The New Old Age Blog: Study: More to Meal Delivery Than Food

What’s a simpler idea than Meals on Wheels? Older, lower-income people who have trouble driving, cooking or shopping — or paying for food — sign up with a local agency. Each day, volunteers or paid staff come by and drop off a hot lunch. Federal and state dollars and local charities foot the bill.

At the Mobile Meals of Essex headquarters in my town in New Jersey on a recent morning, staffers were stuffing slices of whole wheat bread, pints of low-fat milk and containers of sliced peaches into paper bags. Next, they would ladle the day’s entree — West Indian curried chicken with brown rice and broccoli — onto aluminum trays.

Drivers in vans would fan out through the county, from downtown Newark through the sprawling suburbs, delivering the meals to 475 clients.

The benefit goes beyond food, of course. When his clients answer the door, often using walkers and canes, “I ask them how their morning’s going,” said a driver, Louis Belfiore, who would make 31 stops this day. “I give them their meal, I say, ‘Have a good day.’ They tell me, ‘You have a nice day, too.’”

This may represent the only face-to-face social interaction some homebound people have in the course of a day. And if they don’t come to the door, a series of phone calls ensues. “We’ve had people yell back, ‘I’m on the floor and I can’t get up.’ It doesn’t happen only in commercials,” said Gail Gonnelli, the program’s operations director.

Meals on Wheels advocates have always believed that something this fundamental – a hot meal, a greeting, another set of eyes – can help keep people in their homes longer.

But they didn’t have much evidence to point to, until a couple of Brown University health researchers crunched numbers — from Medicare, states and counties, the federal Administration on Aging and more than 16,000 nursing homes — from 2000 to 2009, publishing their findings in the journal Health Services Research.

The connection they discovered between home-delivered meals and the nursing home population will come as welcome news (though not really news) to Meals on Wheels believers: States that spent more than the average to deliver meals showed greater reductions in the proportion of nursing home residents who didn’t need to be there.

The researchers call these people “low-care” residents. Most people living in nursing homes require around-the-clock skilled care, and policymakers have been pushing to find other ways to care for those who don’t. Still, in 2010 about 12 percent of long-term nursing home patients — a proportion that varies considerably by state — didn’t need this level of care.

“They’re not fully dependent,” explained a co-author of the study, Vincent Mor. “They could be cared for in a community setting, whether that’s assisted living or with a few hours of home care.”

That’s how most older people prefer to live, which is reason enough to try to reserve nursing homes for those who can’t survive any other way. But political budget cutters should love Meals on Wheels, too. For every additional $25 a state spends on home-delivered meals each year per person over 65, the low-care nursing home population decreases by a percentage point, the researchers calculated — a great return on investment.

“We spend a lot on crazy medical interventions that don’t have as much effect as a $5 meal,” Dr. Mor concluded. With this data, “we’re able to see this relationship for the first time.”

(Co-author Kali Thomas — herself a volunteer Meals on Wheels driver in Providence, R.I. — has compiled a state by state list, posted on the Brown University LTCfocus.org Web site, showing how much states could save on Medicaid by delivering more meals.)

Sadly, though, appropriations for home-delivered meals are not increasing. The program served more than 868,000 people in 2010, the latest numbers available. But federal financing through the Older Americans Act has been flat for most of the decade, while food and gas costs — and the number of older people — have risen.

Given current budget pressures, advocates hope they can just hold the line (the “sequester” cuts to the federal budget are still looming unless Congress and the White House can reach agreement on the debt limit and a spending plan). Already, “we’ve seen millions and millions fewer meals,” said Tim Gearan, senior legislative representative at AARP. “Cuts from five-day service to three-day service. A lot more frozen food, which can be inappropriate for people who can’t operate ovens and microwaves. It’s been hard to watch.”

My urban/suburban county, Ms. Gonnelli said, maintains a waiting list: There are always about 65 seniors who qualify for Meals on Wheels, but there is no money to provide the food.

It can be a big step for an older person or his family to acknowledge that they need this kind of basic help and apply. It must be difficult, I said to Ms. Gonnelli, who has run the program for 15 years, to tell applicants she can’t help feed them.

