Government Executive - Authors - Maggie Fox

Supreme Court saves centerpiece of health care reform law

Maggie Fox, National Journal — Thu, 28 Jun 2012 10:27:00 -0400

The Supreme Court upheld the health care reform law on Thursday in a ruling in which conservative Chief Justice John Roberts sided with the liberal wing and spelled out ways to keep the highly controversial law within the bounds of the Constitution. The ruling vindicates President Obama’s signature domestic policy initiative, even if it doesn’t stop the political debate over the sweeping Affordable Care Act.

The 5-4 ruling lets stand the mandate -- the requirement that just about everyone carry health insurance or pay a fine. But the ruling calls the fine a tax, allowing the law to escape arguments that it violates the Commerce Clause of the Constitution.

And the ruling, written by Roberts himself, also addresses the law’s controversial requirement that states expand Medicaid coverage to millions more. It says the federal government may ask the state to do so and can even pony up the cash, but it cannot withhold its share of Medicaid funds to coerce them to do it.

"Nothing in our opinion precludes Congress from offering funds under the ACA to expand the availability of health care, and requiring that states accepting such funds comply with the conditions on their use,” the ruling said. “What Congress is not free to do is to penalize states that choose not to participate in that new program by taking away their existing Medicaid funding."

Not all the justices were convinced. "In our view, the entire Act before us is invalid in its entirety,” conservative justice Anthony Kennedy -- who many court watchers thought would be the swing vote -- wrote in his dissent.

“Today’s Supreme Court ruling is a clear, unambiguous, and complete victory for long-overdue health care reform. It sends an unmistakable message that the building of a better, fairer health care system will continue to move forward,” Ron Pollack, executive director of the pro-health reform group Families USA, said in a statement.

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Long-awaited bird flu study shows it’s still a threat

Maggie Fox, National Journal — Thu, 21 Jun 2012 17:07:00 -0400

Commentaries questioned the wisdom of an unprecedented U.S. government request to delay the research, while experts debated whether it was too dangerous to make public. One cyberexpert said that experience with hackers shows it’s likely a waste of time to try to delay or limit such experiments.

The studies, published in the journal Science, demonstrate that only a few mutations could transform H5N1 bird flu into a version that is easily passed through the air from one animal to another--and, by inference, from one person to another. The research used ferrets, the animals that most closely resemble human beings when it comes to influenza.

They show these mutations not only can occur easily in nature but that some already have. Reassuringly, the ferrets did not die and the mutant viruses were treatable with existing flu drugs.

“We now know that we're living on a fault line,” Derek Smith of Cambridge University in Britain, who worked on one of the studies, told reporters in a teleconference.

The researchers said their findings show that the benefits of such experiments far outweigh any risks. And one flu-vaccine expert said that the findings demonstrate the need for regulators to make it far easier to make flu vaccines fast so they can be distributed quickly enough to avert a pandemic.

“It's our hope that [Thursday’s] publication will help to make the world safer, particularly by stimulating many more scientists and policymakers to focus on preparing defenses,” Bruce Alberts, editor in chief of Science, told the teleconference.

H5N1 bird flu has killed nearly 60 percent of nearly 600 people reported infected since 2003. It mostly kills chickens, but experts believe that H5N1 could cause the next big deadly pandemic, such as those that struck in 1918, 1957, and 1968.

Luckily, the infection doesn’t spread well from birds to people or from one person to another. But like all versions of the flu virus, it evolves and mutates in several different ways. Scientists have been working for years to figure out just which mutations would allow H5N1 to spread easily from one person to another.

The work concerned some experts, and last December the National Science Advisory Board for Biosecurity asked two teams of researchers to hold off on publishing their findings.

The U.S. government also asked all flu researchers to agree to a moratorium on genetically changing flu viruses until ground rules could be agreed on. The worry was that the virus could escape and accidentally cause a pandemic or that terrorists could somehow get hold of the work and use it to make a biological weapon. But the restrictions caused a furor among researchers, who are used to freely sharing their work.

The biosecurity board agreed earlier this year to let the researchers publish their findings.

Dr. Anthony Fauci, head of the National Institute for Allergy and Infectious Diseases, said that the benefits of the work outweighed any risks. NIAID, one of the National Institutes of Health, helped pay for both H5N1 studies.

And cyberexpert Bruce Schneier of BT Managed Security Solutions in Minneapolis said that it does little good to try to keep such research secret.

“First, security based on secrecy is inherently fragile. The more secrets a system has, the less secure it is,” Schneier wrote in a commentary in Science. “A door lock that has a secret but unchangeable locking mechanism is less secure than a commercially purchased door lock with an easily changeable key,” he added.

The researchers say it’s now important to do a better job of monitoring for H5N1 mutations in people, chickens, and other animals. Dr. Rino Rappuoli, global head of vaccines research for Novartis Vaccines and Diagnostics, also asked regulators to change the rules to make it easier to make vaccine quickly in case of a pandemic.

He pointed to failures in the 2009 pandemic of H1N1 swine flu, when it took so long to make and distribute vaccines that the pandemic had peaked before most people could be vaccinated. And poorer countries missed out altogether.

The United States would have to loosen its reluctance to use vaccines that have additives called adjuvants, Rappuoli said. They are widely used in Europe but U.S. regulators have been more conservative, meaning doses of U.S.-licensed vaccine don’t go nearly as far. He also asked for regulators to loosen restrictions on the basic ingredients of vaccines, freeing makers to use DNA sequences alone to reformulate flu vaccines and to use cell cultures instead of the current, decades-old technology of injecting virus into eggs and spending weeks growing it to make vaccines.]]>

Romney strongly defended individual mandate in Massachusetts, emails show

Maggie Fox, National Journal — Tue, 05 Jun 2012 10:18:37 -0400

When Mitt Romney was governor of Massachusetts and getting health reform passed there, emails demonstrate he strongly defended the individual mandate, the Wall Street Journal reports.

Republicans now criticize the much-hated requirement that everyone get health insurance and it's the center of some of the strongest challenges to the 2010 health reform law. But the emails join other historical evidence that the mandate was originally a Republican idea, one that President Obama only reluctantly embraced later.

The Wall Street Journal said it obtained to be the most complete set of Romney's internal emails to date. "We must have an individual mandate for any plan to work," Tim Murphy, Romney's health secretary, writes in one to the then-governor and several aides on Feb. 16, 2006.

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Tailored weight loss program for veterans disappoints

Maggie Fox, National Journal — Mon, 21 May 2012 08:43:58 -0400

An intensive, one-on-one weight loss program developed by the Veterans Affairs Department failed to attract many comers, and the few who did take part didn’t lose much weight, researchers report.

