BALTIMORE (AP) — Manufacturers and distributors of impermeable gowns and full-body suits meant to protect medical workers from Ebola are scrambling to keep up with a surge of new orders from U.S. hospitals, with at least one doubling its staff and still facing a weekslong backlog. Many hospitals say they already have the proper equipment in place but are ordering more supplies to prepare for a possible new case of Ebola.
This gear is made of material that does not absorb fluids and is crucial to preventing the spread of the virus, which has infected thousands across West Africa, many of whom caught the disease while caring for those infected. Ebola is transmitted through direct contact, through cuts or mucous membranes, with bodily fluids such as blood, vomit and feces, and proper protective equipment helps prevent doctors and nurses from accidentally getting any fluids in their eyes, nose or mouth.
Hospitals are paying close attention to the type of protective gear they stock after two nurses contracted Ebola earlier this month while caring for a Liberian man dying of the disease at a Dallas hospital. The nurses were exposed to the disease during what the Centers for Disease Control and Prevention has called a "breach in protocol" at the hospital. But some medical professionals criticized the CDC for distributing guidelines that do not require medical staff caring for infected patients to don full-body suits or wear multiple layers of gloves.
The CDC announced new guidelines Monday night calling in part for health workers caring for Ebola patients to wear face shields, hoods, boot covers and other garb that leave no part of the body exposed.
Last week the University Medical Center of Southern Nevada in Las Vegas ordered 30 cases of impermeable isolation gowns, with 50 gowns per case to add to their existing 10-case cache. The Lawrence and Memorial Hospital in New London, Connecticut recently placed a new order for one-piece full-coverage suits, even though the hospital already has plenty on hand.
"We had an ample supply to cover us in each of our hospitals with any immediate emergency situation," hospital spokesman Michael O'Farrell said Monday, "but in preparation mode we ordered more to have on hand, just in case."
The nation's largest hospital chain, HCA Holdings Inc., has stocked its hospitals with routine protective equipment like impervious gowns and leg and shoe coverings. It also bought respirators for its medical personnel when the H1N1 flu outbreak hit in 2009, and it has been updating that stockpile, said chief medical officer Dr. Jonathan Perlin.
The hospital chain also has stockpiles of hazardous materials suits and hoods that it can distribute to its hospitals as needed, but it needs to obtain more to have a "completely sufficient" number, spokesman Ed Fishbough said.
HCA runs more than 160 hospitals in 20 states and England. Its hospitals have yet to treat an Ebola patient, but its staff would be required to wear that protective clothing, plus a double layer of gloves and the respirator when dealing with any Ebola patients.
In an informal survey, Associated Press reporters spoke to 102 hospitals of varying sizes across the country, and all but two said they have protective gear in stock. The vast majority of the 102 hospitals said their protective gear provides full-body coverage, including either a one-piece suit or pieces that include a hood, goggles, face mask, leg and foot covers. Only 10 hospitals said their equipment left some skin exposed, and seven of those hospitals said they had either already placed orders for better gear or intended to do so.
Fletcher Allen Health Care in Vermont and the University of Virginia Medical Center in Charlottesville both said their equipment left part of the neck exposed but that they have already placed orders for hoods or full-coverage equipment. MultiCare Tacoma General Hospital in Washington also said it was working to procure gear that covers the neck, but that hoods and full-body suits are in short supply these days.
Tony Baumgartner, president of DQE Inc., an Indiana-based emergency services company that distributes gear recommended under federal guidelines, said he's doubled his production staff to keep up with the orders. Since Sept. 30, when the first case of Ebola was reported in the United States, Baumgartner said demand for his personal protective equipment kits, containing impermeable gowns, foot covers, face masks and other respiratory protection, has been "unprecedented."
"We're up ten-fold, if not 20-fold, from this time last year," Baumgartner said. Most popular now is a full-body suit, Baumgartner said. Those suits are currently on a 12-week backlog. "We get orders in that vary from a few suits to a few boxes of suits, supplementing existing stock to hospitals that are very concerned, and we have others who are ordering hundreds of suits. The order volume, the number of orders, has just been overwhelming."
Executives at Medline Industries, a personal protective equipment manufacturer that is one of three companies whose combined sales account for 72 percent of the surgical gown market, say they are receiving 150 calls a day from hospital customers asking about protective gear. As a result, Medline has increased production from multiple U.S. manufacturing locations to stay ahead of demand. But Stephanie Pasko Nelson, a vice president with 12,000-employee company, said there was no risk of running out of product.
Chemical industry giant DuPont says it has tripled production of hazmat equipment used to treat highly-infectious patients, including suits, aprons, foot coverings and sleeves. The company's leading Tychem suit is designed to protect against bacteria, viruses, microbes and fungi.