“You have no idea,” she said.

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Paula Span is the author of “When the Time Comes: Families With Aging Parents Share Their Struggles and Solutions.”

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Gadgetwise Blog: Q&A: Translating PDF to Word

I know you can save a Microsoft Word document as a PDF file, but can you go the other way and save a PDF as a Word document that can be edited?

Several third-party sites or shareware programs can do the job for free or for a small fee, which may be the best option if you just have a small number of files to convert. The converter page on the PDF Online site, the Smart PDF Converter page and shareware like Free PDF to Word Converter for Windows are among the options.

Adobe, which originally developed the PDF format, has instructions for converting PDF files to Word files with its $20-a-year Acrobat.com ExportPDF service on its site. The company also has conversion instructions posted for those using its Acrobat desktop software.

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Pakistan Supreme Court Orders Arrest of Prime Minister

W. Khan/European Pressphoto Agency

Supporters of Muhammad Tahir ul Qadri, who addressed protesters outside parliament on Tuesday, repeated calls for the ouster of the government.

ISLAMABAD, Pakistan – Pakistan’s supreme court ordered the arrest of Prime Minister Raja Pervez Ashraf in a corruption case on Tuesday afternoon, dramatically raising the stakes in a tense standoff between the government and its opponents.

The court order came as an enigmatic preacher turned politician, Muhammad Tahir ul Qadri, addressed thousands of supporters outside parliament and repeated calls for the government’s ouster. In earlier speeches, he said that a caretaker administration led by technocrats should take its place.

The confluence of the two events stoked growing speculation that Pakistan’s powerful military was quietly supporting moves that would delay general elections that are due to take place this spring, most likely through the imposition of a military-backed caretaker administration.

“Victory, victory, victory. By the grace of God,” Mr. Qadri at the conclusion of a speech to his supporters who were camped outside the parliament.

It was not certain that the two events were linked. Some analysts said that in calling for the prime minister’s arrest, the court, which is led by the independent-minded chief justice Iftikhar Muhammad Chaudhry, was simply taking advantage of anti-government sentiment generated by Mr. Qadri in order to pursue its longstanding grudge against President Asif Ali Zardari.  

Whatever the motivations, the court’s actions added to the chaos in Pakistan, with the stock market dropping 3 percent after word of the court’s order came down.

In its order issued Tuesday, the Supreme Court ordered the National Accountability Bureau, a government body that investigates graft, to arrest Mr. Ashraf and 15 other senior current or former officials, including a former finance minister and a former finance secretary.

The case relates to longstanding allegations that Mr. Ashraf took millions of dollars in kickbacks as part of a deal to build two electricity power plants while serving as minister for water and power between March 2008 and February 2011.

The order comes more than a year after two opposition figures filed a complaint in the supreme court against Mr. Ashraf. Three months later, in March 2012, the court ruled that that power plants were illegal, ordered their closure, and instituted proceedings against Mr. Ashraf.

The case has particular political resonance because Pakistan’s energy crisis, which has seen severe electricity rationing across the country, is the source of some of the main complaints against the government.

Fawad Chaudhry, a senior adviser to Mr. Ashraf , said that any attempt by the court to arrest the prime minister be "illegal and unconstitutional."

"Under the law, the court cannot arrest him," he said, adding that his office was awaiting official notification of the reported court order. "If it has done so, it is illegal and unconstitutional." 

President Zardari has called a meeting of senior advisers at his Karachi residence to discuss the crisis late Tuesday, he added. 

Mr. Zardari’s supporters have painted the prosecution as part of a politically-tinged drive by Justice Chaudhry to unseat Mr. Zardari. Mr. Ashraf came to power last summer after the supreme court forced his predecessor, Yousaf Raza Gilani, to resign from office over another corruption-related case.

Whether there was any link between the court order and Mr. Qadri’s march on Islamabad – billed by the preacher as a “million man march” but in reality far smaller – the timing was certainly striking.

In his speech Mr. Qadri – who returned barely one month ago to Pakistan from Canada, where he also holds citizenship – demanded the immediate resignation of the government, and painted the country’s elected politicians as “criminals” who deserved to be prosecuted for corruption.

