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.

A version of this article appeared in print on 01/13/2013, on page A21 of the NewYork edition with the headline: New York Declares Health Emergency.

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Illinois' 'fracking' future fractured

Thousands of landowners downstate have sold their rights to drill for oil and natural gas for upfront fees ranging from $50 to $350 per acre, plus a cut of the profits.

Others are fighting to prevent the drilling out of fear that they could be exposed to drinking water contamination, earthquakes, toxic gases and industrialization.

In the middle of this battle are Illinois legislators who have yet to pass laws to deal with horizontal hydraulic fracturing, better known as fracking. The issue is expected to be taken up again this year.

Horizontal hydraulic fracturing has opened up vast reserves of natural gas deposits in the U.S. that until now were impossible to tap. The drilling technique uses pressurized sand, water and chemicals to crack open layers of rock that trap such fuels hundreds or thousands of feet below ground.

The stampede to unleash such fuels has been compared to the Gold Rush of the 1840s. And in addition to the money being made by landowners in selling drilling rights, the fracking rush has brought jobs to other parts of the country.

"Other states have found the way to find the sweet spot to protect the environment and bring jobs; we should not miss that boat," said Tom Wolf, executive director of the Energy Council at the Illinois Chamber of Commerce.

For people desperate for jobs, a shale gas boom downstate can't come soon enough. Many counties are dealing with unemployment rates that top 10 percent.

Proponents of fracking hope to inject new life into areas of the state where a once-vibrant coal industry has declined precipitously. At the same time, there's a fear drilling will never begin unless the companies that want to extract the gas know what regulatory risks they face.

"If legislation doesn't pass at some point this year, from the state's perspective the risk is that the industry might invest elsewhere in other states that have more favorable conditions to invest in and develop these sorts of wells," said Leonard Kurfirst, a partner at Edwards Wildman Palmer LLP in Chicago who practices environmental law, chemical product liability litigation and regulatory compliance.

The state has laws to deal with gas and oil wells, but those regulations date to 1983 — before modern horizontal drilling techniques were used.

Without meaningful regulation, some landowners are learning that their property rights don't necessarily extend to what's buried beneath the surface. Some have found that their mineral rights were sold years before or that if enough neighbors give permission to drill, they can be forced to join them. Others, who want to test their drinking water for the presence of fracking chemicals, are learning they could be denied access to such information if companies claim it's proprietary.

Commonly referred to as the New Albany shale play, the gas lies in the Illinois basin, a 60,000-square-mile area that encompasses parts of Illinois, Indiana and Kentucky. The U.S. Energy Information Administration estimates New Albany holds 11 trillion cubic feet of shale gas, approximately enough to meet the needs of about 5 million households for 30 years, according to the American Gas Association.

Hydraulic fracturing has been around for more than 60 years, but the modern methods that have led to the shale gas boom were not used until the turn of this century. Unlike vertical wells of the past, modern horizontal wells vastly multiply the exploitable area of a well and involve more chemicals and water.

According to the Colorado Oil and Gas Conservation Commission, about 250,000 gallons might be used to frack a vertical well compared with as much as 5 million gallons to frack a horizontal well.

Southern Illinoisans Against Fracturing Our Environment (SAFE) is one of several organizations and environmental groups that want a moratorium on fracking in Illinois until a task force looks into the risks associated with hydraulic fracturing and recommends what kinds of regulations need to be in place.

The Illinois Chamber of Commerce is among those opposed to SAFE's proposal, which is similar to what New York state adopted with a four-year-old moratorium that has stalled natural gas development efforts.

"There is no energy source that is perfect for the environment or the economy. If there was, we would be using it," Wolf said.

Without regulations in place, a tacit moratorium already exists, Wolf said, explaining that drillers won't go forward with wells only to learn later that they face environmental regulations, new taxes or other unexpected hurdles.

The chamber released a study last month from David Loomis, a professor of economics at Illinois State University and director of the Center for Renewable Energy, estimating that downstate fracking could create 1,000 to 47,000 direct and indirect jobs depending on how many wells were drilled and what level of local resources were used.

Opponents countered that such jobs studies tend to be overly optimistic and don't take into account harmful environmental and quality-of-life issues that could come with fracking.

