Number of swine flu deaths three times higher than previously estimated, CDC says

New estimates from the Centers for Disease Control and Prevention cite at least 22 million U.S. cases of the H1N1 influenza and 3,900 deaths, including about 540 children. This is about three times the number of laboratory-confirmed deaths the agency has been reporting.

According to an article today by Times staff writer Thomas H. Maugh II, the new numbers reflect epidemiologists’ more accurate estimates, which include cases that might be listed on death certificates as pneumonia or other infections but were ultimately caused by swine flu. Previous reports included only laboratory-confirmed cases.

The H1N1 influenza differs from the traditional flu in a few ways -- it is very easily spread, affects young people more than old and doesn’t seem to follow the standard cold-weather transmission patterns, says an article from our health blog Booster Shots. 

Blog commenters and Twitter users have been alternately supportive and skeptical of being vaccinated against H1N1 so far, using the hashtag #swine on their updates. People are also quick to defend themselves when they sneeze or give other indications that they might have the flu:

cidelson wrote: Don't be lulled into complacency on swine flu, public health officials note how it continues to spread

Aaron Nichols wrote: This is fear mongering at the highest level – Now that makes me sick!

Soupking wrote: This is all HYPE. You couldn't pay me thousands of dollars to get "vaccinated".

Lindy Lee wrote: In our city, one child has died and thirty three percent of a local high school has the influenza. Many have been hospitalized. There are NO vaccines. Nobody was prepared and Obama was dishonest with us.

Connor_Davidson wrote: Is not all that well. P.S it's not Swine Flu

What do you think about the CDC’s report estimating so many H1N1 deaths? Have you gotten immunized or have you decided not to?

There has been a shortage of vaccines in California. Do you think the state is doing enough to respond to the outbreak of H1N1? Should President Obama and the federal government be doing more to help, or do you feel they have it under control?

-- Kelsey Ramos

Photo: A vial of H1N1 flu vaccine. Credit: Mark Boster / Los Angeles Times

Medical marijuana for an L.A. Times columnist

For a lot of people, the details about medical marijuana can be hazy. Hundreds of dispensaries have grown like weeds around Los Angeles, some of which are open as late as fast-food restaurants (a blessed coincidence). But how does one get a prescription to use this medicine?

Thankfully, L.A. Times columnist Steve Lopez broke down part of the process in his column today about his visit to the medical marijuana doctor.

In his account, Lopez educates us about obtaining a marijuana “recommendation” from an obstetrician who had advertised as being someone who could write a script for the controversial bud. 

So the question is: Is Lopez’s account of visiting the doctor an accurate depiction of the experience?

Do you agree with him that we’re better off legalizing the plant? Or do the recreational users who abuse the system need to be, excuse the pun, weeded out?

Our interactive map of L.A. marijuana dispensaries shows which are licensed and which have been denied applications -- it also marks their proximity to schools, parks and libraries. What do you think about the location of these dispensaries? Does it matter that they are so close to schools and public spaces? Or do you consider this much ado about nothing?

-- Kelsey Ramos

Photo: Various strains of medical marijuana sit on a shelf inside Green Oasis, a medical mariujuana dispensary in Los Angeles. Credit: Genaro Molina / Los Angeles Times

Obama gets medical consultation in healthcare reform pitch

President Obama told doctors this morning that he was confident that Congress would move on healthcare reform this year, though he acknowledged that there were details still to be worked out.

“You look spiffy in your coats,” Obama told the crowd of about 150 in the Rose Garden, most of whom were wearing lab coats. He praised the doctors as being among the medical professionals who know first-hand how important it is to make changes in the healthcare system.

The Senate Finance Committee is expected to pass its version of healthcare reform soon, making it five bills that have worked their way through committees in both houses. The Senate will have to reconcile two bills and the House three.

But among details still to be worked out is what shape a public option might take, whether robust, a government-sponsored health insurance program, some form of cooperatives or just an exchange to make insurance costs more transparent.

The final version of the House bill is expected to have the strongest public option; the version in the Finance Committee is the weakest. Other issues include how to pay for the changes and what consumer protections to demand from the insurance companies.

-- Michael Muskal

Photo: Shawn Thew / EPA

After the jump, check out the latest Twitter updates from Michael Muskal, and your comments.

