For Hourly Workers After the Storm, No Work, No Pay


Chantal Sainvilus, a home health aide in Brooklyn who makes $10 an hour, does not get paid if she does not show up. So it is no wonder that she joined the thousands of people taking extreme measures to get to work this week, even, in her case, hiking over the Williamsburg Bridge.


While salaried employees worked if they could, often from home after Hurricane Sandy, many of the poorest New Yorkers faced the prospect of losing days, even a crucial week, of pay on top of the economic ground they have lost since the recession.


Low-wage workers, more likely to be paid hourly and work at the whim of their employers, have fared worse in the recovery than those at the top of the income scale — in New York City the bottom 20 percent lost $463 in annual income from 2010 to 2011, in contrast to a gain of almost $2,000 for the top quintile. And there are an increasing number of part-time and hourly workers, the type that safety net programs like unemployment are not designed to serve. Since 2009, when the recovery began, 86 percent of the jobs added nationally have been hourly. Over all, about 60 percent of the nation’s jobs are hourly.


Even as the sluggish economy has accentuated this divide, Hurricane Sandy has acted as a further wedge, threatening to take a far greater toll on the have-littles who live from paycheck to paycheck.


“There’s a lot of people in our society that are living in a very precarious situation in terms of low wages or very insecure work,” said Arne L. Kalleberg, a sociologist at the University of North Carolina at Chapel Hill and author of “Good Jobs, Bad Jobs.” “That’s why it’s important to have a safety net that’s based on the idea of people working insecure jobs like this.”


On Friday, Gov. Andrew M. Cuomo announced that New York City and four suburban counties were eligible for disaster unemployment relief, which covers a broader spectrum of workers than regular unemployment benefits, including the self-employed like taxi drivers and street vendors as well as those who were unable to get to work.


New Jersey has also declared people in 10 counties eligible for disaster unemployment assistance. In Connecticut, residents of four counties and the Mashantucket Pequot Indian Reservation are eligible.


A New York Department of Labor spokesman emphasized that workers who lost wages should call to apply because the program is flexible and many eligibility issues would be determined on a case-by-case basis.


But the program might not help people whose commute simply lasted longer or cost more, like Ibezim Oki, a cabdriver who spent $50 on a cab to get from his Brooklyn home to Manhattan on Friday, rather than risk long bus delays, and “now I don’t know how long I’m going to have to wait for gas.”


The commute alone represented a hardship for workers whose jobs require a physical presence, while neighborhood coffee shops in the boroughs and suburbs overflowed with those who needed nothing more than a laptop and Wi-Fi to stay connected to work.


Ms. Sainvilus estimated that on Thursday, she had traveled eight hours to work for five, making her effective pay less than $4 an hour.


Others could not work because their place of business was closed. At a food distribution center in Chelsea, Mike Samuel, 55, a delivery man for a florist, was feeling the pain of five days of lost income. “We don’t work, we don’t get no tips, we don’t get no pay,” he said.


Muta Prather said the chemical company where he works in Newark was flooded, causing him to miss three days of work. He worked part of the day on Thursday helping to clean up, but worried about how he would pay for damage to his own roof.


“It hurts, you know,” said Mr. Prather, who is 49 and lives in West Orange, N.J. “I looked up at my roof, and it’s going to cost me like seven grand. I don’t make that kind of money.”


But at a playground in the Clinton Hill section of Brooklyn, Damien Carney stood with his baby daughter strapped to his chest and his toddler on a nearby swing, enjoying a surprise week off. For Mr. Carney, a salaried portfolio manager for a wine distributor that was closed because it had no power, the storm was amounting to something like a paid vacation with time for cooking and rearranging the living room. “They basically said, ‘Don’t worry about it,’ ” Mr. Carney said of his employers.


Federal labor laws include more protections for salaried workers than hourly workers when a disaster hits. Employers must continue to pay salaries if the worksite is closed for less than a week, even though they are allowed to require employees to use vacation or paid leave for the duration of the closure. Hourly workers, on the other hand, do not have to be paid if the worksite closes. If the workplace is open but salaried workers cannot get there, their pay may be reduced.


Of course, policies vary from workplace to workplace, and some hourly workers were luckier than others. Cassandra Williams, 54, waiting for the bus from Brooklyn to Manhattan with her 6-year-old granddaughter, said the family for whom she keeps house would pay her full wages despite her missing three days of work. Tinash Makots, a 24-year-old salesman at the Nike store in Midtown Manhattan, said he would be paid for the days missed as well.


One nanny in the bus line said she would be paid her regular wages, while another said she would not be compensated for hours missed.


A financial district worker who would identify himself only as William S. said he did not strictly need to go into Manhattan to do his job, but felt that he should make an appearance after one of his staff members showed up every day at 6 a.m. and another paid $40 a day to get to a distant office in Queens.


But Anthony Howell, a 42-year-old hair stylist in Chelsea, said he hadn’t worked all week because his salon, like his high-rise apartment, has no electricity.


“That’s the brutal part,” he said. “The hair industry is like that. You don’t do the work, you don’t get the money.”


Read More..

Second Illness Infects Meningitis Sufferers





Just when they might have thought they were in the clear, people recovering from meningitis in an outbreak caused by a contaminated steroid drug have been struck by a second illness.




The new problem, called an epidural abscess, is an infection near the spine at the site where the drug — contaminated by a fungus — was injected to treat back or neck pain. The abscesses are a localized infection, different from meningitis, which affects the membranes covering the brain and spinal cord. But in some cases, an untreated abscess can cause meningitis. The abscesses have formed even while patients were taking powerful antifungal medicines, putting them back in the hospital for more treatment, often with surgery.


