Islands regain some air, sea access after monster storm
By CALEB JONES and JENNIFER SINCO KELLEHER
Sunday, October 28
Some airport and shipping access has returned to a U.S. Pacific territory ravaged by a super typhoon, but tens of thousands of residents still without power and sifting through rubble face a long road to recovery.
Saipan International Airport reopened with limited service Sunday after Super Typhoon Yutu slammed the Northern Mariana Islands this week as a Category 5 storm.
A statement posted on the Facebook page of Northern Marianas Gov. Ralph Torres said the airport will be open from 6 a.m. to 6 p.m. but will receive only six international flights per day. Inbound flights are restricted to residents and humanitarian aid, the statement said.
Thursday’s storm was the strongest to hit any part of the United States this year. It ripped off roofs, overturned cars, toppled trees and killed a woman who took shelter in an abandoned building that collapsed. Others were injured, including three people who needed surgery.
The airport sustained significant damage to buildings, and several crumpled, small planes were scattered around the tarmac. Officials said the airport is still mostly without power, and the Transportation Security Administration has only one working scanning machine. Baggage and cargo may have to be examined by hand, the statement said.
All airports on Saipan, Tinian and Rota were closed due to the storm. The airport on Tinian remains closed except to military planes. Rota’s airport is now open.
The U.S. Coast Guard said Saturday all ports in the Northern Mariana Islands have also reopened.
Commander of Coast Guard Sector Guam Capt. Christopher Chase said in a statement that crews were working to assess and restore shipping access to make sure supplies can reach the islands. The Coast Guard is also working with local officials in search and rescue operations.
A Coast Guard airplane from Hawaii flew over Saipan and reported minimal damage to shipping lanes.
The U.S. government is sending supplies to the Northern Marianas as residents dig through the wreckage.
“The rebuilding of this island is beginning already as time waits for nobody,” Jan Reyes, who lives on the territory’s most populated island of Saipan, wrote in an email to The Associated Press. “Despite the casualties, we the people of the Commonwealth of the Northern Mariana Islands are resilient people.”
To help the recovery, military planes brought in food, water, tarps and other supplies.
U.S. Federal Emergency Management Agency spokesman David Gervino said the agency is focused on helping restore power, opening sea and air ports, and ensuring cellphone towers can operate on emergency power until electricity returns.
Super Typhoon Yutu packed maximum sustained winds of 180 mph (290 kph) as it passed over the islands of Tinian and Saipan, the National Weather Service said. By Saturday, power was still out across Saipan, with 50,000 residents, and Tinian, with 3,000 people.
Many homes were destroyed because some families can’t afford concrete homes that conform to building codes meant to withstand typhoon winds, said Edwin Propst, a member of the territory’s House of Representatives.
Some people build houses with concrete foundations and walls, but the structures have wooden or tin roofs.
Reyes and her family lost everything.
“Everything my family and I have bought and added to our home over 13 years laid on the flooded floor as every window in our house shattered,” Reyes wrote.
A cousin was trapped under debris for seven hours, Reyes said.
Her family rode out the storm in a hotel room, overturning a bed to create a barricade against the wind, rain and debris. When the worst passed, she said it took half an hour to navigate fallen poles and trees for what would normally be a five-minute drive to their home.
“The foundation of our culture is selflessness and family values, and this is what has always helped us get through hard times,” she wrote. “We will always remain hopeful and prepared for the worst. This is our way of life.”
Michelle Francis hid in a closet while the storm destroyed her Saipan house, saying in a Facebook message that many people lost their homes and belongings. “Now everyone is trying to stand strong, have faith.”
People in the islands are used to riding out monster storms, but many said Yutu was the worst they have experienced.
Because of severe weather, people “listen to warnings from local officials, they take shelter when directed to do so, they stock up on supplies in advance of the storm,” Gervino said.
The territory’s only hospital, in Saipan, said it saw 133 people in its emergency room Thursday, and three patients had severe injuries that needed surgery.