It’s not clear why the program did not work, but it doesn’t bode well for efforts to help the two-thirds of Americans who are overweight or obese lose weight. Most studies looking at how to help people take off the pounds suggest such just such a personalized, lifestyle-changing approach.

Alyson Littman of the Seattle Epidemiologic Research and Information Center and colleagues looked at the VA’s MOVE! Weight Management Program for Veterans.

Out of all the VA patients, 76,599 were classified as candidates for the program, based on their records, height, and weight. “A total of 3,192 (4.2 percent) patients participated in MOVE!,” Littman’s team wrote in the Centers for Disease Control and Prevention journal Preventing Chronic Disease.

About half of these only showed up for one session. Those who showed up more often lost more weight but the effects also didn’t last much longer than a few months, on average. “Participants lost approximately 1 to 2 pounds during 6 to 12 months of follow-up,” Littman’s team wrote.

The program was intense and carefully planned, using dietitians, physical and recreational therapists, social workers, and mental-health professionals. Each participant had a tailored diet, exercise, and counseling regime. But most people did not stick with the program, perhaps demonstrating just how difficult it is to change lifestyle to lose weight.

Obesity in the military and afterwards is a serious problem. “An estimated 70 percent of veterans are overweight or obese, with a body mass index (BMI, in kg/m²) of 25.0 or more, consistent with the prevalence of overweight and obesity among demographically similar nonveterans,” Littman’s team wrote.

Being obese raises the risk of heart disease, stroke, diabetes, arthritis, and several types of cancer.

“Weight loss as small as 5 percent can reduce the risk of chronic conditions associated with obesity,” Littman’s team wrote—and some other programs have worked better. The MOVE! Program worked about as well as other “real world” studies, however, Littman pointed out.

“Evaluating the effectiveness of MOVE! is challenging because it is not clear that the program was implemented as intended. Sustained and intensive treatments are associated with better outcomes,” her team added.

National Journal will examine the issue of overweight military personnel in more detail on Wednesday.

(Image via forestpath /Shutterstock.com)

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New agreement leases drug flops to NIH for further study

Maggie Fox, National Journal — Thu, 03 May 2012 17:10:14 -0400

The federal government said on Thursday that it will team up even more closely with drug companies to test old drugs for new uses. The National Institutes of Health’s National Center for Advancing Translational Sciences signed a deal with Pfizer, AstraZeneca, and Eli Lilly and Co. under which the drug companies agreed to make dozens of compounds available for NIH-funded testing.

"Clearly, we need to speed the pace at which we are turning discoveries into better health outcomes," NIH Director Francis Collins said in a statement.

NIH already often does the basic, most risky research on potential new drugs and then licenses them to companies to develop into commercial products. Under this new agreement, the companies will let NIH commission studies on compounds that flopped.

The hope is that a drug that failed against one disease might work against another. The first AIDS drug, AZT, is an example. It didn’t work against cancer but it fights the human immunodeficiency virus. Viagra’s extra properties were discovered when it was being tested against heart disease; now it’s an impotence drug.

"Americans are eagerly awaiting the next generation of cures and treatments to help them live longer and healthier lives. To accelerate our nation's therapeutic development process, it is essential that we forge strong, innovative, and strategic partnerships across government, academia, and industry," said Health and Human Services Secretary Kathleen Sebelius.

NIH says that while researchers have identified the causes of more than 4,500 diseases, effective treatments exist for only about 250 of them.

"Discovering and developing new medicines, regardless of the therapeutic area being studied, is a complex and expensive process, and we look forward to collaborating with the NIH and academia for the benefit of the patients we all serve,” said Lilly’s Jan Lundberg.

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One of two nearly censored bird flu papers published

Maggie Fox, National Journal — Wed, 02 May 2012 17:11:00 -0400

One of two now-notorious bird flu studies was published on Wednesday, four months after a panel of U.S. federal advisers asked researchers and scientific journals to hold on, just in case the information in the paper was dangerous.

In the paper, flu expert Yoshihiro Kawaoka of the University of Wisconsin (Madison) describes how he genetically engineered H5N1 bird flu—the virus that’s been decimating poultry in Asia, Egypt, and elsewhere—using pieces of the virus that caused the 2009 pandemic of H1N1 swine flu in people.

The paper itself is interesting to scientists and flu junkies. Published in Nature, it shows that four genetic changes can make the usually hard-to-catch H5N1 virus spread more easily among ferrets—animals that acquire flu in much the same way that people do.

“After wanting to read it for so long, it was like eating again after fasting,” Vincent Racaniello, a virologist at Columbia University, is quoted by Nature’s news section as saying. “And it does not disappoint.”

But the paper has historical significance because it’s the first big test of scientific censorship by the federal government. A second paper, by flu expert Ron Fouchier of Erasmus Medical Center in Rotterdam, the Netherlands, is being reviewed for publication in the rival journal Science.

The National Science Advisory Board for Biosecurity, which advises the Health and Human Services Department, said in December that publishing the papers could threaten national security and public health. It said the decision was too big for the scientific community to make on its own, comparing it to the 1940s Manhattan Project. The scientists, both of whom got funding from the National Institutes of Health, were not bound by the NSABB’s request, but reluctantly agreed. “It’s the first time they have seen results where they determined there should be restrictions,” Dr. Amy Patterson, executive director of the NSABB, told National Journal.

The decision divided the scientific community, with some researchers arguing that any censorship was dangerous and a waste of time, and others saying the viruses are too dangerous to risk tipping off terrorists or rogue governments about ways to unleash a deadly mutant.

After plenty of back-and-forth, including an emergency meeting at the World Health Organization in February and many editorials, the committee said there was no need for the government to intervene this time.

Since it started spreading in 2003, H5N1 bird flu has killed about 359 of the 600 people it is known to have infected—a mortality rate of 59 percent. This compares to a 2.5 percent fatality rate for the 1918 flu, which killed tens of millions of people, or 30 percent for smallpox before it was eliminated in 1979. Luckily, H5N1 doesn’t infect people easily, though it spreads rapidly through flocks of chickens. All flu viruses mutate, and most flu experts fear it is only a matter of time before H5N1 either evolves or mixes up with another flu virus to make a form that can easily infect people.

Kawaoka and Fouchier have been taking different approaches to see what new mutants might be possible—and whether genetic changes making a virus easier to catch might make it less deadly.