The problem has just begun to emerge, so far mostly in Michigan, which has had more people sickened by the drug — 112 out of 404 nationwide — than any other state.


“We’re hearing about it in Michigan and other locations as well,” said Dr. Tom M. Chiller, the deputy chief of the mycotic diseases branch of the Centers for Disease Control and Prevention. “We don’t have a good handle on how many people are coming back.”


He added, “We are just learning about this and trying to assess how best to manage these patients. They’re very complicated.”


In the last few days, about a third of the 53 patients treated for meningitis at St. Joseph Mercy Hospital in Ann Arbor, Mich., have returned with abscesses, said Dr. Lakshmi K. Halasyamani, the chief medical officer.


“This is a significant shift in the presentation of this fungal infection, and quite concerning,” she said. “An epidural abscess is very serious. It’s not something we expected.”


She and other experts said they were especially puzzled that the infections could occur even though patients were taking drugs that, at least in tests, appeared to work against the fungus causing the infection, a type of black mold called Exserohilum.


The main symptom is severe pain near the injection site. But the abscesses are internal, with no visible signs on the skin, so it takes an M.R.I. scan to make the diagnosis. Some patients have more than one abscess. In some cases, the infection can be drained or cleaned out by a neurosurgeon.


But sometimes fungal strands and abnormal tissue are wrapped around nerves and cannot be surgically removed, said Dr. Carol A. Kauffman, an expert on fungal diseases at the University of Michigan. In such cases, all doctors can do is give a combination of antifungal drugs and hope for the best. They have very little experience with this type of infection.


Some patients have had epidural abscesses without meningitis; St. Joseph Mercy Hospital has had 34 such cases.


A spokesman for the health department in Tennessee, which has had 78 meningitis cases, said that a few cases of epidural abscess had also occurred there, and that the state was trying to assess the extent of the problem.


Dr. Chiller said doctors were also reporting that some patients exposed to the tainted drug had arachnoiditis, a nerve inflammation near the spine that can cause intense pain, bladder problems and numbness.


“Unfortunately, we know from the rare cases of fungal meningitis that occur, that you can have complicated courses for this disease, and it requires prolonged therapy and can have some devastating consequences,” he said.


The meningitis outbreak, first recognized in late September, is one of the worst public health disasters ever caused by a contaminated drug. So far, 29 people have died, often from strokes caused by the infection. The case count is continuing to rise. The drug was a steroid, methylprednisolone acetate, made by the New England Compounding Center in Framingham, Mass. Three contaminated lots of the drug, more than 17,000 vials, were shipped around the country, and about 14,000 people were injected with the drug, mostly for neck and back pain. But some received injections for arthritic joints and have developed joint infections.


Inspections of the compounding center have revealed extensive contamination. It has been shut down, as has another Massachusetts company, Ameridose, with some of the same owners. Both companies have had their products recalled.


Compounding pharmacies, which mix their own drugs, have had little regulation from either states or the federal government, and several others have been shut down recently after inspections found sanitation problems.


Read More..

Second Illness Infects Meningitis Sufferers





Just when they might have thought they were in the clear, people recovering from meningitis in an outbreak caused by a contaminated steroid drug have been struck by a second illness.




The new problem, called an epidural abscess, is an infection near the spine at the site where the drug — contaminated by a fungus — was injected to treat back or neck pain. The abscesses are a localized infection, different from meningitis, which affects the membranes covering the brain and spinal cord. But in some cases, an untreated abscess can cause meningitis. The abscesses have formed even while patients were taking powerful antifungal medicines, putting them back in the hospital for more treatment, often with surgery.


The problem has just begun to emerge, so far mostly in Michigan, which has had more people sickened by the drug — 112 out of 404 nationwide — than any other state.


“We’re hearing about it in Michigan and other locations as well,” said Dr. Tom M. Chiller, the deputy chief of the mycotic diseases branch of the Centers for Disease Control and Prevention. “We don’t have a good handle on how many people are coming back.”


He added, “We are just learning about this and trying to assess how best to manage these patients. They’re very complicated.”


In the last few days, about a third of the 53 patients treated for meningitis at St. Joseph Mercy Hospital in Ann Arbor, Mich., have returned with abscesses, said Dr. Lakshmi K. Halasyamani, the chief medical officer.


“This is a significant shift in the presentation of this fungal infection, and quite concerning,” she said. “An epidural abscess is very serious. It’s not something we expected.”


She and other experts said they were especially puzzled that the infections could occur even though patients were taking drugs that, at least in tests, appeared to work against the fungus causing the infection, a type of black mold called Exserohilum.


The main symptom is severe pain near the injection site. But the abscesses are internal, with no visible signs on the skin, so it takes an M.R.I. scan to make the diagnosis. Some patients have more than one abscess. In some cases, the infection can be drained or cleaned out by a neurosurgeon.


But sometimes fungal strands and abnormal tissue are wrapped around nerves and cannot be surgically removed, said Dr. Carol A. Kauffman, an expert on fungal diseases at the University of Michigan. In such cases, all doctors can do is give a combination of antifungal drugs and hope for the best. They have very little experience with this type of infection.


Some patients have had epidural abscesses without meningitis; St. Joseph Mercy Hospital has had 34 such cases.


A spokesman for the health department in Tennessee, which has had 78 meningitis cases, said that a few cases of epidural abscess had also occurred there, and that the state was trying to assess the extent of the problem.