Gregorio Kilili Camacho Sablan, the territory’s delegate to Congress, said residents will need major help and many months to recover.
FEMA has 220,000 liters of water and 260,000 meals stored on Guam for shipment to the Northern Marianas, a half-hour plane ride away.
FEMA made changes after Hurricane Maria, a Category 5 storm that struck Puerto Rico last year, creating task forces to tackle those needs.
More than 800 people were in shelters across the islands, and space was running out, officials said.
Saipan is a popular tourist destination for visitors from China and South Korea, just a few hours away by plane. Some 650,000 tourists visited in the 2017 fiscal year, according to the Marianas Visitors Authority.
Jones and Kelleher reported from Honolulu. Associated Press writer Audrey McAvoy in Honolulu contributed to this report.
Get a flu shot now – for your benefit and your neighbors’
October 25, 2018
Dr. Patricia Schnabel Ruppert
Commissioner of Health and Hospitals of Rockland County, Fellows Ambassador New York Academy of Medicine, Adjunct Professor in the Institute of Public Health, New York Medical College, Certified Physician Executive, Assistant Professor of Medicine, Columbia University Medical Center
Dr. Patricia Schnabel Ruppert does not work for, consult, own shares in or receive funding from any company or organization that would benefit from this article, and has disclosed no relevant affiliations beyond their academic appointment.
If you do nothing else the next few days, get a flu shot.
The best time to get a flu shot is by the end of October, the Centers for Disease Control and Prevention advises. Considering the severity of last year’s flu, it is especially important for everyone over age six months to be vaccinated. This includes pregnant women.
Last year’s flu killed 80,000 people, the CDC reported, making it the most lethal flu epidemic in decades. Also, about 710,000 people were hospitalized because of it.
As of Oct. 6, 2018, 183 of those deaths were in children, the CDC reported. Additionally, there has already been one pediatric death this current flu season. And 80 percent of those children who died last year along with the recent pediatric death had not been vaccinated.
You play an important role in stopping the spread of flu, not just to yourself but to others. As a doctor and public health professional who has treated many people with influenza, I’ll explain why.
Protecting yourself, protecting others
The influenza vaccine has been shown to be one of the most important preventive measures against the flu. Though the effectiveness of the vaccine can vary – and last year’s rate was low, at about 40 percent – this still meant that the flu vaccine reduced a person’s overall risk of having to seek medical care at a doctor’s office for flu illness by 40 percent. Considering the seriousness of the illness, however, you need all the protection you can get.
And the vaccine reduces the severity and potential complications of your illness if you do get the flu. A large study published in 2017 of patients hospitalized during the 2013-2014 flu season found that vaccinated adults were 52 to 79 percent less likely to die than unvaccinated patients. Put another way, a hospitalized flu patient who was unvaccinated was two to five times more likely to die than someone who had been vaccinated.
Almost everyone can receive the flu vaccine. Exceptions include babies younger than six months and people who have serious reactions to the flu vaccine, like anaphylaxis, a life-threatening reaction.
Some people gets hives from eggs, but this is not considered a serious reaction. If you are one of these people, it is still OK for you to get a flu shot from standard providers. Even those who have a serious egg allergy can get the flu vaccine in a medical setting.
Getting the vaccine is not just good for you but also for the larger community. About 70 percent of the population needs to receive the flu vaccine to ensure what we call “herd immunity .” That happens when a critical portion of a community is immunized against a contagious disease.
When that occurs, most members of the community, including those who are not vaccinated, are protected against that disease because there is little opportunity for an outbreak. Even those who are not eligible for certain vaccines get some protection because the spread of contagious disease is contained. This can effectively stop the spread of disease in the community.
You might even consider getting the vaccine to be a civic duty.
Other things to know
While the vaccine has been shown to be one of the most important preventive measures against the flu, you can do other things, too. Wash your hands. If you cough or sneeze, cover your mouth or nose with your sleeve, not your hands. Avoid those who are ill. Stay home if you are sick.
Antiviral medication can help you feel better if you contract the flu, but it must be started early in your illness, so call your health provider when symptoms begin.
