity in the air was “Beyond Index,” the terminology for levels above 500; the “Crazy Bad” label was used just once, in November 2010, by an embassy employee using the Twitter account. According to the Environmental Protection Agency, levels between 301 and 500 are “Hazardous,” meaning people should avoid all outdoor activity. The World Health Organization has standards that judge a score above 500 to be more than 20 times the level of particulate matter in the air deemed safe.

In online conversations, Beijing residents tried to make sense of the latest readings.

“This is a historic record for Beijing,” Zhao Jing, a prominent Internet commentator who uses the pen name Michael Anti, wrote on Twitter. “I’ve closed the doors and windows; the air purifiers are all running automatically at full power.”

Other Beijing residents online described the air as “postapocalyptic,” “terrifying” and “beyond belief.”

The municipal government reported levels as high as 478 on Saturday in central Beijing, according to The Associated Press. It was not immediately clear why the number was lower, but even that level is considered hazardous according to the United States Environmental Protection Agency standards. (By comparison, the air quality index in New York City, using the same standard, was 19 at 6 a.m. on Saturday.)

Pollution levels in Beijing had been creeping up for days, and readings were regularly surging above 300 by midweek. The interior of the gleaming Terminal 3 of the Beijing Capital International Airport was filled with a thick haze on Thursday. The next day, people working in office towers in downtown Beijing found it impossible to make out skyscrapers just a few blocks away. Some city residents scoured stores in search of masks and air filters.

Still, there was little warning that the United States Embassy reading would jump above 700 on Saturday. Some people speculated that the monitoring system, which measures fine particles called PM 2.5 because they are 2.5 microns in diameter or smaller, might have malfunctioned once it got beyond 500.

But Nolan Barkhouse, an embassy spokesman, said the monitor was operating correctly.

It was unclear exactly what was responsible for the rise in levels of particulate matter, beyond the factors that regularly sully the air here. Factories operating in neighboring Hebei Province ring this city of more than 20 million. The number of cars on Beijing’s streets has been multiplying at an astounding rate. And Beijing sits on a plain flanked by hills and escarpments that can trap pollution on days with little wind. Meanwhile, one person hiking at the Great Wall in the hills at Mutianyu, north of Beijing, took photographs of crisp blue skies there.

Xinhua, the state news agency, reported on Dec. 31 that Beijing’s air quality had improved for 14 years straight, and the level of major pollutants had decreased. A municipal government spokesman told Xinhua that the annual average concentration of PM 10, or particles 10 microns in diameter or smaller, had dropped by 4 percent in 2012, compared with one year earlier.

Chinese officials prefer to publicly release air pollution measurements that give only levels of PM 10, although foreign health and environmental experts say PM 2.5 can be deadlier and more important to track.

There has been a growing outcry among Chinese for municipal governments to release fuller air quality data, in part because of the United States Embassy Twitter feed. As a result, Beijing began announcing PM 2.5 numbers last January. Major Chinese cities have had the equipment to track those levels, but had refused for a long time to release the data.

The existence of the embassy’s machine and the @BeijingAir Twitter feed have been a diplomatic sore point for Chinese officials. In July 2009, a Chinese Foreign Ministry official, Wang Shu’ai, told American diplomats to halt the Twitter feed, saying that the data “is not only confusing but also insulting,” according to a State Department cable obtained by WikiLeaks. Mr. Wang said the embassy’s data could lead to “social consequences.”

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RIM shares climb as investors bet on new BlackBerry

TORONTO (Reuters) – Shares of Research In Motion rallied on Friday as investors positioned themselves ahead of the launch of its new make-or-break BlackBerry 10 smartphones at the end of the month.

Morningstar analyst Brian Colello did not see any one news story driving the stock, which climbed steadily through much of the day. The new phones are to be formally unveiled on January 30.

“The stock has been extremely volatile, based on BlackBerry 10 rumors and the potential for success in the market,” said Colello.

Several blog posts published on Friday showed purportedly leaked photos of what could be the new phones, and a number of tech sites confirmed that Sprint Nextel Corp would carry BlackBerry 10.

“Sprint plans to bring BlackBerry 10 to our customers later this year. We will share more details soon,” Mark Elliot, a spokesman for the U.S. carrier, said in an email.

Earlier this week, executives at Verizon Communications, AT&T Inc and T-Mobile USA all confirmed they would carry the smartphones, and said they are looking forward to the new devices.

“There are, I think, good indications that they’re going to get a seat at all the tables that matter,” said IDC analyst John Jackson, who called carrier support “necessary, but not sufficient” to ensure the success of BlackBerry 10.

Throughout the autumn of 2012, RIM’s stock rose as investors grew more optimistic about BlackBerry 10. Morningstar’s Colello said the market went from pricing in no chance of success, to betting on at least some chance of success for the new products.

But the rally broke off after RIM reported earnings in December, revealing that it would roll out a new fee structure for its services segment which some fear could put pressure on the high-margin business.

The new line’s success is crucial to the future of RIM, which has lost ground to competitors such as Apple Inc and Samsung Electronics, and in December reported its first-ever decline in total subscribers.

BGC Partners analyst Colin Gillis said the news that all four major U.S. carriers would offer BlackBerry 10 was likely lifting the stock, along with Nokia’s stronger-than-expected quarterly results — a sign that Google Inc’s Android smartphones have not completely taken over its market.

“The smartphone market is one of the most robust, largest markets in the world … it’s also dynamic,” said Gillis. “The winners and losers are going to be shifting. That said, it’s a difficult road the company is facing.”