The nation's largest manufacturer of surgical face masks, Kimberly-Clark, is seeing a surge of orders and executives say they are staging materials, workers and production lines to stay ahead of demand. The company also sells fluid-resistant surgical gowns, examination gloves and other protective equipment.
When orders for masks outpace supply, the company uses a pandemic preparedness plan to fill orders, prioritizing shipments to first-line responders and hospital workers, followed by medical researchers and transportation authorities.
Judson Booth, manufacturing director with the company, says the most in-demand product right now is the Fluidshield surgical mask, which includes an eye shield to protect against blood and other bodily fluids.
"People are trying to get as prepared as they think they need to be," he said.
Associated Press writers Matthew Perrone in Washington, D.C., and Tom Murphy in Indianapolis contributed to this report.
CAPE CANAVERAL, Fla. (AP) — North Americans, get set for the fourth and final eclipse of the year.
On Thursday, most of North America will have prime viewing of a partial solar eclipse. The new moon will hide part of the sun from view. The eclipse will unfold slowly following its start near the Kamchatka Peninsula in far eastern Russia.
The best views will be in the U.S. Northwest and northern Canada, especially Prince of Wales Island. New England and the Canadian Maritime provinces will miss out.
In the eastern half of the U.S., the eclipse will occur near sunset.
Sky gazers are urged to protect their eyes with special filtered glasses. Regular sunglasses are not good enough.
This makes for two solar and two lunar eclipses this year.
WASHINGTON (AP) — Two years after the Obama administration backed off a rule that would have banned children from dangerous agriculture jobs, public health advocates and lawmakers are trying anew to get kids off tobacco farms.
The new efforts were jumpstarted by a Human Rights Watch report in May that said nearly three-quarters of the children interviewed by the group reported vomiting, nausea and headaches while working on tobacco farms. Those symptoms are consistent with nicotine poisoning, often called Green Tobacco Sickness, which occurs when workers absorb nicotine through their skin while handling tobacco plants.
"I think that many members of Congress have been shocked that children are suffering nicotine poisoning from working in U.S. tobacco fields," said Jo Becker, Human Rights Watch's children's rights advocacy director. "In response, they are pushing tobacco companies to adopt stronger child labor policies, introducing legislation and urging the Department of Labor to take action."
The approach includes legislation to ban kids under 18 from working on such farms, pursuit of a narrower federal rule than the one that was scuttled and public pressure on tobacco companies from lawmakers and health groups.
There has been some movement within the industry. This month, the Tobacco Growers Association of North Carolina said it "does not condone the use of child labor" and said tobacco growers and farm labor contractors should not employ workers under 16 years old.
Philip Morris International, which limits the type of work children can do on tobacco farms, says it would like to see stronger U.S. regulations in this area.
And the Labor Department said in a statement that its Occupational Safety and Health Administration is working to determine best practices to reduce worker exposure to nicotine during tobacco harvests.
In 2011, the Labor Department proposed preventing some children from working in dangerous farm jobs, including cultivation, harvesting and curing of tobacco. The department tried to pre-empt a backlash from small farmers by excluding from the rule children who worked on their parents' farms.
Nevertheless, the proposal became a political punching bag for Republicans, who called it an impractical, heavy-handed regulation that ignored the reality of small farms.
In an election-year decision, the Labor Department withdrew the proposed rule in 2012. In doing so, officials appeared to close the door on any action even after the presidential election: "To be clear, this regulation will not be pursued for the duration of the Obama administration," the Labor Department said in withdrawing the rule in April 2012.
But the release of the Human Rights Watch report, based on interviews with more than 140 children working on tobacco farms in North Carolina, Kentucky, Tennessee and Virginia, sparked new interest in the issue.
Last month, 35 House Democrats wrote to Labor Secretary Thomas Perez, calling for a new rule focused solely on banning children from working in the cultivation or curing of tobacco. The department hasn't yet responded to the lawmakers' letter.
Reid Maki, coordinator of the Child Labor Coalition, a Washington-based advocacy group, called the prospect of action by the Obama administration a long shot, given the Labor Department's 2012 statement.
"When it comes to the health and safety of children, the administration should not worry about promises it made in the middle of an election, especially when that promise concerned a refusal to protect children from known safety hazards in the workplace," he said.
Rep. David Cicilline, D-R.I., who signed the letter to Perez, has sponsored a bill to amend the Fair Labor Standards Act of 1938 to ban children under 18 from jobs where they have direct contact with tobacco plants or leaves. There's no companion bill in the Senate, but Sen. Tom Harkin, D-Iowa, chairman of the Senate committee on Health, Education, Labor and Pensions, said in a statement that he's working with other lawmakers and the administration to find common ground.