The Kawaoka paper is published in Nature with an unusual risk-analysis questionnaire that the journal points out comes from an agency outside the U.S. government. “Are there potential risks to public health from application or utilization of this information? If so, please describe,” it asks.

“There is no doubt that this information could be used by an exceptionally competent laboratory to provide the foundation for a program to develop a pandemic strain of this virus. There is no evidence that this reassortant virus would be fully pathogenic in humans,” is the answer. “A highly competent laboratory could exploit this information immediately, although as pointed out above, this paper does not provide sufficient information to produce fully competent dangerous pathogen.”

For its part, Nature’s editorial board says it will not edit future papers, or limit their distribution, based on fears that bad guys might use the information.

“First, it was worth deliberating at length on the possibility of redacting the key findings of the paper instead of simply rejecting it. (Rejection has long been an option if Nature is advised by security experts that the risks of publication exceed the benefits),” reads a commentary. “There was also the option that the full paper might be distributed by some third party, to selected recipients only. Having now considered these matters in depth, the editors of this journal have decided that we will not consider either alternative for papers in Nature in the foreseeable future. A paper that omits key results or methods disables subsequent research and peer review," it says.

"Furthermore, after much internal and external deliberation, we cannot imagine any mechanism or criterion by which to sensibly judge who should or should not be allowed to see the work. Nor do we believe that any restricted information distributed to university laboratories would stay confidential for long.”

Dr. Anthony Fauci, director of the National Institute of Allergy and Infectious Diseases, which paid for the research, says the policies on reviewing so-called dual-use studies—those that can be used for either good or for evil—are not really limiting research. “I don’t think it is going to have an impact at all,” Fauci said in a recent interview.

“Out of 300 to 400 grants, we have just a handful of grants, really, that would rise to the level of needing additional scrutiny due to dual-use research. That doesn’t mean you can’t do the research -- you just need to make sure you are meeting a checklist.”

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FDA issues draft guidance on nano-food

Maggie Fox, National Journal — Fri, 20 Apr 2012 16:00:00 -0400

The Food and Drug Administration on Friday issued new draft guidance on how food and cosmetic makers can get approval for products that use nanotechnology.

Products such as nano-chocolate dusted on to diet foods, microscopic particles of silver used to keep food smelling fresh, and special nano-formulations of vitamins could all have unexpected effects in the body, FDA said -- and the agency will consider the safety of each individually, rather than as a class as a whole.

“We are taking a prudent scientific approach to assess each product on its own merits and to not make broad, general assumptions about the safety of nanotechnology products,” FDA Commissioner Margaret Hamburg said in a statement.

Nano-materials are defined as particles on the nanometer scale (equal to one-billionth of a meter). The tiny size often gives these materials unusual chemical, physical, and biological properties -- sometimes innocuous but sometimes dangerous. Nanoparticles of salt spread on the surface of food can make something taste far saltier than it really is -- good for health – but they might also be inhaled deep into the lung accidentally, having unforeseen effects.

“Evidence suggests that in addition to direct exposure to tissues locally via dermal, inhalation, and oral routes, nano-materials may also become systemically absorbed, creating exposure to other tissues and organs,” FDA says in its guidance.

Nano-materials used in packaging can also seep into food. FDA says it will consider safety issues on a case-by-case basis.

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Court upholds FDA requirement to put graphic warnings on cigarette packs

Maggie Fox, National Journal — Mon, 19 Mar 2012 16:02:00 -0400

A federal appeals court upheld a law on Monday that would force tobacco companies to put prominent, graphic warnings on packs of cigarettes, but it also ruled that the companies should be able to use colorful advertising themselves.

The 6th Circuit Court of Appeals in Cincinnati also upheld a law that lets the Food and Drug Administration ban marketing that might appeal to children and teens, such as sponsorship of events, free samples, and branded hats and t-shirts.

“We affirm the decision of the district court upholding the Family Smoking Prevention and Tobacco Control Act’s restrictions on the marketing of modified-risk tobacco products; bans on event sponsorship, branding nontobacco merchandise, and free sampling; and the requirement that tobacco manufacturers reserve significant packaging space for textual health warnings,” U.S. Circuit Judges Eric Clay, Jane Branstetter Stranch, and Michael Barrett wrote.

The court also ruled that FDA can make cigarette companies feature big, graphic warnings on packs, with Clay, who wrote the ruling, also dissenting from that piece.

“Where I part with the majority is on what I consider to be a constitutional flaw in the requirement for color graphic warning labels,” Clay wrote, calling the requirement unprecedented and designed to create a visceral reaction rather than to inform.

“Although the government has demonstrated that an information deficit still exists among potential tobacco consumers, which may render warning-less tobacco products inherently deceptive, it has not adequately shown that the inclusion of color graphic warning labels is a properly or reasonably tailored response to address that harm,” Clay wrote.

Last month, U.S. District Judge Richard Leon sided with tobacco companies who sued FDA, saying the agency had no right to require new, graphic pictures on cigarette packages.

Advocates say they hope a Washington appeals court will take the Cincinnati ruling into consideration next month when the Obama administration argues its appeal of Leon’s decision. “We hope it influences their decision and the D.C. Circuit overturns Leon's decision,” said Mary Rouvelas, senior counsel for the American Cancer Society Cancer Action Network.

Four of the five largest tobacco companies filed suit in August against the law requiring the labels and imposing other restrictions, saying the requirements violate their right to free speech.

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Former FDA chief leads push to reform his old agency

Maggie Fox, National Journal — Tue, 14 Feb 2012 16:11:00 -0500

The right-leaning Manhattan Institute launched a new initiative on Tuesday to push for reform at the Food and Drug Administration, in part by speeding drug reviews. The think tank, which advocates for free-market policies, named former FDA commissioner Dr. Andrew von Eschenbach to chair the project.

Eschenbach, also a former director of the National Cancer Institute, immediately called on Congress to “remake—not merely tweak” FDA.

“Over the years, Congress has repeatedly expanded the FDA's responsibilities, and today the agency monitors products that account for 25 cents of every dollar in U.S. consumer spending—including tobacco, the food supply, cosmetics, and drugs ranging from aspirin to the latest biotech medicines for patients and pets,” he writes in a commentary in The Wall Street Journal.

“It has not ensured that the agency is keeping pace with the enormous scientific advances made since the human genome was decoded in 2000. Congress and the Obama administration need to make that a priority.”

Legislation that has drug and device makers pay FDA to review their products—money that makes up a big hunk of the agency’s funding—is currently under review on the Hill for renewal.