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Susan Nolen-Hoeksema, Psychologist Who Studied Depression in Women, Dies at 53

Susan Nolen-Hoeksema, a psychologist and writer whose work helped explain why women are twice as prone to depression as men and why such low moods can be so hard to shake, died on Jan. 2 in New Haven. She was 53.

Andrew Sacks

Susan Nolen-Hoeksema at the University of Michigan in 2003. Dr. Nolen-Hoeksema's research showed that women were more prone to ruminate, or dwell on the sources of problems rather than solutions, more than men.

Her death followed heart surgery to correct a congenitally weak valve, said her husband, Richard Nolen-Hoeksema.

Dr. Nolen-Hoeksema, a professor at Yale University, began studying depression in the 1980s, a time of great excitement in psychiatry and psychology. New drugs like Prozac were entering the market; novel talking therapies were proving effective, too, particularly cognitive behavior therapy, in which people learn to defuse upsetting thoughts by questioning their basis.

Her studies, first in children and later in adults, exposed one of the most deceptively upsetting of these patterns: rumination, the natural instinct to dwell on the sources of problems rather than their possible solutions. Women were more prone to ruminate than men, the studies found, and in a landmark 1987 paper she argued that this difference accounted for the two-to-one ratio of depressed women to depressed men.

She later linked rumination to a variety of mood and behavior problems, including anxiety, eating disorders and substance abuse.

“The way I think she’d put it is that, when bad things happen, women brood — they’re cerebral, which can feed into the depression,” said Martin Seligman, a professor of psychology at the University of Pennsylvania, who oversaw her doctoral work. “Men are more inclined to act, to do something, plan, beat someone up, play basketball.”

Dr. Seligman added, “She was the leading figure in sex differences in depression of her generation.”

Dr. Nolen-Hoeksema wrote several books about her research for general readers, including “Women Who Think Too Much: How to Break Free of Overthinking and Reclaim Your Life.” These books described why rumination could be so corrosive — it is deeply distracting; it tends to highlight negative memories — and how such thoughts could be alleviated.

Susan Kay Nolen was born on May 22, 1959, in Springfield, Ill., to John and Catherine Nolen. Her father ran a construction business, where her mother was the office manager; Susan was the eldest of three children.

She entered Illinois State University before transferring to Yale. She graduated summa cum laude in 1982 with a degree in psychology.

After earning a Ph.D. in psychology at the University of Pennsylvania, she joined the faculty at Stanford. She later moved to the University of Michigan, before returning to Yale in 2004.

Along the way she published scores of studies and a popular textbook. In 2003 she became the editor of the Annual Review of Clinical Psychology, an influential journal.

Dr. Nolen-Hoeksema moved smoothly between academic work and articles and books for the general reader.

“I think part of what allowed her to move so easily between those two worlds was that she was an extremely clear thinker, and an extremely clear writer,” said Marcia K. Johnson, a psychology professor and colleague at Yale.

Dr. Nolen-Hoeksema lived in Bethany, Conn. In addition to her husband, a science writer, she is survived by a son, Michael; her brothers, Jeff and Steve; and her father, John.

“Over the past four decades women have experienced unprecedented growth in independence and opportunities,” Dr. Nolen-Hoeksema wrote in 2003, adding, “We have many reasons to be happy and confident.”

“Yet when there is any pause in our daily activities,” she continued, “many of us are flooded with worries, thoughts and emotions that swirl out of control, sucking our emotions and energy down, down, down. We are suffering from an epidemic of overthinking.”

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Susan Nolen-Hoeksema, Psychologist Who Studied Depression in Women, Dies at 53

Susan Nolen-Hoeksema, a psychologist and writer whose work helped explain why women are twice as prone to depression as men and why such low moods can be so hard to shake, died on Jan. 2 in New Haven. She was 53.

Andrew Sacks

Susan Nolen-Hoeksema at the University of Michigan in 2003. Dr. Nolen-Hoeksema's research showed that women were more prone to ruminate, or dwell on the sources of problems rather than solutions, more than men.

Her death followed heart surgery to correct a congenitally weak valve, said her husband, Richard Nolen-Hoeksema.