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Chicago's top cop calls for more gun laws

Chicago Police Superintendent Garry McCarthy today called for tougher gun laws and reiterated his opposition to legalizing the concealed carry of handguns in Illinois.

“The answer to guns is not more guns,” McCarthy said during a panel discussion about gun violence that was part of the Rainbow/PUSH Coalition’s weekly forum at its headquarters in the city’s Kenwood neighborhood.

McCarthy, the Rev. Jesse Jackson Sr., WVON-AM radio host Cliff Kelley and others discussed gun laws, Chicago’s homicide rate and recent mass killings in Newtown, Conn., and Aurora, Colo., in front of an audience of a few hundred people.

McCarthy stressed his opposition to allowing the concealed carry of handguns in Illinois, even though Illinois is the only state in the country that doesn’t permit the practice.

“Just because it’s 49 to one doesn’t mean that Illinois is wrong,” McCarthy said.

Kelley pointed out that recent court rulings have put the future of the state’s ban on concealed carry in doubt. Last month, a 7th U.S. Circuit Court of Appeals panel in Chicago threw out the state ban, giving lawmakers six months to figure out how to let people carry guns legally outside their homes.

But McCarthy said those who support concealed carry don’t realize the potential effects of allowing people to carry guns in public.

“When people say concealed carry, I say Trayvon Martin,” McCarthy said, referring to the unarmed 17-year-old who was shot and killed last February by a neighborhood watch volunteer in Florida, sparking controversy across the country.

“I say Trayvon Martin,” McCarthy continued. “Because the answer to guns is not more guns, and just simply putting guns in people’s hands is going to lead to more tragedy.”

McCarthy also outlined five steps that he said would cut down on gun violence and prevent felons and gang members from acquiring guns: banning assault weapons; banning high-capacity magazines; requiring background checks for anyone who buys a gun; mandatory reporting of the sale, transfer, loss or theft of a gun; and mandatory minimum prison sentences for people convicted of illegally possessing a gun.

“All five of these points are reasonable,” McCarthy said.

McCarthy also criticized the politicization of the debate over gun control in the wake of the Newtown massacre at an elementary school last month. Those debating the future of gun laws should be able to find a “middle-of-the-road solution,” he said.

Jackson opened the discussion by saying that the United States is “the most violent nation on Earth” and asked McCarthy about Chicago’s role in the national discussion about gun violence.

McCarthy said the number of guns available on Chicago’s streets is a primary reason why the city’s homicide total is so high.

“Every single year the Chicago Police Department seizes more guns than any city in the country,” the superintendent said. The department seized about 7,400 guns last year, he said.

While addressing the media after the discussion, McCarthy said only about 300 of the guns seized by the department last year were assault weapons. That fact shows that discussions about tightening gun laws should focus on all types of guns, not just assault weapons, he said.
 
Jackson did not address the media after the forum and did not mention his daughter-in-law Sandi Jackson during the event. Sandi Jackson resigned as Chicago's 7th Ward alderman Friday, citing “very painful family health matters.”

Her resignation came less than two months after her husband, Jesse Jackson Jr., quit his congressional seat amid ongoing federal ethics probes into his campaign finances and a diagnosis of bipolar depression.
 
rhaggerty@tribune.com
Twitter @RyanTHaggerty

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“Storage Wars” porn lawsuit: alleged Brandi Passante video distributor found in contempt

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“The Middle” will gladly take longevity over awards

LOS ANGELES (TheWrap.com) – ABC’s “The Middle” doesn’t get the recognition, ratings or Emmy Awards that “Modern Family” does, but the cast and creators are fine with cruising under the radar if they can continue producing more episodes.

“I say slow and steady wins the race,” series star Neil Flynn rationalized at the Television Critics Association’s winter press tour.

Despite averaging a middling 2.8 rating in the 18-49 demographic this season – a feeble number compared to the 5.4 for “Modern Family” and the 6.4 for CBS’s top-rated “Big Bang Theory” – “The Middle” has lasted 83 episodes over the course of four seasons. (The rating counts live viewing plus seven days of DVR viewing.)

“Before you know it, we’ll have done 120 episodes,” Flyn continued. “I’d much rather be underrated than overrated.”

And although the show has only been nominated for one Emmy – in the Outstanding Makeup for a Single-Camera Series (Non-Prosthetic) category – executive producers Eileen Heisler and DeAnn Heline joke that they consider it an award every time critics label the show “underrated.”

