Abandoning Afghanistan a bad idea

U.S. Marines from the 3rd Battalion 8th Marines Regiment start their patrol in Helmand Province on June 27.

STORY HIGHLIGHTS

• White House aide suggested all U.S. troops could be withdrawn from Afghanistan


• Peter Bergen said the idea would be dangerous and send the wrong message


• He says U.S. has abandoned Afghanistan before and saw the rise of the Taliban


• Bergen: U.S. is seeking agreement that military will have immunity from prosecution

Editor's note: Peter Bergen is CNN's national security analyst and the author of "Manhunt: The Ten-Year Search for bin Laden, from 9/11 to Abbottabad."

(CNN) -- Afghan President Hamid Karzai will meet with President Barack Obama on Friday to discuss the post-2014 American presence in Afghanistan.

The U.S. military has already given Obama options under which as few as 6,000 or as many as 20,000 soldiers would remain in Afghanistan after 2014. Those forces would work as advisers to the Afghan army and mount special operations raids against the Taliban and al Qaeda.

Read more: U.S. may remove all troops from Afghanistan after 2014

Peter Bergen

But on Tuesday, Ben Rhodes, the White House's deputy national security adviser, told reporters that the Obama administration is mulling the idea of removing all U.S. troops from Afghanistan after the NATO combat mission finishes at the end of 2014.

This may be a negotiating ploy by the Obama administration as it gets down to some hard bargaining with Karzai, who has long criticized many aspects of the U.S. military presence and who is likely to be reluctant to accede to a key American demand: That any U.S. soldiers who remain in Afghanistan after 2014 retain immunity from prosecution in the dysfunctional Afghan court system. It was this issue that led the U.S. to pull all its troops out of Iraq in December, 2011 after failing to negotiate an agreement with the Nuri al-Maliki government.

Read more: Defense officials to press Karzai on what he needs

Or this may represent the real views of those in the Obama administration who have long called for a much-reduced U.S. presence in Afghanistan, and it is also in keeping with the emerging Obama doctrine of attacking al Qaeda and its allies with drones but no American boots on the ground. And it certainly aligns with the view of most Americans, only around a quarter of whom now support the war in Afghanistan, according to a poll taken in September.

Security Clearance: Afghanistan options emerge

In any case, zeroing out U.S. troop levels in the post-2014 Afghanistan is a bad idea on its face -- and even raising this concept publicly is maladroit strategic messaging to Afghanistan and the region writ large.

Why so? Afghans well remember something that most Americans have forgotten.

After the Soviet Union withdrew from Afghanistan, something that was accomplished at the cost of more than a million Afghan lives and billions of dollars of U.S. aid, the United States closed its embassy in Afghanistan in 1989 during the George H. W. Bush administration and then zeroed out aid to one of the poorest countries in the world under the Clinton administration. It essentially turned its back on Afghans once they had served their purpose of dealing a deathblow to the Soviets.

As a result, the United States had virtually no understanding of the subsequent vacuum in Afghanistan into which eventually stepped the Taliban, who rose to power in the mid-1990s. The Taliban granted shelter to Osama bin Laden and his al Qaeda organization from 1996 onward.

Read more: Court considers demand that U.S. release photos of bin Laden's body

After the overthrow of the Taliban, a form of this mistake was made again by the George W. Bush administration, which had an ideological disdain for nation building and was distracted by the Iraq War, so that in the first years after the fall of the Taliban, only a few thousand U.S. soldiers were stationed in Afghanistan.

The relatively small number of American boots on the ground in Afghanistan helped to create a vacuum of security in the country, which the Taliban would deftly exploit, so that by 2007, they once again posed a significant military threat in Afghanistan.

In 2009, Obama ordered a surge of 30,000 troops into Afghanistan to blunt the Taliban's gathering momentum, which it has certainly accomplished.

Read more: Inside the Taliban

But when Obama announced the new troops of the Afghan surge, most media accounts of the speech seized on the fact that the president also said that some of those troops would be coming home in July 2011.

This had the unintended effect of signaling to the Taliban that the U.S. was pulling out of Afghanistan reasonably soon and fit into the longstanding narrative that many Afghans have that the U.S. will abandon them again.

Similarly, the current public discussion of zero U.S. troop presence in Afghanistan after 2014 will encourage those hardliner elements of the Taliban who have no interest in a negotiated settlement and believe they can simply wait the Americans out.

It also discourages the many millions of Afghans who see a longtime U.S. presence as the best guarantor that the Taliban won't come back in any meaningful way and also an important element in dissuading powerful neighbors such as Pakistan from interference in Afghanistan's internal affairs.

Read related: Afghanistan vet finds a new way to serve

Instead of publicly discussing the zero option on troops in Afghanistan after 2014, a much smarter American messaging strategy for the country and the region would be to emphasize that the Strategic Partnership Agreement that the United States has already negotiated with Afghanistan last year guarantees that the U.S. will have some form of partnership with the Afghans until 2024.

In this messaging strategy, the point should be made that the exact size of the American troop presence after 2014 is less important than the fact that U.S. soldiers will stay in the country for many years, with Afghan consent, as a guarantor of Afghanistan's stability.

The United States continues to station thousands of troops in South Korea more than five decades after the end of the Korean War. Under this American security umbrella, South Korea has gone from being one of the poorest countries in the world to one of the richest.

It is this kind of model that most Afghans want and the U.S. needs to provide so Afghanistan doesn't revert to the kind of chaos that beset it in the mid-1990s and from which the Taliban first emerged.

Read more: What's at stake for Afghan women?

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Chavez not in coma, responding well to treatment: brother

CARACAS Ailing Venezuelan President Hugo Chavez is not in a coma and is responding well to cancer treatment in Cuba, making daily progress, his brother said Saturday.

"Reports that the president is in a coma and that the family is discussing ending life support, are totally false," Adan Chavez, governor of the state of Barinas, said in a statement.

He "continues to respond well to his medical care and to make daily progress in his recovery."

Chavez has been out of public sight since undergoing surgery in Havana on December 11, the fourth such operation in the 18 months since his condition was made public.

Officials have said the fiery leftist leader is suffering from a severe pulmonary infection that has resulted in a "respiratory insufficiency," fueling speculation about his prospects for a full recovery -- and his political future.

The uncertainty surrounding Chavez's condition has rattled Venezuela, the nation with the world's largest proven oil reserves.

The government was forced to postpone the president's scheduled inauguration Thursday, as it became clear that he could not attend. Authorities insist the country's constitution allows Chavez to take the oath of office later on.

But the opposition has cried foul, calling for a medical board to review the absent leader's health -- a demand rejected by the Supreme Court, which said the delayed swearing-in was constitutional.

In Cuba on Saturday, President Raul Castro voiced his support for the Venezuelan leadership, his government's closest and most critical economic and political ally.

Castro made the comments during a meeting with Venezuelan Vice President Nicolas Maduro, who arrived in the Cuban capital late Friday to check on his ailing boss, who had a difficult fourth round of cancer surgery last month.

Raul Castro "expressed his confidence in the ability of the Venezuelan people and their institutions to address and overcome any challenge," a government statement said.

"Raul and Maduro shared their mutual satisfaction with the emotional demonstration of support for Venezuela and President Chavez on January 10 in Caracas," it added.

Two Chavez allies, Argentine President Cristina Kirchner and Peruvian President Ollanta Humala, also arrived in Havana on Friday.

"We all hope for a quick recovery," Humala said.

Kirchner refused to comment on Chavez's health when asked by reporters, saying it should be left to his family. She did, however, thank retired revolutionary icon Fidel Castro, 86, for hosting a luncheon for her in his home Friday.

Like Chavez, Castro has been sidelined by health problems and rarely appears in public since stepping aside as president of the communist country in 2006.

Throughout his illness, first detected in June 2011, Chavez -- in power for 14 years -- has refused to relinquish the powers of the presidency, even when leaving for Cuba for his latest surgery.