South Carolina Rep. Joe Wilson yells 'You lie!' to the president

It was a perfect storm of hot buttons that evoked an utterance of such negativity that it turned heads. President Barack Obama was giving a speech to Congress and he started talking about healthcare and illegal immigrants and money, and unexpectedly, Rep. Joe Wilson of South Carolina spoke up.

"You lie!" the Republican congressman blurted out on the floor of the House immediately after the president said: "the reforms I’m proposing would not apply to those who are here illegally."

It was Rep. Wilson who had been reinforcing the belief that the healthcare reform would include the so-called Death Panels. He called it an "end-of-life counseling program, which has been correctly highlighted by former Alaska Gov. Sarah Palin as a program which could lead to seniors being encouraged to seek less care in order to protect the government´s bottom line."

Minutes before Wilson's wail, the president had debunked the theory that grandma's plug would be pulled in order to save federal dollars. "It's a lie, plain and simple," he said, which brought most of the attendees to their feet.

After the speech, the criticism for Wilson was bipartisan. "I've never seen anything like that before," said Rep. Earl Pomeroy (D-N.D.) "We do not invite the president of the United States into the House of Representatives and hurl insults."

Sen. John McCain (R-Ariz.) said the outburst was "totally disrespectful" and demanded that Rep. Wilson apologize to the president. "No place for it in that setting or any other, and he should apologize for it immediately," McCain told Larry King on CNN.

Wilson apologized shortly after the speech for how he acted out: “This evening I let my emotions get the best of me when listening to the president’s remarks regarding the coverage of illegal immigrants in the healthcare bill. While I disagree with the president’s statement, my comments were inappropriate and regrettable. I extend sincere apologies to the president for this lack of civility.”

So how did you feel about the speech, the outburst, and/or the apology? Blurt out your comments in the field below. 

-- Tony Pierce

Photo: Rep. Joe Wilson (R-S.C.) shouts "You lie!" as President Barack Obama addresses a joint session of Congress at the Capitol on Wednesday. Credit: Chip Somodevilla / Getty Images

Related:

Rep. Joe Wilson's response to Obama's speech: 'You lie!'

Text of Obama's speech: Now is the season for action

Steve Lopez and the Glenn Beck fan club

Recently Times columnist Steve Lopez went in search of fans of Glenn Beck, the Fox News personality who has garnered a large viewership since moving from CNN but has lost dozens of sponsors after he called President Obama a racist.

Lopez found a Santa Clarita group on the Internet that claimed to have 82 members, most of whom were united through Beck's TV program, which served as a rallying call against the Obama administration. Of that group was a 20-year-old woman who promised that they "will win this fight against radicalism."

Another woman wrote on the group's website, "I love my God, family and country and want to save this country from ruin."

Lopez met a man named Jason Hole, the Beck meet-up group's organizer. Hole has his differences with the Beck, but is more concerned with what he feels the Obama administration has in store for conservatives like himself. "I'm a hard-working American guy that wants to be able to worship Jesus Christ, go shooting, say what I want and enjoy life," Hole wrote.  He added: "Our government is preparing for civil unrest right now. I've seen documentation that states people will be considered terrorists if they wear blue jeans and talk excessively about the constitution. You're thinking I'm a kook, right? Look it up and you'll find it to be true."

So are you thinking that Hole and the Santa Clarita members of the meet-up group are kooks? Do you think, as Hole's uncle believes, that America is on the road to socialism? And if you are a Beck fan, do you think the people interviewed in Lopez's column reflect your beliefs?

Also, what do you think of Beck? Do you think that this is all an act for TV ratings? Or do you think he truly believes that the mixed-race president is a racist who has "a deep-seated hatred for white people or the white culture"?

Use your freedom of speech in the comment box below, but keep it clean; we can't accept anything here that they couldn't air on Fox.

-- Tony Pierce

Photo: Glenn Beck. Credit: Carolyn Cole / Los Angeles Times

Healthcare debate Q&A

What do you think of the proposed healthcare reforms? Will any of the reforms affect you? How will a potential healthcare overhaul affect the country?

Do you have healthcare reform questions? Post them here.

