Your Money: After the Storm: Managing Your Homeowner’s Claim

There is a sort of honeymoon period that occurs after a big storm like Hurricane Sandy, when insurance executives appear on the local news offering reassuring words. Their brightly painted vans pull into residential neighborhoods amid the standing water and debris. Everyone is hopeful. Handshakes and back-patting all around.

Tom Mihalek/Reuters

Mark Baronowski shoveled sand from the living room of a beach front property in Bay Head, N.J., last week. Many victims of Hurricane Sandy are novices when it comes to catastrophic insurance claims.

That period is about to end. Prices for roofers and construction materials will rise, disadvantageous parsing of policy language will commence and gangs of class-action lawyers will round up aggrieved clients who still have months of homelessness ahead of them. Many claims will take years to settle.

It happens every time, and so it will with this storm. That’s not to say that a majority of people with insurance claims won’t be satisfied with the check they receive or won’t get one quickly.

But when this many people have extensive damage to their most significant asset, billions of dollars are at stake for the companies that have the power to make them whole. So there is no reason for policyholders to be anything but wary until their own big check clears.

Many victims of Hurricane Sandy are novices when it comes to catastrophic insurance claims. So to see what sort of resistance they should expect shortly, I turned to the lawyers and adjusters-for-hire who do nothing but negotiate with insurance companies all day long. Some of them used to work for the companies, in fact.

Here are the things they warn people to watch out for:

THAT INDEPENDENT ADJUSTER Many people with damaged homes have started to meet with representatives who assessed their damaged homes to estimate repair costs. They may have introduced themselves as “independent adjusters,” but this is a misnomer. They represent the insurance company and are not neutral.

In storms like this, large numbers of these freelance claims adjusters parachute in from out of town. In the industry, they are known as storm troopers. They work 18-hour days for a while since no insurance company has enough of its own full-time staff to deploy after a storm like this one. Often, they make enough money not to work for months afterward.

“These guys have a lot of work to do, and it’s a thankless job,” said Matthew Tennenbaum, who used to be an independent adjuster but switched sides and now works for policyholders as a “public” adjuster in Cherry Hill, N.J.

Mr. Tennenbaum worries about the storm troopers’ thoroughness. “They’re going to see 10 properties a day and they’re quickly writing estimates,” he said. “If they spend an extra three or four hours properly writing one estimate, they could have written three more and made more money.”

Though many of them are former builders or contractors, they may not, if time is of the essence, always pull up every floor, explore every inch of the attic or look behind every wall. And they may not know much about your insurance company’s policy.

“The insurance companies hand them a manual, and they may not really understand the manual,” said J. Robert Hunter, the director of insurance for the Consumer Federation of America, who has worked for insurance companies and once ran the federal flood insurance program.  “It’s a crash course at that point.”

  The good news here is that these are not the people who make the final call on your claim. But many policyholders assume that their word is the final word.

WIND VERSUS FLOOD Back at headquarters, other adjusters have their eye on an exclusion that will be crucial for this storm, with its horrific storm surges but relatively mild winds: homeowner’s insurance generally does not cover floods.

Unfortunately, many people do not know this and many more have not purchased or renewed policies with the federal flood insurance program that covers up to $250,000 of flood damage. Researchers from the Wharton Risk Management and Decision Processes Center, working with colleagues at Florida State, the University of Miami and Columbia University, surveyed people in the storm’s path by telephone three days before it hit.

Among people within a block of a body of water, 46 percent had no flood insurance. In areas that had been evacuated in past storms or where the authorities advised people to leave, 58 percent did not have it. Moreover, 39 percent of all the people who thought they did have flood coverage mistakenly believed that their homeowner’s insurance covered it.

People without coverage but lots of damage from the storm surge might do one of a couple of things. A few stubborn ones will sue, arguing that if the wind drove the surge then it’s not really a flood. Judges haven’t taken kindly to this line of reasoning over the years, but that probably won’t keep people from trying again. The Federal Emergency Management Agency may also offer some assistance.

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States Face Tight Health Care Deadlines

After nearly three years of legal and political threats that kept President Obama’s health care law in a constant state of uncertainty, his re-election on Tuesday all but guarantees that the historic legislation will survive.