Dr. Nolen-Hoeksema, a professor at Yale University, began studying depression in the 1980s, a time of great excitement in psychiatry and psychology. New drugs like Prozac were entering the market; novel talking therapies were proving effective, too, particularly cognitive behavior therapy, in which people learn to defuse upsetting thoughts by questioning their basis.

Her studies, first in children and later in adults, exposed one of the most deceptively upsetting of these patterns: rumination, the natural instinct to dwell on the sources of problems rather than their possible solutions. Women were more prone to ruminate than men, the studies found, and in a landmark 1987 paper she argued that this difference accounted for the two-to-one ratio of depressed women to depressed men.

She later linked rumination to a variety of mood and behavior problems, including anxiety, eating disorders and substance abuse.

“The way I think she’d put it is that, when bad things happen, women brood — they’re cerebral, which can feed into the depression,” said Martin Seligman, a professor of psychology at the University of Pennsylvania, who oversaw her doctoral work. “Men are more inclined to act, to do something, plan, beat someone up, play basketball.”

Dr. Seligman added, “She was the leading figure in sex differences in depression of her generation.”

Dr. Nolen-Hoeksema wrote several books about her research for general readers, including “Women Who Think Too Much: How to Break Free of Overthinking and Reclaim Your Life.” These books described why rumination could be so corrosive — it is deeply distracting; it tends to highlight negative memories — and how such thoughts could be alleviated.

Susan Kay Nolen was born on May 22, 1959, in Springfield, Ill., to John and Catherine Nolen. Her father ran a construction business, where her mother was the office manager; Susan was the eldest of three children.

She entered Illinois State University before transferring to Yale. She graduated summa cum laude in 1982 with a degree in psychology.

After earning a Ph.D. in psychology at the University of Pennsylvania, she joined the faculty at Stanford. She later moved to the University of Michigan, before returning to Yale in 2004.

Along the way she published scores of studies and a popular textbook. In 2003 she became the editor of the Annual Review of Clinical Psychology, an influential journal.

Dr. Nolen-Hoeksema moved smoothly between academic work and articles and books for the general reader.

“I think part of what allowed her to move so easily between those two worlds was that she was an extremely clear thinker, and an extremely clear writer,” said Marcia K. Johnson, a psychology professor and colleague at Yale.

Dr. Nolen-Hoeksema lived in Bethany, Conn. In addition to her husband, a science writer, she is survived by a son, Michael; her brothers, Jeff and Steve; and her father, John.

“Over the past four decades women have experienced unprecedented growth in independence and opportunities,” Dr. Nolen-Hoeksema wrote in 2003, adding, “We have many reasons to be happy and confident.”

“Yet when there is any pause in our daily activities,” she continued, “many of us are flooded with worries, thoughts and emotions that swirl out of control, sucking our emotions and energy down, down, down. We are suffering from an epidemic of overthinking.”

Read More..

Electronic Records Systems Have Not Reduced Health Costs, Report Says

The conversion to electronic health records has failed so far to produce the hoped-for savings in health care costs and has had mixed results, at best, in improving efficiency and patient care, according to a new analysis by the influential RAND Corporation.

Jim Wilson/The New York Times

Dr. Alvin Rajkomar tracks patient data on a Samsung Galaxy Note. A new report questions whether electronic records reduce health care costs.

Optimistic predictions by RAND in 2005 helped drive explosive growth in the electronic records industry and encouraged the federal government to give billions of dollars in financial incentives to hospitals and doctors that put the systems in place.

“We’ve not achieved the productivity and quality benefits that are unquestionably there for the taking,” said Dr. Arthur L. Kellermann, one of the authors of a reassessment by RAND that was published in this month’s edition of Health Affairs, an academic journal.

RAND’s 2005 report was paid for by a group of companies, including General Electric and Cerner Corporation, that have profited by developing and selling electronic records systems to hospitals and physician practices. Cerner’s revenue has nearly tripled since the report was released, to a projected $3 billion in 2013, from $1 billion in 2005.