Dr. Chiller said doctors were also reporting that some patients exposed to the tainted drug had arachnoiditis, a nerve inflammation near the spine that can cause intense pain, bladder problems and numbness.


“Unfortunately, we know from the rare cases of fungal meningitis that occur, that you can have complicated courses for this disease, and it requires prolonged therapy and can have some devastating consequences,” he said.


The meningitis outbreak, first recognized in late September, is one of the worst public health disasters ever caused by a contaminated drug. So far, 29 people have died, often from strokes caused by the infection. The case count is continuing to rise. The drug was a steroid, methylprednisolone acetate, made by the New England Compounding Center in Framingham, Mass. Three contaminated lots of the drug, more than 17,000 vials, were shipped around the country, and about 14,000 people were injected with the drug, mostly for neck and back pain. But some received injections for arthritic joints and have developed joint infections.


Inspections of the compounding center have revealed extensive contamination. It has been shut down, as has another Massachusetts company, Ameridose, with some of the same owners. Both companies have had their products recalled.


Compounding pharmacies, which mix their own drugs, have had little regulation from either states or the federal government, and several others have been shut down recently after inspections found sanitation problems.


Read More..

Bits Blog: Data Shows Twitter Posts That Resonate With Electorate

In Florida, voters responded most when Mitt Romney posted about education and when President Obama did the same about foreign affairs. In Ohio, Mr. Obama’s posted about gay rights, more so than any other topic, held the most traction. For Mr. Romney, it was his posts about the economy.

Twitter introduced an interactive map on Thursday showing which of the candidates’ tweets drove the most engagement — measured by the number of times the tweet was reposted or favorited — on Twitter at the national and state levels.

Nationwide, Mr. Obama’s most popular post was, “No family should have to set aside a college acceptance letter because they don’t have the money.” His second most popular post was actually a quote from Vice President Biden about women’s rights:  “VP Biden: I do not believe that we have a right to tell other people, women, that they can’t control their bodies.” Interestingly, at the state level, that post resonated most with voters in Wyoming, followed by Iowa, South Dakota and West Virginia — states where women’s rights are not considered the pivotal issue.

Mr. Romney’s most popular post was this remark on Sept. 11th: “On this most somber day, America is united under God in its quest for peace and freedom at home and across the world.” Second most popular was a comment about wealth distribution: “I am running for president to get us creating wealth again – not to redistribute it.”

In swing states, Twitter’s map tells an interesting, and sometimes counter intuitive story. According to the latest polls, Virginia, Wisconsin, Ohio, Iowa, Nevada, New Hampshire, Colorado and Florida are still toss-ups.

In the last presidential election, the President won Virginia by seven percentage points. This year, the race is expected to be much closer. There, voters’ response was highest when the candidates posted about issues related to retirement.

The same was true for Wisconsin. Democrats carried the state in the last six presidential elections, but the addition of one of their own, Representative Paul D. Ryan, to Mr. Romney’s ticket has kept the race tight. There, retirement was also the issue that seemed to have the most traction on Twitter.

In Iowa, where six electoral votes are up for grabs, voters were most engaged when Mr. Obama posted about topics related to energy and the environment and when Romney posted about health care.

Nevada voters responded most to Obama’s comments on taxes. Mr. Obama’s most popular post in that state was “1,240,000 middle-class families in Nevada could face a tax increase under Mitt Romney.” Mr. Romney’s posts about education drove the highest level of engagement. “With over 60k jobs lost & the highest unemployment rate in the nation, Nevadans aren’t better off under @BarackObama,” was Mr. Romney’s most popular post.

In Colorado, women’s issues have taken center stage after women proved crucial to two Democratic victories in the 2010 races for Senate and governor. But according to Twitter’s data, Colorado voters responded in the largest numbers when Mr. Obama posted about taxes. For Mr. Romney, it was his remarks about terrorism.

If, as in the 2004 election, the race comes down to Florida, then the candidates may do well to defy conventional wisdom that retirement is all Florida voters care about. Within Florida, Mr. Romney’s posts about retirement did not resonate as well as those about education and foreign affairs. Likewise, Mr. Obama’s posts about topics relevant to retirement had less traction than his those about terrorism and foreign affairs.

Despite the perception that Twitter is just a place for East and West coasters to talk to each other, Twitter’s map shows a surprising level of engagement in states like Wyoming, Utah, Texas, Mississippi and Oklahoma. The opposite proved true for New Hampshire and Vermont, where Twitter noted it was not able to collect enough data to draw conclusions.

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Petraeus’s Lower C.I.A. Profile Leaves Benghazi Void





WASHINGTON — In 14 months as C.I.A. director, David H. Petraeus has shunned the spotlight he once courted as America’s most famous general. His low-profile style has won the loyalty of the White House, easing old tensions with President Obama, and he has overcome some of the skepticism he faced from the agency’s work force, which is always wary of the military brass.







Brendan Smialowski/Getty Images

The low-profile style of David H. Petraeus, right, has won the loyalty of the White House, easing old tensions with President Obama.








Win Mcnamee/Getty Images

C.I.A. director, David H. Petraeus, right, appeared before the Senate Select Committee on Intelligence in Washington in January.






But since an attack killed four Americans seven weeks ago in Benghazi, Libya, his deliberately low profile, and the C.I.A.’s penchant for secrecy, have left a void that has been filled by a news media and Congressional furor over whether it could have been prevented. Rather than acknowledge the C.I.A.’s presence in Benghazi, Mr. Petraeus and other agency officials fought a losing battle to keep it secret, even as the events there became a point of contention in the presidential campaign.


