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WASHINGTON, D.C. – It’s a convergence of two health crises: the ongoing coronavirus pandemic and a new flu season now underway.“There’s not much flu in the northern hemisphere in the summer - but there is a lot in the southern hemisphere,” said Dr. Amesh Adalja, a senior scholar at the Johns Hopkins Center for Health Security and an infectious disease critical care and emergency medicine physician.Dr. Adalja said health care professionals have observed the flu in places like Australia and New Zealand during the past several months, which could offer clues into what might be expected here as our weather gets colder.“The southern hemisphere has had a remarkable flu season mostly because it's 99% lower than what they've seen in prior years,” Dr. Adalja said. “This has to do with the fact that the social distancing that people are doing for COVID-19 also has an impact on influenza because they're both spread in the same manner.”However, the U.S. has failed to control the spread of the coronavirus, leading to fears that the country might be facing a “twindemic,” where COVID-19 and the flu collide.The one silver lining: less international travel around the world may make it harder for the flu to spread globally like it has in years past.“The point we have to continue to emphasize is we don't know for sure if we'll have a light flu season and we have to prepare for one that's severe,” Dr. Adalja said.So far, the coronavirus has killed more than 210,000 people in the U.S. this year. According to the Centers for Disease Control, that’s more than the previous five flu seasons combined.Estimated flu season deaths:2015-16: 23,0002016-17: 38,0002017-18: 61,0002018-19: 34,0002019-20: 22,000Total 2015-2020: 178,000Still, any uptick in hospitalizations because of the flu could further strain hospitals already dealing with COVID-19. One region of concern is the upper Midwest, in places like Wisconsin, which is a current coronavirus hotspot."It is stretching our hospital capacity, and it is overwhelming our public health infrastructure,” said Andrea Palm of the Wisconsin Department of Health Services.One step that could help is to ensure everyone gets a flu shot, even if it doesn’t end up being a perfect match to this year’s strain.“Even if it isn't a complete match and it doesn't prevent you from getting the flu, it still will prevent you from dying from influenza and getting hospitalized with influenza or getting complications from influenza,” Dr. Adalja said.It is also now one of the few tools available in a time of great uncertainty. 2573

WASHINGTON (AP) — The White House said Wednesday it does not favor an immigration agreement with Congress that would involve extending protections for young immigrants for three years in exchange for three years of border wall funding.Deputy press secretary Raj Shah said the administration continues to negotiate an immigration overhaul that would address the Obama-era Deferred Action for Childhood Arrivals program that protects young immigrants from deportation, while also stopping illegal immigration and modernizing the legal immigration system.Two Republican officials briefed on the talks said the so-called "three-for-three" proposal had been floated in staff-level discussions in recent days.The officials spoke on condition of anonymity because they weren't authorized to speak publicly. The discussions were first reported by The Washington Post, which said the idea was being discussed as part of an upcoming spending bill.President Donald Trump has proposed a path to citizenship for about 1.8 million immigrants brought to the U.S. illegally as children in exchange for billion for a border wall with Mexico and other security measures, along with curbing legal immigration. Many Democrats have opposed the proposals.Trump visited the U.S.-Mexico border Tuesday to see prototypes of the barrier that he wants built. Calls to build the wall — a rallying cry of his presidential campaign — and Trump's insistence that Mexico pay for it have led to a coarsening in ties between the U.S. and its southern neighbor.Trump ended the Obama program last September, saying he believed DACA was unconstitutional. Trump pledged to work with Democrats and Republicans to protect the young immigrants, often referred to as Dreamers, from deportation. At one point he promised to accept whatever bipartisan proposal was brought to him, but negotiations broke down after Trump used offensive language to describe some countries in a meeting with lawmakers.The Department of Homeland Security is under a court order to maintain the DACA protections while supporters of the program challenge Trump's decision to end it. 2129