The Venezuelan constitution says new elections must be held within 30 days if the president-elect or president dies or is permanently incapacitated, either before he takes office or in the first four years of his six-year term.

-AFP/ac

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Making job stress worth enduring

Defense Secretary Leon Panetta swears in reenlisting troops in Turkey. A survey found that military jobs tend to be the most stressful.

STORY HIGHLIGHTS

• Marci Alboher: Annual list of most stressful jobs drew attention


• She says the right issue is whether job rewards compensate for stress


• People who take on stressful jobs that help others report satisfaction, she says

Editor's note: Marci Alboher, is a Vice President of Encore.org, a nonprofit making it easier for people to pursue second acts for the greater good. Her latest book is, "The Encore Career Handbook: How to Make a Difference and a Living in the Second Half of Life" (Workman: January 2013).

(CNN) -- A recent study with a catchy headline about the most stressful jobs of 2013 found its way to the soft hour of news this week.

The annual study by careercast.com created some buzz in the online water cooler and I was asked to appear on the "Today" show to talk about it. Colleagues e-mailed me and posted on my Facebook page about where their chosen professions ranked. My media friends couldn't help noticing that public relations professionals, reporters and photojournalists all made it into the top 10 for stress.

The "study," referred to in quotes in some of the commentary, considered some logical criteria to come up with these rankings. Proximity to risk of death (yours or others'), travel, deadlines, working in the public eye and physical demands all racked up points on the stress scale. And there's no arguing that military personnel, firefighters and police officers -- all high-rankers on the most-stressed list -- are exposed to higher stakes than your typical seamstress (holder of the second-least stressful job slot).

Marci Alboher

The job that snagged the "least stressful" slot, according to the survey, was "university professor," a designation that caused outrage among people who actually hold that job. One commenter conceded that most academic jobs don't put you in personal danger (though you can argue that point), but anyone who's ever been around professors knows that faculty politics, difficult students and pressure to "publish or perish" can cause even the most calm character to crack.

We could debate whether these designations make any sense. And whether every police officer, firefighter and member of the military faces the same amount of stress.

But let's make sure we are having the right conversation. How many people choose a profession based on how high the stress level is? And how can you measure stress objectively? If you're prone to stress, perhaps you're just as likely to feel stressed out whether you work as a librarian, a massage therapist or a commercial airline pilot (No. 4 on the stress list).

People choose their line of work for a lot of reasons. For those who are committed to making our communities and the world safer and healthier for the rest of us, minimizing stress is probably not so high on their list of criteria. And it shouldn't be. Folks who choose helping jobs that may have a high level of stress are fueled by other motivators, like wanting their work to have meaning.

They aren't deterred by the fact that their job will likely come with stress. And some people are simply by their own nature and personalities drawn to work that may be to others, dauntingly stressful. How many FBI agents do you think would prefer a gig as an audiologist (sixth-least stressful job)?

When I talk to men and women in their 50s and 60s who've decided to take on encore careers as teachers, they tell me that the work is often exhausting and stressful. They are on their feet all day, often with inadequate resources, with kids who are themselves highly stressed; even those who come from leadership roles in other sectors say they've never worked harder. Yet they almost always tell me that doing something that matters to others -- and that puts them in touch with young people every day -- compensates for the added stress.

The same is true of those tackling some of the world's most intractable problems. When I talk to Stephen and Elizabeth Alderman, whose foundation trains health-care professionals around the world to work with victims of trauma, or Judith Broder, who founded The Soldiers Project, which works with returning veterans, they rarely talk about stress. Instead they talk about how they are compelled to do what they do, because moving the needle even a fraction is better than doing nothing.

Rather than discouraging people to take on jobs that might have a lot of stress, let's instead encourage those who are designed for those jobs to do them. And let's make sure to support our friends and family members who go down these paths.

It's hard to grab headlines in the crowded space of morning television, but a good survey with a catchy title will always do that. So let's use these kinds of surveys to have the right kinds of conversations. Like why so many jobs that keep us safe and healthy, and that care for our children and the environment rarely show up on lists of the most highly compensated jobs. Now there's a conversation I'd most like to be having.

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The opinions expressed in this commentary are solely those of Marci Alboher.

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Treasury: No $1 trillion coin

A Treasury Department spokesman announced today that the department will not mint a platinum coin to sidestep raising the federal government's borrowing limit, telling the Washington Post that "neither the Treasury Department nor the Federal Reserve believes that the law can or should be used to facilitate the production of platinum coins for the purpose of avoiding an increase in the debt limit."

The idea, which had gained traction among some congressional Democrats and political analysts as a way of defanging the debt ceiling as a bargaining chip, was that the Treasury Department could simply mint a platinum coin, declare the value at $1 trillion, and deposit it into the Federal Reserve to allow continued spending in the absence of a vote to raise the debt ceiling.

With the idea now buried by Treasury, the stage is set for a full-on fight about the debt ceiling. President Obama and congressional Democrats have signaled that they simply will not negotiate on a vote to raise the borrowing limit, saying that it is Congress's duty to pay bills it has already accrued.

But congressional Republicans have given every indication that they plan to use the debt limit as a bargaining chip to extract deep spending cuts from reluctant Democrats.

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Poisoned Lottery Winner's Kin Were Suspicious

Urooj Khan had just brought home his $425,000 lottery check when he unexpectedly died the following day. Now, certain members of Khan's family are speaking publicly about the mystery -- and his nephew told ABC News they knew something was not right.

"He was a healthy guy, you know?" said the nephew, Minhaj Khan. "He worked so hard. He was always going about his business and, the thing is: After he won the lottery and the next day later he passes away -- it's awkward. It raises some eyebrows."

The medical examiner initially ruled Urooj Khan, 46, an immigrant from India who owned dry-cleaning businesses in Chicago, died July 20, 2012, of natural causes. But after a family member demanded more tests, authorities in November found a lethal amount of cyanide in his blood, turning the case into a homicide investigation.

"When we found out there was cyanide in his blood after the extensive toxicology reports, we had to believe that ... somebody had to kill him," Minhaj Khan said. "It had to happen, because where can you get cyanide?"

In Photos: Biggest Lotto Jackpot Winners

Authorities could be one step closer to learning what happened to Urooj Khan. A judge Friday approved an order to exhume his body at Rosehill Cemetery in Chicago as early as Thursday to perform further tests.

Lottery Winner Murdered: Widow Questioned By Police Watch Video

Moments after the court hearing, Urooj Khan's sister, Meraj Khan, remembered her brother as the kind of person who would've shared his jackpot with anyone. Speaking at the Cook County Courthouse, she hoped the exhumation would help the investigation.

"It's very hard because I wanted my brother to rest in peace, but then we have to have justice served," she said, according to ABC News station WLS in Chicago. "So if that's what it takes for him to bring justice and peace, then that's what needs to be done."

Khan reportedly did not have a will. With the investigation moving forward, his family is waging a legal fight against his widow, Shabana Ansari, 32, over more than $1 million, including Urooj Khan's lottery winnings, as well as his business and real estate holdings.

Khan's brother filed a petition Wednesday to a judge asking Citibank to release information about Khan's assets to "ultimately ensure" that [Khan's] minor daughter from a prior marriage "receives her proper share."

Ansari may have tried to cash the jackpot check after Khan's death, according to court documents, which also showed Urooj Khan's family is questioning if the couple was ever even legally married.

Ansari, Urooj Khan's second wife, who still works at the couple's dry cleaning business, has insisted they were married legally.

She has told reporters the night before her husband died, she cooked a traditional Indian meal for him and their family, including Khan's daughter and Ansari's father. Not feeling well, Khan retired early, Ansari told the Chicago Sun-Times, falling asleep in a chair, waking up in agony, then collapsing in the middle of the night. She said she called 911.

"It has been an incredibly hard time," she told ABC News earlier this week. "We went from being the happiest the day we got the check. It was the best sleep I've had. And then the next day, everything was gone.