“This presents a rare opportunity to examine the FDA's overall needs and performance,” Eschenbach wrote. “Congress should not only set the fees and add resources for the agency but also modernize it from the bottom up.”

For instance, Eschenbach said trials of a new approach called regenerative medicine could and should go ahead in paying patients—in place of current standard practice in which labs test experimental drugs and procedures in volunteers first for safety and then in two stages to show whether they work.

“Instead, after proof of concept and safety testing, the product could be approved for marketing with every eligible patient entered in a registry so the company and the FDA can establish efficacy through post-market studies,” Eschenbach suggests.

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NASA launches mission to Mars

Maggie Fox — Mon, 28 Nov 2011 00:00:00 -0500

The Atlas V rocket carrying the Mars Science Laboratory lifted off right on time from Cape Canaveral, Fla., shortly after 10 a.m. After achieving Earth orbit a second burst from the upper stage pushed it out of orbit and onto its 352-million-mile trajectory to Mars.

It will take the spacecraft nine months to reach Mars and if all goes well, the car-sized Curiosity rover will be parachuted to the planet's surface next August.

NASA has been struggling to keep its budget and define its relevance with the end of the space shuttle program this past summer. It escaped big cuts in the latest round of appropriations in Congress but is under pressure to perform.

The space agency is relying on public-private partnerships such as this one, with United Launch Alliance.

Curiosity is much larger than the spectacularly successful rovers Spirit and Opportunity, which crept around the surface of Mars for years longer than planned. Spirit was declared dead in May after lasting six years.

"It will go longer. It will discover more than we could ever possibly imagine," Colleen Hartman, assistant associate administrator, NASA Science Mission Directorate, told a news conference earlier this week.

"Mars really is the Bermuda triangle of the solar system. It is the death planet. And the United States is the only nation in the world that has landed and driven robot explorers on the surface of Mars."

The one-ton rover has a robotic arm, a drill, video cameras and other equipment for collecting and analyzing rocks and soil in search of evidence of past or present life.

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Obama nominates new Medicare chief

Maggie Fox — Wed, 23 Nov 2011 00:00:00 -0500

Obama sidestepped the traditional confirmation process in July 2010 to make a recess appointment of Berwick.

Tavenner, Berwick's principal deputy, was the Virginia secretary of health and human resources.

"Before entering government service, Ms. Tavenner spent nearly 35 years working with healthcare providers in significantly increasing levels of responsibility, including almost 20 years in nursing, 3 years as a hospital CEO and 10 years in various senior executive level positions for Hospital Corporation of America (HCA)," the White House said in a statement.

"She has served as a board member of the American Hospital Association and as president of the Virginia Hospital Association. Ms. Tavenner holds a B.S. in nursing and an M.A. in health administration, both from the Virginia Commonwealth University."

Since his nomination in April 2010, Republicans have been critical of Berwick, due in part to statements he has made that seemingly favor the idea of holding back some medical treatments as a means to slow down rising health care costs.

In March, 42 Republican senators wrote President Obama requesting that he withdraw Berwick's nomination.

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White House pushes FDA-strengthening legislation to blunt impact of drug shortages

Maggie Fox — Mon, 31 Oct 2011 00:00:00 -0400

The White House also asked the Justice Department to work with FDA to make sure the shortages aren't leading to price gouging.

"The shortage of prescription drugs drives up costs, leaves consumers vulnerable to price gouging, and threatens our health and safety," President Obama said in a statement. "This is a problem we can't wait to fix. That's why today I am directing my administration to take steps to protect consumers from drug shortages, and I'm committed to working with Congress and industry to keep tackling this problem going forward."

Health and Human Services Secretary Kathleen Sebelius admitted that the order didn't have much clout and urged Congress to hurry up with the legislation. "We don't have a lot of teeth in terms of enforcement," she told reporters on a conference call. "We were hoping that by this point, Congress would have acted."

Joint bills to give FDA more clout to prevent drug shortages have been introduced: S. 296 sponsored by Sen. Amy Klobuchar, D-Minn., and H.R. 2245 by Rep. Diana DeGette, D-Colo. Both have bipartisan support and no real opposition.

The executive order directs FDA to broaden reporting of potential shortages of certain prescription drugs and to speed up work to prevent or respond to shortages. FDA Commissioner Dr. Peggy Hamburg said even a little more notice can help the agency ensure that hospitals and clinics that need the drugs the most get them.

Hamburg said the order would raise the number of FDA staff working directly on the issue from five to 11.

"While FDA successfully prevented 137 drug shortages between Jan. 1, 2010 and Sept. 26, 2011, prescription drug shortages continue to threaten the health and safety of the American people," the White House said in a statement.

"These shortages could lead to price gouging, which has raised serious concerns. For example, the ranking member of the House Committee on Oversight and Government Reforms, when announcing his investigation into so-called gray markets, expressed concerns about a report that a leukemia drug whose typical contract price is about $12 per vial was being sold at $990 per vial - 80 times higher," the White House statement said.

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Fewer people driving drunk, CDC finds

Maggie Fox — Wed, 05 Oct 2011 00:00:00 -0400

That said, an estimated 4 million U.S. adults admitted to driving drunk at least once in 2010, the CDC found.

"In fact, nearly 11,000 people are killed every year in crashes that involve an alcohol-impaired driver," CDC Director Thomas Frieden said in a statement.

The CDC team used a national survey to find drinking and driving, not surprisingly, carries an element of deliberate risk taking. Young men and people who fail to use seat belts are also more likely to drink and drive, the CDC found.

The survey found that men were responsible for 81 percent of drinking and driving in 2010 -- especially young men aged 21 to 34.

But there was good news. "Since 2006, self-reported alcohol-impaired driving episodes have declined 30 percent, reaching a low of an estimated 112 million episodes in 2010," the CDC report reads. It gives two possible reasons -- people may not be driving as much because of the poor economy, or perhaps people are drinking more at home.

Because fewer people are drinking and driving, fewer are dying as a consequence. "Alcohol-impaired driving fatalities declined 20 percent from 13,491 to 10,839 from 2006 to 2009, the most recent year for which fatality data are available," the CDC said. But road deaths are down overall, so drunk driving accounts for about a third of these deaths, the same as before.

The CDC supports using sobriety checkpoints, minimum age drinking laws, and ignition locks to help prevent drunk driving.

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Rare virus catches CDC's eye

Maggie Fox — Fri, 30 Sep 2011 00:00:00 -0400

The virus has been around for decades, but for some reason it's been causing clusters of serious illness over the past three years, the national Centers for Disease Control and Prevention reports.