Now comes another big hurdle: making it work.

States will need to hustle to put in place the various pieces meant to help their residents meet the contentious requirement of having health insurance by Jan. 1, 2014. The federal government is under immense pressure to provide more guidance, while building its own tools to ensure the law’s success.

With Mitt Romney’s vow to “repeal and replace” the law no longer a threat, its supporters are exulting. Bill Foster, a Democrat elected to the House from a suburban Chicago district, summarized the message of the election this way: “For our district and for our country, the debate on Obamacare is over.’

But Mr. Obama and his allies must now step up efforts to promote and explain it to a public that remains sharply divided and confused about it. In exit polls on Tuesday, nearly half of voters said the law should be either partially or fully repealed..

“There is still a tremendous amount of disinformation out there,” said Jeff Goldsmith, a health industry analyst based in Virginia. “If you actually are going to implement this law, people need to know what’s in it – not just the puppies-and-ice-cream parts, but ‘Here are the broader social changes intended and how they can help you.'”

The health care overhaul still faces resistance from many Republican members of Congress, governors and state legislators. In the 11 weeks before Inauguration Day, Mr. Obama faces crucial choices about strategy that could determine the success of the law in the next few years: Will the administration, for example, try to address the concerns of insurers, employers and some consumer groups who worry that the law’s requirements could increase premiums? Or will it insist on the stringent standards favored by liberal policy advocates inside and outside the government?

Much now depends on the states, where lawmakers will decide in the coming weeks and months whether to build online marketplaces known as insurance exchanges, where individuals and small businesses can shop for health plans, and whether to expand their Medicaid programs to reach many more low-income people.

The clock is ticking on the exchange question in particular: states have until Nov. 16 to decide whether they will build their own exchange or let the federal government run one for them.

So far, only about 15 states and the District of Columbia have created the framework for exchanges through legislation or executive orders; three others have committed to running exchanges in partnership with the federal government. A number of Republican governors, including those in Arizona, Idaho, New Jersey, Virginia and Tennessee, had said they would decide after the election, giving themselves only a 10-day window before the deadline.

“I would expect that starting today there are a significant number of fascinating conversations going on behind closed doors in state capitols all over America,” said John McDonough, a professor of public health at Harvard who helped draft the law.

State efforts to carry out the new law will coincide with epic negotiations between Mr. Obama and Congress over federal spending and taxes.

Some observers believe that costly provisions of the health care law, like federal subsidies to help families with incomes up to 400 percent of the poverty level pay their insurance premiums, could be scaled back in the name of deficit reduction.

“We know folks on the Hill are talking about this already,” said David Smith, an analyst at Leavitt Partners, a consulting firm that advises states on the law. “There are a lot of competing factors, but they have to find the savings and we believe health care will be one of the places where they will go.”

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Exclusive: Google Ventures beefs up fund size to $300 million a year

SAN FRANCISCO (Reuters) - Google will increase the cash it allocates to its venture-capital arm to up to $300 million a year from $200 million, catapulting Google Ventures into the top echelon of corporate venture-capital funds.

Access to that sizeable checkbook means Google Ventures will be able to invest in more later-stage financing rounds, which tend to be in the tens of millions of dollars or more per investor.

It puts the firm on the same footing as more established corporate venture funds such as Intel's Intel Capital, which typically invests $300-$500 million a year.

"It puts a lot more wood behind the arrow if we need it," said Bill Maris, managing partner of Google Ventures.

Part of the rationale behind the increase is that Google Ventures is a relatively young firm, founded in 2009. Some of the companies it backed two or three years ago are now at later stages, potentially requiring larger cash infusions to grow further.

Google Ventures has taken an eclectic approach, investing in a broad spectrum of companies ranging from medicine to clean power to coupon companies.

Every year, it typically funds 40-50 "seed-stage" deals where it invests $250,000 or less in a company, and perhaps around 15 deals where it invests up to $10 million, Maris said. It aims to complete one or two deals annually in the $20-$50 million range, Maris said.