Finally, on Thursday, with Mr. Petraeus away on a visit to the Middle East, pressure from critics prompted intelligence officials to give their own account of the chaotic night when two security officers died along with the American ambassador, J. Christopher Stevens, and another diplomat. The officials acknowledged for the first time that the security officers, both former members of the Navy SEALs, worked on contract for the C.I.A., which occupied one of the buildings that were attacked.


The Benghazi crisis is the biggest challenge so far in the first civilian job held by Mr. Petraeus, who retired from the Army and dropped the “General” when he went to the C.I.A. He gets mostly high marks from government colleagues and outside experts for his overall performance. But the transition has meant learning a markedly different culture, at an agency famously resistant to outsiders.


“I think he’s a brilliant man, but he’s also a four-star general,” said Senator Dianne Feinstein, the chairwoman of the Senate Intelligence Committee. “Four-stars are saluted, not questioned. He’s now running an agency where everything is questioned, whether you’re a four-star or a senator. It’s a culture change.”


Mr. Petraeus, who turns 60 next week, has had to learn that C.I.A. officers will not automatically defer to his judgments, as military subordinates often did. “The attitude at the agency is, ‘You may be the director, but I’m the Thailand analyst,’ ” said one C.I.A. veteran.


Long a media star as the most prominent military leader of his generation, Mr. Petraeus abruptly abandoned that style at the C.I.A. Operating amid widespread complaints about leaks of classified information, he has stopped giving interviews, speaks to Congress in closed sessions and travels the globe to consult with foreign spy services with little news media notice.


“He thinks he has to be very discreet and let others in the government do the talking,” said Michael E. O’Hanlon, a Brookings Institution scholar who is a friend of Mr. Petraeus’s and a member of the C.I.A.’s advisory board.


Mr. Petraeus’s no-news, no-nonsense style stands out especially starkly against that of his effusive predecessor, Leon E. Panetta, who is now the defense secretary.


Mr. Panetta, a gregarious politician by profession, was unusually open with Congress and sometimes with the public — to a fault, some might say, when he spoke candidly after leaving the C.I.A. about a Pakistani doctor’s role in helping hunt for Osama bin Laden, or about the agency’s drone operations.


Mr. Petraeus’s discretion and relentless work ethic have had a positive side for him: old tensions with Mr. Obama, which grew out of differing views on the wars in Iraq and Afghanistan, appear to be gone. Mr. Petraeus is at the White House several times a week, attending National Security Council sessions and meeting weekly with James R. Clapper Jr., the director of national intelligence, and Thomas E. Donilon, Mr. Obama’s national security adviser. Mr. Donilon said recently that the C.I.A. director “has done an exceptional job,” bringing “deep experience, intellectual rigor and enthusiasm” to his work.


Read More..

Modest Jobs Growth in Final Report Before Election





The economy may have some more underlying strength than earlier believed, according to the final job market report released before Tuesday’s presidential election.




The nation’s employers added 171,000 positions in October, the Labor Department reported on Friday, and more jobs than initially estimated in both August and September. Hiring was broad-based, with just about every industry except state government adding at least a handful of jobs. The unemployment rate ticked up slightly to 7.9 percent in October, from 7.8 percent in September, but for a good reason: more workers joined the labor force and so officially counted as unemployed.


None of this makes for a game-changer in the presidential race, analysts said. But it appeared to provide some relief for President Obama, whose campaign could have been sideswiped by bad news from the notoriously volatile monthly jobs report.


In fact, the latest numbers showed that the economy finally shows a net gain of jobs under his presidency, whereas his record had previously been weighed down by huge layoffs in his first year in office.


The report also allayed widespread suspicion that September’s plunge in the unemployment rate — to below 8 percent for the first time since the month he took office — might have been a one-month statistical fluke.


“Generally, the report shows that things are better than we’d expected and certainly better than we’d thought a few months ago,” said Paul Dales, senior United States economist for Capital Economics. “But we’re still not making enough progress to bring that unemployment rate down significantly and rapidly.”


Mitt Romney, the Republican presidential nominee, said in a statement that the jobs report was evidence of the need to change the nation’s economic policies.


“Today’s increase in the unemployment rate is a sad reminder that the economy is at a virtual standstill,” he said. He also noted that October’s unemployment rate of 7.9 percent was higher than the 7.8 percent when Mr. Obama took office in January 2009.


Economists were hopeful that once the election was over and Congress addressed the major fiscal tightening scheduled for the end of this year, job growth could speed up further.


“If we can do this kind of job growth with all the uncertainty out there, imagine if we were to clear up those tax issues and hold back the majority of tax increases that are pending at the end of the year,” said John Ryding, chief economist at RDQ Economics. “We could do much better in 2013, maybe as well as we appeared to be doing earlier this year.”


In October, the biggest job gains were in professional and business services, health care and retail trade, the Labor Department said. Government payrolls dipped slightly. State and local governments have been shedding jobs most months over the last three years.


One of the lowlights of the report was in hourly wages, which remained flat in October after showing barely any growth in the previous several months.


“Perhaps the decline in real wages is a factor here in being able to employ more people,” Mr. Ryding said. “It’s something to keep in mind when we think about creating jobs and whether we’re maybe creating the wrong sort of jobs.”


A report from the National Employment Law Project, a liberal research and advocacy organization that focuses on labor issues, found that while the majority of jobs lost in the downturn were middle-income jobs, the majority of the jobs created since then have been lower-wage ones.