"I am cooperating with the investigation," Ansari told ABC News. "I want the truth to come out."

Ansari has not been named a suspect, but her attorney, Steven Kozicki, said investigators did question her for more than four hours.

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Saudi execution: Brutal and illegal?

STORY HIGHLIGHTS

• Saudi authorities beheaded Rizana Nafeek, a Sri Lankan woman


• She was convicted of killing a baby of the family employing her as a housemaid


• This was despite Nafeek's claims that the baby died in a choking accident


• Becker says her fate "should spotlight the precarious existence of domestic workers"

Jo Becker is the Children's Rights Advocacy Director for Human Rights Watch and author of 'Campaigning for Justice: Human Rights Advocacy in Practice.' Follow Jo Becker on Twitter.

(CNN) -- Rizana Nafeek was a child herself -- 17 years old, according to her birth certificate -- when a four-month-old baby died in her care in Saudi Arabia. She had migrated from Sri Lanka only weeks earlier to be a domestic worker for a Saudi family.

Although Rizana said the baby died in a choking accident, Saudi courts convicted her of murder and sentenced her to death. On Wednesday, the Saudi government carried out the sentence in a gruesome fashion, by beheading Rizana.

Jo Becker

Read more: Outrage over beheading of Sri Lankan woman by Saudi Arabia

Rizana's case was rife with problems from the beginning. A recruitment agency in Sri Lanka knew she was legally too young to migrate, but she had falsified papers to say she was 23. After the baby died, Rizana gave a confession that she said was made under duress -- she later retracted it. She had no lawyer to defend her until after she was sentenced to death and no competent interpreter during her trial. Her sentence violated international law, which prohibits the death penalty for crimes committed before age 18.

Rizana's fate should arouse international outrage. But it should also spotlight the precarious existence of other domestic workers. At least 1.5 million work in Saudi Arabia alone and more than 50 million -- mainly women and girls -- are employed worldwide according to the International Labour Organization (ILO).

Read more: Indonesian maid escapes execution in Saudi Arabia

Again according to the ILO, the number of domestic workers worldwide has grown by more than 50% since the mid-1990s. Many, like Rizana, seek employment in foreign countries where they may be unfamiliar with the language and legal system and have few rights.

When Rizana traveled to Saudi Arabia, for example, she may not have known that many Saudi employers confiscate domestic workers' passports and confine them inside their home, cutting them off from the outside world and sources of help.

It is unlikely that anyone ever told her about Saudi Arabia's flawed criminal justice system or that while many domestic workers find kind employers who treat them well, others are forced to work for months or even years without pay and subjected to physical or sexual abuse.

Passport photo of Rizana Nafeek

Read more: Saudi woman beheaded for 'witchcraft and sorcery'

Conditions for migrant domestic workers in Saudi Arabia are among some of the worst, but domestic workers in other countries rarely enjoy the same rights as other workers. In a new report this week, the International Labour Organization says that nearly 30% of the world's domestic workers are completely excluded from national labor laws. They typically earn only 40% of the average wage of other workers. Forty-five percent aren't even entitled by law to a weekly day off.

Last year, I interviewed young girls in Morocco who worked 12 hours a day, 7 days a week for a fraction of the minimum wage. One girl began working at age 12 and told me: "I don't mind working, but to be beaten and not to have enough food, this is the hardest part."

Many governments have finally begun to recognize the risks and exploitation domestic workers face. During 2012, dozens of countries took action to strengthen protections for domestic workers. Thailand, and Singapore approved measures to give domestic workers a weekly day off, while Venezuela and the Philippines adopted broad laws for domestic workers ensuring a minimum wage, paid holidays, and limits to their working hours. Brazil is amending its constitution to state that domestic workers have all the same rights as other workers. Bahrain codified access to mediation of labor disputes.

Read more: Convicted killer beheaded, put on display in Saudi Arabia

Perhaps most significantly, eight countries acted in 2012 to ratify -- and therefore be legally bound by -- the Domestic Workers Convention, with more poised to follow suit this year. The convention is a groundbreaking treaty adopted in 2011 to guarantee domestic workers the same protections available to other workers, including weekly days off, effective complaints procedures and protection from violence.

The Convention also has specific protections for domestic workers under the age of 18 and provisions for regulating and monitoring recruitment agencies. All governments should ratify the convention.

Many reforms are needed to prevent another tragic case like that of Rizana Nafeek. The obvious one is for Saudi Arabia to stop its use of the death penalty and end its outlier status as one of only three countries worldwide to execute people for crimes committed while a child.

Labor reforms are also critically important. They may have prevented the recruitment of a 17 year old for migration abroad in the first place. And they can protect millions of other domestic workers who labor with precariously few guarantees for their safety and rights.

Read more: Malala, others on front lines in fight for women

The opinions expressed in this commentary are solely those of Jo Becker.

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US mulls aid to French in Mali, including drones

WASHINGTON: The US military is weighing support for French forces in Mali including surveillance drones, a US official said Friday, as Washington backed moves to deny safe haven to extremists in the country.

US commanders were looking at providing intelligence and aerial refueling tankers among a range of options, such as logistical backup and boosting intelligence sharing, which would involve surveillance drones, the official, who spoke on condition of anonymity, told AFP.

Backed by French air power, Mali on Friday unleashed an offensive against Islamist rebels who have seized control of the north of the West African country and are now threatening to push south.

Senior US officials held talks with their counterparts in the French capital and other allies on drawing up an action plan, the official said.

President Francois Hollande confirmed in Paris that French forces were supporting an attack aimed at repelling the Al-Qaeda-linked radicals who have triggered international alarm with moves towards the capital Bamako.

The United States said Friday it shared France's goal of denying the extremists safe haven in Mali.

"We are monitoring the situation closely," National Security Council spokesman Tommy Vietor told AFP.

"We have noted that the government of Mali has asked for support, and we share the French goal of denying terrorists a safe haven in the region."

Hollande gave no indication of the scale of French involvement, but said it would last "for as long as is necessary."

The American military has a network of air bases in Italy, Spain and elsewhere in the region that could provide refueling tankers and other assistance to the French.

Former colonial power France has warned that the Islamist rebels were seeking to transform the vast nation into a "terrorist state."

State Department spokesman Victoria Nuland meanwhile said Washington was "consulting very closely" with the French government on the fighting.

"Obviously we remain deeply concerned by the recent events in Mali. We echo the international community's condemnation of these recent aggressive acts."

Earlier Friday, French Defense Minister Jean-Yves Le Drian briefed his US counterpart Leon Panetta about the situation.

-AFP/ac

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Why death comes sooner in America

A report finds that Americans have "shorter lives and poorer health," coming in last in key areas behind 16 other rich nations

STORY HIGHLIGHTS

• Aaron Carroll: New study shows U.S. health and lifespan worst of 17 rich countries


• He says it's because of personal choices, systemic woes. Poverty high, health care uneven


• He says this particularly affects youth, plagued by sickness, violence, high mortality


• Carroll: Don't make it political. The richest country in the world must improve public health

Editor's note: Dr. Aaron E. Carroll is an associate professor of pediatrics at the Indiana University School of Medicine and the director of the university's Center for Health Policy and Professionalism Research. He blogs about health policy at The Incidental Economist and tweets at @aaronecarroll.

(CNN) -- A just-released report from the Institute of Medicine and National Research Council is making news by clearly illustrating that Americans have "shorter lives and poorer health." This is somewhat shocking, given how much we spend on health care each year — more than any of the 16 other rich countries surveyed in the study. What's even more upsetting is that this report focused quite heavily on people who are young. In the United States, even that group fared poorly.

Aaron Carroll

Why is this?

Some of the reasons involve choices make at a personal level. We eat too much, abuse drugs too often, wear seat belts too rarely and commit violence against each other to often.