LACKING SUPERSTARS

Some of its investments include Nest, a smart-thermostat company; Foundation Medicine, which applies genomic analysis to cancer care; Relay Rides, a carsharing service; and smart-grid company Silver Spring Networks. Last year, its portfolio company HomeAway raised $216 million in an initial public offering.

Still, Google Ventures lacks superstar companies such as microblogging service Twitter or online bulletin-board company Pinterest. The firm's recent hiring of high-profile entrepreneur Kevin Rose as a partner could help attract higher-profile deals.

Soon it could have even more cash to play around with. "Larry has repeatedly asked me: 'What do you think you could do with a billion a year?'" said Maris, referring to Google chief executive Larry Page.

(Editing by Muralikumar Anantharaman)

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Man pleads no contest in 'Bling Ring' case

LOS ANGELES (AP) — A man who had been accused of burglarizing Paris Hilton's home pleaded no contest on Thursday to receiving jewelry stolen from the house during a rash of break-ins by a group dubbed the "Bling Ring."

Roy Lopez Jr. was then sentenced to serve three years of supervised probation.

Lopez, 30, was initially charged with felony residential burglary and conspiring with other members of the ring that targeted the swank, Hollywood Hills homes of stars such as Hilton, Lindsay Lohan, Orlando Bloom and others.

Hilton's home was burglarized in December 2008, and police were able to return some of her property.

The burglary charge and other counts against Lopez were dropped. Deputy District Attorney Christine Kee said Hilton has opted not to receive restitution in the case.

Much of the estimated $3 million in high-end jewelry, clothes and art that was taken from the celebrities has never been recovered.

"We're pleased that the district attorney was able to work with us on this case and allow Roy to get his life back on track," defense attorney David Diamond said after the hearing.

Evidence in the case supported his contention that Lopez had never been in Hilton's residence, Diamond said.

Several other defendants, including the alleged ringleaders, have taken plea deals to end their cases. The remaining defendant, Courtney Leigh Ames, returns to court on Dec. 14.

Diana Tamayo, who pleaded no contest to burglarizing Lohan's home, might still be required to pay restitution in the case. Lohan has indicated she may seek restitution against Tamayo, but the actress was not available to be in court on Thursday, Kee said.

The case hit a snag recently after it was revealed that the lead police investigator was paid to consult and appear in an upcoming Sofia Coppola film based on the case.

Los Angeles Police Officer Brett Goodkin failed to disclose the work to his superiors and prosecutors ahead of time.

Superior Court Judge Larry Paul Fidler has called Goodkin's actions "stupid and a gift to defense attorneys," but not enough to warrant dismissal of any charges.

Fidler referenced the issue by telling Lopez, "You got a break because of what's happened in this case."

___

Anthony McCartney can be reached at http://twitter.com/mccartneyAP

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Well: The Presidential Health Quiz

Whether it’s George Washington’s teeth or Bill Clinton’s former hamburger habit, Americans have always been fascinated by the health of the president and presidential candidates.

With help from the Web site DoctorZebra, which has compiled an exhaustive list of the medical history of American presidents, we’ve created an Election Day quiz to test your knowledge of presidential fitness and health.

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DealBook: On Wall Street, Time to Mend Fences With Obama

Del Frisco’s, an expensive steakhouse with floor-to-ceiling windows overlooking the Boston harbor, was a festive scene on Tuesday evening. The hedge fund billionaires Steven A. Cohen, Paul Singer and Daniel Loeb were among the titans of finance there dining among the gray velvet banquettes before heading several blocks away to what they hoped would be a victory party for their presidential candidate, Mitt Romney.

The next morning was a cold, sobering one for these executives.

Few industries have made such a one-sided bet as Wall Street did in opposing President Obama and supporting his Republican rival. The top five sources of contributions to Mr. Romney, a former top private equity executive, were big banks like Goldman Sachs and JPMorgan Chase, according to the Center for Responsive Politics. Wealthy financiers — led by hedge fund investors — were the biggest group of givers to the main “super PAC” backing Mr. Romney, providing almost $33 million, and gave generously to outside groups in races around the country.