WASHINGTON (AP) — U.S. officials say the Pentagon is developing plans to withdraw up to half of the 14,000 American troops serving in Afghanistan, marking a sharp change in the Trump administration's policy aimed at forcing the Taliban to the peace table after more than 17 years of war.One official says the troops could be out by summer, but no final decision has been made.President Donald Trump has long pressed to pull troops out of Afghanistan, but was persuaded by Defense Secretary Jim Mattis and others to keep them there to pressure the Taliban and battle a stubborn Islamic State insurgency.Officials say the latest White House push for withdrawal was another key factor in Mattis' decision to resign Thursday.The officials spoke on condition of anonymity to discuss internal deliberations. 809

We're now LIVE! ??Watch all the nominations excitement unfold! #GRAMMYshttps://t.co/Ii7azHHMln https://t.co/jXm96YmJin— Recording Academy / GRAMMYs (@RecordingAcad) November 24, 2020 190

WASHINGTON (AP) — The actual crisis of the coronavirus pandemic and a manufactured crisis over voting fraud featured heavily in President Donald Trump's misstatements during the 2020 campaign's final week. Democrat Joe Biden went astray on trade as he assailed the president's record on China.Straining to make the pandemic look less dire than it is, Trump baselessly alleged that the death count is inflated by instances of doctors falsifying the cause of death. He produced no evidence of that, and there is strong contrary evidence that the death toll attributed to COVID-19 actually understates how many Americans are dying from it.A sampling of political rhetoric from the week:TRUMP: "You know, our doctors get more money if somebody dies from COVID. You know that right? I mean, our doctors are very smart people. So what they do is they say, 'I'm sorry, but, you know, everybody dies of COVID.'" — rally Friday in Waterford Township, Michigan.THE FACTS: No, the virus death count has not been overstated because of doctors lying to get more money. No evidence has emerged of such systemic fraud.Almost 230,000 deaths from COVID-19 have been confirmed as of Saturday. The true number is almost certainly higher by a considerable margin.As of Oct. 3, the Centers for Disease Control and Prevention counted 299,000 more U.S. deaths than would be expected in a normal year. Some of those deaths are sure to have been from COVID-19 — how many cannot be known.It's true that hospitals may get higher reimbursement from the government to treat COVID-19 patients. Hospitals were given a 20% add-on for Medicare patients who test positive for the virus to cover the additional costs of treating the disease, such as buying supplies. The higher reimbursements are based on a COVID-19 diagnosis, not on the cause of death as Trump stated.The Healthcare Financial Management Association, which works with hospitals on billing matters, says providers must support COVID-19 billing with test results or a physician's statement. The organization says hospitals expect to be audited for this billing and know that Medicare cheaters may have to pay back three times what they overcharged or even lose access to Medicaid patients.Susan R. Bailey, president of the American Medical Association, said Trump's allegation of COVID-19 overcounting, which he has made several times, "is a malicious, outrageous, and completely misguided charge."___VIRUSTRUMP: "In California, you have a special mask. You cannot under any circumstances take it off. You have to eat through the mask." — Arizona rally on Wednesday.THE FACTS: Those statements are false.California residents are not required to wear "special" masks nor are they required to wear them all the time and "eat through the mask."Gov. Gavin Newsom's statewide mask order allows Californians to wear basic coverings such as homemade ones and people are not required to wear them when at home, outdoors more than 6 feet from others, or when eating and drinking.His office this month did tweet out a graphic advising people to "keep your mask on in between bites" when going out to eat at restaurants. That was mocked because Californians were also advised to minimize the number of times they touch their masks. Newsom told reporters that one of his staffers had sent out the tweet, which the governor said was intended to indicate that if people start to read a book at the table, they may want to put their mask back on.