Three people, two in the Philippines and one in Japan, died from an HEV68 outbreak during 2008-2010, CDC and other scientists report in this week's newsletter on illness and death. There were also several clusters of the virus outbreak in the United States that sent batches of patients to the hospital, including in Georgia, Pennsylvania, and Arizona.

"HEV68 is not new, but clusters involving large numbers of people with this virus are a recent phenomenon. This may be due in part to improved respiratory diagnostics; however, long-term surveillance at some sites showed that HEV68 was an unusual cause of respiratory illness in other years," according to the CDC report.

"First isolated in California in 1962 from four children with bronchiolitis and pneumonia, HEV68 has been reported rarely since that time and the full spectrum of illness that it can cause is unknown."

Doctors need to be aware of the virus, the CDC said, and report any clusters of unexplained respiratory illness. Telltale symptoms may include sudden wheezing and worsening of asthma, CDC said.

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Cancer report urges better funding for NIH

Maggie Fox — Tue, 20 Sep 2011 00:00:00 -0400

The 85-page report paints a picture of success that could be jeopardized if the momentum isn't maintained, and outlines many of the advances made since President Nixon signed the 1971 National Cancer Act.

"Unfortunately, the declining NIH and NCI (National Cancer Institute) budgets are creating an environment where researchers face numerous disincentives to continue or even enter into research careers in the first place," the report from the American Association for Cancer Research reads. "These disincentives are resulting in a loss of taxpayer-funded training and are adversely affecting the nation's ability to maintain an optimal workforce for cancer research and to generate innovative scientific ideas for future implementation."

The report, signed by AACR immediate past president and Nobel Prize-winner Elizabeth Blackburn of the University of California San Francisco, AACR President Dr. Judy Garber of Harvard Medical School and the Dana-Farber Cancer Institute, and two dozen other cancer researchers, says the NIH has lost 13 percent of its purchasing power over 8 years because of flat funding and inflation.

"In order to fulfill the extraordinary scientific and medical promise of cancer and biomedical research, the AACR respectfully recommends that Congress provide the NIH and NCI with annual budget increases of at least 5 percent above the biomedical inflation rate," the report reads. "This level of sustained support will enable the future scientific advances needed to seize today's scientific momentum, capitalize on prior investments in cancer research, save countless lives, and spur innovation and economic prosperity for our country and all of our citizens."

The report makes the case that strong funding has paid off big. "We now understand in detail that cancer is complex at every level - ranging from populations to the very genes and molecules that drive a patient's cancer," it says. "It is, in fact, not a single disease, but more than 200 diseases - all of which have different causes and require different treatments."

Better screening has helped patients survive because their tumors can be treated at an earlier stage. "As a result, the 5-year survival rates for cervical, breast, and prostate cancers are well over 90 percent, and mortality due to colorectal cancer continues to decline," the report noted. "As a result of our nation's investments in cancer and biomedical research, about 12 million cancer survivors are alive in the U.S. today, and 15 percent of these cancer survivors were diagnosed 20 or more years ago."

Government and corporate researchers have worked to create a whole new class of targeted drugs, which home in on a tumor's specific mutations and kill cancer cells without causing the unpleasant and often deadly side effects of old-fashioned chemotherapy and radiation.

"There are now 32 Food and Drug Administration-approved drugs that target tumor cells with far fewer side effects. For example, the drug imatinib (Gleevec), which targets a specific chromosomal defect found in 95 percent of all chronic myelogenous leukemia (CML) patients, has transformed this disease from a death sentence into a chronic condition with a 5-year survival of 95 percent," the report says.

Death rates from cancer plummeted by 22 percent for men between 1990 and 2007, and by 14 percent for women. "Today, more than 68 percent of adults are living 5 or more years after initial diagnosis, up from 50 percent in 1975," it adds. Yet half of all men and one-third of all U.S. women will be diagnosed with cancer at some point, and it remains the No. 2 killer of Americans, after heart disease, taking 570,000 lives every year. "It is no wonder that a cancer diagnosis remains the worst fear of Americans as determined by an AACR survey conducted in 2000," the report concludes.

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Studies find higher cancer rates in 9/11 rescuers

Maggie Fox — Fri, 02 Sep 2011 00:00:00 -0400

But so far, anyway, they are no more likely to die sooner than the average person of similar age and background, a third study found.

The studies are certain to add to the debate over long-term health effects from the collapse of the twin World Trade Center towers, which sent a cloud of dust and ash over much of lower Manhattan.

"Over 50,000 workers were exposed while responding to the World Trade Center incident, attempting to rescue survivors and recover the dead, clearing the site, or cleaning the surrounding buildings," James Melius of the Laborers' Health Fund in Albany wrote in a commentary published alongside the Lancet studies.

"These workers were exposed to an incompletely characterized mix of asbestos, alkaline cement dust, pulverized building materials, and fire smoke for many days and weeks, often without proper protection," Melius wrote. "Hundreds of these people are disabled and can no longer work, and thousands have become ill and continue to receive medical treatment nearly 10 years after 9/11."

For the study on cancer, the New York City Fire Department's chief medical officer, Dr. David Prezant, and colleagues at Yeshiva University and Montefiore Medical Center studied more than 9,800 male firefighters. Those who worked at the World Trade Center site were 19 percent more likely to have cancer than colleagues who didn't go to the site, they found.

They found 263 cases of cancer in the men who went to the World Trade Center. In a normal population of men of similar age and background, 238 cases would be expected. The findings are notable because firefighters generally have lower rates of cancer than the general population, probably because they are fit, healthy, and less likely to smoke.

The firefighters were especially likely to have been diagnosed with melanoma, thyroid cancer, prostate cancer, and non-Hodgkin's lymphoma.

"An association between ... World Trade Center exposure and cancer is biologically plausible, because some contaminants in the WTC dust, such as polycyclic aromatic hydrocarbons, polychlorinated biphenyls, and dioxins, are known carcinogens," Prezant's team wrote. "Continued follow-up will be important and should include cancer screening and prevention strategies."

Melius added: "The study also comes at an important time for the federally funded medical follow-up of these workers, which has just been guaranteed for the next 5 years. This medical program does not currently cover cancer treatment."

In a second study, data from 27,000 first-responders and cleanup workers show high rates of asthma, sinus infections, and inflammation and gastrooesophageal reflux disease, or GERD. More than 40 percent of the men had reduced lung function nine years after the attcks, Dr. Juan Wisnivesky of the Mount Sinai School of Medicine and colleagues reported.