On Wednesday, Mr. Loeb, who had supported Mr. Obama in 2008, was sanguine. “You win some, you lose some,” he said in an interview. “We can all disagree. I have friends and we have spirited discussions. Sure, I am not getting invited to the White House anytime soon, but as citizens of the country we are all friendly.”

Wall Street, however, now has to come to terms with an administration it has vilified. What Washington does next will be critically important for the industry, as regulatory agencies work to put their final stamp on financial regulations and as tax increases and spending cuts are set to take effect in the new year unless a deal to avert them is reached. To not have a friend in the White House at this time is one thing, but to have an enemy is quite another.

“Wall Street is now going to have to figure out how to make this relationship work,” said Glenn Schorr, an analyst who follows the big banks for the investment bank Nomura. “It’s not impossible, but it’s not the starting point they had hoped for.”

Traditionally, the financial industry has tended to support Republican candidates, but, being pragmatic about power, has also donated to Democrats. That script got a rewrite in 2008, when many on Wall Street supported Mr. Obama as an intelligent leader for a country reeling from the financial crisis. Goldman employees were the leading source of campaign donations for Mr. Obama, who reaped far more contributions — roughly $16 million — from Wall Street than did his opponent, John McCain.

The love affair between Wall Street and Mr. Obama soured soon after he took office and championed an overhaul in financial regulations that became the Dodd-Frank Act.

Some financial executives complained that in meetings with the president, they found him uninterested and disengaged, while others on Wall Street never forgave Mr. Obama for calling them “fat cats.”

The disillusionment with the president spawned reams of critical commentary from Wall Street executives.

“So long as our leaders tell us that we must trust them to regulate and redistribute our way back to prosperity, we will not break out of this economic quagmire,” Mr. Loeb wrote in one letter to his investors.

The rhetoric at times became extreme, like the time Steven A. Schwarzman, co-founder of the private equity firm Blackstone Group, compared a tax proposal to “when Hitler invaded Poland in 1939.” (Mr. Schwarzman later apologized for the remark.)

Mr. Loeb was not alone in switching allegiances in the recent presidential race. Hedge fund executives like Leon Cooperman who had supported Mr. Obama in 2008 were big backers of Mr. Romney in 2012. And Wall Street chieftains like Jamie Dimon of JPMorgan Chase and Lloyd C. Blankfein of Goldman Sachs, who have publicly been Democrats in the past, kept a low profile during this election. But their firms’ employees gave money to Mr. Romney in waves.

Starting over with the Obama White House will not be easy. One senior Wall Street lawyer who spoke on condition of anonymity said Wall Street “made a bad mistake” in pushing so hard for Mr. Romney. “They are going to pay a price,” he said. “It will soften over time, but there will be a price.”

Mr. Obama is not without supporters on Wall Street. Prominent executives like Hamilton James of Blackstone, and Robert Wolf, a former top banker at UBS, were in Chicago on Tuesday night, celebrating with the president.

“What we learned is the people on Wall Street have one vote just like everyone else,” Mr. Wolf said. Still, while the support Wall Street gave Mr. Romney is undeniable, Mr. Wolf said, “Mr. Obama wants a healthy private sector, and that includes Wall Street.

“If you look at fiscal reform, infrastructure, immigration and education, they are all bipartisan issues and are more aligned than some people make it seem.”

Reshma Saujani, a former hedge fund lawyer who was among Mr. Obama’s top bundlers this year and is planning to run for city office next year, agreed.

“Most people in the financial services sector are social liberals who support gay marriage and believe in a woman’s right to choose, so I think many of them will swing back to Democrats in the future,” she said.

---

This post has been revised to reflect the following correction:

Correction: November 8, 2012

An earlier version of this article misidentified Reshma Saujani as a male.

A version of this article appeared in print on 11/08/2012, on page B1 of the NewYork edition with the headline: On Wall Street, Time to Mend Fences With Obama.

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News Analysis: Obama Wins a Clear Victory, but Balance of Power Is Unchanged in Washington

Kirsten Luce for The New York Times

Democrats not only retained the presidency, but held and slightly added to their majority in the Senate.

After $4 billion, two dozen presidential primary election days, a pair of national conventions, four general election debates, hundreds of Congressional contests and more television advertisements than anyone would ever want to watch, the two major political parties in America essentially fought to a standstill.