___TRUMP: "We have a spike in cases ... And you know why we have so many cases? Because we test more." — Michigan rally Tuesday.THE FACTS: No, increased testing does not fully account for the rise in recorded cases, and Trump is contradicted by his own top health officials. People are also infecting each other more than before as distancing rules recede, some shun masks and community spread picks up.Adm. Brett Giroir, the Health and Human Services Department official overseeing the nation's coronavirus testing efforts, stressed anew that the increases can't be explained by just additional testing."We do believe and the data show that cases are going up," Giroir told NBC's "Today" show on Wednesday. "Yes, we're getting more cases identified, but the cases are actually going up. And we know that, too, because hospitalizations are going up."More testing actually does not mean more infections at all; people are getting sick regardless of whether their illness is recorded. More testing can help prevent the disease's spread by letting people know COVID-19 is rising in their area.Practically every state is now seeing a rise in cases. The virus has now killed over 228,000 in the U.S., according to the count kept by Johns Hopkins University.Giroir warned that local governments may be forced to take "draconian measures" if Americans don't take safety precautions seriously. "Cases will go up if we don't make a change," he said.___TRADEBIDEN, comparing Trump's record on trade with that of the Obama administration: "We have a trade deficit that's larger with China than when we were there." – interview on "60 Minutes," Oct. 25.THE FACTS: Biden's claim is outdated and no longer true. The U.S. deficit in the trade of goods and services with China fell last year to 8 billion — the lowest since 2013 — as Trump slapped taxes on most Chinese imports to the United States. And the gap is down again so far this year.In the first two years of the Trump presidency, however, the United States ran higher trade deficits with China — 0 billion in 2018 and 7 billion in 2017 — than any recorded during the Obama administration. The deficit was 0 billion in 2016, the last year of the Obama presidency.___2020 ELECTIONTRUMP: "It would be very, very proper and very nice if a winner were declared on November third, instead of counting ballots for two weeks, which is totally inappropriate and I don't believe that that's by our laws." — remarks to reporters Tuesday.THE FACTS: "Our laws" don't require the immediate reporting of all election results in the country on election night. Delayed counting is unavoidable.Apart from the usual lags in rounding up and reporting totals from every precinct in the country, the U.S. is seeing unprecedented numbers of early votes, and some battleground states won't even start counting them until Election Day votes have been tallied.Indeed, the Supreme Court is allowing Pennsylvania to count mailed ballots that are not even received by elections officials for three days after the election, as long as there's no evidence that such ballots were filled out after Nov. 3. The decision isn't final: Justices left open the possibility of reviewing the matter after the election.The court is also allowing absentee ballots in North Carolina to be received and counted up to nine days after Election Day.Earlier in the campaign, Trump asserted that the winner should be declared on election night, another outcome no one can guarantee and one that may elude the country Tuesday. There is no requirement that the winner is determined on Election Day.He once raised the question of delaying the election, then dropped the thought, but has persisted in groundless allegations that the election is certain to be plagued by fraud.___TRUMP: "Strongly Trending (Google) since immediately after the second debate is CAN I CHANGE MY VOTE? This refers to changing it to me. The answer in most states is YES. Go do it. Most important Election of your life!" — tweet Tuesday.THE FACTS: Not so fast. Some states allow voters to switch their early vote, but laws vary and many have restrictions.Minnesota, for instance, allows voters to "clawback" their vote and change it, but the deadline for that has passed. Wisconsin allows people to change their vote up to three times, though it doesn't happen often. Florida allows voters who received mail ballots to choose to vote in person instead, but they cannot vote more than once.If a voter has already sent his or her mail-in ballot and then goes to vote in person, "the (mail) ballot is deemed cast and the voter to have voted," according to Florida law.David Becker of the Center for Election Innovation said changing a vote in states where that is possible is "extremely rare" and very complicated."It's hard enough to get people to vote once — it's highly unlikely anybody will go through this process twice," he said.Trump's suggestion that he did so well in the debate that people who already voted for Biden wished they could switch to him is not borne out by the search engine's statistics.Google searches for "change my vote" did not crack the top 20 searches that night or after. Jill Biden was the subject of Google's 20th most popular search that day. On Friday, the new "Borat" movie, presidential polls, and college football were among the subjects drawing the top 20 attention.