Op-Ed Contributor: Labs, Washed Away





BEDPAN ALLEY is the affectionate name given to a stretch of First Avenue in Manhattan that is packed with more hospitals than many cities possess. This stretch also happened to be right in the flood zone during Hurricane Sandy. Water damage and power failures closed down all three of the New York University teaching hospitals — Bellevue Hospital, Tisch Hospital and the Manhattan V.A. Two months later, they are still not admitting patients, though two are on schedule to begin doing so shortly.




The harrowing evacuation of hundreds of patients made headlines nationwide. The disruption of regular medical care for tens of thousands of outpatients was a clinical nightmare that is finally easing. And the education of hundreds of medical students and residents is being patched back together.


All academic medical centers, however, rest on a tripod — patient care, education and research. The effect of the hurricane on the third leg of that tripod — research — has gotten the least attention, partly because rescuing cell cultures just isn’t as dramatic as carrying an I.C.U. patient on a ventilator down flights of stairs in the dark.


But, of course, there is an incontrovertible link between those cell cultures and that patient. For every medication that a patient takes, someone researched the basic chemistry of the drug, someone designed the clinical trial to test its efficacy, and of course a volunteer stepped forward to be the first to take the pill. Scientific research has engineered the impressive advancements of medical treatment, and every patient is a beneficiary.


When the hospitals were hit by Hurricane Sandy, hundreds of experiments were obliterated by the loss of power. Precious biological samples carefully frozen over years were destroyed. Temperature-sensitive reagents and equipment were ruined. Medications and records for patients in clinical trials were rendered inaccessible. And sadly, many laboratory mice and rats perished (though 600 cages of animals were rescued during the night by staff members who used crowbars on inaccessible doors and carried the cages out through holes cut in the ceiling).


On a slushy, rainy day earlier this month, I sat in on a meeting of N.Y.U.’s research community. Hundreds of scientists packed the chilly lecture hall to discuss what the future might hold. It was clear that the damage to laboratories and samples would not be amenable to easy repair. Some 400 researchers were being relocated to a patchwork of temporary sites so that they could restart their work.


But scientists can’t just walk in to a new space with a lab coat and a notebook; they need centrifuges, deep-freezes, lab animals, electron microscopes, incubators, autoclaves, gamma counters, PET scanners. They come with graduate students, lab techs, post-docs and collaborating investigators. For clinical researchers, there are also the patients enrolled in their clinical trials, with their medications and voluminous records.


Even beyond their eagerness to get back to work, researchers felt a sense of loss, not just in time, money, momentum, samples and grants, but of a part of their lives. Some senior scientists lost decades of archived samples. Others lost irreplaceable mice with genetic mutations for studying how coronary plaques resolve, the role of inflammation in lymphoma and the development of neural networks. At the other end of the spectrum were post-docs whose nascent careers were suddenly up in the air. Some were in tears.


Walking down First Avenue after the meeting, I passed a young researcher pushing a cart laden with cages, transporting lab rats to their new home. There was a blanket over the cages to protect them from the rain, but it kept slipping. She slogged up the wet avenue, one hand pushing the cart, the other struggling to keep the cover over her charges.


The logistical efforts to relocate and reignite such a vast research enterprise are staggeringly complicated. But the administration has cataloged each person’s research needs to match them with available space elsewhere, and hundreds of researchers have successfully rekindled their investigations despite the prodigious challenges.


Bellevue and Tisch are returning to their clinical operations and will be able to admit patients shortly. But even after the hospital wards and clinics are bustling at full capacity, the ribbon won’t feel ready to snip until the researchers are restored to their homes as well. For many patients, the thrum of research within a medical center is invisible. But it is an integral — and very human — part of a hospital. When a hurricane disrupts research, it is a loss that resonates well beyond the laboratories.


Danielle Ofri, an associate professor at New York University School of Medicine, is the editor of the Bellevue Literary Review and the author, most recently, of “Medicine in Translation: Journeys With My Patients.”