Nine years into the study, 28 percent of the workers had asthma, 42 percent had sinusitis, and 39 percent had GERD. "Inhalation of toxic, highly alkaline dust is the probable cause of upper- and lower-respiratory injury in rescue and recovery workers," Wisnivesky and colleagues wrote.

This compares to a rate of about 10 percent of asthma and sinusitis and 6 percent for GERD in the men before the attacks.

Among police, rates for depression grew from 1.7 percent a year after the attacks to 7 percent by year nine. Rates of post-traumatic stress disorder rose from 2.5 percent the first year to 9.3 percent of police officers involved in rescue and recovery nine years later. Rates were higher for other rescue workers; depression rates more than doubled, from 10.8 percent the first year to 27.5 percent the ninth year.

"Our findings show a substantial burden of persistent physical and mental disorders in rescue and recovery workers who rushed to the site of the WTC and labored there for weeks and months 10 years ago. Many of these individuals now suffer from multiple health problems," Wisnivesky's team wrote.

The good news is that death rates have not risen for these workers.

But death rates are higher for people exposed to the dust who were not involved in the rescue or recovery efforts, found Dr. Hannah Jordan, Dr. Steven Stellman, and colleagues at the New York City Department of Health and Mental Hygiene.

"Among World Trade Center Health Registry participants residing in New York City, overall death rates in 2003-09 were not higher than expected when compared to the general New York City population," they wote.

"However, within the cohort, non-rescue and non-recovery participants with high levels of WTC-related exposure had an increased risk of all-cause mortality and heart-disease-related mortality compared with those with low exposure. Continued monitoring of all-cause mortality and disease-specific mortality will be needed."

The administrations of then-President George W. Bush and then-New York City Mayor Rudolph Giuliani were both accused at the time of downplaying the health risks of the debris and dust. "The air quality is safe and acceptable," Giuliani said weeks after the attacks.

In November 2001, Giuliani suggested to Congress that New York's liability for any World Trade Center-related illnesses be limited to $350 million. First-responders and others have sued the city, saying firefighters, police, and rescue workers were not issued proper face ventilators to protect them from toxic dust.

In March 2010, U.S. District Judge Alvin Hellerstein rejected a legal settlement that would have given at least $575 million to people sickened by ash and dust from the attacks, saying the deal shortchanged 10,000 Ground Zero workers whom he called heroes. "In my judgment, this settlement is not enough," he said at the time.

In November, plaintiffs accepted a $625 million settlement. In December, the Democratic-led Senate passed a 9/11 Health Bill providing $1.8 billion until 2015 to monitor and treat injuries caused by toxic dust and debris, but Republicans blocked it and proposed a less-costly version.

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After 9/11, anthrax attacks seemed too natural

Maggie Fox — Thu, 01 Sep 2011 00:00:00 -0400

Powdered doughnuts. A coffee table. Rolled-up dollar bills. Dead birds. Disposable underpants.

The suspect samples rolled in and public health officials, some working literally in converted closets, worked day and night to test them. The anthrax attacks that followed Sept. 11 tested the limits of the U.S. public health system and changed for a decade the way Americans looked at the mail carrier.

In the days that followed the Sept. 11 attacks, many bioterrorism experts wondered the same thing - was a biological attack next? For years, these specialists had met, talking about the potential threat of smallpox, nerve gas, plague and Ebola virus. But the No. 1 suspect always was anthrax.

Bioweapons seem like an obvious choice for a terror attack. Powdered anthrax spores released, say, from a small plane could infect hundreds of thousands of people, who wouldn't know until it was almost too late. Anthrax, a type of bacteria found naturally in the soil, is easily treated with antibiotics. But it grows spores that can settle deep in the lungs and by the time they cause symptoms, it is almost always too late to save the victim.

Biological weapons are difficult to trace, and Iraq, Russia, and many other countries were known to have biological weapons programs. The United States had its own program for a while, closed by President Nixon in the late 1960s. The shuttered "anthrax tower" remained standing in 2001 at Fort Detrick, Md., outside Washington.

Powdered anthrax sent through the mail in September and October of 2001 ended up infecting at least 22 Americans and killing five. It was a fitting follow-up to Sept. 11. -- almost too perfect, in fact. As it turned out, the FBI fingered one of the very experts who had been warning of the threat for years. A motive was never discovered, but the suspect, Bruce Ivins, had a history of mental disturbances and ended up committing suicide in 2008 as federal investigators closed in.

In a review of the response to the attacks released on Thursday by the Trust for America's Health and the Robert Wood Johnson Foundation, public health officials recount some of what they had to deal with in the weeks and months following the attacks.

Lab technicians ran more than a million tests on 125,000 samples. "We realized there was no cavalry coming to sort things out. We would have to manage most of this ourselves," emergency physician Dan Hanfling, special adviser on emergency preparedness and disaster response to the Inova Health System, said in the report.

News organizations and congressional offices were targeted by the anthrax letters. Thousands of Hill workers took antibiotics for weeks on end to prevent infection. Anthrax spores can stay dormant in the lungs for months, and the only way to prevent them from becoming quietly but fatally active is to take drugs continuously. Mail rooms around the country were closed as each letter took on an ominous aspect.

"On October 12, 2001, we received our first anthrax laden letter which was mailed to the office of NBC News here in NYC," Sara Beatrice of the New York City Public Health Laboratory said in the report. "The ensuing investigation and media coverage resulted in our Public Health Laboratory receiving thousands of clinical specimens and environmental samples for testing… coffee tables from a department store, suitcases from the airport, dollar bills that had been rolled up, you name it."

"Here was a typical scenario: A jittery and unnerved town resident would discover 'suspicious' white powder in his community," recalled Howard Koh, now the Health and Human Services assistant secretary for health. "Immediate notification of the local police or fire department would trigger both the closing of the local post office and the sudden arrival of HAZMAT teams, bedecked in imposing space-suit paraphernalia.

"A hastily arranged press conference would feature harried state and local officials trying to explain the unfolding developments to an increasingly anxious public. And when testing in the laboratory subsequently yielded negative results for anthrax, that finding would prompt yet another round of news announcements as well. Multiply this situation by several thousand -- and that was the fall of 2001 in our state, and indeed, around the country."

Anything the least suspicious-looking was sent to hapless state and local public health offices for examination.

"The types of environmental samples received were variable to say the least. From the obvious bulk mail from post offices, suspicious mail from homeowners and powder samples (including powdered doughnuts), to the more obscure airline seat covers, dead birds, body bags, teddy bears, disposable underpants, a Marilyn Monroe effigy and residential mail boxes together with post and concrete anchor.... each presented a new challenge," recounted Phil Lee of the Florida Department of Health.