In fact, they revel in “kindly being called under-appreciated” so much that star Patricia Heaton jokes that they have developed a drinking game for every time the show receives the compliment.

“We’re on fourth season with a show that people love and we’re incredibly, incredibly grateful for that,” Heaton concluded, in all seriousness. “Would it be nice to have more? Yeah, but it’s fantastic and I certainly can’t complain.”

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‘Bodega Clinicas’ Draw Interest of Health Officials

HUNTINGTON PARK, Calif. — The “bodega clinicas” that line the bustling commercial streets of immigrant neighborhoods around Los Angeles are wedged between money order kiosks and pawnshops. These storefront offices, staffed with Spanish-speaking medical providers, treat ailments for cash: a doctor’s visit is $20 to $40; a cardiology exam is $120; and at one bustling clinic, a colonoscopy is advertised on an erasable board for $700.

County health officials describe the clinics as a parallel health care system, serving a vast number of uninsured Latino residents. Yet they say they have little understanding of who owns and operates them, how they are regulated and what quality of medical care they provide. Few of these low-rent corner clinics accept private insurance or participate in Medicaid managed care plans.

“Someone has to figure out if there’s a basic level of competence,” said Dr. Patrick Dowling, the chairman of the family medicine department at the David Geffen School of Medicine at the University of California, Los Angeles.

Not that researchers have not tried. Dr. Dowling, for one, has canvassed the clinics for years to document physician shortages as part of his research for the state. What he and others found was that the owners were reluctant to answer questions. Indeed, multiple attempts in recent weeks to interview owners and employees at a half-dozen of the clinics in Southern California proved fruitless.

What is certain, however, is that despite their name, many of these clinics are actually private doctor’s offices, not licensed clinics, which are required to report regularly to federal and state oversight bodies.

It is a distinction that deeply concerns Kimberly Wyard, the chief executive of the Northeast Valley Health Corporation, a nonprofit group that runs 13 accredited health clinics for low-income Southern Californians. “They are off the radar screen,” said Ms. Wyard of the bodega clinicas, “and it’s unclear what they’re doing.”

But with deadlines set by the federal Affordable Care Act quickly approaching, health officials in Los Angeles are vexed over whether to embrace the clinics and bring them — selectively and gingerly — into the network of tightly regulated public and nonprofit health centers that are driven more by mission than by profit to serve the uninsured.

Health officials see in the clinics an opportunity to fill persistent and profound gaps in the county’s strained safety net, including a chronic shortage of primary care physicians. By January 2014, up to two million uninsured Angelenos will need to enroll in Medicaid or buy insurance and find primary care.

And the clinics, public health officials point out, are already well established in the county’s poorest neighborhoods, where they are meeting the needs of Spanish-speaking residents. The clinics also could continue to serve a market that the Affordable Care Act does not touch: illegal immigrants who are prohibited from getting health insurance under the law.

Dr. Mark Ghaly, the deputy director of community health for the Los Angeles County Department of Health Services, said bodega clinicas — a term he seems to have coined — that agree to some scrutiny could be a good way of addressing the physician shortage in those neighborhoods.

“Where are we going to find those providers?” he said. “One logical place to consider looking is these clinics.”

Los Angeles is not the only city with a sizable Latino population where the clinics have become a part of the streetscape. Health care providers in Phoenix and Miami say there are clinics in many Latino neighborhoods.

But their presence in parts of the Los Angeles area can be striking, with dozens in certain areas. Visits to more than two dozen clinics in South Los Angeles and the San Fernando Valley found Latino women in brightly colored scrubs handing out cards and coupons that promised a range of services like pregnancy tests and endoscopies. Others advertised evening and weekend hours, and some were open around the clock.

Such all-hours access and upfront pricing are critical, Latino health experts say, to a population that often works around the clock for low wages.

Also important, officials say, is that new immigrants from Mexico and Central America are more accustomed to corner clinics, which are common in their home countries, than to the sprawling medical complexes or large community health centers found in the United States. And they can get the kind of medical treatments — including injections of hypertension drugs, intravenous vitamins and liberally dispensed antibiotics — that are frowned upon in traditional American medicine.

