The flu season has reached epidemic levels and has yet to reach its peak, despite a drop-off in cases in some states. Nationwide, nearly four dozen children, about half of them under the age of five, have already died this flu season, which began in November and typically runs into March. New York City doctors, hospitals and pharmacists report quickly rising numbers of flu cases, particularly among children and the city has asked doctors to prioritize vaccines for those with the highest risk. That means the elderly, people with compromised immune systems, pregnant women and children, particularly those under two years of age.
Doctors are calling this the most intense flu season for children since the Hong Kong flu of 1968-69. New York City is reporting widespread activity and the number of reported flu-like illnesses, such as pneumonia, continues to rise, as do deaths from these illnesses.
People with chronic conditions such as asthma and diabetes, from which many New York City children suffer, are at increased risk for complications from the flu. Children with the flu are also at particular risk for ear and sinus infections; it's the bacterial illnesses that can lead to hospitalization and death, although death from influenza is rare for children, an average of 92 annually. This season is worse than usual because two of the three strains currently spreading are particularly harsh, and A/Fujian, one of the more virulent strains, was not included in this year's vaccine. Fujian has the strongest link to severe illness and deaths of children and teens.
ABUSE CHARGED AT THE EDWIN GOULD ACADEMY
Six current and former students of the Edwin Gould Academy in Rockland County have filed a civil suit against the school, charging that the staff beat them and slammed them into walls, broke bones, smoked marijuana in front of them and came to work intoxicated. At least one teen was being injected with Thorazine, an anti-psychosis drug, without parental consent or knowledge, says the suit.
The residential school for troubled, abandoned and abused children, located in Spring Valley, is publicly funded as a special school district of the state. It educates up to 200 children ages 12 to 20, most of whom are from New York City. The school's mission is to provide a safe environment in which children can get an education and a new start. The lawsuit was filed in December in the State Supreme Court in the Bronx; the students in the suit reside in Brooklyn. The suit asks unspecified damages.
The school's superintendent said that state officials had investigated abuse allegations and that some of the named staffers had been fired.
CITY COUNCIL PASSES LEAD PAINT BILL
The New York City Council passed a controversial lead paint bill that makes landlords responsible for lead paint and requires them to remove under a stringent schedule.While many in health and social services are in favor of the bill, others are opposed, including non-profit housing developers. They say lead paint is only one of many problems in the housing stock and this bill be result in the reduction of housing renovation in low and moderate-income neighborhoods.
The mayor vetoed the bill on December 20, saying that it could actually harm families with children because landlords will be reluctant to rent apartments to families with small children. The City Council is expected to override his veto.
Sasha Nyary, formerly on the staff of Life Magazine, edits the newsletter of The Fifth Avenue Committee, a community-based organization.
![]() Catalina Pena and her two sons. High lead levels were found in their Washington Heights apartment. |
To many advocates in health and social services, lead contamination poses an unacceptable threat to the welfare of young children, particularly in low-income neighborhoods. To many housing advocates, lead is but one of several serious health-related dangers common to poorly maintained, deteriorated buildings. These two different points of view are at odds in the contentious debate over the City Council's Childhood Lead Poisoning Prevention Act of 2003. The bill, which the City Council passed into law on Monday, December 15, holds landlords responsible for the presence of lead paint and lead dust and sets up a stringent schedule for inspection, removal, and clean-up.
In support of this bill, many advocates urge the eradication of lead wherever it is found -- particularly in the older buildings of what has come to be called the "lead belt," which runs from Bedford-Stuyvesant, East Flatbush, Williamsburg, and Fort Greene north into Jamaica, Queens.
These largely minority lead-belt neighborhoods have a disproportionately high rate of childhood lead poisoning. Indeed, nearly all of the city's children identified as suffering from lead poisoning -- which can cause immune-system and neurological deficiencies as well as amnesia and kidney disease -- are black, Hispanic, or Asian, and most are from low-income households.
Many housing developers, however, including distinguished nonprofit groups like Phipps Houses and the Settlement Housing Fund, oppose the bill, saying that it will reduce investment in low and moderate-income neighborhoods. They argue that the rehabilitation of older housing stock, which contain many health hazards, should take priority over any single issue, even one as serious and explosive as lead.
What's more, they fear that in making landlords solely responsible for the existence of lead-based paint, the bill is setting excessively high and misplaced legal standards of liability. Tenants and tort lawyers will have a clear path to sue property owners, even those who are not at fault.
They maintain that the 1999 law, called Local Law 38, basically worked well.
It eliminated the 1982 law's hazardous directive to abate intact lead paint while adding powerful provisions for safe work practices in lead removal. It required owners of buildings constructed before 1960 to determine if children under age six lived there and to conduct annual inspections for lead paint hazards if they did.
Local Law 38 was struck down in October 2000 by New York State Supreme Court Judge Louis York, who agreed with the Coalition to End Lead Poisoning and the New York Public Interest Research Group that the City Council had passed the law without the state-mandated review of what its environmental effects might be.
