first_imgOct 29, 2009 (CIDRAP News) – A report from the Centers for Disease Control and Prevention (CDC) estimates that the true number of H1N1 influenza cases in the first 4 months of the epidemic may have been as high as 5.7 million, or more than 100 times the official case count.The report also estimates that as many as 21,000 people might have been hospitalized for H1N1 in that period, more than four times the official 5,000, and that there may have been up to 1,300 deaths instead of the recorded 302.CDC officials have said repeatedly that the actual number of cases is probably far more than the number of known, confirmed cases. Today’s report in Emerging Infectious Diseases appears to be the agency’s first methodical attempt to estimate the true numbers.The number of lab-confirmed H1N1 infections from the virus’s emergence in April until Jul 23 was 43,677, says the report by Dr. Carrie Reed, several other CDC researchers, and Marc Lipsitch of Harvard University. This total included 5,009 hospitalizations and 302 deaths.But the official case count is believed to be a gross underestimate, for several reasons: some sick people don’t seek medical care and have specimens collected, not all specimens are sent to a public health lab for confirmatory testing, and some specimens yield false-negative results because of timing or quality problems.To estimate the real number of cases and hospitalizations, the authors used a probabilistic multiplier model similar to one that has been used to estimate the extent of foodborne disease in the United States.For each step, they identified a range of values derived from previous studies and from recent surveys and investigations of H1N1 outbreaks. They adjusted for the fact that confirmatory testing was done much more often in the first few weeks of the epidemic than it was later, after physicians were encouraged to reserve testing mainly for hospital patients.Using this method, the researchers estimated that each known H1N1 case represented a total of between 47 and 148 cases, with a median of 79 cases. This yielded an estimated total of between 1.8 million and 5.7 million cases, with a median estimate of 3.0 million, in a nation with a current estimated population, according to the Census Bureau, of about 307 million.Patients hospitalized with H1N1 are much more likely to be tested and have their infection confirmed than outpatients are, the authors note. They estimate that each confirmed hospital case represented between 1.9 and 4.3 cases, with a median of 2.7 cases. Nationally, this translates into between 9,000 and 21,000 cases, with a median of 14,000.The report also hazards an estimate of H1N1 deaths, though with more caveats than the other estimates.Among confirmed hospital cases through Jul 23, 6% of the patients died. Applying this percentage to the hospitalization estimates from the model yielded a range of estimated deaths from 550 to 1,300, with a median of 800, the authors report. But they say this approach has several limitations, and more sophisticated models are being developed in an effort to come up with better estimates.The report also offers estimates of H1N1’s impact in different age-groups, which align with the general view that children and young people have been hit hardest. The median estimated incidence of cases is lowest in people aged 65 and older: 107 per 100,000. At the other end of the scale are those between 5 and 24 years old, with an estimate of 2,196 cases per 100,000.The incidence of hospitalization was estimated to be highest in children under 5 years old, with a median of 13 cases per 100,000. Elderly people (65 and up) had the lowest estimated hospitalization rate: a median of 1.7 per 100,000.The authors call their estimation method “a relatively quick and simple approach” that can be used while more complete data and more rigorous studies are awaited. They note that a spreadsheet version of the model is available online so health officials can use it and adapt to their local circumstances.The CDC has not come up with estimates of total cases and hospitalizations for the period since Jul 23, CDC officials said today. Reed, lead author of the study, told CIDRAP News that the agency is receiving reports of confirmed H1N1 hospitalizations and deaths from about 30 states, and officials are looking at ways to generate more current estimates with it. But she said she is unsure how well the multipliers used in the study apply to the current situation.She noted that the agency stopped trying to count total cases months ago because of the burdens that testing imposed on the medical system.At a news briefing today, Dr. Anne Schuchat, head of the CDC’s National Center for Immunization and Respiratory Diseases, made similar comments. “We believe that many millions of people have already contracted this virus here in the US and that we have had probably by now well more than 20,000 hospitalizations,” she said.Reed C, Angulo FJ, Swerdlow DL, et al. Estimates of the prevalence of pandemic (H1N1) 2009, United States, April-July 2009. Emerg Infect Dis 2009 Dec (published online Oct 28) [Full text]See also: CDC Oct 28 Q&A on article FluView weekly flu surveillance reports read more

first_imgIt should come as no surprise to anyone following the GOP’s tax bill that the party’s policy ideas have no basis in reality. Yes, the Clinton-era changes did reduce the number of people on welfare, as Republicans predicted.But citing that as a positive would be like saying Americans are healthier when there are fewer people on Medicare.In fact, poverty has increased since the bill’s passage even while the government is spending more on anti-poverty programs.Adding work requirements for food stamps and cutting subsidized housing make little sense, either.The majority of people benefiting from food stamps are children, elderly or disabled.Of those who can work, most are already employed or find employment within one year of going on food stamps. “The greatness of a nation can be judged by how it treats its weakest member,” goes the apocryphal quote.Even if you don’t agree with that sentiment, it should be clear that the GOP won’t attack the only poorest among us.They will move up the class ladder. Ryan promises that Medicare cuts will follow Medicaid cuts, and Social Security cuts are likely to follow.Demonizing the poor is simply Republicans’ way of easing into that.Now it’s up to voters to stop them.James Downie is The Washington Post’s Digital