The report predicted that widespread use of electronic records could save the United States health care system at least $81 billion a year, a figure RAND now says was overstated. The study was widely praised within the technology industry and helped persuade Congress and the Obama administration to authorize billions of dollars in federal stimulus money in 2009 to help hospitals and doctors pay for the installation of electronic records systems.

“RAND got a lot of attention and a lot of buzz with the original analysis,” said Dr. Kellermann, who was not involved in the 2005 study. “The industry quickly embraced it.”

But evidence of significant savings is scant, and there is increasing concern that electronic records have actually added to costs by making it easier to bill more for some services.

Health care spending has risen $800 billion since the first report was issued, according to federal figures. The reasons are many, from the aging of the baby boomer population, to the cost of medical advances, to higher usage of medical services over all.

Officials at RAND said their new analysis did not try to put a dollar figure on how much electronic record-keeping had helped or hurt efforts to reduce costs. But the firm’s acknowledgment that its earlier analysis was overly optimistic adds to a chorus of concern about the cost of the new systems and the haste with which they have been adopted.

The recent analysis was sharply critical of the commercial systems now in place, many of which are hard to use and do not allow doctors and patients to share medical information across systems. “We could be getting much more if we could take the time to do a little more planning and to set more standards,” said Marc Probst, chief information officer for Intermountain Healthcare, a large health system in Salt Lake City that developed its own electronic records system and is cited by RAND as an example of how the technology can help improve care and reduce costs.

The RAND researchers pointed to a number of other reasons the expected savings had not materialized. The rate of adoption has been slow, they said, and electronic records do not address the fact that doctors and hospitals reap the benefits of high volumes of care.

Many experts say the available systems seem to be aimed more at increasing billing by providers than at improving care or saving money. Federal regulators are investigating whether electronic records make it easier for hospitals and doctors to bill for services they did not provide and whether Medicare and other federal agencies are adequately monitoring the use of electronic records.

Technology “is only a tool,” said Dr. David Blumenthal, who helped oversee the federal push for the adoption of electronic records under President Obama and is now president of the Commonwealth Fund, a nonprofit health group. “Like any tool, it can be used well or poorly.” While there is strong evidence that electronic records can contribute to better care and more efficiency, Dr. Blumenthal said, the systems in place do not always work in ways that help achieve those benefits.

Federal officials say they are drafting new rules to address many of the concerns about the current systems.

This article has been revised to reflect the following correction:

Correction: January 14, 2013

An article on Friday about a new RAND Corporation study that found few savings from electronic health records misstated, in some copies, the name of the city in Florida that is home to a physician practice that is suing a health care technology firm that stopped supporting a system it sold to doctors in the practice. It is in Panama City, not Panama.

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IHT Rendezvous: IHT Quick Read: Jan. 14

NEWS French fighter jets struck deep inside Islamist strongholds in northern Mali on Sunday, shoving aside months of international hesitation about storming the region after every other effort by the United States and its allies to thwart the extremists had failed. Adam Nossiter, Eric Schmitt and and Mark Mazzetti report.

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. David D. Kirkpatrick reports from Cairo.

For many Greeks, new mining operations are a symbol of their country’s willingness to accept any economic development, regardless of the environmental cost. Suzanne Daley reports from Ierissos, Greece.

Cubans will be allowed to spend more time overseas before they forfeit their residency, a concession that reflects the government’s desire for closer ties with Cubans living abroad. Victoria Burnett reports from Havana.

An outspoken former prime minister and the current foreign minister will face each other in the Czech Republic’s presidential runoff in two weeks, according to the results of the first round of voting released Saturday. This is the first direct popular vote for a head of state in the Czech Republic.The winner will succeed President Vaclav Klaus, a vociferous critic of the European Union who has dominated Czech politics for decades. Dan Bilefsky reports.

ARTS Hundreds of organizations have chosen the name Bauhaus: from a Hong Kong furniture store and a solar energy conference in Frankfurt, to a Madrid investment bank and a hostel in the Belgian city of Bruges. What’s in a name? Alice Rawsthorn on design.

FASHION It should have been the kickoff celebration of 60 years in fashion. Instead, there was a pall of sadness over the Missoni show Sunday as the search continued for the small plane that disappeared Jan. 7 in Venezuela with Vittorio Missoni, the son who always wore the brightest and cuddliest of the family’s iconic knits. Suzy Menkes writes from Milan.

