Boy, that's a pretty big jump. The new numbers include deaths indirectly caused by flu complications like pneumonia:

Swine flu has killed nearly 4,000 people in the US, including 540 children, officials said after devising a new counting method.

The Centers for Disease Control and Prevention (CDC) said the new system is based on more precise figures provided by 10 states.

The previous estimated death toll from the H1N1 virus in the US was 672.

Latest figures show about 22 million Americans contracted the virus in six months with some 98,000 hospitalised.

"This is just the first six months and I am expecting all of these numbers, unfortunately, to continue to rise," said Dr Anne Schuchat of the CDC.

She said that, although still imprecise, the new statistics provide "a bigger picture of what has been going on in the first six months of the pandemic".

The CDC now estimates that 3,900 people in the US have died from the virus in the past six months.

Dr Schuchat said that in children under 18, an estimated eight million have had swine flu, with 36,000 hospitalised and 540 deaths.

The new estimated death toll for children is four times higher than the previous estimate.

"We will be updating the toll that the pandemic has taken... about every three to four weeks," she said.

Yeah, they need to fix this bill. But this is a good idea that deserves support, and shouldn't leave the decision to offer sick leave for swine flu in the hands of the employer. (We all know how shaky that can be.) What's wrong with simply requiring a doctor's note?

With H1N1 flu fears spreading as fast as the sickness itself, a leading House Democrat wants rapid action on legislation that would give employees five paid sick days.

But in rushing out the measure on Tuesday, November 3, Rep. George Miller, D-California and chairman of the House Education and Labor Committee, roiled paid leave advocates who worry that he gives employers too much power to determine who can stay home.

The author of broader paid sick leave legislation, Rep. Rosa DeLauro, D-Connecticut, is not on board.

“I am concerned that the Miller bill —while a modest step forward — would establish a limp paid leave benefit that is triggered by the employer and can also be taken away by the employer; and it offers no real guarantee that a working parent can care for a sick child,” DeLauro said in a statement Thursday, November 4, to Workforce Management.

DeLauro added that she “can work with Chairman Miller to make it a better bill.”

The House labor committee will hold a hearing on Miller’s measure, the Emergency Influenza Containment Act, the week of November 16. It’s unclear when or if a companion Senate bill will be introduced.

President Barack Obama declared the H1N1 pandemic — popularly known as swine flu — a national emergency on October 24.

Miller caught some in the advocacy community and on Capitol Hill by surprise with his proposal, which would guarantee five paid sick days to an employee if an employer “directs” or “advises” him or her to go home. The employer can end the leave at any time.

“Sick workers advised to stay home by their employers shouldn’t have to choose between their livelihood and their co-workers’ or customers’ health,” Miller said in a statement.

He asserts that at least 50 million workers lack paid sick leave.

The bill applies to companies with 15 or more employees but exempts those that already offer at least five days of sick leave.

DeLauro’s bill, the Healthy Families Act, would allow workers to accrue up to seven days of paid sick leave a year and gives them time off to care for sick family members.

They're released data from the earliest cases of swine flu deaths, showing that people over 50 who were admitted to the hospital were likelier to die. This has a different curve from seasonal flu deaths, where adult deaths are typically people over 80:

An analysis of more than 1,000 California patients hospitalized with H1N1 flu during the first four months of the pandemic found that infants were most likely to be admitted, and patients 50 and older were most likely to die once admitted.

In the first four months of the pandemic, H1N1, like the seasonal flu, was especially severe in older people, who are more likely to have underlying health conditions, says lead author Janice Louie, a public-health medical officer at the California Department of Public Health.

However, Louie says, unlike seasonal flu, older people are far less likely than children and young adults to contract the H1N1 flu in the first place. For that reason, the study won't lead the Centers for Disease Control and Prevention to add healthy older people to the list of priority groups for H1N1 vaccine, director Thomas Frieden told reporters Tuesday.

Of 1,088 patients hospitalized with H1N1 flu in California, 11%, or 118 patients, died, and 30%, or 340 patients, were admitted to intensive-care units, Louie and her co-authors report in today's Journal of the American Medical Association. In patients 50 and older, the death rate was up to 20%, compared with about 2% in hospitalized patients under age 18.

The study focuses on patients who were hospitalized between April 23 and Aug. 11. Whether H1N1, or swine flu, will eventually mutate and cause more severe illness is not yet known, Louie says: "Influenza is pretty unpredictable."

