February 26, 2015
City News Service
Officials at Ronald Reagan UCLA Medical Center continued outreach efforts as of February 20, to patients potentially affected by a “superbug” outbreak that has infected at least seven people, killing two. The hospital notified 179 patients who underwent endoscopic procedures between Oct. 3, 2014, and Jan. 28 that they may have been exposed. Seven patients have been infected with the bacteria, and two of them have died, hospital officials said.
Hospital officials insisted Thursday February 19, they followed all required procedures in handling the outbreak. They are even reaching out to patients who likely were not treated with a pair of medical scopes later found to be infected with the potentially deadly carbapenem-resistant Enterobacteriaceae, or CRE, bacteria. The infections were traced to two of seven Olympus-manufactured duodenoscopes used by the hospital for the procedures, which are conducted to diagnose and treat diseases of the liver, bile ducts and pancreas.
The hospital is notifying all 179 of the patients, even though not all of them were treated with the two scopes that carried the bacteria.
“We’re being very cautions and we’re actually contacting all patients who underwent (endoscopic procedures) ... even if another scope was used on them,” said Dr. Zachary Rubin, the hospital’s director of infection prevention.
Dr. Robert Cherry, the hospital’s chief medical and quality officer, said a wider range of notification – including to patients not treated with the suspect scopes – was decided upon out of “an abundance of caution.”
“We’ve sent letters out, we’ve placed phone calls to each of those patients. We are offering free testing for those patients as well as any type of potential treatment options and discussions about those options,” he said.
The Food and Drug Administration issued a warning to hospitals through its safety communications systems about duodenoscopes. It said the design of the scopes may make them more difficult to clean, and it urged that they be washed meticulously. UCLA officials said they had been following all the required steps for sterilizing the scopes, which are inserted through the throat and considered minimally invasive, but the infections still managed to spread.
The hospital has now switched to a more thorough cleaning system, involving a disinfection process at the hospital, then at an off-site process that uses ethylene oxide gas to sterilize the equipment. Potentially exposed patients at UCLA are being offered a home testing kit that will then be analyzed at the hospital. Hospital officials said similar exposures to CRE have been reported at other American hospitals that use the same type of scopes.
As soon as the infection was identified at UCLA, hospital officials said they notified the Los Angeles County Department of Public Health. Dr. Benjamin Schwartz, the department’s deputy chief of acute communicable disease control, hailed the work done by UCLA to identify the infection and reach out to patients.
The hospital “followed the procedures appropriately throughout,” Schwartz said.
He also stressed that the outbreak “is not a threat to the health of the public in L.A. County.” Officials at the U.S. Centers for Disease Control and Prevention said they are assisting the Los Angeles County Department of Public Health in its investigation of the UCLA infections. CRE is a family of bacteria that is resistant to many common antibiotics. The bacteria can cause infections in patients who have other serious medical problems or who are “undergoing operations or other invasive procedures,” hospital officials said.
Since 2012, there have been about a half-dozen outbreaks affecting up to 150 patients in Illinois, Pennsylvania and Washington State, the Los Angeles Times reported. Last month, Virginia Mason Medical Center in Seattle acknowledged that 32 patients were sickened by contaminated endoscopes from 2012 to 2014 with a bacterial strain similar to CRE. Eleven died. But, according to The Times, Virginia Mason said other factors may have contributed to their deaths because many of them were already critically ill.
February 19, 2015
By FENIT NIRAPPIL
Officials are considering new water restrictions as California's drought drags on, possibly forcing residents to ask for water at restaurants and for fresh towels and sheets at hotels.
The State Water Resources Control Board floated the ideas at an informational hearing Tuesday as it considers extending and expanding mandatory water-use rules.
The board last summer imposed emergency regulations prohibiting Californians from washing their cars with hoses that don't shut off and limiting how often they can water their lawns. Board members appeared ready to extend those rules and add new ones Tuesday.
“I find it galling when whole sets of water glasses end up on a (restaurant) table, even in Sacramento,” said Felicia Marcus, chairwoman of the board. “The key is to get away from very light mandatory restrictions.”
The board has the sweeping power to define when water use is unreasonable, and it could eventually expand the definition to include using drinking water to maintain golf courses and cemeteries. Marcus said the board would likely take smaller steps first, such as prohibiting decorative outdoor water fountains.
Existing emergency regulations have authorized agencies to fine water wasters up to $500 a day, though such stringent enforcement has been rare.
For homeowners, new rules also could include a ban on watering lawns during cold and rainy periods.
Some proposals presented Tuesday targeted businesses, such as requiring restaurants to only serve water on request and telling hotels not to automatically provide guests with fresh towels and sheets every day. Some cities have similar rules already in place.