SPORTS Wu Di is the first Chinese man to play singles in any Grand Slam tournament in the 45-year-old Open era. Christopher Clarey reports from the Australian Open in Melbourne.

Real’s coach, José Mourinho, virtually conceded the title following his team’s goalless draw Saturday in Pamplona, against the club at the bottom of the standings, Osasuna. Rob Hughes on soccer.

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Treasury Will Not Mint $1 Trillion Coin to Raise Debt Ceiling

WASHINGTON — The Treasury Department said Saturday that it will not mint a trillion-dollar platinum coin to head off an imminent battle with Congress over raising the government’s borrowing limit.

“Neither the Treasury Department nor the Federal Reserve believes that the law can or should be used to facilitate the production of platinum coins for the purpose of avoiding an increase in the debt limit,” Anthony Coley, a Treasury spokesman, said in a written statement.

The Obama administration has indicated that the only way for the country to avoid a cash-management crisis as soon as next month is for Congress to raise the “debt ceiling,” which is the statutory limit on government borrowing. The cap is $16.4 trillion.

“There are only two options to deal with the debt limit: Congress can pay its bills, or it can fail to act and put the nation into default,” Jay Carney, the White House press secretary, said in a statement. “Congress needs to do its job.”

In recent weeks, some Republicans have indicated that they would not agree to raise the debt limit unless Democrats agreed to make cuts to entitlement programs like Social Security.

The White House has said it would not negotiate spending cuts in exchange for Congressional authority to borrow more, and it has insisted that Congress raise the ceiling as a matter of course, to cover expenses already authorized by Congress. In broader fiscal negotiations, it has said it would not agree to spending cuts without commensurate tax increases.

The idea of minting a trillion-dollar coin drew wide if puzzling attention recently after some bloggers and economic commentators had suggested it as an alternative to involving Congress.

By virtue of an obscure law meant to apply to commemorative coins, the Treasury secretary could order the production of a high-denomination platinum coin and deposit it at the Federal Reserve, where it would count as a government asset and give the country more breathing room under its debt ceiling. Once Congress raised the debt ceiling, the Treasury secretary could then order the coin destroyed.

Mr. Carney, the press secretary, fielded questions about the theoretical tactic at a news conference last week. But the idea is now formally off the table.

The White House has also rejected the idea that it could mount a challenge to the debt ceiling itself, on the strength of the Fourteenth Amendment to the Constitution, which holds that the “validity of the public debt” of the United States “shall not be questioned.”

The Washington Post earlier published a report that the Obama administration had rejected the platinum-coin idea.

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City Room: Cuomo Declares Public Health Emergency Over Flu Outbreak

With the nation in the grip of a severe influenza outbreak that has seen deaths reach epidemic levels, New York State declared a public health emergency on Saturday, making access to vaccines more easily available.

There have been nearly 20,000 cases of flu reported across the state so far this season, officials said. Last season, 4,400 positive laboratory tests were reported.

“We are experiencing the worst flu season since at least 2009, and influenza activity in New York State is widespread, with cases reported in all 57 counties and all five boroughs of New York City,” Gov. Andrew M. Cuomo said in a statement.

Under the order, pharmacists will be allowed to administer flu vaccinations to patients between 6 months and 18 years old, temporarily suspending a state law that prohibits pharmacists from administering immunizations to children.

While children and older people tend to be the most likely to become seriously ill from the flu, Mr. Cuomo urged all New Yorkers to get vaccinated.

On Friday, the Centers for Disease Control and Prevention in Atlanta said that deaths from the flu had reached epidemic levels, with at least 20 children having died nationwide. Officials cautioned that deaths from pneumonia and the flu typically reach epidemic levels for a week or two every year. The severity of the outbreak will be determined by how long the death toll remains high or if it climbs higher.

There was some evidence that caseloads may be peaking, federal officials said on Friday.

In New York City, public health officials announced on Thursday that flu-related illnesses had reached epidemic levels, and they joined the chorus of authorities urging people to get vaccinated.