Systemic issues are also to blame. We have higher levels of poverty than comparable countries, and our safety net programs are less capable of catching people when they fall. And too many also have too much trouble accessing the health care system, resulting in inefficient, ineffective and often absent care.

It's far too easy to let these dreadful statistics become obscured in a politically charged argument. Let's avoid that. This report is so stark that it's going to take a concerted effort on the part of the government, the media, the health care system and everyday citizens to turn things around. Our personal choices are bad. Our safety nets are bad. Our health care system is bad. It's all bad. How bad?

When compared with peer countries, the United States was the absolute worst with respect to still births, infant mortality and low birth weight. Some have tried to blame this on "coding" differences. In other words, they will claim that other countries will refuse to define a premature birth as we do, resulting in artificially high numbers in the United States. But when this report recalculated the rates to exclude such births equally in all countries, we still ranked last.

Things don't get better after birth. The chance that a child in the United States will die before age 5 is higher than in any of the other 16 peer countries. Injuries are the most common cause of death, but the United States also has the highest rate of deaths caused by negligence or abuse.

And violence is decidedly an American problem. Homicide is the third most common cause of death in children age 1-4.

From age 5-19, the trend continues. Kids this age in the United States have the worst health ranking of the 17 studied countries. More than one-third of U.S. children age 5-17 are obese or overweight, the highest of any peer country. The adolescent pregnancy rate in the United States is about 3.5 times the average of others. Additionally, the rates of sexually transmitted infections, including syphilis, gonorrhea and chlamydia are the worst compared to peer countries.

Nor are these children exempt from death. Injury deaths are more common in 15- to 19-year-olds in the United States than in any other studied country. Homicide claims the second highest number of lives in 15- to -24-year-olds, and 4 in 5 of those deaths involve guns. Males between the ages of 15 and 19 are five times as likely to die from violence in the United States than in other countries.

Even as young adults, ages 25-34, mortality remains consistently upsetting and preventable. Unintentional injuries remain the No. 1 cause of death. The risk of dying by violence remains seven times higher for males in the United States ages 20-24 than in other countries.

We have to work together to make these numbers better. Some of them can be improved with public health measures. We need to help Americans be less obese, to have fewer accidents and to commit less violence. There are lots of local studies and initiatives that propose ways to fix these things, but our public health system is woefully underfunded, and translating any promising findings to meaningful societal change poses a huge challenge.

We also need to improve our safety nets to help children at the lowest end of the socioeconomic ladder do better, even before they are born. Pregnant women, babies and children suffer from hunger and malnutrition far too often in the richest country in the world. Yet we still debate the merits of the federally funded WIC (Womens, Infants and Children) program, school lunches and food assistance to needy families.

Finally, we need to find a way to improve access to the health care system. The Medicaid program covers one in every three births and one in every three children in the United States, and it's still not enough. As some states balk at expanding Medicaid to cover many of the poorest uninsured, some are still talking about reducing funding to the already stretched program. There's no question that we have the capability, the knowledge and the resources to care for people. It's just a matter of doing it better.

There will be some who deny these results. Others will try to use them for political gain. That would be a mistake. We have to accept these findings and begin to work holistically to improve them. Being last just isn't the American way.

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The opinions expressed in this commentary are solely those of Aaron Carroll.

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Pa. VA hospital knew of bacteria problem before death

(CBS News) There's been an outbreak other than the flu at the VA Hospital in Pittsburgh. It raises the question: What do patients have the right to know?

The bacterium that causes the respiratory illness known as Legionnaires' disease was found in the hospital's water system. The hospital and government officials knew about the outbreak but not the patients who were admitted there.

In November, 87-year-old William Nicklas, a Navy veteran, felt nauseated from medication. He went to the Pittsburgh VA hospital. His sons, Bob and Dave Nicklas, weren't particularly concerned.

"He had full trust in the VA," Dave said. "He was loyal to the military, loyal to the treatment he would receive there.It should be the best care in the world."

But in the hospital, he picked up an infection.

"The doctors wanted to meet with us Wednesday night. The family got together, and that's when she told us it was the Legionella bacteria that was the infection," Bob said.

William fought for his life for three days. The day after Thanks giving he was dead. His family thought they would be bringing him home.

What the family didn't know when William checked in was that the Pittsburgh VA had been battling an outbreak of Legionnaires' disease. There were at least four infections before William, and the outbreak had been reported in the hospital's water nearly a year before his death.

The manufacturer of the hospital's Legionella prevention equipment, Liquitech, claims that in December 2011 the Pittsburgh VA told them it had a Legionella problem. In emails, Liquitech wrote the had been made aware of the bacteria and an investigation showed the hospital systems were not being properly maintained.

"If they knew that there was an outbreak at that hospital then you've got two other, you know, world renowned hospitals located directly across the street from the Veterans Hospital," Dave said. "They could have easily transferred those patients so they weren't exposed."

The hospital did report the problem to the county health department and the federal Centers for Disease Control, but it wasn't until two weeks after William was admitted that it went public. It acknowledged that patients had contracted Legionnaire's disease in the hospital. Two weeks later, the hospital announced 24 more were treated there, but the hospital said the origin of 16 of those infections was unknown.

"The facility has worked... to formulate a plan to suppress the Legionella. Testing results indicate remediation... has been successful," Pittsburgh VA said in a statement, declining an interview.

A federal investigation has begun into whether the hospital was prudent in protecting its patients. The hospital said it is under no legal requirement to report Legionnaires' disease cases or outbreaks to the public or its patients. The Nicklas family plans to sue.

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Obama Promises Faster Transition in Afghanistan

President Obama and Afghan President Hamid Karzai said today that most U.S. combat operations in Afghanistan would end this spring, signaling a quickening troop drawdown that will bring the decade-long war to a close at the end of 2014.

"Our troops will continue to fight alongside Afghans when needed, but let me say it as plainly as I can: Starting this spring, our troops will have a different mission -- training, advising, assisting Afghan forces," Obama announced at an East Room news conference in Washington.

"It will be a historic moment and another step toward full Afghan sovereignty, something I know that President Karzai cares deeply about, as do the Afghan people," he said.

Administration officials said Afghan forces were "exceeding initial expectations" in their capabilities. Afghan security forces are expected to lead 90 percent of security operations across the country in February.

"By the end of next year -- 2014 -- the transition will be complete," Obama said. "Afghans will have full responsibility for their security, and this war will come to a responsible end."

The rosy assessments belied the serious political, economic and security challenges that remain.

Left unanswered by Obama and Karzai: How many U.S. troops might stay after 2014; what their mission would be and whether they could be effective; and whether the forces would have immunity from prosecution in Afghan courts.

Charles Dharapak/AP Photo

President Hamid Karzai Addresses Afghan Sovereignty at White House Watch Video

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Afghanistan Troop Surge Ends at Tumultuous Point Watch Video

Obama said he was still reviewing recommendations from the Pentagon and will make an announcement in the coming weeks after penning an anticipated bilateral security agreement with Afghanistan. Karzai said the exact number would be up to the United States to decide.

Both leaders confirmed in a statement that the United States "does not seek permanent bases in Afghanistan."

They also agreed today to turn over battlefield combatants held by the U.S. military in Afghanistan to Afghan government control, which has been long-sought by Karzai.

Roughly 66,000 U.S. troops are serving in Afghanistan. The military has proposed keeping several thousand troops in the country after 2014 as advisers, trainers and logistical support for Afghan forces; the White House has said it remains open to pulling out all troops entirely.

Obama's visit with Karzai was the first face-to-face encounter since the November election and since last year's dramatic increase in so-called green-on-blue attacks, when U.S. and NATO soldiers have been killed by the Afghans they are training or working alongside.

There were 45 insider attacks in 2012 that resulted in 62 deaths among coalition forces, including 35 Americans. There has been one attack already in the first 11 days of 2013.

The White House summit included a private Oval Office meeting between Obama, Karzai and Vice President Joe Biden. The trio also attended a private lunch in the Old Family Dining Room.