A new, higher-dose vaccine is available for the elderly. If you are 65 or older, ask your doctor about this. About 54 to 70 percent of hospitalizations for flu occur among people 65 and older. No matter which formulation you receive, it is essential to be vaccinated. Don’t miss the opportunity to do so.
Remember that getting the vaccine will not give you the flu. That is because vaccines today are made with killed viruses. A killed virus cannot infect anybody. If you hear someone say they came down with symptoms after receiving the vaccine, it could be because they had been exposed to flu before they were vaccinated.
Even if you can’t get to your doctor or pharmacy by the end of October, you should still get the flu vaccine. While the best immunity is conferred if you get the vaccine earlier, you will be protected.
And remember, even if it’s not a perfect match, it can protect you and your loved ones from getting a potentially life-threatening, yet preventable, disease.
Good advice: Stay home if you have the flu. Better advice: Get the flu vaccine!
Editor’s note: This is an updated version of an article that originally was published Oct. 23, 2016.
Jon Richfield, logged in via Facebook: 80 percent of those children who died last year along with the recent pediatric death had not been vaccinated.
What kind of half-witted irresponsibility on the part of a parent does it take to ignore or fail to understand such figures? The best I can hope for is that it is natural selection in action.
Why did the flu kill 80,000 Americans last year?
October 23, 2018
Patricia L. Foster
Professor Emerita of Biology, Indiana University
Patricia L. Foster receives funding from the US Army Research Office. She is affiliated with Union of Concerned Scientists and Concerned Scientists at Indiana University.
Indiana University provides funding as a member of The Conversation US.
The 2017-2018 flu season was historically severe. Public health officials estimate that 900,000 Americans were hospitalized and 80,000 died from the flu and its complications. For comparison, the previous worst season from the past decade, 2010-2011, saw 56,000 deaths. In a typical season, 30,000 Americans die.
So why was the 2017-2018 season such a bad year for flu? There were two big factors.
First, one of the circulating strains of the influenza virus, A(H3N2), is particularly virulent, and vaccines targeting it are less effective than those aimed at other strains. In addition, most of the vaccine produced was mismatched to the circulating A(H3N2) subtype.
These problems reflect the special biology of the influenza virus and the methods by which vaccines are produced.
Flu virus is a quick change artist
Influenza is not a single, static virus. There are three species – A, B and C – that can infect people. A is the most serious and C is rare, producing only mild symptoms. Flu is further divided into various subtypes and strains, based on the viral properties.
Viruses consist of protein packages surrounding the viral genome, which, in the influenza virus, consists of RNA divided into eight separate segments. The influenza virus is enveloped by a membrane layer derived from the host cell. Sticking through this membrane are spikes made up of the proteins haemagglutinin (HA) and neuraminidase (NA), both of which are required for the virus to successfully cause an infection.
Your immune system reacts first to these two proteins. Their properties determine the H and N designations of various viral strains – for instance, the H1N1 “swine flu” that swept the globe in 2009.
Both HA and NA proteins are constantly changing. The process that copies the viral RNA genome is inherently sloppy, plus these two proteins are under strong pressure to evolve so they can evade attack by the immune system. This evolution of the HA and NA proteins, called antigenic drift, prevents people from developing lasting immunity to the virus. Although the immune system may be prepared to shutdown previously encountered strains, even slight changes can require the development of a completely new immune response before the infected person becomes resistant. Thus we have seasonal flu outbreaks.
In addition, various subtypes of influenza A infect animals, the most important of which, for humans, are domestic birds and pigs. If an animal is simultaneously infected with two different subtypes, the segments of their genomes can be scrambled together. Any resulting virus may have new properties, to which humans may have little or no immune defense. This process, called antigenic shift, is responsible for the major pandemics that have swept the world in the last century.
Forecasting flu, producing vaccine
Against this background of antigenic change, every year the World Health Organization predicts which strains of flu virus will be circulating during the next flu season, and vaccines are formulated based on this information.