The attacks did mean that public health labs, badly neglected for decades, got a boost in funding. Congress increased biological warfare-related funding at the National Institute of Allergy and Infectious Diseases by $1.5 billion in 2003. The Project Bioshield Act, which provided $5.6 billion over 10 years to buy new vaccines and drugs, was passed in 2004.

States began stockpiling "biological countermeasures" from latex gloves to face masks. "Cipro" -- short for ciprofloxacin, the most effective antibiotic for treating anthrax -- entered the common vernacular. An embarrassed Centers for Disease Control and Prevention was forced to explain why mostly white congressional staffers got weeks of cipro while mostly black D.C. postal workers whose workplace ended up being contaminated got no such protections. Two D.C. postal workers -- Thomas Morris Jr. and Joseph Curseen -- died.

The FBI estimates it cost $1 billion to clean up the mess. The anthrax spores got into the equipment used to sort and process mail. It took more than two years and cost $130 million to clean up the Brentwood center in Washington where Morris and Curseen worked. The Environmental Protection Agency spent $41.7 million to clean up government buildings in Washington, including Senate office buildings.

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NASA to work with Colorado company on launch rocket

Maggie Fox — Mon, 18 Jul 2011 00:00:00 -0400

NASA and the United Launch Alliance announced a formal agreement on Monday to look at using the giant Atlas V rocket to send astronauts into space as a commercial venture. The U.S. government officially ended its role in directly sending astronauts into orbit earlier this month with the final launch of a space shuttle. It is scheduled to land Thursday. NASA will contract out launches from now on - for the next few years, to the Russians, but later to U.S. commercial companies. "Having ULA on board may speed the development of a commercial crew transportation system for the International Space Station, allowing NASA to concentrate its resources on exploring beyond low Earth orbit," NASA Administrator Charles Bolden said in a statement. The United Launch Alliance hopes that its Atlas V rockets will carry the new launch vehicles, the cone-shaped capsules known as multipurpose crew vehicles or MPCVs -- unofficially, Orion -- made by Lockheed Martin. "This program will develop the capability to deliver U.S. astronauts to the International Space Station," George Sowers of the United Launch Alliance told reporters on a conference call. "We feel strongly that the U.S. aerospace industry is capable of developing and delivering this capability affordably and safely." The unfunded agreement calls for NASA to consult with ULA on how to make the rocket into a safe and reliable launch vehicle. Last month, NASA's Office of Inspector General asked the space agency to do a better job telling contractors what it needs. NASA already uses Atlas Vs for some of its highest-profile projects, including the upcoming Juno mission to Jupiter, scheduled to launch August 5. "The next step for Atlas is to launch humans," Sowers said. The end of the shuttle program has cost thousands of jobs. Contractors to the Kennedy Space Center on the coast of central Florida have announced 7,000 layoffs this year. ULA employs 1,700 people in Centennial, Colorado.

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Shuttle crew loading space station

Maggie Fox — Mon, 11 Jul 2011 00:00:00 -0400

Atlantis, which tooks off for its final journey into orbit Friday, has docked with the International Space Station and its four crew are busy loading 9,000 pounds of supplies and equipment onto the station.

The shuttle is scheduled to stay in orbit for 12 or 13 days -- NASA wants to extend the mission if possible -- getting the space station fixed up. Most of the cargo is in a module called Raffaelo.

"The 21-foot long, 15-foot diameter Raffaello is packed with 9,403 pounds of spare parts, spare equipment, and other supplies -- including 2,677 pounds of food -- that will sustain space station operations for a year," NASA said ina statement.

The shuttle program is being retired after 30 years. NASA has been contracting out human space travel to private, U.S. companies. Until they can finish a new system for getting people into space, NASA will rely on Russian missions to get astronauts to and from the space station.

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Last shuttle mission takes off

Maggie Fox — Fri, 08 Jul 2011 00:00:00 -0400

KENNEDY SPACE CENTER, Florida -- The space shuttle Atlantis lifted into orbit on Friday morning despite the threat of thunderstorms.

The four astronauts aboard are the last to ride the shuttle into space. NASA is retiring the 30-year-old program's reuseable spacecraft after this mission; the two other remaining shuttles -- Endeavour and Discovery -- have already been retired.

The shuttle shot into orbit, boosted with liquid and solid fuel rockets generating 7 million pounds of thrust. The astronauts are carrying scientific equipment and supplies to the International Space Station.

The United States will now rely on Russian Space Agency missions to carry astronauts to the International Space Station. NASA is working on its next generation of equipment to take men and women into space -- the Multi-Purpose Crew Vehicle, also known as Orion. The cone-shaped capsule will sit on the head of a rocket and can comfortably carry four astronauts and equipment. It is designed to be safe and, unlike the shuttle, cannot be guided back to Earth. It will splash down in the water like the earlier Apollo missions and as Russian missions now do.

Space shuttles were originally designed to be big space trucks, cheaply and efficiently carrying cargo and astronauts into space and then gliding back to Earth to be used over and over again. But costs quickly ballooned over early estimates, and the loss of two shuttles -- Columbia in 2003 and Challenger in 1986 -- made many Americans wonder if the vehicles were worth the risk.

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NASA IG: Commercial partners don't quite copy

Maggie Fox — Fri, 01 Jul 2011 00:00:00 -0400

NASA is well on its way to kick-starting a commercial space industry to get people in and out of orbit, but needs to clarify requirements to commercial developers, deal with potential conflicts of interest better and cooperate more with the Federal Aviation Administration, the space agency's inspector general said on Thursday.

The last space shuttle launch is scheduled for next week; after that, the United States must rely on Russia to get astronauts to the International Space Station and back to Earth again. NASA needs to work fast to fill this void, space agency Inspector General Paul Martin said in his report released on Thursday.

"NASA faces an imperative to nurture development of a U.S. commercial transportation service to reestablish the nation's ability to access low Earth orbit and the Space Station as soon as possible," Martin wrote.

"While NASA has over 50 years of experience with contractor-built, government-owned space vehicles, the agency has never procured transportation for its astronauts aboard a commercially developed vehicle. Of primary concern in this new paradigm is how the agency will work with its commercial partners to ensure that commercially developed vehicles meet NASA's safety and human-rating requirements," the report states.

Martin said NASA is making good progress but faces some challenges. For instance, the space agency issued health and medical, engineering, and safety and mission-assurance requirements for contractors in December.