Where do you stand on the vaccination debate?

Neil Young had a hit with the tune "Needle and the Damage Done," but it seems like the Booster Shots blog struck a nerve after The Times interviewed author Chris Mooney about his book, "Unscientific America: How Scientific Illiteracy Threatens Our Future."

Apparently the use of vaccinations and their relationship (or lack thereof) with autism is still a hot topic. One in which emotions run high as people debate science.

While some readers like George Harvey don't think that vaccines cause autism, "I don't think that vaccines cause autism. There are several toxins in our common environment that are far more powerful in their possible effects than those in vaccines"; others, like OZ, said that science is not blameless, "Bad science has as much a role to play in Americans' distrust of 'big science' as any other reason given."

Over 50 comments have been submitted to the Booster Shots post, including this one from someone who seems quite well-versed on the topic:

I am a former scientist (molecular geneticist) and now a parent to a son with autism, who had speech and eye contact and several words until age 18 months. He received 5 vaccines on one day, and then became ill, lethargic and irritable. He lost all speech and eye contact. I question the live viruses given in both the Varicella and Measles vaccine (MMR) in that they cause neuro-inflammation in a subset of genetically predisposed children. I am really tired of listening to those in my (own) scientific community take an authoritative stance that there is absolutely no connection between autism and vaccines. I have studied those 'studies' and they are either paid for by the very vaccine companies themselves or filled with flaws in sample size, testing methods, conclusions. No researcher has studied the neuro-inflammation in infants when given 36 vaccines before their 2 year birthday. No researcher has studied all vaccines or combinations of vaccines. Safety studies/clinical trials on single vaccines- yes- but we aren't giving our children just one vaccine are we? No, in fact, we have 150+ vaccines in clinical trials just waiting to release to the pediatric population. I am not anti-vaccine. I believe in vaccines for life threatening illnesses. However, are we going to have vaccines for every infectious pathogen?

So what are you thoughts on this sensitive, but very important matter?

-- Tony Pierce

Photo credit: Tim Sloan / AFP/Getty Images

Is the health insurance industry serious about reform?

They jury is out, to say the least.

In December, the health insurance industry's trade group, AHIP (for America's Health Insurance Plans), said it had decided for the first time to support the principle of universal healthcare -- insuring everyone in America, regardless of health condition.

I was skeptical. And what I found by reading AHIP's 16-page policy brochure was that its position hadn't changed at all. Its version of "reform" comprises the same wish list that the industry has been pushing for decades.

Briefly, the industry wants the government to assume the cost of treating the sickest, and therefore most expensive, Americans. It wants the government to clamp down hard on doctors' and hospitals' fees. And it wants permission to offer stripped-down, low-benefit policies freed from pesky state regulations limiting their premiums.

Figuring out the industry's stance on healthcare reform is of paramount importance this year. President Obama's healthcare forum last Thursday demonstrated that the administration and Congress are girding for a big push to remake a tattered employer-based system that has left more than 45 million people without coverage.

But what role will private insurers play? What role do you think they should play?

Read the full column: Insurers' commitment to healthcare reform is only skin-deep

-- Michael Hiltzik

photo credit: Bob Chamberlin / Los Angeles Times

Nadya Suleman's website an honest call for help?

Nadya Suleman, the woman who recently gave birth to octuplets through in vitro treatments, now has a website that invites visitors to "meet the octuplets" and show their support. 

This  mother of 14 children, who already has $50,000 in student loans, receives food stamps and lives with her parents, contends that she needs no assistance from the government.  But her new website will take donations via credit card or PayPal, along with good wishes and donated items.

The majority of our commenters seem to think this is a scam, and have already expressed outrage at her behavior (much like our own Tim Rutten): 

voracious reader says: Sure, I'll donate. I'll donate to the lawsuit against the doctor for ethics violations and violating the guidlines of standard care. I'll donate to a charity that helps women and children in need. Donate to Ms. Suleman? I think not. I hope the State of California has the ability to sort out this mess and get all of her children a standard of care that they rightfully deserve.

Christy says: I'm just disgusted by the whole thing. What a publicity stunt. Asking for money...what about giving the $$ to those couples who truely can't get pregnant that are desperate for a baby. She can donate her money to hook them up wtih her doctor!!
Unbelieveable.