Most everyone agrees that the national lead clean-up of the 1970s -- that banned leaded gasoline, lead oxide in paint, and lead in pipe solder, food storage cans, pottery, and toothpaste -- has been an environmental success story. The steep declines in the incidence of childhood lead poisoning back this up.
The federal government's official "level of concern" –- the level of lead in children at which parents are advised to seek medical treatment for the youngster –- has dropped steadily. In 1960 parents were urged to have children medically treated if the lead level in their blood tested at 60 micrograms per deciliter or more. Many children in those high-lead days tested at these levels. By 1985, children were treated if they tested at 25 micrograms. In 1991, the Centers for Disease Control and Prevention (CDC) reduced the level to 10, where it has basically remained.
Yet many experts are uneasy. Most people retain about 70 percent of all the lead they've ever ingested, says Roger Bason, an environmental consultant and adjunct professor at Columbia University. In this way, it resembles calcium rather than the many toxins that the body eliminates. A child's relatively small size and rapid metabolism exacerbate the problem. So you really do want to avoid it, Bason says.
But the problem was never really lead chips, says Bason, as the City Council's 1999 law assumed. It was paint dust, which can be created constantly by swinging doors and opening and shutting windows. That dust then gets on things, and because small children put so many things in their mouths, they can then ingest the lead.
Most everyone agrees that the bill before the council has taken an important step by identifying lead dust. But what is the best way of ameliorating the problem and improving the health of young children?
No one contends that landlords did anything illegal, immoral, or even stupid to create the existing problem. Until 1960 lead-based paint was used routinely as an interior and decorative paint -- even on children's furniture, playpens, and toys -- in houses, schools, and playgrounds.
Nonetheless, if a child is tested and found to have elevated blood levels in his or her blood, the council bill declares landlords responsible for that lead content regardless of the real reason for the problem, a claim more important to litigation than to a child's health. The Department of Health says that of New York City's roughly 5,000 cases of children with elevated lead levels, some 1,250 involve a foreign-born child. Of children with the most serious condition, less than half could be confidently traced to paint, rather than to the many other potential causes, including contaminated dishes and pottery.
But, of course, the source of the lead is the entire game. A child in an otherwise lead-free apartment who is eating hot food off traditional Mexican plates may well become ill, with no landlord responsibility. But the council bill assumes --and stipulates as legal fact -- that any elevated lead level is due to lead paint in the residence.
Further, Commissioner Thomas Frieden testified that the bill inadequately distinguishes between apartments with high and low risks of lead paint exposure. Forcing removal of lead paint in relatively safe buildings can do more harm than good by exposing children to hazards where none had existed, he said. That is because intact lead paint is susually not a problem, but the danger of lead often lies in its disturbance.
The bill even establishes a presumption that lead paint is present in all pre-1960 apartments unless the landlord proves otherwise. As Joseph Strasburg, president of the Rent Stabilization Association, wrote in the New York Post, the bill's "presumption" clause makes it hard for a property owner to fight a lawsuit even if there is no lead paint in the apartment. He says that city data show that more than 75 percent of presumptive lead paint violations in the past two years were issued in error.
Under the bill, any rehabilitation will trigger lead testing. This, combined with high liability, could be catastrophic for the ongoing rehabilitation of the city's housing stock, particularly in poorer neighborhoods. In many cases, under the bill, existing paint would have to be stripped.
"If you create a regimen by which it's impossible to renovate, you're going to do enormous damage," says Michael Lappin, president of the Community Preservation Corporation, the consortium of banks that has financed much of the housing rehabilitation in older neighborhoods. "The council's liability standards will make it very hard for even the most responsible owners to defend themselves. This bill will be a Petri dish for law suits, which will have the effect of jeopardizing insurance for rehabilitation in older neighborhoods."
Carol Lamberg, executive director of the Settlement Housing Fund, which operates 22 buildings providing over 7,500 units of affordable housing, said, "This bill is unworkable on its face. The schedules set up for removal are much too tight, much tighter than anywhere else. Plus, if we can't get insurance we will have to shut down."
That, says Lappin, could be disastrous for the health of children. "Health-related renovations don't just involve paint," he points out. "Renovations that replace plumbing and correct fire and safety violations are every bit as important as paint issues."
The housing producers fear that renovation with tenants remaining in occupancy, which is how most moderate rehabilitation is done, will become almost impossible under the bill because of the requirement that existing paint be removed. Frank Braconi, executive director of the Citizens Housing & Planning Council, notes that their "alarm is born of the reality that they have to schedule these rehabilitation with real contractors, real lawyers, real families."
The bill's advocates scoff, saying that landlord groups had opposed the 1999 bill as well.