There have now been 25 consecutive months of jobs gains in the United States, but the increases have been barely large enough to absorb the increase in the population. A queue of about 12 million unemployed people remain waiting for work, about two out of five of whom have been out of a job for more than six months.


That is in addition to more than eight million people who are working part-time but really want full-time jobs.


“I’m not just competing against all the other people who are out of work,” said Griff Coxey, 57, of Cascade, Wis., who was laid off in May from his controller job at a small business. “I’m also competing against all those people who are actually working but are underemployed.”


Like two million other idle workers, Mr. Coxey is scheduled to lose his unemployment benefits the last week of the year, when the federal extensions abruptly expire. He said he still has some savings to fall back on, but many workers do not.


Labor advocates and many economists have been urging Congress to renew the benefits as part of their discussions of the “fiscal cliff” during their postelection session. So far, though, the issue has received little attention, and analysts worry that ending extended benefits could disrupt what modest forward momentum the economy currently has.


“Federal unemployment benefits are one of the most effective stimuli we have,” said Christine L. Owens, the executive director of the National Employment Law Project.


“The recovery is still fragile,” she said, “and to pull that amount of income and expenditure out of the economy — particularly at a time when people thinking about the holiday season — will have a significant impact on not just those individuals and their families but the economy as a whole.”


Friday’s jobs report was unlikely to affect policy from the Federal Reserve, which has pledged open-ended stimulus until the job market improves “substantially.”


“The Fed desires both a substantial and sustainable improvement in labor market conditions and is likely to read recent payroll growth as a positive step in the right direction, but just one step in a longer journey,” said Michael Gapen, director of United States research and global asset allocation at Barclays Capital.


The jobs snapshot for October was based on surveys conducted too early in the month to capture work disruptions across the East Coast caused by Hurricane Sandy. Economists expect that businesses and employment will resume their normal activity by the next jobs survey, in mid-November, and that some industries are likely to show an increase in hiring precisely because of the storm.


“We had a lot of lost hours worked and production stuff still delayed, but much of that will be offsets by hiring of emergency workers, government workers and construction, to do all that emergency fixing,” said Diane Swonk, chief economist at Mesirow Financial.


Read More..

At Bellevue, a Desperate Fight to Ensure the Patients’ Safety


Uli Seit for The New York Times


Ralston Davis had a triple heart bypass operation at Bellevue, but when the hospital lost power, he walked down 10 flights of stairs and was moved to another medical center.







From the moment the water lapped above street level in Lower Manhattan, the doctors and nurses of Bellevue Hospital Center began a desperate struggle to keep patients safe. By 9 p.m. Monday, the hospital was on backup power, and an hour later, the basement was flooded.




Officials rushed to move the most critically ill patients closer to an emergency generator. After midnight, doctors heard shouts in the hallway. The basement fuel pumps had stopped working, and medical residents, nurses and administrators formed a bucket brigade to ferry fuel up 13 flights to the main backup generators.


By Tuesday, the elevator shafts at Bellevue, the country’s oldest public hospital, had flooded, so all 32 elevators stopped working. There was limited compressed air to run ventilators, so oxygen tanks were placed next to the beds of patients who needed them. Water faucets went dry, food ran low, and buckets of water had to be carried up to flush toilets.


Some doctors began urging evacuations, and on Tuesday, at least two dozen ambulances lined up around the block to pick up many of the 725 patients housed there. People carried babies down flights of stairs. The National Guard was called in to help. On Thursday afternoon, the last two patients were waiting to be taken out.


The evacuation went quickly only because Bellevue had planned for such a possibility before Hurricane Irene hit last year, several doctors said. But the city, which had evacuated two nearby hospitals before that storm, decided not to clear out Bellevue. In the wake of Hurricane Sandy, the consequences of bad calls, bad luck and equipment failures cascaded through the region’s health care system, as sleep-deprived health care workers and patients were confronted by a new kind of disarray.


A patient recovering from a triple bypass operation at Bellevue walked down 10 flights of stairs to a waiting ambulance, one of the dozens provided through the Federal Emergency Management Agency to speed patients across the metropolitan region.


Mount Sinai Medical Center, already dealing with the 2 a.m. arrival of a dozen psychiatric patients who spoke only Chinese, was struggling to identify the relatives of brain-injured traffic victims from Bellevue who arrived three hours later with only rudimentary medical records.


Maimonides Medical Center in Brooklyn was straining to meet a rising need for emergency dialysis for hundreds of people shut out of storm-crippled private dialysis centers. Patients who would normally get three hours of dialysis were getting only two, to ensure the maximum number of people received at least a minimal amount of care.


“The catastrophe is growing by the minute,” said Eileen Tynion, a Maimonides spokeswoman. “Here we thought we’d reached a quiet point after the storm.”


Every hospital maintains an elaborate disaster plan, but after Hurricane Sandy, the fact that many health care facilities are in low-lying areas proved to be something of an Achilles’ heel. Bellevue became the third hospital in the city to evacuate after the storm’s landfall, after NYU Langone Medical Center, just north of Bellevue, and Coney Island Hospital, another public hospital.


New York Downtown Hospital, the only hospital south of 14th Street in Manhattan, and the Veterans Affairs Hospital, just below Bellevue, had evacuated before the storm.


Hospital executives were reluctant to criticize their colleagues or city officials. But the sequence of events left them with many questions.


“All hospitals are required to do disaster planning and disaster drills,” Pamela Brier, the chief executive of Maimonides, noted. “All hospitals are required as a condition of being accredited, to have generators, backup generators.”