PR Person says: I think it's very interesting that this website is made to look homemade but the credit line is that of her PR firm. Yet another way she is trying to manipulate opinions. I would never contribute to someone like this -- I would instead contribute to an agency that would find these children proper homes and have the disability payments actually go to help the three kids who have them, not to the mother to have more IVF treatments and get her nails done. In my opinion this is a manipulative woman who is manipulating the system and thinks she can get a windfall.

ms.c0ll33n says: Donating to this bottomfeeder is the same as rewarding her and others like her for making selfish reasons at the expense of the innocent children. I, as a Californian taxpayer, am already paying for her 14 mistakes. I, as a Kaiser Permanente member, am paying for her 14 mistakes via higher monthly payments. Put me down for $0 as my donation to this freak circus.

LilyC says: While I feel for her children who never asked for this, I cannot imagine giving money to this woman. She really should have thought about how she was going to support her family back around her 3rd child, the 4th, 5th, 6th, when told how many embryos took, when she decided to not give any up for adoption, etc. She has had many opportunities to make adult financial decisions to ensure she could care for her kids. She has failed to do so. And thus I fail to see how this is our problem. I support child services with my taxes. And there are many financially stable families who would give anything to adopt her babies when they are taken from her.

What do you think about her new website?  Does she need the money or is this just another publicity stunt?  Who will have to pay to support her children?  Should her doctor be held responsible?  Put in your comments here.

-- Stephanie Chang

Image: Screen shot of thenadyasulemanfamily.com

Returning soldiers and the lingering effects of head trauma

Share your thoughts on Jia-Rui Chong's story about the long-term effects of traumatic brain injuries on soldiers returning from combat.  An excerpt:

A recent Rand Corp. report, which Yochelson worked on, estimated that 19% of the troops returning from Iraq and Afghanistan, or more than 300,000 people, have come back with traumatic brain injuries. It estimated that treatments for such injuries and the loss in productivity have cost the nation, conservatively, about $554 million.

Do you think the Department of Veterans Affairs deals effectively with these patients?  Have you, a family member or friend been personally affected by head trauma?  Weigh in here.

Photo: U.S. Marine Brian Vargas, 20, connects with a punching bag at Scripps Hospital Encinitas brain injury recovery ward. Don Bartletti/Los Angeles Times.

Discuss the new "conscience" rule

The "conscience" rule, which the outgoing Bush administration plans to announce, could set the stage for an abortion controversy in the early months of Barack Obama's administration. The rule will permit healthcare workers to refuse to participate in any procedure they find morally objectionable, including abortion and possibly even artificial insemination and birth control.

Whereas an existing federal law has long dictated that doctors and nurses may refuse to perform abortions, the "conscience" rule covers more employees, who can refuse to provide information to patients who might want an abortion.

Share your thoughts on the new rule here.

Discuss the health insurance series

Share your thoughts on this series. Have you, your family or friends been affected by the nation's health insurance crisis? How so? And what should be done to fix things?

Part 1 ran today here.  An excerpt from the piece:

Today, four publicly traded corporations -- WellPoint Inc., UnitedHealth Group, Aetna Inc. and Cigna Corp. -- dominate the market, covering more than 85 million people, or almost half of all Americans with private insurance.

On Wall Street, they showcase their efforts to hold down expenses and maximize shareholder returns by excluding customers likely to need expensive care, including those with chronic diseases such as asthma and diabetes. The companies lobby governments to take over responsibility for their sickest customers so they can reserve the healthiest (and most profitable) for themselves.

Meanwhile, insurance premiums are becoming a heavier burden on employers, many of which say that rising healthcare costs cut into their ability to compete and, in some cases, to survive.

As a result, the percentage of Americans covered by traditional group health insurance has steadily declined. Nearly 46 million have no insurance at all. Medical debt has become a leading cause of personal bankruptcy and a growth business for collection agencies.

Even some top insurance executives agree the system is inefficient and sometimes inhumane.

Read all of Part 1 here.

Photo: Joe Raedle / Getty Images

Give me trans fats or give me death!