Karzai Thursday attended meetings with Defense Secretary Leon Panetta and top military brass at the Pentagon, where he was afforded all the pomp and circumstance accorded a head of state: a 21-gun salute, and marching bands and honor guards from the Army, Navy, Air Force, Marines and Coast Guard.

Karzai's relationship with the United States has at times been a rocky one as he has sometimes made critical statements about the allied troop presence in his country. U.S. officials believe he has made those comments out of political expediency to improve his standing with Afghans and show his independence.

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Captain blames faulty brakes, motor for NY ferry accident

NEW YORK: The captain of a packed ferry that crashed into a New York City pier injuring 74 people blamed malfunctioning brakes and a faulty motor for the accident, US investigators said Thursday.

"As the boat was coming in, the captain found that the reverse thrust was not operating as anticipated," said Robert Sumwalt of the National Transportation Safety Board, which is investigating the accident.

The captain said there was also a problem with the motor on the vessel, telling investigators that at some point "both diesel engines shut off," while he steered it toward the pier, Sumwalt told reporters.

There were 326 passengers and five crew on board the ferry at the time of Wednesday's mishap.

The accident took place during the morning rush hour at Pier 11 in lower Manhattan's East River, not far from Wall Street. The ferry was arriving from New Jersey.

Sumwalt said the captain, who is 36 years old, has 12 years of experience as a ferryboat captain and tested negative for alchohol use, as did the entire crew. Results of drug testing have yet to be completed, he said.

Some witnesses reported that the ferry, the Seastreak Wall Street, was going too quickly as it approached the pier.

Weather conditions were good at the time of the accident, with hardly any wind and good visibility.

Dozens of ferries bring thousands of commuters from New Jersey or Brooklyn to Manhattan every day, but accidents are rare.

The most serious mishap, in October 2003, killed 11 people and injured 70 others when a Staten Island ferry slammed into a pier at full speed.

- AFP/ck

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Beheading exposes exploitation

(File photo) Sri Lankan women protest outside the Saudi Arabia embassy in Colombo on November 9, 2010.

STORY HIGHLIGHTS

• Saudi authorities beheaded Rizana Nafeek, a Sri Lankan woman


• She was convicted of killing a baby of the family employing her as a housemaid


• This was despite Nafeek's claims that the baby died in a choking accident


• Becker says her fate "should spotlight the precarious existence of domestic workers"

Jo Becker is the Children's Rights Advocacy Director for Human Rights Watch and author of 'Campaigning for Justice: Human Rights Advocacy in Practice.' Follow Jo Becker on Twitter.

(CNN) -- Rizana Nafeek was a child herself -- 17 years old according to her birth certificate -- when a four-month-old baby died in her care in Saudi Arabia. She had migrated from Sri Lanka only weeks earlier to be a domestic worker for a Saudi family.

Although Rizana said the baby died in a choking accident, Saudi courts convicted her of murder and sentenced her to death. On Wednesday, the Saudi government carried out the sentence in a gruesome fashion, by beheading Rizana.

Jo Becker

Read more: Outrage over beheading of Sri Lankan woman by Saudi Arabia

Rizana's case was rife with problems from the beginning. A recruitment agency in Sri Lanka knew she was legally too young to migrate, but she had falsified papers to say she was 23. After the baby died, Rizana gave a confession that she said was made under duress -- she later retracted it. She had no lawyer to defend her until after she was sentenced to death and no competent interpreter during her trial. Her sentence violated international law, which prohibits the death penalty for crimes committed before age 18.

Rizana's fate should arouse international outrage. But it should also spotlight the precarious existence of other domestic workers. At least 1.5 million work in Saudi Arabia alone and more than 50 million -- mainly women and girls -- are employed worldwide according to the International Labour Organization (ILO).

Read more: Indonesian maid escapes execution in Saudi Arabia

Again according to the ILO, the number of domestic workers worldwide has grown by more than 50% since the mid-1990s. Many, like Rizana, seek employment in foreign countries where they may be unfamiliar with the language and legal system, and have few rights.

When Rizana traveled to Saudi Arabia, for example, she may not have known that many Saudi employers confiscate domestic workers' passports and confine them inside their home, cutting them off from the outside world and sources of help.

It is unlikely that anyone ever told her about Saudi Arabia's flawed criminal justice system, or that while many domestic workers find kind employers who treat them well, others are forced to work for months or even years without pay, and subjected to physical or sexual abuse.

Passport photo of Rizana Nafeek

Read more: Saudi woman beheaded for 'witchcraft and sorcery'

Conditions for migrant domestic workers in Saudi Arabia are among some of the worst, but domestic workers in other countries rarely enjoy the same rights as other workers. In a new report this week, the International Labour Organization says that nearly 30% of the world's domestic workers are completely excluded from national labor laws. They typically earn only 40% of the average wage of other workers. Forty-five percent aren't even entitled by law to a weekly day off.

Last year, I interviewed young girls in Morocco who worked 12 hours a day, 7 days a week for a fraction of the minimum wage. One girl began working at age 12 and told me: "I don't mind working, but to be beaten and not to have enough food, this is the hardest part."

Many governments have finally begun to recognize the risks and exploitation domestic workers face. During 2012, dozens of countries took action to strengthen protections for domestic workers. Thailand, and Singapore approved measures to give domestic workers a weekly day off, while Venezuela and the Philippines adopted broad laws for domestic workers ensuring a minimum wage, paid holidays, and limits to their working hours. Brazil is amending its constitution to state that domestic workers have all the same rights as other workers. Bahrain codified access to mediation of labor disputes.

Read more: Convicted killer beheaded, put on display in Saudi Arabia

Perhaps most significantly, eight countries acted in 2012 to ratify -- and therefore be legally bound by -- the Domestic Workers Convention, with more poised to follow suit this year. The convention is a groundbreaking treaty adopted in 2011 to guarantee domestic workers the same protections available to other workers, including weekly days off, effective complaints procedures and protection from violence.

The Convention also has specific protections for domestic workers under the age of 18 and provisions for regulating and monitoring recruitment agencies. All governments should ratify the convention.

Many reforms are needed to prevent another tragic case like that of Rizana Nafeek. The obvious one is for Saudi Arabia to stop its use of the death penalty and end its outlier status as one of only three countries worldwide to execute people for crimes committed while a child.

Labor reforms are also critically important. They may have prevented the recruitment of a 17 year old for migration abroad in the first place. And they can protect millions of other domestic workers who labor with precariously few guarantees for their safety and rights.

Read more: Malala, others on front lines in fight for women

The opinions expressed in this commentary are solely those of Jo Becker.

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Student shot at Calif. high school by classmate

Updated at 5:48 p.m. ET

TAFT, Calif. A 16-year-old student armed with a shotgun walked into class in a rural California high school on Thursday and shot one student, fired at another but missed, and then was talked into surrendering by a teacher and another staff member, officials said.

The teen victim was in critical but stable condition, Kern County Sheriff Donny Youngblood told a press conference. The sheriff said the teacher suffered a minor pellet wound to the head but declined treatment.

The gunman had as many as 20 rounds of ammunition in his pocket, the sheriff said.

When the shots were fired, the teacher tried to get the more than two dozen students out a back door and also engaged the shooter in conversation to distract him, Youngblood said. A campus supervisor responding to a call of shots fired also began talking to the gunman.

"They talked him into putting that shotgun down. He in fact told the teacher, `I don't want to shoot you,' and named the person that he wanted to shoot," Youngblood said.

"The heroics of these two people goes without saying. ... They could have just as easily ... tried to get out of the classroom and left students and they didn't," the sheriff said. "They knew not to let him leave the classroom with that shotgun."

The shooter didn't show up for first period then interrupted the class of 28 students.

Investigators had not yet had a chance to interview the student and so had no immediate word on a motive or whether the attacker had a previous disciplinary record. Nor did they know where he got the shotgun.