City health department and emergency officials have been particularly fervent about citywide disaster drills, she added, but “as prepared as we think we are we’ve never had a mock disaster drill where we carried patients downstairs. I’m shocked that we didn’t do that. Now we’re going to.”


The city’s health commissioner, Dr. Thomas Farley, defended the decision not to require evacuations of Bellevue, Coney Island and NYU Langone hospitals before the storm, which he said had been made in consultation with the state health commissioner, Dr. Nirav Shah.


Read More..

At Bellevue, a Desperate Fight to Ensure the Patients’ Safety


Uli Seit for The New York Times


Ralston Davis had a triple heart bypass operation at Bellevue, but when the hospital lost power, he walked down 10 flights of stairs and was moved to another medical center.







From the moment the water lapped above street level in Lower Manhattan, the doctors and nurses of Bellevue Hospital Center began a desperate struggle to keep patients safe. By 9 p.m. Monday, the hospital was on backup power, and an hour later, the basement was flooded.




Officials rushed to move the most critically ill patients closer to an emergency generator. After midnight, doctors heard shouts in the hallway. The basement fuel pumps had stopped working, and medical residents, nurses and administrators formed a bucket brigade to ferry fuel up 13 flights to the main backup generators.


By Tuesday, the elevator shafts at Bellevue, the country’s oldest public hospital, had flooded, so all 32 elevators stopped working. There was limited compressed air to run ventilators, so oxygen tanks were placed next to the beds of patients who needed them. Water faucets went dry, food ran low, and buckets of water had to be carried up to flush toilets.


Some doctors began urging evacuations, and on Tuesday, at least two dozen ambulances lined up around the block to pick up many of the 725 patients housed there. People carried babies down flights of stairs. The National Guard was called in to help. On Thursday afternoon, the last two patients were waiting to be taken out.


The evacuation went quickly only because Bellevue had planned for such a possibility before Hurricane Irene hit last year, several doctors said. But the city, which had evacuated two nearby hospitals before that storm, decided not to clear out Bellevue. In the wake of Hurricane Sandy, the consequences of bad calls, bad luck and equipment failures cascaded through the region’s health care system, as sleep-deprived health care workers and patients were confronted by a new kind of disarray.


A patient recovering from a triple bypass operation at Bellevue walked down 10 flights of stairs to a waiting ambulance, one of the dozens provided through the Federal Emergency Management Agency to speed patients across the metropolitan region.


Mount Sinai Medical Center, already dealing with the 2 a.m. arrival of a dozen psychiatric patients who spoke only Chinese, was struggling to identify the relatives of brain-injured traffic victims from Bellevue who arrived three hours later with only rudimentary medical records.


Maimonides Medical Center in Brooklyn was straining to meet a rising need for emergency dialysis for hundreds of people shut out of storm-crippled private dialysis centers. Patients who would normally get three hours of dialysis were getting only two, to ensure the maximum number of people received at least a minimal amount of care.


“The catastrophe is growing by the minute,” said Eileen Tynion, a Maimonides spokeswoman. “Here we thought we’d reached a quiet point after the storm.”


Every hospital maintains an elaborate disaster plan, but after Hurricane Sandy, the fact that many health care facilities are in low-lying areas proved to be something of an Achilles’ heel. Bellevue became the third hospital in the city to evacuate after the storm’s landfall, after NYU Langone Medical Center, just north of Bellevue, and Coney Island Hospital, another public hospital.


New York Downtown Hospital, the only hospital south of 14th Street in Manhattan, and the Veterans Affairs Hospital, just below Bellevue, had evacuated before the storm.


Hospital executives were reluctant to criticize their colleagues or city officials. But the sequence of events left them with many questions.


“All hospitals are required to do disaster planning and disaster drills,” Pamela Brier, the chief executive of Maimonides, noted. “All hospitals are required as a condition of being accredited, to have generators, backup generators.”


City health department and emergency officials have been particularly fervent about citywide disaster drills, she added, but “as prepared as we think we are we’ve never had a mock disaster drill where we carried patients downstairs. I’m shocked that we didn’t do that. Now we’re going to.”


The city’s health commissioner, Dr. Thomas Farley, defended the decision not to require evacuations of Bellevue, Coney Island and NYU Langone hospitals before the storm, which he said had been made in consultation with the state health commissioner, Dr. Nirav Shah.


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Sony, Sharp and Panasonic Report Significant Losses





TOKYO — After years of bets gone wrong and lost opportunities, three of Japan’s consumer electronics giants are showing some signs of faltering.




In the most dire warning, Sharp forecast on Thursday a 450 billion yen ($5.6 billion) full-year loss and warned that it had “material doubts” about its ability to survive.


On the same day, Panasonic’s shares lost a fifth of their value in Tokyo after the company forecast a 765 billion yen ($9.6 billion) annual net loss from write-downs in its solar-power, battery and mobile handset businesses.


And Sony, perhaps the best positioned of the companies, posted a net loss of 15.5 billion yen ($194 million) for the quarter on Thursday and warned of falling sales in almost every product it sells.


“We have a lot of great technology which we want to tap to revive and generate profit, but the company does not have that vitality,” Takashi Okuda, Sharp’s chief executive, told reporters after the company posted a net loss of 249 billion yen ($3.1 billion) for the three months to September. The loss was far larger than expected.


In a statement, the company said it had a “serious negative operating cash flow” which raised “serious doubts” about its ability to continue as a going concern, and said it was taking steps, including pay cuts, voluntary redundancies and asset sales, to generate cash flow.


While Sharp is in the most serious trouble, the three companies’ woes are similar at the core.