The board has considered making some water restrictions permanent with the prospect of future droughts looming.
“We definitely need permanent regulations,” said Frances Spivy-Weber, the board vice-chairwoman. “I just don't see how we can enter the next 30 years with climate change without them.”
The board could consider the extension of restrictions next month and take up other possible regulations later in the year.
February 12, 2015
By Ricardo Alonso-Zaldivar,
Ahead of a Sunday deadline, consumers are stepping up to enroll for 2015 coverage under President Barack Obama’s health care law, administration officials said on February 11.
The number of people signing up jumped last week, the Health and Human Services Department reported. Nearly 276,000 signed up in the 37 states served by the federal insurance marketplace, compared with about 180,000 the previous week.
Although enrollment centers haven’t seen the same long lines as last year, volunteers from Austin, Texas, to Columbus, Ohio, report a surge this week, not yet captured in official numbers. And the revamped HealthCare.gov website so far has avoided last year's technology meltdown.
Not everything was rosy:
—Average monthly premiums rose by 8 percent in the federal market states, according to preliminary data the administration released earlier in the week. Obama’s law provides taxpayer-subsidized private insurance for people who don't have access to coverage on the job.
That 8-percent increase reflects the “list price” before subsidies. After subsidies, the average monthly premium that consumers themselves pay increased $23 over last year.
It’s “the first official indication of how premiums are going up in plans that people are actually enrolled in,” said Larry Levitt of the nonpartisan Kaiser Family Foundation.
—About 200,000 people who could not clear up lingering questions about their immigration and citizenship status will soon lose coverage, officials said Wednesday. That’s on top of more than 100,000 dropped last year for similar reasons.
Coverage is only available to citizens and legal residents, but advocates for immigrants say the process for validating legal status has been riddled with errors.
Higher premiums and immigration debates may be the least of the administration’s worries.
Opponents are taking a case to the Supreme Court next month that challenges the validity of the law’s subsidies in states that have not set up their own insurance markets, which is most of them.
If the court agrees with the plaintiffs, at least 6.5 million people will lose subsidies for their premiums and other costs. Most would drop coverage.
Wednesday’s enrollment report showed 7.75 million people had signed up in the states served by federal HealthCare.gov as of Feb. 6. That's not counting states that run their own insurance markets, among them California and New York.
All told, the administration seems to be on track to meeting its target of 9.1 million people signed up nationwide by Sunday, the day the open-enrollment period ends.
The target represents customers who seal the deal by paying their premiums
The 2015 sign-up deadline is 11:59 p.m. Sunday, Pacific time, in most states. States running their own markets may have different deadlines.
Federal marketplace consumers who try to enroll, but aren’t able to complete the process before the deadline, will get another chance to do so. That covers anyone in line by 11:59 p.m. on Sunday.
February 12, 2015
By Jazelle Hunt
NNPA Washington Correspondent
The first time Tiffany Perry learned about her conception, she was too innocent to fully understand the gentle explanation her mother was offering, too young to process such a heavy and complicated behavior.
What she distinctly remembers is watching “Oprah” with her mom a few years later, as a 10-year-old. It was the television episode in which Oprah revealed to the world that she was a rape survivor.
“When [Oprah] said herself, and started crying…my mom just fell apart,” the 39-year-old Jersey City, N.J. native recounted. “I tried to console her, but she was inconsolable. It was just so intense.”
At 15 years old, Perry’s mother was raped by her foster mother’s 21-year-old married son. His wife had invited Perry’s mother into their home to babysit their child and to escape her foster mother’s wrath.
Her foster brother raped her repeatedly for two weeks, sometimes at knifepoint. Despite being a virgin at the time and under the care of the state, few people bothered to inquire about the details of the pregnancy. Plus, the fact that he had threatened to kill her, kept Perry’s mother silent.
“Maybe, as a Black person, they just saw this as another teenage pregnancy, and nobody really asked any questions,” Perry said, trying to explain the unexplainable. “I can’t say with certainty…but I’m thinking that if she was White in a foster home and her belly started to grow, then maybe a flag would’ve went up somewhere and somebody would’ve investigated more as to why this foster child is pregnant.”
In subsequent years, freed by the Oprah episode, Perry’s mother became more forthcoming.
“As I grew up, she told me more details of the attack. It was like she had been carrying this around the whole time.”
But opening that door triggered another set of emotions in Perry.
“I went through different feelings of inadequacy, feeling like I had to overcompensate because I was a child of a rape. Even now, when I say the word ‘inadequate,’ I get choked up,” she said, her voice trembling with emotion.