The wounded student was flown to a hospital in Bakersfield. Officials said a female student was hospitalized with possible hearing damage because the shotgun was fired close to her ear, and another girl received minor injuries during the scramble to flee when she fell over a table.

Officials said there's usually an armed officer on campus but the person wasn't there because he was snowed in. Taft police officers arrived within 60 seconds of first reports.

The shooting happened on the second floor of the school's science building around 9 a.m., according to CBS affiliate KBAK in Bakersfield.

As word spread, Dayna Hopper rushed to the school to pick up her son Joseph Sorensen, 16, and daughter, Cheryle Pryor, 15, who had called from Cheryle's cellphone.

"I panicked. I wanted to puke and just get here," Dayna Hopper told The Bakersfield Californian.

KERO-TV Bakersfield reported that the station received phone calls from people inside the school who hid in closets.

The bell had just rung at a nearby school when teachers began shouting for students to get inside buildings, and the principal used an intercom to tell students to stay inside, Felicity Reich, 13, a student at Lincoln Junior High School, told the newspaper.

Shaken, she held the hand of her mother, Ellie Reich, as she spoke.

About 900 students are enrolled at the high school, which includes 9th through 12th grades. Authorities went room by room through the school and expected to spend the day checking backpacks to make sure no other weapons were on campus.

Masses of parents headed to the school football field to find their children, and officials at other schools took action to protect their students as well, the newspaper said.

Wilhelmina Reum, whose daughter Alexis Singleton is a fourth-grader at a nearby elementary school, got word of the attack while she was about 35 miles away in Bakersfield and immediately sped back to Taft.

"I just kept thinking this can't be happening in my little town," she told The Associated Press.

"I was afraid I was going to get hurt," Alexis said. "I just wanted my mom to get here so I could go home."

The Taft shooting came less than a month after a gunman massacred 20 children and six women at Sandy Hook Elementary School in Newtown, Conn., then killed himself.

That shooting prompted President Barack Obama to promise new efforts to curb gun violence. Vice President Joe Biden, who was placed in charge of the initiative, said he would deliver new policy proposals to the president by next week.

At the state Capitol, Assembly Speaker John Perez, D-Los Angeles, said the thoughts and prayers of legislators were with the people at the Taft school.

"It really is just another very sad moment as we deal with the ongoing reality of gun violence that has captured so much of our attention this last year," Perez said.

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Hero Teacher Talks Shooter into Dropping Gun

A California high school teacher is being hailed a hero for talking a 16-year-old shooter into putting down his gun and turning himself in after opening fire on a classroom and wounding another student, police said.

The student victim was taken to a nearby hospital and remains in critical but stable condition, Kern County Sheriff Donny Youngblood told reporters on Thursday.

The teacher, whose name has not yet been officially released by authorities, helped evacuate nearly two dozen students out a door at Taft Union High School in Taft, Calif., while calmly engaging the young gunman, who is a student at Taft Union, in conversation.

Chris McCullah/The Californian/ZUMA

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The teacher and a campus supervisor, who responded to the gunfire and arrived at the classroom, helped convince the teenager to stop shooting.

"They talked him into putting the shotgun down," Youngblood said.

The shooting began around 9 a.m. in the school's science building and sheriff's deputies were on the scene within one minute of the call. An armed security guard who is typically at the school was not on campus because he had been snowed in, the sheriff said.

Two other students received minor injuries: One reported hearing loss and the other fell over a table. The teacher was shot with a pellet, but refused medical treatment, according to police.

The school's 900 students were evacuated from the building and many of them were met by parents within minutes of the first 911 calls.

Today's shooting comes less than month after 20-year-old Adam Lanza opened fire on an elementary school in Newtown, Conn. killing 20 children and six adults.

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Karzai's U.S. visit a time for tough talk

The last time Presidents Obama and Karzai met was in May in Kabul, when they signed a pact regarding U.S. troop withdrawal.

STORY HIGHLIGHTS

• Afghan President Karzai meeting with President Obama in Washington this week


• Felbab-Brown: Afghan politics are corrupt; army not ready for 2014 troop pullout


• She says Taliban, insurgents, splintered army, corrupt officials are all jockeying for power


• U.S. needs to commit to helping Afghan security, she says, and insist corruption be wiped out

Editor's note: Vanda Felbab-Brown is a senior fellow in foreign policy at the Brookings Institution. Her latest book is "Aspiration and Ambivalence: Strategies and Realities of Counterinsurgency and State-Building in Afghanistan."

(CNN) -- Afghan President Hamid Karzai is meeting this week with President Obama in Washington amid increasing ambivalence in the United States about what to do about the war in Afghanistan.

Americans are tired of the war. Too much blood and treasure has been spent. The White House is grappling with troop numbers for 2013 and with the nature and scope of any U.S. mission after 2014. With the persisting corruption and poor governance of the Afghan government and Karzai's fear that the United States is preparing to abandon him, the relationship between Kabul and Washington has steadily deteriorated.

As the United States radically reduces its mission in Afghanistan, it will leave behind a stalled and perilous security situation and a likely severe economic downturn. Many Afghans expect a collapse into civil war, and few see their political system as legitimate.

Karzai and Obama face thorny issues such as the stalled negotiations with the Taliban. Recently, Kabul has persuaded Pakistan to release some Taliban prisoners to jump-start the negotiations, relegating the United States to the back seat. Much to the displeasure of the International Security Assistance Force, the Afghan government also plans to release several hundred Taliban-linked prisoners, although any real momentum in the negotiations is yet to take place.

U.S. may remove all triips from Afghanistan after 2014

Vanda Felbab-Brown

Washington needs to be careful that negotiations are structured in a way that enhances Afghanistan's stability and is not merely a fig leaf for U.S. and NATO troop departure. Countering terrorism will be an important U.S. interest after 2014. The Taliban may have soured on al Qaeda, but fully breaking with the terror group is not in the Taliban's best interest. If negotiations give the insurgents de facto control of parts of the country, the Taliban will at best play it both ways: with the jihadists and with the United States.

Negotiations of a status-of-forces agreement after 2014 will also be on the table between Karzai and Obama. Immunity of U.S. soldiers from Afghan prosecution and control over detainees previously have been major sticking points, and any Afghan release of Taliban-linked prisoners will complicate that discussion.

Karzai has seemed determined to secure commitments from Washington to deliver military enablers until Afghan support forces have built up. The Afghan National Security Forces have improved but cannot function without international enablers -- in areas such as air support, medevac, intelligence and logistical assets and maintenance -- for several years to come. But Washington has signaled that it is contemplating very small troop levels after 2014, as low as 3,000. CNN reports that withdrawing all troops might even be considered.

Everyone is hedging their bets in light of the transition uncertainties and the real possibility of a major security meltdown after 2014. Afghan army commanders are leaking intelligence and weapons to insurgents; Afghan families are sending one son to join the army, one to the Taliban and one to the local warlord's militia.

With Afghan president's visit, nations' post-2014 future takes shape

Patronage networks pervade the Afghan forces, and a crucial question is whether they can avoid splintering along ethnic and patronage lines after 2014. If security forces do fall apart, the chances of Taliban control of large portions of the country and a civil war are much greater. Obama can use the summit to announce concrete measures -- such as providing enablers -- to demonstrate U.S. commitment to heading off a security meltdown. The United States and international security forces also need to strongly focus on countering the rifts within the Afghan army.

Assisting the Afghan army after 2014 is important. But even with better security, it is doubtful that Afghanistan can be stable without improvements in its government.

Afghanistan's political system is preoccupied with the 2014 elections. Corruption, serious crime, land theft and other usurpation of resources, nepotism, a lack of rule of law and exclusionary patronage networks afflict governance. Afghans crave accountability and justice and resent the current mafia-like rule. Whether the 2014 elections will usher in better leaders or trigger violent conflict is another huge question mark.