All three make good quality, even cutting-edge products — but so do their overseas competitors, usually at lower prices. None of the three have managed to generate the brand pizazz of Apple, or the marketing muscle of Samsung Electronics. In addition, a stubbornly strong yen continues to sap their competitiveness, while Japan’s territorial dispute with China has hurt sales there.


The scale of the losses is the result of specific missteps, from huge investments in the wrong technologies to a reluctance to exit loss-making businesses. A manufacturing bubble here in the mid-2000s — fed partly by an unusually weak currency and Americans flush with cash from rising home prices — masked continued weaknesses in their business models and spurred the companies to take big bets that backfired.


When the global financial crisis brought that boom to an end in 2008, the three were saddled with excess capacity, bloated work forces and investments that they could hardly hope to recoup. And their refusal to make a big enough departure from the ways of their glory years is now making a comeback difficult.


“Many investors are longing for reforms that will let all of the pus out,” Yuji Fujimori, technology analyst at Barclays Capital in Tokyo, said in a recent note to clients.


Sharp’s stumble, in many ways, has been the most humbling. It was the biggest beneficiary of the manufacturing bubble: from 2000 to 2007, its profits jumped 150 percent. Sharp’s high-end Aquos liquid-crystal display televisions — which it manufactured at state-of-the-art factories in Kameyama, in western Japan — were a runaway hit in the nascent flat-panel market. The spinoff Aquos cellphone topped Japanese sales rankings. Sharp’s solar batteries also sold briskly, helped by a bubble in green technologies.


The company’s success during this period seemed to validate Japan’s penchant for manufacturing their most important products in-house. In advertisements, Sharp showed off its cutting-edge factories.


But even before the financial crisis, analysts were warning of an impending crash in prices of flat-panel televisions, which were fast becoming commodities that cheap upstarts could emulate. In 2008, the iPhone made its debut in Japan, the end of an era for Japanese-style cellphones. Chinese upstarts were starting to flood global markets with cheap solar panels and batteries. In consumer electronics, outsourced manufacturing became the norm.


Still, Sharp did not change course. It built a new factory in Sakai, Japan, which could make 6 million large LCD panels a year — more than the size of the global market at the time. Sharp missed the smartphone wave, and its cellphone sales in Japan halved from 2007 to 2012. And in late 2011, the solar bubble burst, driving many solar power companies into bankruptcy and Sharp’s solar batteries business into the red. The unit has not turned a profit since.


Now, the Kameyama factories no longer make televisions but panels for Apple’s iPhones and iPads.


Panasonic, for its part, also bet heavily on plasma televisions in 2003, pouring some 600 billion yen into a series of factories in Amagasaki, not far from Sharp’s own plant. It also bet on solar panels and rechargeable batteries, buying Sanyo in 2009.


But with plasma now a fading technology and solar power struggling, Panasonic is saddled with major losses. Last year, it announced that a factory in Amagasaki was closing, less than two years after it opened.


Kazuhiro Tsuga, who took the helm at Panasonic this year, was blunt in describing his company’s predicament. “We are among the losers in consumer electronics," he told a news conference on Wednesday. He now promises to shift the company away from money-losing televisions and gadgets.


Of the three, Sony now seems the most prescient. Its executives have preached the power of networks and content since the 1990s, building up a vast catalog of music and movies to lure users to their devices. Sony has also moved to slash costs and jobs and sell off some unprofitable businesses, refocusing the company on digital cameras and imaging technology, video games and mobile devices. This quarter, the sale of its chemical products business, which made materials for LCDs and optical discs, helped alleviate losses. Sony is now making a push into the medical field with an investment in the endoscope maker Olympus.


Internal squabbling has quashed its efforts to marry its hardware and software, however, and it refuses to abandon one of its biggest money-losers, its television business, which has bled red ink for eight consecutive years.


“We intend to hunker down and build a profitable business,” Masaru Kato, Sony’s chief financial officer, told a news conference Thursday. “And where we can, we will chase new markets.”


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Guinea-Bissau, After Coup, Is Drug-Trafficking Haven


Agence France-Presse — Getty Images


Soldiers in Bissau, the capital.







BISSAU, Guinea-Bissau — When the army ousted the president here just months before his term was to expire, a thirst for power by the officer corps did not fully explain the offensive. But a sizable increase in drug trafficking in this troubled country since the military took over has raised suspicions that the president’s sudden removal was what amounted to a cocaine coup.




The military brass here has long been associated with drug trafficking, but the coup this spring means soldiers now control the drug racket and the country itself, turning Guinea-Bissau in the eyes of some international counternarcotics experts into a nation where illegal drugs are sanctioned at the top.


“They are probably the worst narco-state that’s out there on the continent,” said a senior Drug Enforcement Administration official in Washington, who spoke on the condition of anonymity so as not to jeopardize his work in the region. “They are a major problem.”


Since the April 12 coup, more small twin-engine planes than ever are making the 1,600-mile Atlantic crossing from Latin America to the edge of Africa’s western bulge, landing in Guinea-Bissau’s fields, uninhabited islands and remote estuaries. There they unload their cargos of cocaine for transshipment north, experts say.


The fact that the army has put in place a figurehead government and that military officers continue to call the shots behind the scenes only intensifies the problem.


The political instability continued as soldiers attacked an army barracks on Oct. 21, apparently in an attempt to topple the government. A dissident army captain was arrested on an offshore island on Oct. 27 and accused of being the organizer of the countercoup attempt. Two critics of the government were also assaulted and then left outside the capital.