This much is clear, however: The millions of dollars that will now be put into lead clean-up will not be invested in basic housing rehabilitation. Increasing the costs of rehabilitating apartments for current residents will deter investment and reduce the amount of rehabilitation actually done. If rehabilitation is slowed down or even halted, more children will live in lead-contaminated apartments -- precisely the opposite of what the bill's sponsors hope to achieve.
Julia Vitullo-Martin is a senior fellow at the Manhattan Institute.
The recent chilling plunge in temperatures has been a rude reminder to New Yorkers that, yes, it really is winter. And, yes, unfortunately, flu season has arrived, and this month will be in full swing. (Although the full flu season runs from about October to April, in past years influenza infection has peaked in December or January and continued at its highest levels through early March.) City health officials recently reported that the flu, which this year arrived in New York City on schedule in October, has now spread to all five boroughs, with the number of cases on the rise, as expected.
The flu is dangerous -- not usually to healthy younger adults; but to the elderly; those with challenged immune systems, such as people with HIV, sufferers from serious chronic illnesses such as diabetes and other underlying medical conditions; and young children (generally, those under age five). Although many people think of it as no more than something like a bad cold -- a week or so of coughing, fever, feeling rotten, and perhaps some missed days at the office -- the flu and its complications are, in fact, a leading cause of death in the U.S. In 2001, approximately 36,000 Americans died from the flu. In New York City alone, there were over 2,000 flu-related deaths.
The Commissioner of the New York City Department of Health and Mental Hygiene, Dr. Thomas R. Frieden, is urging New Yorkers -- particularly those with underlying medical conditions, those over the age of 50 and especially those over 65 -- to get the flu shot. "With flu activity increasing markedly in New York City over the past week, now is the time to get a flu shot. There is plenty of vaccine to go around, and you can't get the flu from a flu shot," Frieden stated. "You need this year's flu shot to protect against this year's flu. Get vaccinated now and enjoy a flu-free winter." The health department also notes that new scientific studies of flu vaccination in people over the age of 65 demonstrate that the flu shot cuts in half their risk of illness, hospitalization, and death.
What Exactly Is the Flu?
The flu, or influenza, is a viral infection of the nose, throat, bronchial tubes and lungs. There are many different strains of the flu virus, which tend to change each year. (This is why last year's flu shot won't necessarily protect you from this year's flu.)
Influenza is highly contagious and is easily transmitted through contact with droplets from the nose and throat of an infected person who has been coughing and sneezing.
Typical symptoms include headache, fever, chills, cough, sore throat and body aches. Although most people are ill for only a few days, some people will develop much more serious illnesses, such as pneumonia, and may need to be hospitalized.
Who Should Get A Flu Vaccination?
Most people could benefit from the flu shot, but according to health officials, certain groups are at an increased risk for serious illness with influenza and should definitely get it unless there is a medical reason not to (such as having had an allergic reaction to a previous flu shot or to eggs, or a history of a disorder called Guillain-Barre Syndrome).
These groups include:
· all people 50 years of age and older;
· adults and children with long-term heart or lung problems;
· residents of nursing homes;
· residents of other institutions housing patients of any age who have serious long-term health problems;
· people who have kidney disease, cystic fibrosis, diabetes, anemia, severe asthma, cancer, immunological disorders (such as HIV infection or AIDs), or other medical conditions for which they are under the close supervision of a doctor;
· pregnant women who will be in the second or third trimester of pregnancy during the flu season;
· household contacts of high-risk people;
· health care workers who provide care to high-risk patients;
· employees of nursing homes, chronic care facilities, assisted living and other residences who have contact with persons at high risk; and
· children aged 6-23 months, when feasible.
It is NOT, persistent false rumor to the contrary, possible to get the flu from a flu shot. Only dead viruses are used in the flu vaccine. A minority of people who get the shot may experience a day or two of pain around the injection site, achiness, or even fever, but this is simply a mild reaction to the shot, not the flu; and the symptoms are much less unpleasant, dangerous, and lasting than an actual case of the flu, which can last up to two weeks (or more, if complications develop).
More information on influenza and the flu shot can be found at the city health department's flu information website, which include a flu fact sheet, detailed information on who should and should not receive the vaccine, and the city's Flu Vaccine Facility Locator (see below).
Where New Yorkers can get the flu shot
You can get the flu shot from your doctor or primary care provider, and the city also offers seven walk-in immunization centers citywide. There are sites in all five boroughs that offer vaccinations for free or at low cost to the needy. Public hospitals, clinics, and senior-citizen centers offer the vaccine throughout the city. To find a site near you, you can use the city health department's Flu Vaccine Facility Locator, which allows you to search for a facility by borough, name, zip code, or clicking on an interactive map. Information provided includes the facility's type (hospital, walk-in clinic, senior center), its address, the days and hours the vaccine is being offered, and how much, if anything, the shot costs.
Sue Wilson is a journalist who writes frequently on health and science topics for such outlets as the New York Times, WNET, and UNICEF.