“It’s a bad year,” the city’s health commissioner, Dr. Thomas A. Farley, told reporters on Thursday. “We’ve got lots of flu, it’s mainly type AH3N2, which tends to be a little more severe. So we’re seeing plenty of cases of flu and plenty of people sick with flu. Our message for any people who are listening to this is it’s still not too late to get your flu shot.”

There has been a spike in the number of people going to emergency rooms over the past two weeks with flulike symptoms – including fever, fatigue and coughing – Dr. Farley said.

Mayor Michael R. Bloomberg and Mr. Cuomo made a public display of getting shots this past week.

In a briefing with reporters on Friday, officials from the C.D.C. said that this year’s vaccine was effective in 62 percent of cases.

As officials have stepped up their efforts encouraging vaccinations, there have been scattered reports of shortages. But officials said plenty of the vaccine was available.

According to the C.D.C., makers of the flu vaccine produced about 135 million doses for this year. As of early this month, 128 million doses had been distributed. While that would not be enough for every American, only 37 percent of the population get a flu shot each year.

Federal health officials said they would be happy if that number rose to 50 percent, which would mean that there would be more than enough vaccine for anyone who wanted to be immunized.

Two other diseases – norovirus and whooping cough – are also widespread this winter and are contributing to the number of people getting sick.

The flu can resemble a cold, though the symptoms come on more rapidly and are more severe.

Read More..

City Room: Cuomo Declares Public Health Emergency Over Flu Outbreak

With the nation in the grip of a severe influenza outbreak that has seen deaths reach epidemic levels, New York State declared a public health emergency on Saturday, making access to vaccines more easily available.

There have been nearly 20,000 cases of flu reported across the state so far this season, officials said. Last season, 4,400 positive laboratory tests were reported.

“We are experiencing the worst flu season since at least 2009, and influenza activity in New York State is widespread, with cases reported in all 57 counties and all five boroughs of New York City,” Gov. Andrew M. Cuomo said in a statement.

Under the order, pharmacists will be allowed to administer flu vaccinations to patients between 6 months and 18 years old, temporarily suspending a state law that prohibits pharmacists from administering immunizations to children.

While children and older people tend to be the most likely to become seriously ill from the flu, Mr. Cuomo urged all New Yorkers to get vaccinated.

On Friday, the Centers for Disease Control and Prevention in Atlanta said that deaths from the flu had reached epidemic levels, with at least 20 children having died nationwide. Officials cautioned that deaths from pneumonia and the flu typically reach epidemic levels for a week or two every year. The severity of the outbreak will be determined by how long the death toll remains high or if it climbs higher.

There was some evidence that caseloads may be peaking, federal officials said on Friday.

In New York City, public health officials announced on Thursday that flu-related illnesses had reached epidemic levels, and they joined the chorus of authorities urging people to get vaccinated.

“It’s a bad year,” the city’s health commissioner, Dr. Thomas A. Farley, told reporters on Thursday. “We’ve got lots of flu, it’s mainly type AH3N2, which tends to be a little more severe. So we’re seeing plenty of cases of flu and plenty of people sick with flu. Our message for any people who are listening to this is it’s still not too late to get your flu shot.”

There has been a spike in the number of people going to emergency rooms over the past two weeks with flulike symptoms – including fever, fatigue and coughing – Dr. Farley said.

Mayor Michael R. Bloomberg and Mr. Cuomo made a public display of getting shots this past week.

In a briefing with reporters on Friday, officials from the C.D.C. said that this year’s vaccine was effective in 62 percent of cases.

As officials have stepped up their efforts encouraging vaccinations, there have been scattered reports of shortages. But officials said plenty of the vaccine was available.

According to the C.D.C., makers of the flu vaccine produced about 135 million doses for this year. As of early this month, 128 million doses had been distributed. While that would not be enough for every American, only 37 percent of the population get a flu shot each year.

Federal health officials said they would be happy if that number rose to 50 percent, which would mean that there would be more than enough vaccine for anyone who wanted to be immunized.

Two other diseases – norovirus and whooping cough – are also widespread this winter and are contributing to the number of people getting sick.

The flu can resemble a cold, though the symptoms come on more rapidly and are more severe.

Read More..