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Feds call for new safety review of airport scanners









Responding to critics, the Department of Homeland Security is launching another safety study of full-body scanners used to screen passengers at the nation's airports.


The Department of Homeland Security, which oversees the Transportation Security Administration, plans to award a contract to the National Academy of Sciences to perform the review.


But the nonprofit group of scientists will only be asked to review previous studies on the safety of a particular type of scanner used by the TSA.





The study comes in response to pressure from TSA critics, including Sen. Susan Collins (R-Maine), who introduced a bill this year to test the safety of the scanners.


[Updated, 3:35 p.m. Dec. 20: In a statement, Collins said she welcomes the new review.


"While TSA has told the public that the amount of radiation emitted from these machines is small, passengers and some scientific experts have raised questions about the impact of repeated exposure to this radiation," she said.] 


In an interview, TSA Administrator John Pistole said several previous studies have already shown the scanners do not expose passengers to dangerous levels of radiation, even for frequent travelers.


But he said he welcomes another study to address the concerns of members of Congress. "After all, they fund us," he said of the Senate and House.


The TSA uses two types of full-body scanners, both of which help the agency look for objects hidden under the clothes of passengers. About half of those scanners expose passengers to X-rays to see through their clothes, with the rest using non-ionizing radio frequency energy, known as millimeter waves.


The scanners that use X-rays, or backscatter technology, have received the most criticism from passenger advocates and scientists, including professors from UC San Francisco. The European Union last year banned the use of backscatter scanners at European airports over health concerns.


The Department of Homeland Security posted an advisory last week, saying it was awarding the National Academy of Science a contract to convene a committee to review whether exposure to backscatter scanners complies with health standards. The academy also is asked to determine whether the design of the machines and the procedures used by TSA staff prevent overexposure of radiation to travelers and the workers.


The proposal does not say when the academy should complete its review.


ALSO:


How new TSA body scans will work


TSA scanners pose negligible risk to passengers, new test shows


LAX's controversial full-body scanners out; new, faster scanners in


Follow Hugo Martin on Twitter at @hugomartin





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Unions offer to pay more on pensions if state adds new taxes









A coalition of public employee unions Wednesday blasted legislation to address the state's underfunded worker pension systems and offered instead to make increased contributions — if the state guarantees its share of retirement payments and raises $2 billion by ending corporate tax benefits and imposing new taxes.


Appearing at the James R. Thompson Center, members of the We Are One Illinois coalition said plans backed by Gov. Pat Quinn and another proposal supported by a bipartisan group of lawmakers would violate the state constitution by reducing pension benefits guaranteed to workers. They predicted such a change would be overturned by the courts.


The unions said the primary problem is the state's failure to regularly fund its annual required contribution. The offer to require state workers and teachers to pay 2 percent more toward their retirement was conditional upon getting an "ironclad guarantee" in state law that government would fund its share of pension obligations as workers have done over the years.





To help fund those obligations, the unions proposed eliminating several corporate tax benefits as well as imposing new taxes on auto trade-ins, satellite TV service and downloaded digital entertainment. The new money also could be used to help offset cuts in other public social services, the group said.


But even with a new General Assembly soon to be sworn in, the prospect of closing so-called corporate tax loopholes — many of which have been on the books for decades — as well as imposing new taxes remains politically unpopular.


The proposal was the first comprehensive offer on the pension crisis from the union coalition, which includes the state's two major teacher organizations and the American Federation of State, County and Municipal Employees. The unions also called for a summit with Quinn and legislative leaders when the new General Assembly convenes Jan. 9. Quinn has asked that lame-duck lawmakers consider pension legislation in the days before new lawmakers are sworn in.


Kathy Griffin, vice president of the Illinois Education Association, said teachers and the vast majority of workers covered by the state's pension plans are not eligible for and do not receive Social Security, meaning their state pensions represent their retirement income.