Nearly a third of all the hospitalized patients in her study were reported to have no underlying conditions, such as lung disease, associated with an increased risk of flu complications.

But a disproportionate number of them were obese, an observation that also has been made in other countries, the authors write. Obesity doesn't appear to be a risk factor for seasonal flu.

Of the 361 patients whose body mass index – or BMI, a number based on height and weight – was known, half were obese, and half of those patients were morbidly obese, defined as having a BMI over 39, or roughly 100 pounds overweight.

If this mutates into a more virulent flu, we're in trouble - because we just don't have enough ventilators to treat a major pandemic:

A new government study shows that one quarter of Americans who were sick enough to be hospitalized with swine flu last spring wound up needing intensive care, and 7% of them died.

Health experts say that is a little higher than with ordinary seasonal flu. They say the biggest difference is that nearly half of those hospitalized with the new swine flu have been children and teens. Flu usually strikes hardest in the elderly.

The U.S. Centers for Disease Control and Prevention did the study, with local and state health departments. Results were published online Thursday by the New England Journal of Medicine.

Researchers identified 272 patients hospitalized for at least a day from April through mid-June, when the novel virus caused its first wave of cases. That's about one-fourth of the total hospitalizations for swine flu reported during that time, but researchers only studied lab-confirmed cases and patients who agreed to be part of the study.

Three-fourths of these patients had other health problems, such as diabetes — typical of seasonal flu, too. However, only 5% were 65 and older; ordinary seasonal flu usually hits hardest in the elderly.

We're already seeing problems in other countries:

Oct. 9 (Bloomberg) -- Swine flu drove a 15-fold increase in intensive care admissions for viral lung inflammation in Australia and New Zealand, especially among pregnant women, the obese and people with chronic lung disease, a study found.

During the peak of severe illness, patients with the new H1N1 influenza strain filled 8.9 percent to 19 percent of all intensive-care hospital beds in each state of Australia and New Zealand, according to the study published yesterday in the New England Journal of Medicine. Almost 65 percent of intensive-care H1N1 patients required mechanical ventilation.

The Southern Hemisphere’s winter flu season, studied from June 1 to Aug. 31, may give health officials in the Northern Hemisphere an indication of what to expect in coming months, the researchers said yesterday. The pandemic filled all available beds in some units and prompted doctors to postpone nonessential surgery, New Zealand’s health ministry said in July.

Widespread? Yeah, I think I'm coming down with it myself. (I drove my son to the doctor the other day and had to sit in a tiny room with a flu victim who kept coughing into a soggy tissue.) And the nurse practitioner I saw today wouldn't give me a prescription for Tamiflu because I wasn't sick enough - yet:

Influenza is widespread in most of the United States, with the incidence continuing to increase in some states and to decline very slightly in others, the director of the federal Centers for Disease Control and Prevention said Tuesday. The infections are "overwhelmingly" pandemic H1N1 influenza, commonly known as swine flu.

The flu season generally lasts well into May, so many months of uncertainties lie ahead, said Dr. Thomas R. Frieden, speaking at a morning news conference.

Shipments of intranasal swine flu vaccines to providers have begun, and vaccinations began Monday in several states, with a priority for healthcare providers and young children. About 2.4 million doses of the intranasal vaccine FluMist are now available, and states have already ordered 2.2 million doses, Frieden said. Next week, an injectable vaccine will also become available.

So far, vaccine "demand is outstripping supply, but we expect that fairly soon supply will be outstripping demand." Over the next two to three weeks, he added, tens of millions of additional doses will become available.

There have already been some mismatches between supply and demand, Frieden said. "The first couple of weeks are going to be a bit bumpy as we get the supply chain worked out. What we are seeing now is the tap beginning to flow."

Frieden said that the public has three major concerns about vaccination "despite the clear message that vaccine is the best tool to protect against the flu":

* First, he said, many people believe the flu is a mild illness. It is not. "It can make you pretty sick, knock you out for a day or two or three," Frieden said. It can even put people in the hospital or kill them. In a typical flu season, about 35,000 Americans die from complications.

* Second, some people believe that the vaccine is not safe, that corners have been cut in its production, and that it is a new, experimental vaccine. "In fact, none of that is the case," he said. "It is made the same way the flu vaccine is made each year, in the same facilities and by the same companies." And that seasonal vaccine, he added, has "been used safely in hundreds of millions of people. My children will get it [the swine flu vaccine], other public health and societal leaders will get it and have their families get it."