Readers are taking the ban on cooking with trans fats in California restaurants surprisingly seriously, viewing the measure as an infringement upon our basic civil liberties.  The law won't go into effect until 2010, but many restaurant chains in California have already eliminated the cholesterol-raising ingredient from their food. Nevertheless, Gov. Arnold Schwarzenegger's decision to sign the ban and make the elimination official has made some readers feel very oppressed.  Many of the reader comments left on the original story state that the decision to consume trans fat, a solidified combination of hydrogen and vegetable oil that increases the shelf life of foods, is a deeply personal one.

Show me the Science wrote: "This law is no more based in public health than banning abortion."

Russ' argument also evoked Roe vs. Wade sentiments: "My body, my choice? Apparently not. My life, my choice? Apparently not. My life, my rights? Apparently not. My life, my freedom? Apparently not."

Travis wrote: "What's next, are they going to tell me how to dress, or how to think?"

Luckily for trans fat fans, not all readers who opposed the ban were so hysterical.  jack's argument was actually quite sensible: "When they make donuts w/out trans fat, they are limp and not crispy like they should be."   

eatathome exclaimed that "The fat is where the flavor is at!"

Readers compared Schwarzenegger's governing tactics to Stalinism, fascism, socialism, and communism.  But amidst all the accusations, the law also appears to have a few supporters. Erik explained that "Trans fat is not a food. It's an industrial food processing technique that chemically alters the fat molecule to allow for longer shelf life. Now, if you want to poison yourself at home, go ahead. But public restaurants shouldn't be able to use it."

Should restaurants be allowed to serve trans fatty food to Californians, or is the Governator providing fast-food junkies with much-needed protection?   Share your thoughts!

--Amy Silverstein

Photo credit: Rick Loomis / Los Angeles Times 

Marijuana's THC levels get higher

The L.A. Times' health blog, Booster Shots, this week reported on findings from the University of Mississippi that the active ingredient in marijuana is rising over the decades. Since studies began in the '70s, the report showed that currently the average amount of THC in pot is about 9.6%, more than double what was found in marijuana in the '80s. One of the samples found THC levels as high as 37.2%.

The study prompted a doctor to declare that the results are "worrisome" in that there "is the possibility that the more potent THC might be more effective at triggering the changes in the brain that can lead to addiction; however, more research is needed to establish this link between higher THC potency and higher addiction risk."

The responses by the commentors were mixed:

none:

I hate it when people [like the doctor] make such dumb statements like that. So it's more potent, that just means people don't need as much to get the same amount of thc, it's not like they couldn't get just as much by using more less potent marijuana. Also more potent marijuana would generally cost more... It's quite funny hearing about toxicity and addiction for a drug that is far less harmful in both cases than alcohol, which no one seems to have a problem with.

Matt Smith:

I wonder if this increased potency also carries with it increased risks to human health.

dude:

does this mean I am going to need bigger bags of doritos?

Obesity as a cause of global warming comments

Even though it's relatively new, our health blog Booster Shots has been getting a lot of comments. One post in particular on Friday "Obesity as a cause of global warming?" got over 130 messages from our readers. The reason? Apparently some people thought this was an outrageous thesis.

Walter wrote:

Cute notion but as off the mark as every other cause...the only issue that is never seriously addressed is the only issue that really needs to be; this planet is severely over-populated. Every 'serious global problem' is simply a result of this fundamental fact. Good luck reconciling ever increasing population with rapidly dwindling resources. Be fruitful, dummy...multiply.

Juan calculated:

1 + 1 = 2

18% less food fat people eats = 18% more food the world has around

18% less gass they need to move = 18% less emissions etc. So what is this all about? Fat people are RESPONSIBLE for THAT. They are not to be blamed. But they are to take responsability for their unhealthy and wasteful habits.

sejanus added:

Walter is exactly right. On the other hand it does expand the category of people we can blame for everything that's wrong. We can add fat to the description of angry white middle aged males that cause all the problems. Women, the young, non-whites, gay, lesbian and the trans gendered and are inherently victims and thus incapable of doing harm to the environment.

Art joked:

My mother-in law is a major contributor to global warming if obesity is to blame!

And that was just the beginning of the debate. Read the whole thing here.

photo credit: Brian Vander Brug/Los Angeles Times