"Illinois' pension problem is a revenue problem, and it is crucial that we have a revenue solution," she said.


At an appearance in Cicero, Quinn said he has made the state's full share of pension payments as chief executive, unlike previous governors. But the Democratic governor, who has received sharp criticism from traditional Democratic allies in organized labor, stopped short of backing a guaranteed pension payment.


"We want to work with the labor unions and the employee groups as far as we can, but ultimately the taxpayers come first, and that's what we have to do," Quinn said.


Illinois has the nation's most troubled state public employee pension system, with an unfunded liability of $95 billion.


Quinn has tried to bring public attention to the problem, notably through an online video featuring Squeezy the Pension Python, to demonstrate how the growing amount of tax dollars devoted to pensions threatens to overwhelm funding for education and other services.


The governor has backed a Senate-passed proposal that would require state workers to forgo an automatic compounded 3 percent cost of living increase in their pensions in exchange for accessing state-subsidized health care. Those keeping the cost-of-living increase would lose access to state health care in retirement. In addition, their pension benefits would be capped at their current salary level even if their paychecks went up.


Union officials said Quinn's plan was a "no-win" choice for workers who would see a significant loss of purchasing power as they grew older in their retirement years.


A more recent plan offered by a bipartisan group of lawmakers is also problematic, the unions said, including its cuts in cost-of-living increases and increased retirement ages.


Both bills would be subject to lengthy and costly lawsuits "and we think ultimately the courts will find it unconstitutional, which means all the work that they're putting into those bills will have been for naught," said Henry Bayer, executive director of AFSCME Council 31.


The unions said their offer of increased employee contributions of 2 percent of income would generate about $350 million a year toward pensions, or about $10 billion if amortized over 30 years.


At the same time, the unions proposed the end to more than $1.5 billion worth of tax exemptions. They include repealing recent tax breaks for CME Group Inc. and the Chicago Board Options Exchange, a tax break for for-profit hospitals, lowering the size of estates subject to taxes and curbing spending on economic development incentives for business.


The group also proposed a 5 percent tax on satellite TV service; requiring sales tax to be paid on the entire price of a new car rather than just the remaining balance after trade-in; and imposing the sales tax on e-books, movies, music and games digitally downloaded to smartphones and other electronic devices.


The new-car sales tax would raise an estimated $300 million, the group said; it pegged revenue estimates for the satellite tax at $75 million and the digital tax at $10 million. Quinn already has suggested the new-car sales tax as a way to plug a $300 million hole in repaying bonds used to fund public works projects.


rap30@aol.com mcgarcia@tribune.com





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Leah Remini sued by former managers over “Family Tools” commissions






LOS ANGELES (TheWrap.com) – Leah Remini‘s new TV gig is already giving her a headache, months before it even starts. Former “King of Queens” star Remini is being sued by her former managers, the Collective Management Group, which claims that it’s owed $ 67,000 in commissions relating to her upcoming ABC comedy “Family Tools,” which debuts May 1.


In a complaint filed with Los Angeles Superior Court on Tuesday, the Collective says that it entered into an agreement with the actress in November 2011 that guaranteed the company 10 percent of the earnings that emerged from projects that Remini “discussed, negotiated, contemplated, or procured/booked during Plaintiff’s representation of Remini,” regardless of whether the income was earned after she and the Collective parted ways.






According to the lawsuit, that would include the $ 1 million that it says Remini will earn for the first season of “Family Tools.” (The suit allows that it isn’t owed commission on a $ 330,000 talent holding fee that Remini received from ABC prior to officially being booked on the show.)


Remini, pictured above wearing the self-satisfied smirk of someone who just might stiff her former managers out of their commission, terminated her agreement with the Collective “without warning or justification” in October, the suit says.


Alleging breach of oral contract among other charges, the suit is asking for an order stipulating that it’s owed the $ 67,000, plus unspecified damages, interest and court costs.


Remini’s agent has not yet responded to TheWrap’s request for comment.