* Third is the concern that the vaccine is arriving too late to do much good. "It's too soon to say it is too late," Frieden said, because no one knows what is going to happen for the rest of the flu season. Even if, say, 5% of the population has contracted swine flu, that still leaves 95% vulnerable. "We don't know what the long flu season is going to hold. We have not had a flu season like this in 50 years" -- since the 1957 Asian flu pandemic that killed 70,000 Americans and 2 million people worldwide.

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One of the most significant and troubling manifestations of the real extremism of the "Patriot"/militia movement of the 1990s was the sharp spike in threats against local officials from the law-enforcement system -- particularly judges. There was practically a pandemic of threats against judges in the interior West (particularly Montana).

The threats were a direct outgrowth of the Patriot movement's ardent adoption of the concept of "sovereign citizenship" -- the fantasy belief system built around the idea that the federal government was a run by a secret cabal that for decades had usurped public power for their own nefarious purposes, and so by filing the proper kind of "constitutionalist" documents, one could declare oneself a "sovereign" who was not subject to the restraints of federal laws, including paying taxes and observing land-use ordinances.

This belief system originated with the old Posse Comitatus organization, a racist and radical movement that originated in the 1960s and whose followers had a long record of extreme violence. In the 1990s it was promoted most notably by the Montana Freemen -- but after they began to fade earlier this decade, so did the threats against judges.

Now, that trend is rapidly reversing:

According to the U.S. Marshals Service, the number of threats against federal judges and prosecutors has mushroomed from 500 in 2003 to 1,278 in 2008. It is on track to go even higher this year. There are no statistics on the number of threats against state and local judges.

The problem was examined in some detail last week in the Washington Post:

The threats and other harassing communications against federal court personnel have more than doubled in the past six years, from 592 to 1,278, according to the U.S. Marshals Service. Worried federal officials blame disgruntled defendants whose anger is fueled by the Internet; terrorism and gang cases that bring more violent offenders into federal court; frustration at the economic crisis; and the rise of the "sovereign citizen" movement -- a loose collection of tax protesters, white supremacists and others who don't respect federal authority.

... Hundreds of threats cascaded into the chambers of John M. Roll, the chief U.S. district judge in Arizona, in February after he allowed a lawsuit filed by illegal immigrants against a rancher to go forward. "They cursed him out, threatened to kill his family, said they'd come and take care of him. They really wanted him dead," said a law enforcement official who heard the calls -- which came from as far as Richmond and Baltimore -- but spoke on condition of anonymity because no one has been charged.

You may recall, in fact, that the man who murdered Dr. George Tiller in Kansas on Sunday was in fact a "Freeman" who had previously filed his own set of "sovereign citizenship" papers. Leonard Zeskind has even more details on this at Huffpo:

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Keith Olbermann, on Countdown last night, brought the whammy down on the wingnut talking heads at Fox (and the rest of the conservative media as well) for their ongoing attempts to blame immigrants for the spread of the swine flu from Mexico:

Well, yes, you are a racist. Exactly how does that apply, though, to the people who the Centers for Disease Control confirmed actually carried the Swine Flu from Mexico to the U.S., a group of Catholic school students from New York City, who spent Spring Break in Cancun. Uncontrolled Catholic immigration, open borders for private school kids reckless?

Anyway, unswayed by the facts, the Republican echo chamber tried to stir the American melting pot with a classic recipe of hate and fear.

(BEGIN VIDEO CLIP)

UNIDENTIFIED FEMALE: I thought that this line, though, was very ironic, this morning in one of the articles I read about surveillance at the Mexican border. You thought we had an immigration problem, well now we might actually want to prevent the sick people from crossing over the border.

UNIDENTIFIED MALE: Chaos in Mexico; from earthquakes to Swine Flu, will it mean more illegals heading for the U.S.

GLENN BECK, FOX NEWS ANCHOR: Does anybody wish maybe we could control the border just a little bit at this point.

SHEPPARD SMITH, FOX NEWS ANCHOR: Everybody is e-mailing, going the illegals are bringing it across the border. Relax.

SEAN HANNITY, FOX NEWS ANCHOR: Tonight, Swine Flu spreads from Mexico to the United States. Is this the latest border crisis.