___TRUMP: "Big problems and discrepancies with Mail-In Ballots all over the USA." — tweet Monday.THE FACTS: No, the catastrophe Trump has warned darkly about for months in mail-in voting has not materialized.There have been sporadic reports of voters receiving mail ballots that were incorrectly formatted and other localized hitches in the record early turnout, but large-scale disenfranchisement has not been seen.Trump has conspiratorially inflated local incidents, contending, for example, that mail-in ballots filled out for him are being dumped in rivers or creeks. This is a fabrication.Three trays of mail were found by the side of a road and in a ditch — not a river or creek — in Greenville, Wisconsin, in mid-September. The sheriff initially said "several absentee ballots" were in the mix. The state's elections officer later said no Wisconsin ballots were in the lost mail after all. No one said ballots marked for Trump were thrown out in the incident.Trump's motive for challenging votes by mail is plain: Democrats are dominating that segment of voting. Registered Democrats have also outnumbered registered Republicans in early voting in person at polling places, though the gap is narrower than with mailed ballots.In short, Trump may need supporters to show up in huge numbers Tuesday if not before, and his baseless allegations of early-voting irregularities are designed to motivate them to do so as well as to portray the result as illegitimate if Biden wins.___VOTING FRAUDTRUMP, suggesting that Nevada's Democratic Gov. Steve Sisolak will add fraudulent votes: "We're worried about the governor. ... Some of these people, in Nevada, they want to have the election. They want to have the count weeks after November 3rd. So let's all wait for the governor to count them up good, and how many is he going to add during that two weeks, right?" — Arizona rally Wednesday.TRUMP, on Pennsylvania's Democratic Gov. Tom Wolf: "The governor counts the ballots. ... This is the guy that's counting our ballots? It doesn't work. It doesn't work." — remarks Monday in Pennsylvania.THE FACTS: To be clear, governors don't count the votes, and they can't just manufacture votes in the election.Local county officials in Pennsylvania send out the ballots and count the votes. The state's top elections official is Secretary of State Kathy Boockvar, a Wolf appointee.In Nevada, Sisolak has been a target of Trump's ire after Sisolak in September criticized Trump's indoor rally in a Las Vegas suburb for violating the state's large-scale ban on indoor gatherings. But Sisolak doesn't tally the votes himself, and Trump makes a baseless assertion that he can add fraudulent votes to the count.Nevada's secretary of state oversees that state's new all-mail election. That office is held by Barbara Cegavske and she is a Republican.___TRUMP: "In Nevada, they want to have a thing where you don't have to have any verification of the signature." -- New Hampshire rally Oct. 25.THE FACTS: Not true, despite his frequent assertions to the contrary. The state's existing law requires signature checks on mail ballots. A new law also spells out a process by which election officials are to check a signature against the one in government records.In Nevada's June primary, nearly 7,000 ballots were thrown out due to mismatched or missing signatures.___TRUMP: "I say the biggest risk we have are the fake ballots." — New Hampshire rally.THE FACTS: His claim, frequently made in the last days before the election, is overblown.It's true that many states are expecting a surge in mail-in voting because of the coronavirus pandemic, which may lead to longer times in vote counting. The Supreme Court, for instance, will allow Pennsylvania to count mailed-in ballots received up to three days after the election; it also will allow North Carolina to count votes received nine days after the election so long as ballots are postmarked by Nov. 3.But there is no evidence to indicate that massive fraud is afoot. Any delay in declaring a winner of the presidential race after Tuesday would not in itself be illegal.Broadly speaking, voter fraud has proved exceedingly rare. The Brennan Center for Justice in 2017 ranked the risk of ballot fraud at 0.00004% to 0.0009%, based on studies of past elections.In the five states that regularly send ballots to all voters who have registered, there have been no major cases of fraud or difficulty counting the votes.Even if the election is messy and contested in court, the country will have a president in January — and not have vote counting going on "forever" as he asserts — because the Constitution and federal law ensure it. 13516