RIM’s Nasdaq-listed shares were up 13.2 percent at $ 13.49. Shares jumped 12.6 percent to C$ 13.27 on the Toronto Stock Exchange. That more than doubled the price since the low of C$ 6.10 it touched in September. By late afternoon, RIM was the day’s most heavily-traded stock on the Toronto Stock Exchange.

(Additional reporting by Nicola Leske in New York; Editing by Marguerita Choy and Alden Bentley)

Wireless News Headlines – Yahoo! News

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Inside Story: Life Without Lauren Spierer

By Kristen Mascia and Jeff Truesdell

01/12/2013 at 06:30 PM EST

Lauren Spierer

Jeremy Hogan/Bloomington Herald-Times/Polaris

It's the little things, say Robert and Charlene Spierer, that hurt the most.

For Robert it's the flash of a blonde ponytail on a city street that leaves him aching; for Charlene it's the arrival of the cell-phone bill that still bears her daughter's name.

Nineteen months after Lauren disappeared, her boxes from college remain stacked against her parents' den wall. Long ago they gave up hope that Lauren might unpack them herself.

"I can't bear to move them," says Charlene. "I know they're just boxes. But I can't."

It's difficult for the Spierers to grasp that it's been nearly two years since Lauren, 20, a bright, beautiful sophomore at Indiana University Bloomington, left a friend's off-campus apartment after a night out partying and never returned to her own. In that time their lives have utterly transformed.

For seven months in 2011 they lived in Bloomington, helping coordinate search efforts and hiring their own private investigator. And last year they planned a wedding without her, celebrating in October the marriage of their older daughter Rebecca, 26. Yet as much as their lives change, the status of the search for their daughter remains the same.

"They're not getting the same frequency of leads," says Robert of the investigators working on the case. "It's frustrating because 19 months later we still don't have answers, and we still don't have our child."

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Q&A: Scramble for vaccine as flu season heats up

WASHINGTON (AP) — Missed flu-shot day at the office last fall? And all those "get vaccinated" ads? A scramble for shots is under way as late-comers seek protection from a miserable flu strain already spreading through much of the country.

Federal health officials said Friday that there is still some flu vaccine available and it's not too late to benefit from it. But people may have to call around to find a clinic with shots still on the shelf, or wait a few days for a new shipment.

"We're hearing of spot shortages," said Dr. Thomas Frieden, director of the Centers for Disease Control and Prevention.

Colorado offers an example. Kaiser Permanente, which has 535,000 members in the state, stopped giving flu shots this week. But it expected to resume vaccinations when new shipments arrive, expected this weekend.

Some questions and answers about flu vaccines:

Q: Are we running out of vaccine?

A: It's January — we shouldn't have a lot left. The traditional time to get vaccinated is in the fall, so that people are protected before influenza starts spreading.

Indeed, manufacturers already have shipped nearly 130 million doses to doctors' offices, drugstores and wholesalers, out of the 135 million doses they had planned to make for this year's flu season. At least 112 million have been used so far.

The nation's largest manufacturer, Sanofi Pasteur, said Friday that it still has supplies of two specialty vaccines, a high-dose shot for seniors, and an under-the-skin shot for certain adults, available for immediate shipment. But it also is working to eke out a limited supply of its traditional shots — some doses that it initially hadn't packaged into syringes, said spokesman Michael Szumera. They should be available late this month.

And MedImmune, the maker of the nasal spray vaccine FluMist, said it has 620,000 extra doses available.

Q: Can't they just make more?

A: No. Flu vaccine is complicated to brew, with supplies for each winter made months in advance and at the numbers expected to sell. Although health officials recommend a yearly flu vaccination for nearly everybody, last year 52 percent of children and just 39 percent of adults were immunized. Most years, leftover doses have to be thrown out.

Q: Should I still hunt for a vaccine?

A: It does take two weeks for full protection to kick in. Still, health officials say it's a good idea to be vaccinated even this late, especially for older people, young children and anyone with medical conditions such as heart or lung diseases that put them at high risk of dangerous flu complications. Flu season does tend to be worst in January and February, but it can run through March.

Q: I heard that a new flu strain is spreading. Does the vaccine really work?

A: Flu strains constantly evolve, the reason that people need an updated vaccine every year. But the CDC says this year's is a good match to the types that are circulating, including a new kind of the tough H3N2 strain. That family tends to be harsher than other flu types — and health officials warned last fall that it was coming, and meant this winter would likely be tougher than last year's flu season, the mildest on record.

Q: But don't some people get vaccinated and still get sick?

A: Flu vaccine never is 100 percent effective, and unfortunately it tends to protect younger people better than older ones. But the CDC released a study Friday showing that so far this year, the vaccine appears 62 percent effective, meaning it's working about as well as it has in past flu seasons.

While that may strike some people as low, Frieden said it's the best protection available. "It's a glass 62 percent full," he said. "It's well worth the effort."

Q: What else can I do?

A: Wash your hands often, and avoid touching your eyes, nose and mouth. Viruses can spread by hand, not just through the air. Also, cough in your elbow, not your hand. When you're sick, protect others by staying home.

And people who are in those high-risk groups should call a doctor if they develop symptoms, added CDC spokesman Tom Skinner. They might be prescribed antiviral medication, which works best if given within the first 48 hours of symptoms.

___

AP Medical Writers Lindsey Tanner and Mike Stobbe contributed to this report.

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