(Pamela Chelin contributed to this report)


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Amgen Workers Helped U.S. in Aranesp Marketing Inquiry





“I hope no one is taping this,” the Amgen manager remarked at a company sales meeting in 2005.




The manager then boasted of how she had given a $10,000 unrestricted grant to a pet project of a doctor who was an adviser to the local Medicare contractor. In turn, she said, the doctor would help persuade the contractor to provide reimbursement for an unapproved use of Amgen’s anemia drug, Aranesp.


Someone, it turned out, was taping it. Jill Osiecki, a longtime sales representative at Amgen, was wearing a recording device under her clothes, transmitting the proceedings to agents of the Department of Health and Human Services.


The result of Ms. Osiecki’s undercover work, and information provided by other whistle-blowers, led to Amgen’s agreement this week to pay $762 million to settle federal investigations regarding the marketing of some of its top-selling drugs.


Judge Sterling Johnson Jr. of Federal District Court in Brooklyn accepted the settlement on Wednesday, clearing the way for 10 whistle-blower lawsuits to be unsealed.


Amgen, the world’s largest biotechnology company, will pay $150 million in criminal penalties after pleading guilty to one misdemeanor count of marketing Aranesp for unapproved uses and in unapproved doses.


The rest of the money — $612 million — will go to settle civil false claims lawsuits filed by the federal government, states and whistle-blowers. These contain accusations that go well beyond the off-label marketing of Aranesp.


They include off-label marketing of other drugs like Enbrel for psoriasis and Neulasta, which increases the levels of white blood cells. Amgen is also accused of offering kickbacks to doctors and clinics to induce them to use its drugs. These reportedly came as cash, rebates, free samples, educational and research grants, dinners and travel, and other inducements. The government also accused the company of knowingly misreporting the prices of some of its drugs.


Except for those in the criminal count, Amgen denied the other accusations, though it did issue a statement on Wednesday acknowledging the settlement.


“The government raised important concerns in the criminal prosecution,” Cynthia M. Patton, chief compliance officer at Amgen, said in the statement. “Amgen acknowledges that mistakes were made, and we did not live up to our standards.”


Ms. Osiecki, 52, was one of the main whistle-blowers and will be entitled to a share of the settlement. The amount each whistle-blower will receive has not been determined or is being kept confidential, their lawyers said.


Ms. Osiecki worked as a sales representative for Merck for nine years before joining Amgen in 1990, soon after the biotechnology company won regulatory approval for its first product. The company, based outside Los Angeles, had “good science, good products, strong ethics,” Ms. Osiecki said in an interview.


But, she said, the corporate culture changed starting around 2000. That was when new management came in and Aranesp was approved, setting up a fierce marketing battle with Johnson & Johnson and its rival anemia drug, Procrit.


“It was more important to make your numbers than to follow the rules,” said Ms. Osiecki, who was based in Milwaukee and sold Aranesp.


In August 2004, with her concerns mounting, Ms. Osiecki called the Office of Inspector General of the Department of Health and Human Services and left a message. Within days, she was called back, and she went to see an agent, who persuaded her to secretly record meetings. She did that 13 times over about 15 months, mainly sales meetings.


Aranesp is used mainly in a hospital, clinic or physician’s office. It is bought by the medical practice, which can make a profit if the patient and insurers pay more for the use of the drug than the practice paid.


Ms. Osiecki said Amgen “marketed the spread,” trying to make it more profitable for doctors to use Aranesp rather than Procrit.


Such financial inducements could also spur greater overall use of a drug and can violate anti-kickback laws, said Ms. Osiecki’s lawyer, Brian P. Kenney of Kenney & McCafferty in Blue Bell, Pa.


Ms. Osiecki said the first sales meeting at which she wore the recording device, wrapped around her midriff under baggy clothes, was in October 2004 in a Milwaukee hotel. She could look down from the meeting room and see the car parked across the street containing the agent with the receiving device. She said she was not particularly nervous.