UNIDENTIFIED MALE: The U.S. is not currently testing travelers from Mexico. But customs officials are wearing protective clothing.

MICHAEL SAVAGE, “THE SAVAGE NATION”: Illegal aliens are carriers of the new strain of Human Swine Avian Flu from Mexico. Is this a terrorist attack?

UNIDENTIFIED MALE: Some, though, say the solution is to close the border.

UNIDENTIFIED MALE: Now talk that we should even close the border?

BECK: If this is so important, why haven‘t we closed the border.

NEAL BOORTZ, “THE NEAL BOORTZ SHOW”: There‘s the bio-terrorism angle. What better way to sneak a virus in this country than to give it to Mexicans.

This kind of talk -- directly associating the targets of a "drive them out" campaign with disease -- is classic eliminationist rhetoric. It's not surprising that it's bubbling up out of Fox News' fetid cauldron, either.

Tom Allison at Media Matters put together a first-round look at some of the ugliness:

-- Savage declaring that Mexicans "are a perfect mule -- perfect mules for bringing this virus into America."

-- Michelle Malkin warning that the pandemic was the product of "uncontrolled immigration."

-- Beck warning that the pandemic will create a crush of people trying to flee north across our border.

And that's just scratching the surface. As Eric Ward at Imagine 2050 observes, some of the nativist right's more inflammatory figures were saying even uglier things.

Writes Nezua at The Sanctuary:

The stances of those who most vocally oppose immigration today are so predictable that one could paint a face on a septic-tainted soccer ball and paste up word balloons and rest well, knowing that The Nativist Lobby point of view on any immigration-related topic will end in "deport them all" and "seal the borders" if not "round them up" and other tired ideas. And nobody reading now needs a reminder of how throughout time, both Latin America as well as all immigrants have been slurred and painted with the brush of disease by those resistant to changing demographics.

The NCLR's blog points out that this fearmongering has real life-and-death consequences:

It's unfortunate, then, that certain individuals with an obvious axe to grind are shamelessly exploiting a public health emergency for their own purposes. It's not surprising that some are implying that all immigrants are a threat to our health-that's standard fare on the hate group circuit.

Ironically, the very act of attempting to demonize and stigmatize entire groups, and even entire countries, is likely to impede these and other critical steps that the authorities are taking to protect all Americans from the spread of the flu, for example:

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I presume one of the things officials want to buy are more respirators, which will be very important if there's a pandemic:

More evidence of the global spread of a deadly flu emerged Tuesday, with new cases reported on four continents and a growing number of people in the U.S. requiring hospital treatment.

Health authorities said they have found possible cases of the new strain of A/H1N1 swine flu in the Middle East and Asia.

In the U.S., the number of confirmed cases rose to 66, including five people in California and Texas being treated at hospitals, according to the Centers for Disease Control and Prevention and state health departments.

The new data indicated the strain was causing more severe illness in the U.S. than originally seen; only one of the first 40 confirmed cases had to be hospitalized. President Barack Obama on Tuesday asked Congress for $1.5 billion in additional funds to fight the epidemic, and lawmakers convened for a hearing to evaluate measures taken so far.

Many of the people confirmed with the swine flu outside Mexico were infected on trips to the country, officials said.

There also is evidence of transmission in the U.S.

Officials said 45 people got sick at St. Francis Preparatory School in the New York City borough of Queens after students returned from a trip to Mexico. The 45 ill include several students, staff and relatives who didn't go to Mexico but who may have caught the virus from those who did.

Mayor Michael Bloomberg said Tuesday that it was likely additional students had contracted the virus at St. Francis, a private Catholic school with 2,700 students. Hundreds of students, as well as staff, became sick with flu-like symptoms. The city decided against further testing to instead focus its investigation on new clusters of the virus.

the daily green: Swine flu, factory pig farms and the pandemic waiting to happen

Group News Blog: A Vietnam veteran reflects and writes: "It's easy to tell yourself that 'it's not my job or my business,' or, 'It's more important to move forward, this isn't the time for looking back.' I always have to look back.  Too much of what I see I don't like. We cannot afford to make our national memory like mine."

Blue Gal: Structural Damage vs. Clutter

Lexington's notebook: The living dead...they walk among us

Southern Beale: Karl Rove Memory Hole

OFF THE BEATEN PATH: Unsolved: Mr. E's Blog Stump, The Progressive, Morning Martini, Sick Days