In 2017-2018 the vaccine was directed against specific subtypes of A(H1N1), A(H3N2) and B. The Centers for Disease Control and Prevention estimates that this vaccine was 40 percent effective in preventing influenza overall. But, significantly, it was only 25 percent effective against the especially dangerous A(H3N2) strain. This mismatch probably reflects the way most of the vaccines are produced.
The common way of producing influenza vaccine starts by growing the virus in fertilized chicken eggs. After several days, the viruses are harvested, purified and inactivated, leaving the surface proteins, HA and NA, intact. But, when the virus is grown in eggs, individual viruses with changes in the HA protein that increase its ability to bind to chicken cells can grow better and thus become more common.
When people receive vaccines produced from these egg-adapted viruses, their immune system learns to target the egg-influenced HA proteins and may not react to the HA proteins on the viruses actually circulating in humans. Thus, the virus used to produce much of the 2017-2018 vaccine provoked an immune response that did not fully protect against the A(H3N2) virus circulating in the population – although it may have lessened the severity of the flu.
Small improvements and a universal vaccine
Scientists are on the hunt for a better way to protect the world’s population from influenza.
Two new vaccines that do not use egg-grown viruses are currently available. One, a vaccine made from viruses grown in mammalian cells, proved in preliminary studies to be only 20 percent more effective against A(H3N2) than egg-produced vaccine. The other, a “recombinant” vaccine consisting of only the HA proteins, is produced in insect cells, and its effectiveness is still being evaluated.
The ideal solution is a “universal” vaccine that would protect against all influenza viruses, no matter how the strains mutate and evolve. One effort relies on the fact that flu’s HA protein “stalk” is less variable than the “head” that interacts with the host cell surface; but vaccines made from a cocktail of HA protein “stalks” have proved disappointing so far. A vaccine composed of two proteins internal to the virus, M1 and NP, which are much less variable than surface-exposed proteins, is in clinical trials, as is another vaccine made up of a proprietary mixture of pieces of viral proteins. These vaccines are designed to stimulate the “memory” immune cells that persist after an infection, possibly providing lasting immunity.
Will the 2018-2019 flu season be as bad?
Based mainly on the recent flu season in South America, the World Health Organization recommended changing the A(H3N2) subtype in the vaccine to one that better matches last year’s circulating A(H3N2). They also recommended changing the B subtype to one that appeared in the U.S. late in the 2017-2018 season and became increasingly common elsewhere. The WHO anticipated that the circulating A(H1N1) subtype will be the same as last year and so no change was necessary on that front. So, although the same strains will most likely be circulating, epidemiologists expect the vaccines to provide better protection.
The CDC recommends that everyone 6 months and older get a flu shot every year, but, typically, fewer than half of Americans do so. Flu and its complications can be life-threatening, particularly for the young, the old and the otherwise debilitated. Most years the vaccine is well matched to the circulating virus strain, and even a poorly matched vaccine offers protection. Plus, wide-spread vaccination stops the virus from spreading and protects the vulnerable.
The first flu death of the 2018-2019 season has already occurred – a healthy but unvaccinated child died in Florida – affirming the importance of getting the flu shot.
GM proposes nationwide zero-emissions vehicle sales mandate
By TOM KRISHER
AP Auto Writer
Saturday, October 27
DETROIT (AP) — General Motors says it will ask the federal government for one national gas mileage standard, including a requirement that a percentage of auto companies’ sales be zero-emissions vehicles.
Mark Reuss, GM’s executive vice president of product development, said the company will propose that a certain percentage of nationwide sales be made up of vehicles that run on electricity or hydrogen fuel cells.
“A national zero emissions program will drive the scale and infrastructure investments needed to allow the U.S. to lead the way to a zero emissions future,” Reuss said.
GM, the nation’s largest automaker, spelled out the request Friday in written comments on a Trump administration proposal to roll back Obama-era fuel economy and emissions standards, freezing them at 2020 levels instead of gradually making them tougher.