The speaker was a pharmacist from an oncology practice going through the numbers on how his practice could make a million dollars more a year using Aranesp rather than Procrit.


Ms. Osiecki said Amgen was careful to cover up such marketing. Spreadsheets showing doctors how much more money they could make using Aranesp were “homemade bread,” meaning they were created by each sales representative, not by the company. And representatives were told not to leave the presentations behind after showing them to doctors.


Her 107-page complaint, filed in late 2004, contains many other accusations.


Other whistle-blowers made other accusations. Kassie Westmoreland, a former sales representative, said Amgen overfilled vials of Aranesp, essentially providing free drugs to doctors. They could then bill Medicare or private insurers for the use of that drug, making an extra profit.


“Amgen was offering a kickback in the form of extra product subsidized by the taxpayers,” said Robert M. Thomas Jr., one of Ms. Westmoreland’s lawyers.


Elena Ferrante and Marc Engelman, both former sales representatives, contended that Amgen promoted Enbrel’s off-label use for mild psoriasis when the drug was approved only for moderate or severe cases of the disease.


Lydia Cotz, one of their lawyers, said the two refused to go along with the off-label marketing. They are now pursuing wrongful termination claims against Amgen in arbitration proceedings that Amgen requires be kept confidential, she said.


“It’s been a very long heroic journey for my clients,” she said.


Ms. Osiecki is now also a former Amgen sales representative. She said that she was fired in December 2005 after she let slip that she had retained a company voice mail message that she thought provided evidence of illegal activity. Leaving the pharmaceutical industry, she moved to Amelia Island, Fla. She now works for a small business.


Mosi Secret and Barry Meier contributed reporting.



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Boehner: Blame tax hikes on Obama













John Boehner


US Speaker of the House John Boehner speaks on the "fiscal cliff" during press conference Wednesday.
(Reuters / December 19, 2012)




















































President Barack Obama will be responsible for taxes rising on Americans if he does not "get serious" about a balanced deficit reduction plan or demand Senate passage of a Republican bill to prevent tax increases on all income below $1 million, House Speaker John Boehner charged on Wednesday.

"Tomorrow the House will pass legislation to make permanent tax relief for nearly every American," Boehner said in a short on-camera statement.


"Then the president will have a decision to make. He can call on the Senate Democrats to pass that bill, or he can be responsible for the largest tax increase in American history."







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Chicago prison inmates used bedsheets to escape: official

The scene at the Metropolitan Correctional Center and in Tinley Park, where authorities were searching for two escaped prisoners on Dec. 18, 2012. (Zbigniew Bzdak & Jose M. Osorio/Chicago Tribune)









Officials at a federal Loop jail discovered that two convicted bank robbers had escaped after employees arriving for work at about 7 a.m. today and saw a makeshift rope hanging from the outside of the high-rise facility, federal officials said in charging the two with escape.


Joseph "Jose" Banks and Kenneth Conley made good their escape from the Metropolitan Correctional Center after last being seen for a head count conducted at about 10 p.m. Monday, authorities said.


The two are believed to have scurried down ropes made from bedsheets from the high-rise cell they shared.








Authorities also revealed that in their cell guards found numerous articles of clothing and sheets piled under a blanket in both their beds to make it appear they were asleep.


The window in the cell was broken and the makeshift rope was tied to its bars and hanging down the south side of the MCC, authorities said.


Prosecutors charged both with escape in a criminal complaint filed this afternoon in federal court a few blocks from the scene of the escape.


Authorities said the two are believed to be traveling together and were reportedly last seen this morning in the Tinley Park area.


A widespread manhunt is underway by the FBI with the assistance of numerous federal, state and locallawenforcement agencies.


Both Banks and Conley were awaiting sentencing for bank robbery convictions. If they are captured and convicted of escape, they would face up to an additional five years in prison.


“A rope was fashioned out of bedsheets,’’ said a spokesman for the MCC. “I would imagine that they saved them up."