The waiting rooms at the clinics reflected the everyday maladies of peoples’ lives: a glassy-eyed child resting listlessly on his mother’s lap, a fit-looking young woman waiting with a bag of ice on her wrist, a pensive middle-aged man in work boots staring straight ahead.

For many ordinary complaints, the medical care at these clinics may be suitable, county health officials and medical experts say. But they say problems arise when an illness exceeds the boundaries of a physician’s skills or the patient’s ability to pay cash.

Dr. Raul Joaquin Bendana, who has been practicing general medicine in South Los Angeles for more than 20 years, said the clinics would refer patients to him when, for example, they had uncontrolled diabetes. “They refer to me because they don’t know how to handle the situation,” he said.

The clinic physicians by and large appear to have current medical licenses, a sample showed, but experts say they are unlikely to be board certified or have admitting privileges at area hospitals. That can mean that some clinics try to treat patients who face serious illness.

Olivia Cardenas, 40, a restaurant worker who lives in Woodland Hills, Calif., got a free Pap smear at a clinic that advertises “especialistas,” including in gynecology. The test came back abnormal, and the doctor told Ms. Cardenas that she had cervical cancer. “Come back in a week with $5,000 in cash, and I’ll operate on you,” Ms. Cardenas said the doctor told her. “Otherwise you could die.”

She declined to pay the $5,000. Instead, a family friend helped her apply for Medicaid, and she went to a hospital. The diagnosis, it turned out, was correct.

Health care experts say the clinics’ medical practices would come under greater scrutiny if they were brought closer into the fold.

But being connected would mean the clinics’ cash-only business model would need to change. Dr. Dowling said the lure of newly insured patients in 2014 might draw them in. “To the extent there are payments available,” he said, “the legitimate ones might step up to the plate.”

This article was produced in collaboration with Kaiser Health News, an editorially independent program of the Kaiser Family Foundation.

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The story behind Tribune's broken deal

At the end of 2007, real estate tycoon Sam Zell took control of Tribune Co. in a deal that promised to re-energize the media conglomerate. But the company struggled under the huge debt burden the deal created, and less than a year later, it filed for bankruptcy.

One of Chicago's most iconic companies — parent to the Chicago Tribune — was propelled into a protracted and in many ways unprecedented odyssey through Chapter 11 reorganization.

On Dec. 31, after four years, Tribune Co. finally emerged from court protection under new ownership, but at a heavy cost. The company's value was diminished, its reputation was tarnished and its ability to respond to market opportunities during its long bankruptcy was constrained.

Tribune Co.'s bankruptcy saga began as an era of superheated Wall Street deal-making fueled by cheap money was coming to an end. The company's tale is emblematic of the American financial crisis itself, in which a seemingly insatiable appetite for speculative risk using exotic investment instruments helped trigger an economic collapse of historic proportions.

Tribune reporters Michael Oneal and Steve Mills, in a four-part series that begins today, tell the story of Tribune Co.'s journey into and through bankruptcy, throwing a spotlight on the key decisions and missed opportunities that marked a perilous time in the history of the company, the media industry and the economy.

Read the full story, "Part one: Zell's big gamble," as a digitalPLUS member.
To view videos and photos and for a look at the rest of the series visit, chicagotribune.com/brokendeal.

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Exhumation ordered in lottery winner's death

He won the lottery, then he was poisoned to death. A judge's ruling Friday to have Urooj Khan's body exhumed could give his family and police answers about how cyanide got into his system.

A tearful relative said she hoped "justice will be served" after a judge quickly gave approval today to exhume the body of the million-dollar lottery winner who died of cyanide poisoning.

“We’ve been waiting for justice all this time,” said Meraj Khan, the sister of Urooj Khan. “I’m just so glad that justice will be served.”

Still, she said the thought of having her brother’s remains exhumed is distressing to the entire family. “This is not rest in peace,” she said. “But it’s an investigation, and hopefully the truth will come out.”

Khan died in July and his death was initially believed from natural causes. But after a relative raised concerns, comprehensive toxicological tests showed he had lethal levels of cyanide in his blood.

Judge Susan Coleman gave a quick OK to the request by the medical examiner’s office to exhume the body at Rosehill Cemetery on Chicago’s North Side. Court papers said the body was not embalmed, leading prosecutors to indicate it was “critical” to arrange for the remains to be exhumed as soon as possible.