In June, Harkin and 16 other Democratic senators urged several major tobacco companies to prevent children under 18 from working in direct contact with tobacco. Philip Morris International responded that it prevents children from working in hazardous conditions, including those that could involve physical contact with tobacco plants. The company does allow children to work with seedlings or in barns sorting dried tobacco leaves, but may prohibit those activities depending on specific circumstances.
Philip Morris International spokesman Corey Henry said in an email that the company would "welcome strengthening of the U.S. regulatory framework for child labor in agriculture in line with international standards and the standards we expect to be met on all farms where we source tobacco."
SAINT-JEAN-SUR-RICHELIEU, Quebec (AP) — A young convert to Islam who killed a Canadian soldier in a hit-and-run had been on the radar of federal investigators, who feared he had jihadist ambitions and had seized his passport, authorities said Tuesday.
The suspect was shot dead by police after a chase in the Quebec city of Saint-Jean-Sur-Richelieu. A second soldier suffered minor injuries in Monday's attack.
Public Safety Minister Steven Blaney said the attack "clearly linked to terrorist ideology." Quebec Police spokesman Guy Lapointe said the act was deliberate and that one of the two soldiers was in uniform. Lapointe said there were no other suspects at this time.
An official who spoke on condition of anonymity because he was not authorized to speak publicly about the case identified the suspect as Martin Couture-Rouleau, 25.
The suspect was known to authorities and recently had his passport seized, RCMP Commissioner Bob Paulson said. He was one of 90 suspected extremists in the country who intend to join fights abroad or who have returned from overseas. However, it was not known whether the suspect had any ties to Islamic militant groups.
"He was part of our investigative efforts to try and identify those people who might commit a criminal act travelling abroad for terrorist purposes," Paulson said.
There was no answer at Couture-Rouleau's single story white brick home in Saint-Jean-sur-Richelieu, Quebec, on Tuesday morning, and no sign of police.
Neighbor Daniel Fortin said he had known Couture-Rouleau, who lived with his father, since he was a child.
Fortin said over the past year or so, he grew out his beard and began wearing loose-fitting Muslim clothing but that he never felt threatened by him. Fortin said Couture-Roleau's father was worried as he became increasingly radicalized and "tried everything," to help him.
Another neighbor, who declined to be named, said she didn't know the family well but saw police visit the home on more than one occasion over the past few months.
Prime Minister Stephen Harper said the slain soldier, 53-year-old Warrant Officer Patrice Vincent, was a 28-year veteran with "distinguished service."
"Our thoughts and prayers are with his family members, his friends and his colleagues," the prime minister said.
"This was a despicable act of violence that strikes against not just this soldier and his colleagues but frankly against our very values as a civilized democracy," Harper said in Parliament.
Lapointe said the other victim is in stable condition with minor injuries.
The suspect sat in his car in the parking lot outside a veterans' support center for at least two hours before the hit and run, Lapointe said. A police officer on patrol witnessed what happened and immediately gave chase. He was was pursued for about 4 kilometers (2.5 miles) before he lost control of the car, which rolled over several times.
Lapointe said the man was brandishing a knife when he emerged from the vehicle and police opened fire.
The case is similar to one in London last year in which an al-Qaida-inspired extremist and another man ran over a soldier with a car before hacking the off-duty soldier to death.
Images of Michael Adebolajo, 29, holding a butcher knife and cleaver with bloodied hands in the moments after the May 2013 killing of Fusilier Lee Rigby shocked people around the world and sparked fears of Islamist terrorism in Britain.
The Islamic State group has urged supporters to carry out attacks against Western countries, including Canada, that are participating in the U.S.-led coalition fighting the militants who have taken over large swaths of territory in Iraq and Syria. Eight Canadian fighter jets, including two spares, are set to depart for the region Tuesday.
Gillies contributed from Toronto. Sean Farrell in Montreal also contributed to this report.
ATLANTA (AP) — A coalition of prosecutors from across the country gathered for the first time in Atlanta to discuss ways to fight gun violence.
Prosecutors Against Gun Violence was announced last month and held its first meeting Tuesday in Atlanta.
The group is co-chaired by Manhattan District Attorney Cyrus R. Vance, Jr. and Los Angeles City Attorney Mike Feuer and includes 23 prosecutors from major jurisdictions throughout the nation.
At the meeting in Atlanta prosecutors discussed topics including domestic violence, gun trafficking, mental illness and shared strategies to fight gun violence.
Former astronaut Mark Kelly, whose wife, former U.S. Rep. Gabrielle Giffords has become a face of the gun control movement since being shot through the head during a 2011 attack that killed six people, addressed the group in Atlanta.