Conley and Banks, known as the Second-Hand Bandit who was convicted just last week, were first unaccounted for during a 5 a.m. head count, but it's unclear they were still inside the 27-story Metropolitan Correctional Center at the time, U.S. Marshal's Service spokeswoman Belkis Cantor said.


The makeshift rope could be seen dangling along the south side of the MCC, 71 W. Van Buren St.


The MCC spokesman declined to say whether any guards were under investigation or whether anything was smuggled into them or how the narrow cell window was widened.


Hours after the escape, SWAT teams forced their way into a Tinley Park house where a relative of Conley is believed to live. But no one was found inside, and FBI officials said they believe Conley and Banks had been there hours earlier.


The SWAT officers left the home after about 20 minutes and walked down the street with dogs as neighbors followed, taking pictures with their phones. About two blocks down, the officers searched the Metra stop.

A woman who answered at the home of a relative of Conley said it was "very upsetting for everyone" and declined further comment.


Banks’ cousin, Theresa Ann Banks, pleaded for Banks to turn himself in.

“I just don’t want to see him get hurt or killed,” she said with a shaky voice. “(The family) is trying to hold themselves together. We just have to have faith in God and hope everything goes right.”

Theresa Ann Banks said she received a call about the escape from Banks' father, who heard about it on the news.

When Joseph Banks was arrested in 2008, Theresa Ann Banks said she visited him whenever she had a chance. “When I went to see him, he was calm, he was humble, he was happy to see me,” she said. “He was very positive every time I would go.”


Banks was described as black, 37, 5 feet 8 inches tall and weighing 160 pounds. Conley is white, 38, 6 feet and 185 pounds.


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Samsung Galaxy Muse is like an iPod Shuffle that Syncs with Your Phone






In perhaps the most awkwardly titled tech press release ever, Samsung Mobile announced the launch of the new Samsung Galaxy Muse, a device which appears to have nothing to do with “CORRECTING and REPLACING and ADDING MULTIMEDIA” but everything to do with being a music player crossed with a smartphone accessory.


​Say goodbye to iTunes?






While most handheld music players (and smartphone or tablets with music apps) sync with a PC or Mac music app, like iTunes or Banshee, the Samsung Galaxy Muse syncs with your Android phone itself. It uses the Muse Sync app, which Google Play says will install on devices like the Nexus 7 tablet but which Samsung says will only work with the Galaxy S II, Galaxy S III, Galaxy Note and Galaxy Note II smartphones.


​Plug it in, turn it on


The pebble-shaped Muse connects to your Samsung phone via its headset jack. It doesn’t have a screen, so you have to control it iPod Shuffle style, and use the Muse Sync app to see how much of its 4 GB of space are free and decide which playlists to sync. Since it only has those 4 GB, it can only hold a fraction of the music that can be put on the much more powerful smartphones.


​Who is Samsung selling the Galaxy Muse to?


Samsung says “users can sync the songs they want and leave their phone behind,” the usefulness of which may depend on whether or not you feel limited by having to bring your smartphone with you. The press release mentions its “wearable design and small form factor,” and suggests taking it “in place of [your] smartphone … at the gym or on the go.”


​What other gadgets are like the Galaxy Muse?


The most obvious comparison is to the iPod Shuffle, Apple’s similarly tiny and screen-less portable music player. At $ 49, it costs the same as the Galaxy Muse (although a Droid-Life tipster found a $ 25 off coupon code for the Muse), but comes in seven different colors and has an embossed click-wheel controller instead of a flat and featureless surface. It requires you to use iTunes on a desktop PC or Mac, though.


​On the upside


The Galaxy Muse’s six hours of battery life may not be suitable for all-day listening, but may at least take the pressure off of a battery-hungry smartphone (so long as it’s one of Samsung’s flagship models). And as PCMag’s Chloe Albanesius notes, “it’s not very convenient to strap a 5.5-inch Galaxy Note II to your arm when you hit the gym.”