Emphasizing good governance, not sacrificing it to short-term military expediencies by embracing thuggish government officials, is as important as leaving Afghanistan in a measured and unrushed way -- one that doesn't jeopardize the fledgling institutional and security capacity that the country has managed to build up.

U.S. likely to keep thousands of troops in Afghanistan after NATO forces leave

Karzai has been deaf and blind to the reality that reducing corruption, improving governance and allowing for a more pluralistic political system are essential for Afghanistan's stability. His visit provides an opportunity to deliver the message again -- and strongly.

Follow us on Twitter @CNNOpinion

Join us on Facebook/CNNOpinion

The opinions in this commentary are solely those of Vanda Felbab-Brown.

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EU leaders want UK in union, but not treaty change

LONDON: European leaders on Wednesday stressed the importance of keeping Britain in the EU, but said they opposed treaty changes demanded by Prime Minister David Cameron.

"Britain is an essential part of the EU," Irish Prime Minister Enda Kenny said during a conference in Dublin marking the beginning of his country's six-month presidency of the bloc.

"Great Britain has great value and is a very important member of the EU," added EU President Herman Van Rompuy.

The two leaders highlighted the importance of the union for British businesses, saying that it was essential for them that Britain remained a full and active member.

A majority of Britons favour severing all ties with the union, according to polls, and Cameron is expected to deliver a speech within the next few days spelling out his views on the country's relationship with Brussels.

He insisted last year that he supported Britain's membership, but that he wanted to negotiate a "new agreement" which would allow it to opt out of certain directives.

Kenny and Van Rompuy both repeated their opposition to any treaty changes.

"I don't see a reopening of the treaties, I don't see an issue in treaty change for any individual countries," said the Irish prime minister.

Irish Deputy Prime Minister Eamon Gilmore stressed that the top concern of European citizens, "whether from Liverpool or Limerick", was unemployment.

Van Rompuy reiterated that it would be possible to change the treaties after the 2014 European elections, but added that he strongly supported deeper EU integration as opposed to an "a la carte" union.

He pointed out that there was already scope for increasing EU partnership.

"We don't need, at this stage, a treaty change," he said. "We can deliver for a deeper EU within the treaties."

- AFP/jc

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Wash your hands! Flu spreads fiercely across the U.S.

STORY HIGHLIGHTS

• Boston mayor declares a public health emergency because of flu


• Massachusetts General Hospital alone has already counted 532 cases of flu among patients


• It's not too late to get a flu vaccine


• In most cases, flu patients don't need to go to the emergency room

(CNN) -- The flu has been spreading fiercely across the United States, with more than half of states reporting widespread activity. The season has started earlier, and cases are more severe than last year, health officials say.

The latest Centers for Disease Control and Prevention flu advisory report, which covers the week of December 23 to 29, suggests that 41 states have widespread influenza activity, which was an increase of 31 states from the previous week. The CDC will issue an update on the flu situation Friday.

There have so far been 2,257 hospitalizations associated with laboratory-confirmed flu virus, the CDC report said. Among children, there have been 18 deaths reported during this season.

In Massachusetts, one of the 29 states that the CDC has identified as having high activity of influenza-like illness, Boston Mayor Thomas Menino declared a public health emergency in the city because of the flu.

Since October 1, there have been 700 confirmed influenza cases among Boston residents, according to Menino's office; that's 10 times more than were seen in all of last year's flu season.

Menino is collaborating with the Boston Public Health Commission and community health centers to offer free vaccination clinics this weekend. The mayor urged residents to stay home from work or school if they are sick, and to get their flu shots.

"This is the worst flu season we've seen since 2009, and people should take the threat of flu seriously," Menino said in a statement. More than 4% of emergency department visits at Boston hospitals are from flu cases, up from 1% during non-flu season.

Experts: Flu spreading faster than usual

Massachusetts General Hospital has already counted 532 cases of flu among patients, which is more than the hospital saw in any of the previous three flu seasons, said spokeswoman Kristen Stanton.

Signs posted throughout the hospital discourage anyone from visiting who has a cough or fever, she said, and anyone who does visit with those symptoms must wear a mask and perform hand hygiene. All staff must wear a mask when providing care for possible flu cases. Any staff member who has not been vaccinated must wear a mask while caring for any patient.

Pennsylvania has had 22 flu-related deaths so far this season, according to data from the state's Department of Health. Most of these deaths occurred among people older than 65, but the fatalities included two individuals younger than 50 who were otherwise healthy.

Lehigh Valley Hospital-Cedar Crest in Allentown, Pennsylvania, set up a heated tent outside the hospital to serve as a clinic. Anyone with mild flu symptoms can be treated quickly and discharged, isolated from more serious cases. The hospital has been seeing an additional 80 to 100 patients with flu-like symptoms daily, officials told CNN affiliate WPVI.

In Michigan, there have been four pediatric deaths related to the flu, said Angela Minicuci, public information officer for the Michigan Department of Community Health.

Dr. David Zich, internal medicine and emergency medicine physician at Northwestern Memorial Hospital in Chicago, said this is the worst flu season he's seen in his 12 years at his hospital, in terms of the concentration of patients.

Northwestern Memorial Hospital is on "bypass," which happens when it is beyond capacity because of an influx of patients, such as during flu season.

That means advanced-life support ambulances with patients who are stable are referred to the next closest hospital, no more than five minutes away, Zich said, and transfers are not accepted from outside hospitals. For everyone else, they are open for business.

"The majority of flu patients are sent home, with very little else done, so we can handle that," he said.

FDA approves new type of flu shot

Why so many cases?

Zich theorizes that one reason there are so many flu cases is that the heart of the flu season coincided with the December holiday season, meaning many people were already sleep-deprived from parties and were more likely to get sick.

Those who went to gatherings of family or friends may have already begun to feel sick, and spread the virus to others. People are generally contagious the day before symptoms start, and for five days after becoming sick, according to the Centers for Disease Control and Prevention.

Last flu season was light, but this year has brought with it some "ominous signs," Dr. Anthony Fauci, director of the National Institute of Allergy and Infectious Diseases at the National Institutes of Health, told CNN's Wolf Blitzer Tuesday.

Flu cases started going up early, toward the end of November and the beginning of December, he said.

"And it went up on a pretty steep trajectory," he said. "The last time we saw that happen that way was the flu season of 2003 and 2004, which turned out to be a bad flu season.'

The type of flu that is going around is called H3N2, which is often linked to more serious disease compared to other flu varieties, Fauci said.

But there's good news: That type of flu matches up well to the vaccine that is being distributed and given out throughout the United States.

People may get more complications from this particular strain of H3N2, "which may make them ill for a longer period of time," Dr. Michael Jhung, medical epidemiologist in the influenza division at CDC, told CNN's Mary Snow.

Best new ways to avoid the cold and flu

"But symptoms typically last up to seven days for a normal infection, a noncomplicated infection with influenza," he said. "And we usually see that from year to year regardless of what strains are circulating."

In a "light" year, a few thousand people may still die, but a particularly serious year could see up to 49,000 deaths from the flu, Fauci said. "There's an average of about 200,000 hospitalizations and there's a lot of economic burdens."

Protect yourself

If you haven't gotten an annual flu vaccine, it's not too late, doctors say. To further protect yourself, try to avoid anyone who is sneezing and coughing, and wash your hands. Also, exercise and eat healthy foods, Zich said.

Most flu patients should not go to an emergency room, Zich said. They will likely be sent home, as there is very little that can be done for them. A fever as high as 103 degrees Fahrenheit is common in the flu.

Patients with normal flu symptoms should get a lot of rest and take painkillers to help with muscle aches, Zich said. "In five to seven days, you're going to be feeling yourself again," he said.

But there are scenarios in which going to a hospital is necessary. If a patient is short of breath, or can't keep fluids down because of nausea, these are signs of a problem that needs immediate attention, as vomiting or sweating from fever can lead to dehydration, Zich said.