California Gov. Jerry Brown, whose state was one of many opponents to the mileage rollbacks filing objections to the Trump plan, stood in front of Interstate 5 in Sacramento on Friday to urge the cause of cleaner cars and condemn the administration’s proposal.
“Foolishly, it mandates gas guzzlers instead of clean and zero-emission vehicles,” Brown told reporters as trucks and passenger traffic roared past. “Wrong way to go, Donald. Get with it. Bad.”
Under a regulation finalized by the Environmental Protection Agency at the end of the Obama administration, the fleet of new automobiles would have to get 36 miles per gallon (15 kilometers per liter) by 2025, 10 miles per gallon (4 kilometers per liter) higher than the current requirement.
But the Trump administration’s preferred plan is to freeze the standards starting in 2021. Administration officials say waiving the tougher fuel efficiency requirements would make vehicles more affordable, which would get safer cars into consumer hands more quickly.
GM on Thursday said it doesn’t support the freeze, but wants flexibility to deal with consumers’ shift from cars to less-efficient SUVs and trucks.
Its proposed requirement would be based on current standards now required in California and nine other states. Under those rules, GM must sell a minimum of around 2,200 fully electric vehicles in California this year, or about 1.1 percent of the roughly 200,000 cars, trucks and SUVs that it normally sells in the state each year.
California sets the requirements based on a complex formula that considers the total number of vehicles sold by an automaker and gives credits for fully electric vehicle sales and partial credits for plug-in gas-electric hybrid vehicles. Credits can be banked or sold to other automakers that need them.
GM’s proposal would set lower zero-emissions vehicle requirements than California, but spread them to the entire nation. The requirements would gradually increase until 2025.
Reuss said GM’s proposal is a starting point for discussions on one set of national fuel efficiency and zero-emissions vehicle standards.
“We want really one national set of standards,” he said. “Engineering to multiple standards is very costly and frankly, unnecessary.”
Federal and California gas mileage standards have been the same since 2010. But if President Donald Trump’s administration ends up relaxing the requirements, it could create two standards, one for California and states that follow it, and another for the rest of the nation.
California, whose unique authority to set its own vehicle emissions standards would be rolled back under the administration’s proposal, submitted more than 400 pages of analysis rejecting the plan and the research behind it.
California argues freezing emissions standards for six model years would exacerbate climate change, depress research in cleaner technologies and lead to higher spending on gasoline. It also says the plan endangers the U.S. auto industry by allowing other countries to take the lead in developing affordable electric vehicles and batteries.
“I think a lot of the car companies know they’ve got to build clean, electric or hydrogen cars,” Brown said at Friday’s interstate news conference. “If they don’t, they’ll be working for Chinese companies.”
Separately, 21 attorneys general and five cities signed a letter saying the administration’s proposal is illegal.
Trump could challenge California’s power to set its own standards, granted under the Clean Air Act, and that could set up a lengthy legal battle since California has pledged to defend its quest to reduce pollution.
The EPA’s acting administrator, Andrew Wheeler, has said he wants a single mileage standard nationally. Wheeler “has pledged to work in earnest with states and stakeholders to find a solution as we take comments on the new proposal,” agency spokesman James Hewitt said Friday.
Environmental groups still are likely to oppose any changes in the standards. Daniel Becker of the Safe Climate Campaign, an environmental advocacy group, said automakers like GM want the federal government to set standards rather than California because it’s easier to lobby for loopholes in Washington.
“The auto companies want to be able to make a small number of electric vehicles and a large number of gas-guzzling SUVs and other trucks instead of complying with the existing mileage and emissions rules,” Becker said.
The deadline for written comments on the Trump administration plan were due Friday, with a final decision expected in March.
GM, which offers the all-electric Chevrolet Bolt with 238 miles of range, and the plug-in hybrid Chevrolet Volt, has invested millions to develop battery technology so additional electric vehicle sales nationwide would help its bottom line. The company has promised to introduce 20 new all-electric vehicles globally by 2023.
Ellen Knickmeyer in Washington, D.C., and Jonathan J. Cooper in Sacramento, California, contributed to this report.