Opinions Editor. He previously wrote for The New Republic and Foreign Policy magazine.More from The Daily Gazette:EDITORIAL: Thruway tax unfair to working motoristsEDITORIAL: Urgent: Today is the last day to complete the censusFoss: Should main downtown branch of the Schenectady County Public Library reopen?EDITORIAL: Beware of voter intimidationEDITORIAL: Find a way to get family members into nursing homes It’s a GOP classic: Through the 1980s and 1990s, Republicans encouraged the “welfare queen” stereotype — lazy minorities living high and mighty off tax dollars — to drive down support for welfare (and win elections).It worked.Opposition to the program became so overwhelming that in 1996, Democrat Bill Clinton signed a Republican-written “reform” bill instituting work requirements, time limits on assistance and stricter enforcement.Republicans argue today, as they did then, that these changes would get people back to work, helping both themselves and the economy.As Rep. Rod Blum (R-Iowa) puts it, “For us to achieve 3 percent GDP growth over the next 10 years from tax reform, we have to have welfare reform.”The list of targeted programs has broadened.A bill introduced by Rep. Jim Jordan, R-Ohio, and Sen. Mike Lee, R-Utah, would add work requirements for food stamps, implement more work requirements for welfare and slash federal spending on subsidized housing programs by 50 percent over 10 years. Categories: Editorial, OpinionIt’s no secret that the GOP tax plan working its way through Congress is weighted toward the wealthy.The richest Americans get the bulk of the tax cuts, and the poorest Americans see a tax increase. But Republicans aren’t satisfied with one blow for inequality:They’re openly positioning to attack the poor on several fronts.The first attack will be welfare reform.RELATED: Republicans nearing agreement on final tax billcenter_img Kentucky alone projects that 95,000 fewer people will us Medicaid if work requirements are implemented.In many cases, this will create a terrible cycle: People too ill to work will lose their best hope of regaining their ability to work.Back in Washington, the “reforms” described earlier are just a prelude to what House Speaker Paul Ryan, R-Wis., and allies really want: the destruction of America’s social safety net.“We’re going to have to get back next year at entitlement reform, which is how you tackle the debt and the deficit,” Ryan said Wednesday.“Frankly, it’s the health care entitlements that are the big drivers of our debt.” In other words, it’s not just Medicaid in the crosshairs — it’s Medicare as well.Even before the House and Senate finished passing their versions of the tax cut, Republicans were dancing a familiar step: increase the deficit by slashing revenues, then turn around and claim the country needs to cut spending by cutting entitlements.“You also have to bring spending under control,” Sen. Marco Rubio, R-Fla., said last week. “The driver of our debt is the structure of Social Security and Medicare for future beneficiaries.”(Note the phrase “for future beneficiaries” — the GOP won’t touch the benefits of its older base.) And at a time when housing shortages are driving up prices in many major urban centers, the government should be investing more, not less, in subsidized housing.But evidence won’t stop the GOP from plowing ahead.Republicans at the state level aren’t even waiting for Congress to act.Wisconsin Gov. Scott Walker, under whom the state’s poverty rate has reached its highest in 30 years, now wants to drug-test some food stamp recipients, despite the failure of a similar program in Florida.The Agriculture Department looks set to give Wisconsin and other states the go-ahead to do so.Last month, the Trump administration announced that it would allow states to add work requirements for Medicaid enrollees.At least a half-dozen GOP-controlled states are expected to do so, even though three-quarters of Medicaid recipients are in households where at least one member has a part-time or full-time job.last_img read more

first_imgRisto Murto, CEO, VarmaVarma chief executive Risto Murto said the provider’s first-quarter return on investments of 5.1% had already made up for the loss of 2% reported for the whole of 2018.The company’s equities portfolio returned 10%, with listed equities performing the best at 13.1%. Fixed income generated a 1.9% return and hedge funds made 2%.The market value of Varma’s portfolio was €45.8bn at the end of March, up from €44bn at the end of December.Murto warned that the global economy was giving mixed messages, adding to uncertainty about the state of Finland’s export markets at a time when the Nordic country had a new government in place.He said: “The [US Federal Reserve] abandoned its tightening monetary policy, and the equity markets reacted positively to this change. Messages concerning the phase of the global business cycle, however, remain mixed.“It is still unclear whether Finland’s next government will face a tailwind or headwind in the export market when it starts its work.”Finland’s centre-left Social Democratic Party gained the highest proportion of votes in the country’s general election on 14 April, and is now heading towards formal coalition talks to form a government, replacing the previous centre-right coalition. Varma, one of Finland’s biggest pension providers, has overhauled its environmental, social and corporate governance (ESG) policy. The €45.8bn pension insurer said its revamped sustainability programme included an assessment of its investments according to recommendations made by the Taskforce for Climate-related Financial Disclosures (TCFD) in its annual and corporate social responsibility report.All companies in which it invested were required to report what they were doing to combat climate change in both their business operations and their future growth prospects, Varma said, as recommended by the TCFD.Varma added that it had stopped investing in tobacco and nuclear weapons in 2004, and also excluded manufacturers of other controversial weapons and companies that rely on coal operations for more than 30% of their net sales. In its recent annual and sustainability report, Varma said its analysis showed that its equity portfolio was in line with keeping global warming below 1.75°C above pre-industrial levels.“Maintaining this situation, however, requires the continuous reduction of emissions in the future,” it added.First-quarter gain makes up for 2018 losslast_img read more