"However, NASA has not finalized the processes Agency officials will use to verify that commercial partners have met these requirements and subsequently certify that a commercial partner's vehicle can safely transport NASA personnel," the report reads.

Other communications could be better, too, Martin suggests. "Specifically, NASA should clearly articulate to its commercial partners as soon as possible all requirements for commercially developed systems and the processes NASA will use for certifying such systems," he wrote.

He also suggests "robust communication with the emerging commercial spaceflight industry" to make sure NASA has enough oversight. And the agency needs to resolve some potential conflicts of interest with the FAA over regulating flight, he said.

"Finally, NASA must consider whether to continue purchasing additional seats on the Russian Soyuz vehicle as a contingency to possible delays in obtaining commercial crew transportation," Martin wrote.

"Currently, NASA has purchased seats on the Soyuz vehicle to ensure continued U.S. access to the Space Station through June 2016. Because of the long lead-time required for procuring Soyuz seats and planning a mission to the Space Station, NASA would have to make the decision to purchase additional seats in 2013, approximately 3 years before commercial systems are expected to be ready," the IG report says.

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FDA releases new warning labels for cigarette packages

Maggie Fox — Tue, 21 Jun 2011 00:00:00 -0400

The Food and Drug Administration released new warning labels for cigarette packages on Tuesday morning, with photographs showing a dead body after an autopsy, a man exhaling smoke through a tracheostomy, and other images of health problems meant to deter smokers.

Tobacco companies have until next year to put them on all packs of cigarettes.

"These new warning labels have the potential to encourage adults to give up their deadly addiction to cigarettes and deter children from starting in the first place," John Seffrin, CEO of the American Cancer Society, said in a statement.

"With 4,100 kids picking up their first cigarette every day, and the vast majority of adult smokers starting as youth, these new graphic warning labels will help educate children and adults about the dangers of smoking from the moment they pick up a pack of cigarettes or see a cigarette ad," Seffrin said.

"These warnings mark the first change in cigarette warnings in more than 25 years and are a significant advancement in communicating the dangers of smoking," the FDA said in a statement.

The FDA proposed the new labels in February and settled on nine pictures to illustrate nine separate warnings, including: "Tobacco use can rapidly lead to the development of nicotine addiction, which in turn increases the frequency of tobacco use and prevents people from quitting. Research suggests that nicotine is as addictive as heroin, cocaine, or alcohol."

One illustration shows a cartoon image of a premature baby, with the caption, "Warning: Smoking during pregnancy can harm your baby." Another shows the damaged teeth and gums of a smoker.

"We found in the past in research that we conducted... that in particular, the picture with the mouth, with the teeth, communicates the message more effectively," Roswell Park Cancer Institute behavioral scientist Maansi Bansal-Travers, who tested the warnings and others in several countries, told National Journal.

Bansal-Travers said testing has shown the pictures draw attention to the written warnings and people are more likely to remember them. "Pictures really do communicate better than words," she said.

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Space shuttle Endeavour makes its final landing

Sara Sorcher and Maggie Fox — Wed, 01 Jun 2011 00:00:00 -0400

Endeavour and its crew of six landed for the last time early Wednesday morning, completing their 16-day mission to outfit the International Space Station.

At 2:35 a.m., shuttle commander Mark Kelly touched down on a brightly lit landing strip at the Kennedy Space Center. Kelly left behind his wife, Rep. Gabrielle Giffords, D-Ariz., who has been rehabilitating since she was shot in the head by an attacker in Tucson in January. The two will reunite on Thursday in Houston, according to the Associated Press.

It is the last mission for Endeavour and the second-to-the-last for the U.S. space shuttle program, which will end after the Atlantis mission scheduled for July. The Endeavour is headed to the California Science Center in Los Angeles.

"Your landing ends a vibrant legacy for this amazing vehicle that will long be remembered," Mission Control told Kelly and his crewmates, according to the AP. "It's sad to see her land for the last time," Kelly replied, "but she really has a great legacy."

Since its first mission on May 7, 1992, the Endeavour spent 299 days in space and traveled more than 122.8 million miles during its 25 flights, NASA said in a statement.

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Space shuttle Endeavour gets set to attempt its final landing

Maggie Fox — Tue, 31 May 2011 00:00:00 -0400

The space shuttle Endeavour is scheduled to land for the last time on Wednesday after a 16-day mission to outfit the International Space Station.

It is the last mission for Endeavour and the second-to-the-last for the U.S. space-shuttle program, which will end after the Atlantis mission scheduled for July.

Endeavour's mission was special for many Americans, as shuttle commander Mark Kelly left behind his wife, Arizona Rep. Gabrielle Giffords , D-Ariz., who has been rehabilitating since she was shot in the head by an attacker in Tucson in January.

"If Endeavour lands Wednesday, it will have spent 299 days in space and traveled more than 122.8 million miles during its 25 flights. It launched on its first mission on May 7, 1992," NASA said of the craft in a statement.

The landing opportunities for the shuttle at NASA's Kennedy Space Center in Florida will be at 2:35 a.m. and 4:11 a.m. "If the shuttle is unable to return Wednesday, additional opportunities are available on Thursday at Kennedy and at backup landing site Edwards Air Force Base in California," NASA said.

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NASA scrubs shuttle launch due to engineering problem

Maggie Fox and Josh Smith — Fri, 29 Apr 2011 00:00:00 -0400

NASA scrubbed the last scheduled launch of the space shuttle Endeavour on Friday, citing problems with failed heaters. Astronauts on buses heading to the shuttle turned around mid-route.

The next possible launch date is Sunday. Commander Mark Kelly, husband of injured Rep. Gabrielle Giffords, D-Ariz., was leading the mission and Giffords was scheduled to watch the launch, along with President Obama and his family.

Space shuttle launches are often delayed and re-scheduled.

The shuttle is loaded with a $2 billion particle physics detector that will seek out antimatter and dark energy across the universe. Many in and outside NASA say the experiment, if successful, could validate science operations at the decade-old orbiting lab.

As many as 750,000 people were expected to crowd nearby coastal communities for the liftoff, the Associated Press reported. The very last shuttle mission is scheduled for June 28. After that, the United States will rely on Russian spacecraft to get astronauts in and out of orbit.

The Kennedy Space Center was groaning with 45,000 guests, including more than three dozen members of Congress, at least two former NASA administrators, and a score of high-level academic and space industry officials.

President Obama, who was touring tornado-struck Alabama, had not yet arrived.

NASA is ending the shuttle program this summer, after the last trip by Atlantis. Obama is pushing private space initiatives and encouraging robotic scientific mission.

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