BATON ROUGE, La. (AP) — An old political standby — the future of Medicare — is emerging as the go-to issue in Louisiana's bitter Senate race as the candidates woo seniors who typically wield strong influence in midterm elections.
The challenge for voters is to figure out which side, if either, is telling the whole truth about who would cut and who would protect the popular insurance program. Medicare serves more than 50 million people and accounts for about 15 percent of federal spending, with about 10,000 new beneficiaries added daily as baby boomers reach age 65. The issue is so powerful that it's cropping up in North Carolina and Iowa, too, amid a national battle for control of the Senate.
Louisiana Sen. Mary Landrieu got hundreds of seniors grumbling at a recent forum when she told them her top Republican rival, Rep. Bill Cassidy, wants to turn Medicare into a "voucher system" and has voted to raise the retirement age to make Americans wait longer for benefits.
"No wonder Bill Cassidy didn't come today, because he didn't want you to know this," said Landrieu, who finds herself in another tough re-election bid as she seeks a fourth term.
Landrieu has made the issue of entitlement programs for the elderly a centerpiece of her campaign, traveling Tuesday to three senior centers across south Louisiana to announce a new endorsement from the National Committee to Preserve Social Security and Medicare, a Washington-based advocacy group.
The Senate Democrats' campaign arm has aired an ad against Cassidy featuring three older white women — a crucial demographic for Landrieu in a state that President Barack Obama twice lost badly — bemoaning Cassidy's plan that "(requires) seniors to buy private insurance with fewer benefits and higher costs." Democrats have hit Iowa Republican Senate nominee Joni Ernst with similar ads.
Cassidy and his backers answer that it's Landrieu who cut Medicare when she voted in 2010 for Obama's signature health care overhaul, which reduced payments for private policies under the Medicare Advantage program.
Americans for Prosperity, the political action organization backed by the conservative billionaire Koch brothers, Charles and David, cites that Affordable Care Act vote in similar ads opposing Landrieu and her North Carolina colleague, Sen. Kay Hagan.
The three races are among the handful that will decide which party controls the Senate for the final two years of Obama's presidency. Republicans must net six more seats for a majority.
The back-and-forth reprises a major theme of the 2012 presidential election. Obama and Republican nominee Mitt Romney leveled the same attacks, with Romney prevailing among voters older than 55. The issue also helped Republicans in 2010, when the GOP used dissatisfaction and confusion over the new health care law to win a House majority.
While Republican Medicare attacks are based on the health care law, the Democratic attacks are based mostly on House Republicans' budget blueprint, the Paul "Ryan Budget," so-named for the Wisconsin congressman and budget chairman who was Romney's running mate.
The Affordable Care Act changed how Medicare pays doctors and hospitals and included reductions — the $700 billion in cuts the GOP cites — in Medicare Advantage, which allows seniors in certain markets to purchase coverage from private insurers.
Ryan's budgets, meanwhile, propose a long-term shift to a voucher system for seniors' health care, where beneficiaries would get taxpayer money and then choose among traditional Medicare and private policies sold on the open market — similar to the exchanges the health care law set up for working-age Americans. The House has stopped short of passing legislation that would actually implement the overhauls assumed in their budget plans, and the budget votes have been largely symbolic anyway since Republicans have the political cover of a Democratic Senate, which routinely kills legislation passed in the House.
Medicare's latest annual report, issued this summer, projects that the program's hospital trust fund won't be exhausted until 2030, at which time payroll taxes are projected to cover just 85 percent of Medicare's costs. Yet each side persists in attacking the other's proposals as untenable "cuts."
"The $700 billion that Obamacare cut from Medicare spends it on other programs," Cassidy said, referring to the law shifting some health care spending to premium subsidies for working-age policy holders. "The $700 billion in the Ryan budget puts it back into the trust fund."
Landrieu and Democrats argue that the new law covers more Americans and, thus, lowers health care costs across the board by saving on treating the uninsured.
Democrats also note Congressional Budget Office projections that premiums for traditional Medicare could nearly double under the Ryan proposal, leaving seniors to choose the more expensive public insurance or less expensive private plans with lower benefits and more out-of-pocket expenses.
Analyses from the insurance industry and independent groups note that under both parties' models there would be rural areas where private firms may not offer policies at all.
Landrieu's most aggressive criticism of Republican Medicare plans, meanwhile, ignores that the changes would not affect anyone who is old enough now to qualify for Medicare. That means none of those voters Landrieu stirred up at a senior center would be forced off traditional coverage under plans Cassidy has supported.
Nonetheless, Landrieu defends her attacks. "You can only judge what somebody's going to do based on what they've already done," she said.