Jared Spurbeck is an open-source software enthusiast, who uses an Android phone and an Ubuntu laptop PC. He has been writing about technology and electronics since 2008.
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Newsman’s disappearance largely kept secret






NEW YORK (AP) — NBC was able to keep the abduction of chief Middle East correspondent Richard Engel in Syria largely a secret until he escaped late Monday because it persuaded some of this country’s most prominent news organizations to hold back on the story.


Otherwise, the disappearance of Engel — probably the most high-profile international television reporter on a U.S. network — would have been big news.






Engel and three colleagues, producers Ghazi Balkiz and Aziz Akyavas and photographer John Kooistra, escaped during a firefight between rebels and their captors, forces sympathetic to the Syrian government. The journalists were dragged from their cars, kept bound and blindfolded and threatened with death.


NBC said it did not know what had happened to the men until after their escape. The first sign of trouble came last Thursday, when Engel did not check back with his office at an agreed-upon time.


The Associated Press learned of Engel’s disappearance independently and was asked to keep the news quiet upon contacting NBC, said John Daniszewski, the AP’s vice president and senior managing editor.


“A general principle of our reporting is that we don’t want to write stories that are going to endanger the lives of the people that we are writing about,” Daniszewski said. The first few days after an abduction are often crucial to securing the captive’s release.


CBS News also said that it had honored NBC’s request, but a spokeswoman declined to discuss it. ABC, Fox News and CNN were also contacted by NBC.


CNN, in an editor’s note affixed to a website story on Engel’s escape, noted NBC’s request. CNN said it complied to allow fact-finding and negotiations to free the captors before it became a worldwide story.


“Hostage negotiators say that once the global spotlight is on the missing, the hostages’ value soars, making it much harder to negotiate their freedom,” CNN said.


For similar reasons, the AP did not report its own news several years ago when a photographer was kidnapped in the Gaza Strip, securing his release within a day. In one celebrated case of secrecy, The New York Times withheld news that reporter David Rohde was kidnapped while trying to make contact with a Taliban commander in Afghanistan. Rohde escaped after seven months in captivity.


It wasn’t clear whether Engel’s abductors knew what they had at the time. That knowledge, CNN argued, could have greatly complicated any negotiations. In this case, the captors did not make any ransom demands during the time he was missing.


This isn’t simply a professional courtesy; the AP has withheld news involving overseas contractors in the past, Daniszewski said. For similar reasons, the organization does not reveal details of military or police actions it learns about beforehand if the news will put people at risk, and doesn’t write about leaders heading into war zones until they are safely there.


Still, it’s not a decision lightly taken by news organizations. “The obligation of journalists is to report information, not withhold it, except in exceptional circumstances,” said Robert Steele, a journalism ethics professor at DePauw University.


The news that Engel was missing was first reported Monday by Turkish journalists who had heard about Akyavas’ involvement, and was picked up by the U.S. website Gawker.com. In explaining why the news was reported, Gawker’s John Cook wrote that no one had told him of a specific or even general threat to Engel’s safety.


“I would not have written a post if someone had told me that there was a reasonable or even remote suspicion that anything specific would happen if I wrote the post,” Cook wrote.


He also noted that China’s Xinhua News Agency and the Breitbart website had also reported on Engel’s disappearance. Breitbart’s John Nolte attached a note to his report saying that he wasn’t even aware of any news embargo until after hearing that Engel had been released.


The news was also tweeted by a small number of journalists, apparently unaware of the embargo request.


Whether a disappearance has become widely known could influence a decision by AP on whether to withhold the news, Daniszewski said. In this case, it wasn’t clear that it had been widely circulated, he said.


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Attackers in Pakistan Kill Anti-Polio Workers


Rizwan Tabassum/Agence France-Presse — Getty Images


A Pakistani mother mourned her daughter, who was killed on Tuesday in an attack on health workers participating in a drive to eradicate polio from Pakistan.