Flu can be deadly, even in healthy kids

An otherwise healthy person will not get much benefit from antiviral medications designed to treat symptoms that the flu causes, Zich said. The side effects from both oseltamivir (Tamiflu) and zanamivir (Relenza) include nausea.

The CDC recommends that people who have a higher risk of complications from the flu receive antiviral treatment. These include people with chronic illnesses such as pulmonary, cardiovascular and neurological conditions, as well as anyone 65 years and older and children under age 2.

What many people don't know is that the flu vaccine becomes less effective as you get older or develop other medical problems, Zich said. The flu shot relies on the body's antibodies against the flu, so if the immune system is already compromised, it will not work as well.

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Hilda Solis stepping down as labor secretary

Hilda Solis announced that she is stepping down from her post as labor secretary, CBS News has confirmed. She sent a letter to President Obama today notifying him of her retirement.

Solis was nominated to the position the same day the president was inaugurated in 2009, serving through the president's entire first term. She ran the Labor Department during the worst economic recession since the Great Depression. The department, which calculates unemployment statistics, came under criticism during the presidential campaign for a steep drop in the jobless numbers from above 8 percent to below 8 percent right before Election Day.

President Obama called her "a critical member" of his economic team who has helped put "millions" of people back to work. "Hilda Solis has been a tireless champion for working families," the president wrote in a statement.

Before her current position, she was a member of Congress, representing California since 2001 but left that job to be the first Hispanic woman to run the agency.

The president must now name a replacement that must go through the Senate confirmation process. CBS News learned today that the president intends to nominate his chief of staff, Jack Lew, to run the Treasury Department.

Solis joins Secretary of State Hillary Clinton, Treasury Secretary Timothy Geithner, CIA Director David Petraeus and Defense Secretary Leon Panetta in stepping down from their cabinet-level posts.

A White House official says Health and Human Services Secretary Kathleen Sebelius, Veterans Affairs Secretary Eric Shinseki and Attorney General Eric Holder plan to remain in their positions.

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White House Won't Rule Out $1 Trillion Coin

(United States Mint/Wikimedia Commons)

White House Press Secretary Jay Carney today flatly ruled out any negotiations with Congress over raising the debt ceiling, but there’s one odd-ball solution he would not rule out:  minting trillion dollars coins to pay off the debt.

“There is no Plan B. There is no backup plan. There is Congress’s responsibility to pay the bills of the United States,” White House Press Secretary Jay Carney told reporters at the daily White House briefing.

READ: $1-Trillion Coins: The Ultimate Debt Ceiling End-Around?

Asked if the administration would rule out minting trillion dollars coins if Congress fails to act, Carney deflected saying “you could speculate about a lot of things.”

“Nothing needs to come to these kinds of… speculative notions about how to deal with a problem that is easily resolved by Congress doing its job, very simply,” he added.

Pressed further on why they won’t offer a clear yes-or-no answer to the question, Carney referred questions to the Treasury Department.

“I answered it thoroughly,” he later joked. “And I have no coins in my pocket.”

Some have suggested the President could invoke the 14^th Amendment to the Constitution – which states, “the validity of the public debt of the United States … shall not be questioned” – and ignore the debt ceiling altogether.  On that question, Carney has offered a straight answer:  the 14 Amendment does not apply to the debt ceiling.

“We just don’t believe that it provides the authority that some believe it does,” Carney said.

The trillion-dollar-coin idea has been floated by, among others, an economist at the American Enterprise Institute.

Here’s our full Q and A:

KARL: I heard you unequivocally rule out using the 14th Amendment on the debt ceiling. I heard you unequivocally rule out negotiating with Congress. But you did not rule out this trillion-dollar coin idea. So can I ask you just a yes-or-no question? Does the White House rule out the idea of minting trillion-dollar coins as a way of dealing with the debt ceiling?

CARNEY: I would refer you to Treasury for the specifics of this question. I can tell you that the president does not believe that there is a backup plan or a plan B or an off-ramp. The only viable option here is Congress to fulfill its — that Congress fulfills its responsibility and ensures that the United States of America pays its bills, as it has always paid its bills throughout its history.

KARL: But why have we ruled out the 14th Amendment and not ruled out the trillion-dollar coin idea?

CARNEY: Again, I can tell you that there are no back-up plans. There are no plan B’s. I’d refer you to the Treasury.

–

KARL: Jay, the speaker of the House has made it perfectly clear that he is willing to increase the debt ceiling, but the principle is for every dollar the debt ceiling is increased, a dollar of spending must be cut. Given that you’re saying that the White House will not negotiate on raising the debt ceiling, are you willing to accept that principle from the speaker, a dollar in cuts for every dollar increase?

MR. CARNEY: I think the president’s been very clear that his absolute principle is that we need to reduce our deficit in a balanced way that does not shift all the burden, through cuts exclusively, on senior citizens, on families who have disabled children, on families who are trying to send their kids to school. That’s just unacceptable.

You know, one of the things we learned in the process that we just went through late in — late last year is that when it comes to specificity, we never saw any specificity from Republicans in terms of how exactly they would achieve the kind of sweeping cuts that they say they want and out of whose — you know, from whom would they demand that payment.

And what the president has been very clear about is he will not negotiate on Congress’ responsibility to pay its bills. He will negotiate and is willing to compromise, as he has demonstrated repeatedly, when it comes to moving forward in a balanced way to reduce our deficit. We have to deal with the sequester. We have to deal with a variety of budgetary and economic and fiscal challenges.

But he will not negotiate over the debt ceiling. And the threat itself is a problem, as we saw in the summer of 2011. The binary choice that Republicans seem to want to present to the American public is either we gut Medicare and Social Security or we tank the global economy. I’m not a communications director for the speaker of the House or the Senate minority leader, but I would think selling that would be very hard.

KARL: But help me understand how this works. You say you will not negotiate on this issue. They’ve put out a principle, so they produce something — and they say they will — that cuts a dollar for every dollar increase. And you’re saying you won’t negotiate on that?

MR. CARNEY: Have you seen that?

KARL: Well, this is what they say they are going to go forward.

MR. CARNEY: Well, I mean, you know –

KARL: So either –

MR. CARNEY: — words are not actions, and there has been, at — to this date, very little specificity, you know, since we — since the Ryan plan, which itself was lacking in specifics. And if their — if their position is we’re going to voucherize Medicare or tank the global economy, they should say so. That is unacceptable to the American people. It’s certainly unacceptable to the president.

Look, here’s the thing. Congress has the authority to authorize money, right, not the president. Congress racked up these bills. Congress has to pay these bills. We are very interested in a discussion and negotiation about getting our fiscal house in order. This president has already signed into law over $2 trillion in deficit reduction. He is eager to do more in a balanced way.

But it is not appropriate to — in this president’s view — to say that if I don’t get what I want, I’m not going to raise the debt limit. That is basically saying, I will abandon the history of the United States maintaining the full faith and credit of its currency and its — and its treasury by refusing to pay bills because I didn’t get what I want politically.

And that’s just not acceptable to the president.

KARL:  I’m not sure I understand how that works — you’re not going to negotiate at all? –

MR. CARNEY: We’re not going to negotiate. Congress has a — if Congress wants to give the president the responsibility to raise the debt ceiling, he would take it, as we saw when — in 2010 or — I forget, there have been so many of these confrontations — in — when — in 2011 when the so-called McConnell plan was adopted, you know. But they assigned themselves this responsibility. They need to be — the fact that they, you know, assigned it to them is something that they have to deal with. They assigned it to themselves, they need to act, and they need to, without drama or delay, raise the debt ceiling. We still have — there is plenty of opportunity outside of threatening the full faith and credit of the United States to debate fundamental differences over our economic and fiscal policy proposals, but it is not wise to do that around raising the debt ceiling, not wise to do it around the simple principle that we, the United States of America, pay our debts.

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