In an affidavit, Chief Medical Examiner Stephen J. Cina said it was necessary to do a full autopsy to “further confirm the results of the blood analysis as well as to rule out any other natural causes that might have contributed to or caused Mr. Khan’s death.”

Authorities said the exhumation and autopsy could occur next week.

After the brief court hearing, Meraj Khan and her husband, Mohammed Zaman, were mobbed by reporters, cameramen and photographers.

Zaman said the last time they saw Urooj Khan was the day before his death. He came over to their house as usual, talked with their children and left. He seemed happy and healthy, Zaman said.

Meraj Khan recounted that at about 4 a.m. the next day, July 20, she was awakened by a phone call from her brother’s line. It was the first day of the Muslim holy month of Ramadan and she thought her brother was up early because of that. Instead, she said, she heard horrible screaming at the other end of the line.

“I couldn’t understand what was happening,” she said. “I heard screaming, and that’s all. So I woke him (Zaman) up. But I still don’t know who made that call.”

He died a short time later at an Evanston hospital.

“It’s hard for me to believe even now,” Meraj Khan said. “How could they do this, whoever did it?”

Meraj Khan and her husband said they could not comment on the police investigation, but they said they knew that at the time of his death, the only people in the home were Khan, his wife, Shabana Ansari, her father Fareedun Ansari, and Khan’s teenage daughter from a previous marriage.

Asked about IRS liens that had been placed against Fareedun Ansari, because of $120,000 in tax debt, Zaman said they were shocked to read about it in the Tribune this week. He said neither Urooj Khan nor Fareedun Ansari ever mentioned it to them.

Zaman said Fareedun Ansari had returned to live with his daughter and Khan last year after he’d moved to New Jersey to run a small convenience store that ultimately failed. He said Fareedun Ansari spent decades working for Urooj Khan’s father in India before coming to Chicago to help out with Khan’s growing dry cleaning and real estate businesses.

Meraj Khan, who last year was granted custody of her brother’s 17-year-old daughter, Jasmeen, said the girl is having a rough time dealing with the mystery surrounding her father’s death and all the recent media attention to the case.

“She’s very devastated. I’m trying to keep her cheerful, but it’s just very hard,” said Meraj Khan, choking back tears. “She’s 17. It’s very hard for her to cope with everything that’s going on.”

The family of Khan's first wife has also expressed concern about Jasmeen. Maria Jones, whose rocky three-year marriage to Khan ended in a bitter divorce in the late 1990s, was told by Khan’s family that he had taken their child back to his native India, according to Jones’ current husband, Bill Jones.

She hadn’t seen her daughter in more than 13 years but learned from the publicity this week about Khan’s death that he and Jasmeen had been living in Chicago all along, Bill Jones said.

But Maria Jones is anxious to rekindle a relationship with her daughter if possible, according to her husband.

"(Jasmeen) was 4 or 5 years old the last time she saw her," Bill Jones said in a telephone interview. "Who knows what she's been told about her mother all these years?"

Maria Jones even changed the family's answering machine in case her daughter calls. “If this is Jasmeen, please leave your number and I will call you,” it now says. “I’ve been waiting to hear from you. I love you.”

According to Cook County court records made public today, Maria Jones obtained multiple orders of protection as part of her 1998 divorce from him.

In one, Maria Jones alleged that Khan repeatedly had threatened to kill her and their daughter, then 4, if she filed for divorce. She also alleged he repeatedly physical abused her son from a previous marriage and contended she had to remove the boy from the home.

jmeisner@tribune.com

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Video game retail sales continued to slide in December, down 22% from 2011

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‘Smash’ season debut sneak peek begins Monday

LOS ANGELES (AP) — NBC is giving viewers a sneak peek at the new season of “Smash.”

Starting next week, the first hour of the drama’s two-hour season debut can be seen online and in the air — where it will be screened on American Airlines flights.

The “Smash” preview will be available through several outlets, including NBC.com, Hulu, iTunes, Amazon and Xbox and on demand. It will be shown on American’s domestic flights starting Tuesday.

“Smash,” set in the world of New York theater, stars Debra Messing, Christian Borle and Angelica Huston. Guest stars this season include Jennifer Hudson.

The sophomore drama begins its second season Feb. 5 on NBC. “Smash” is a nominee at Sunday’s Golden Globe awards for best musical or comedy series.

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