ISLAMABAD, Pakistan — Gunmen shot dead five female health workers who were immunizing children against polio on Tuesday, causing the Pakistani government to suspend vaccinations in two cities and dealing a fresh setback to an eradication campaign dogged by Taliban resistance in a country that is one of the disease’s last global strongholds.




“It is a blow, no doubt,” said Shahnaz Wazir Ali, an adviser on polio to Prime Minister Raja Pervez Ashraf. “Never before have female health workers been targeted like this in Pakistan. Clearly there will have to be more and better arrangements for security.”


No group claimed responsibility for the attacks, but most suspicion focused on the Pakistani Taliban, which has previously blocked polio vaccinators and complained that the United States is using the program as a cover for espionage.


The killings were a serious reversal for the multibillion-dollar global polio immunization effort, which over the past quarter century has reduced the number of endemic countries from 120 to just three: Pakistan, Afghanistan and Nigeria.


Nonetheless, United Nations officials insisted that the drive would be revived after a period for investigation and regrouping, as it had been after previous attacks on vaccinators here, in Afghanistan and elsewhere.


Pakistan has made solid gains against polio, with 56 new recorded cases of the diseases in 2012, compared with 192 at the same point last year, according to the government. Worldwide, cases of death and paralysis from polio have been reduced to less than 1,000 last year, from 350,000 worldwide in 1988.


But the campaign here has been deeply shaken by Taliban threats and intimidation, though several officials said Tuesday that they had never seen such a focused and deadly attack before.


Insurgents have long been suspicious of polio vaccinators, seeing them as potential spies. But that greatly intensified after the C.I.A. used a vaccination team headed by a local doctor, Shakil Afridi, to visit Osama bin Laden’s compound in Abbottabad, reportedly in an attempt to obtain DNA proof that the Bin Laden family was there before an American commando raid on it in May 2011.


In North Waziristan, one prominent warlord has banned polio vaccinations until the United States ceases drone strikes in the area.


Most new infections in Pakistan occur in the tribal belt and adjoining Khyber-Pakhtunkhwa Province — some of the most remote areas of the country, and also those with the strongest militant presence. People fleeing fighting in those areas have also spread the disease to Karachi, the country’s largest city, where the disease has been making a worrisome comeback in recent years.


After Tuesday’s attacks, witnesses described violence that was both disciplined and well coordinated. Five attacks occurred within an hour in different Karachi neighborhoods. In several cases, the killers traveled in pairs on motorcycle, opening fire on female health workers as they administered polio drops or moved between houses in crowded neighborhoods.


Of the five victims, three were teenagers, and some had been shot in the head, a senior government official said. Two male health workers were also wounded by gunfire; early reports incorrectly stated that one of them had died, the official said.


In Peshawar, the capital of Khyber-Pakhtunkhwa Province, gunmen opened fire on two sisters participating in the polio vaccination program, killing one of them. It was unclear whether that shooting was directly linked to the Karachi attacks.


In remote parts of the northwest, the Taliban threat is exacerbated by the government’s crumbling writ. In Bannu, on the edge of the tribal belt, one polio worker, Noor Khan, said he quit work on Tuesday once news of the attacks in Karachi and Peshawar filtered in.


“We were told to stop immediately,” he said by phone.


Still, the Pakistani government has engaged considerable political and financial capital in fighting polio. President Asif Ali Zardari and his daughter Aseefa have been at the forefront of immunization drives. With the help of international donors, including the Bill and Melinda Gates Foundation, they have mounted a huge vaccination campaign aimed at up to 35 million children younger than 5, usually in three-day bursts that can involve 225,000 health workers.


The plan seeks to have every child in Pakistan immunized at least four times per year, although in the hardest-hit areas one child could be reached as many as 12 times in a year.


Declan Walsh reported from Islamabad, and Donald G. McNeil Jr. from New York. Salman Masood contributed reporting from Islamabad, and Zia ur-Rehman from Karachi, Pakistan.



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