“My mom was awesome, she never talked down to me….my mom always praised me, always gave me love,” Perry said. “But I felt like…I owed it to her to be perfect so she doesn’t feel like keeping me was a mistake.”
And there was the question of what she would say when asked about her father. Perry chose to say that he was dead, that he had left, or that she didn’t know him, depending on the questioner. But even while denying his existence, there was also a deep craving to know about this man, wherever he was.
Wanted to know her roots
More than anything else, she did not want her mother to feel badly.
“I didn’t rape her, but when I was younger, I used to feel like it was my fault,” she recalled. “The dreams that she probably could have fulfilled – if she had stayed that innocent virgin who wanted to be a lawyer – she wasn’t going to be able to fulfill those because I was here.”
Instead of pursuing her dreams, Perry’s mother had to shift her focus, looking after the needs of an infant rather than look forward to a career as an attorney.
“Sometimes she was a little more paranoid than I would think is regular,” Perry said. “When I was growing up my mom was so strict, or smothering, when it came down to me, particularly.”
Once, her mother sent her to the corner store for a few items. There, she ran into a family friend, an older man. He offered to buy her something – she chose cookies – and they parted ways.
She thought nothing of it – until her mother went into a rage.
“She flew off the handle. She beat me with an extension cord. And she told me, ‘Don’t ever accept anything from a man, they can’t be trusted, you don’t know their intentions.’ I’m six. I don’t have a clue what she is talking about.
“She cried. When I got older and reminded her about the incident, she explained to me that she didn’t trust anybody, she didn’t trust any man. And she wanted me to be extra careful. She wanted to put that fear in me.”
It instilled both fear and confusion, blurring the lines of what was acceptable with the boys and men in her world.
“It’s just assumed whenever a woman gets raped, she never gets pregnant, or if she does get pregnant, the child is automatically aborted or adopted,” she said. “There’s this group of people who’ve been conceived by rape and nobody ever discusses us. I want to talk about it because we exist. I exist.”
Philadelphia-based author, activist, and scholar Ewuare Osayande wasn’t born of this violence, but also grew up in its shadow.
His mother spent her childhood at the mercy of a sexually abusive stepfather. The oldest of eight children, she was the only one who was not his blood-relative. The abuse was the family’s open secret. She grew up to date, marry, and divorce abusive men.
Justice Department data show that Black women are more likely than their White counterparts to be assaulted, sexually and otherwise by strangers and by family members.
“It was never the case where my mother cowered in the face of her abuse. She didn’t hold her tongue, she always spoke her mind,” Osayande said.
Today, Osayande is the creator of Project ONUS: Redefining Black Manhood, a series of anti-sexist workshops for Black men. It took time and life experiences before he was able to connect the dots and realize how his mother’s abuse – some he had witnessed, some he had not – had affected his own development.
“That processing has been life-long,” he explained. “I’m a divorcée. In that relationship, I found myself becoming like the men I swore for years I would never be. It never got to the point where I became physically abusive, but certainly emotionally abusive.”
As the son of a rape and abuse survivor, and as a formerly abusive person, he also realized he had to address his own internal conflicts and beliefs.
“It’s been a very real, clear determination on my part to make sense of the life I’ve experienced as a Black man, in a gendered way,” he explained. “It’s been my desire to become an effective ally in that struggle, in that engagement in the world in which Black women exist, and experience.”
Secondary survivors need help
In the sea of services for survivors, most resources geared toward family and friends coach them on how to best support the survivor in their life. Although crisis centers and hotlines are equipped to aid and counsel family and friends of survivors, few resources address the challenges these relatives face.
The book, I Will Survive: The African American Guide to Healing from Sexual Assault and Abuse, cites a study that draws parallels between the emotions of boyfriends and husbands of women who have been sexually assaulted, and the wives and girlfriends of war veterans.
“Not surprisingly, past or recent sexual trauma can present unique challenges for the survivor’s partner,” writes Lori Robinson, author of the book. “You are a victim too. Some experts call you the secondary victim. After all you are experiencing many of the same emotions sexual assault victims feel.”
Tiffany Perry’s breaking point came about 20 years ago. A probation officer contacted her out of the blue, looking for her father. He had given her name and birthdate as his next-of-kin. She learned that not only did he know about her, but he knew where she lived. To this day, the two live less than an hour apart. She has never contacted him, but has learned a bit about his life via a cousin and aunt on Facebook.
Perry’s mother remains her primary source of support.
“When I went to go look for support groups for children of rape victims or children conceived out of rape, they’re pretty much nonexistent,” Perry says. “[Rape] is so common we don’t even cringe when we hear about it. Rape is inhumane, and people are not treating it like it’s inhumane. They just treat it like ‘Well, it happens.’”