From April to July there were at least 20 landings in Guinea-Bissau of small planes that United Nations officials suspected were drug flights — traffic that could represent more than half the estimated annual cocaine volume for the region. The planes need to carry a 1.5-ton cargo to make the transatlantic trip viable, officials say. Europe, already the destination for about 50 tons of cocaine annually from West Africa, United Nations officials say, could be in for a far greater flood.


Was the military coup itself a diversion for drug trafficking? Some experts point to signs that as the armed forces were seizing the presidency, taking over radio stations and arresting members government officials, there was a flurry of drug activity on one of the islands of the Bijagós Archipelago, what amounted to a three-day offloading of suspicious sacks.


That surreptitious activity appears to have been simply a prelude for what was to come.


“There has clearly been an increase in Guinea-Bissau in the last several months,” said Pierre Lapaque, head of the regional United Nations Office on Drugs and Crime for West and Central Africa. “We are seeing more and more drugs regularly arriving in this country.”


Mr. Lapaque called the trafficking in Guinea-Bissau “a major worry” and an “open sore,” and, like others, suggested it was no coincidence that trafficking has spiked since the coup.


Joaquin Gonzalez-Ducay, the European Union ambassador in Bissau, said: “As a country it is controlled by those who formed the coup d’état. They can do what they want to do. Now they have free rein.”


The senior D.E.A. official said that “people at the highest levels of the military are involved in the facilitation” of trafficking and added: “In other African countries government officials are part of the problem. In Guinea-Bissau, it is the government itself that is the problem.”


United Nations officials agree. “The coup was perpetrated by people totally embedded in the drugs business,” said one official, who spoke on the condition of anonymity because of the delicacy of the political environment here.


The country’s former prosecutor general, Octávio Inocêncio Alves, said, “A lot of the traffickers have direct relationships with the military.”


The civilian government and the military leadership that sits watchfully in its headquarters in an old Portuguese fort at the other end of town rebuff the United Nations drug accusations.


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Lingering Unemployment Poses Long-Term Risk


Kenneth James for The New York Times


Beatrice Hogg, 55, a college-educated white-collar worker, lost her last job in June 2009. She has been staying at friends’ homes.







WASHINGTON — In the economy-focused presidential campaign, the two candidates and their teams have scarcely mentioned what economists describe as not just one of the labor market’s most pressing problems, but the entire country’s: long-term unemployment.




Nearly five million Americans out of work for more than six months are left to wonder what kind of help might be coming, as the Federal Reserve, the International Monetary Fund and a bipartisan swath of policy experts implore Washington to act — both to alleviate human misery and to ensure the strength of the economy.


The pain of the long-term unemployed has persisted even as the overall jobs picture has brightened a bit and the unemployment rate has fallen to 7.8 percent. The new government report for October was due to be released Friday morning.


“The problem is incredibly urgent,” said Kevin A. Hassett, director of economic policy studies at the American Enterprise Institute and an adviser to Mitt Romney’s campaign. “Spain had a financial crisis in the late 1970s and has never seen its unemployment rate drop back to where it was before that crisis. The unemployed become discouraged, and ultimately the employment to population ratio might take a permanent hit.”


On the agenda for the next Congress and the next president is ensuring that the unusually long spells of unemployment now afflicting jobless workers remain a temporary setback of the recession.


Economists warned that long-term unemployment could be transformed in the next few years into structural unemployment, meaning that the problem is not just too few jobs and too many job seekers, but a large group of workers who no longer match employers’ needs or are no longer considered employable.


“Skills become obsolete, contacts atrophy, information atrophies, and they get stigmatized,” said Harry Holzer of Georgetown University.


That has been the experience of millions of workers like Beatrice Hogg, 55, of Sacramento, a college-educated white-collar worker who has slid from the middle class into poverty.


Her last job — doing administrative work and advising students at a community college — ended in June 2009. Her unemployment benefits ended more than a year ago. She was evicted from her apartment in December and has been staying at friends’ homes and occasionally at train stations. Despite her efforts, she has been turned down for job after job after job, and is surviving on food stamps.


“I don’t enjoy being out of work,” Ms. Hogg said in an interview. “I don’t enjoy having to ask friends to give me rides or get things for me. I want to take care of myself. I’ve been on my own since I was 18 years old. It’s hard for me. It’s demoralizing. It’s hard to ask people for things when you’ve been independent the rest of your life.”


Stronger economic growth may help to whittle the ranks of the long-term unemployed over time, experts said.


“There must have been a lot of workers badly scarred by long bouts of unemployment in the Great Depression,” said Gary Burtless of the Brookings Institution. “Even in 1939 we had unemployment somewhere around 14 percent, as we’d measure it today. A lot of people who were jobless had been jobless for a long, long time. But in the space of a couple of years those disadvantages looked like nothing given that employers had voracious appetites for workers.”


But many economists contended that policies to help the long-term unemployed are needed as well, to ensure that they have the skills necessary to compete for the jobs that the economy is adding — turning construction workers into oil-and-gas extractors and administrative assistants into home health care providers, for example.


In Washington, many politicians support measures for the long-term unemployed; few demand them.


Both Democrats and Republicans have proposed or supported revamping job-training programs, giving states more flexibility in using funds for the unemployed and providing credits to companies that hire workers who have been out of a job for more than six months, for instance.


Annie Lowrey reported from Washington and Catherine Rampell from New York.



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Live Coverage: Burdens of Storm’s Damage Ease Slightly




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State-by-State Guide


A look at the devastation caused in the aftermath of Hurricane Sandy from North Carolina to New England.










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