When all the shouting was done, the American people on Tuesday more or less ratified the status quo that existed at the start of the day: They returned President Obama to the White House for another four years, reaffirmed Republican control of the House and kept the Senate in Democratic hands. As of Wednesday morning, the margins in the House and Senate had each changed by just a seat or two.

The tie in effect went to the Democrats, who had more to lose but did not. Not only did they retain the presidency, they held off a concerted drive to take over the Senate and instead added slightly to their majority. The Republicans lost a signal opportunity to take Senate seats in states that by most measures should be their territory — Indiana, Missouri and apparently North Dakota — while losing seats they had held in Maine and Massachusetts.

For his part, Mr. Obama won a clear victory but less decisively than other re-elected presidents. He garnered just 50 percent of the popular vote, three percentage points lower than in 2008 and a sign of just how divided the country remains over his leadership. His margin in the Electoral College was stronger, but even if he wins Florida, which remained too close to call, he will be the first president since Franklin D. Roosevelt to win a second term with fewer electoral votes than his first election, suggesting the narrowing of his coalition.

But the bottom-line scorecard left Washington as divided as ever, with no resolution of most of the fundamental issues at stake. The profound debate that has raged over the size and role of government, the balance between stimulus spending and austerity and the proper level of taxation has not been settled in the least. The next two years could easily duplicate the last two as the parties battle it out.

In his victory speech around 1:30 a.m., Mr. Obama largely glossed over that result and presented himself as ready for compromise with Republicans over the so-called fiscal cliff looming at the end of the year, when a series of automatic tax increases and spending cuts are slated to take effect unless the president and Congress stop or amend them.

“Tonight, you voted for action, not politics as usual,” Mr. Obama told supporters in Chicago. “You elected us to focus on your jobs, not ours. And in the coming weeks and months, I am looking forward to reaching out and working with leaders of both parties to meet the challenges we can only solve together: reducing our deficit, reforming our tax code, fixing our immigration system, freeing ourselves from foreign oil.”

Speaker John A. Boehner, Republican of Ohio, offered words of conciliation while making it clear that he believed his party’s victory in keeping control of the House meant he had every bit as much of a mandate as Mr. Obama.

“The American people reelected the president and reelected our majority in the House,” Mr. Boehner said in a statement. “If there is a mandate, it is a mandate for both parties to find common ground and take steps together to help our economy grow and create jobs.”

Mr. Boehner scheduled a public appearance for 3:30 p.m. on Wednesday to address the deficit issues

If nothing else, one issue does seem resolved by the election. The president’s health care program, which Mitt Romney had vowed to begin dismantling on the first day of his presidency, now seems certain to survive. While House Republicans continue to oppose it and may find ways to attack it legislatively, they now know that they do not have the ability to overturn it.

It also may be possible for the two sides to come together on another big issue: immigration. In his victory speech, Mr. Obama specifically listed revamping the system as one of four specific goals. While he made little mention of it during campaign speeches, Democrats argue that Republicans may now be willing to find compromise given the election results and the growing power of the Latino vote in America. Some moderate Republicans agree, although it is not clear whether the party as a whole has come to that conclusion.

But it will be the fiscal issues that will play out in the short term and both sides quickly moved to define the election results as a validation of their viewpoint.

Neera Tanden, president of the liberal research group Center for American Progress, called the election “a decisive mandate for a fair tax system where the wealthy contribute to address our deficit challenges.”

Chris Chocola, president of the conservative antitax group Club for Growth, congratulated a series of House Republicans who had won and praised their “record of fighting to limit government and pass pro-growth policies.”

For now, uncertainty will probably continue for at least a few weeks as the newly re-elected president and re-elected Republicans circle warily and plot their next moves. Whether the talk of cooperation translates into action remains unclear, but many are already skeptical.

Dale Brown, president of the Financial Services Institute, cited the “closeness of the election results” in urging Mr. Obama to tread lightly on any new regulatory initiatives, a priority for his group. But looking at the enormous fiscal issues confronting the country, Mr. Brown noted that “the next 13 months are critical” because after then, “Congress will be back in re-election mode and will not tackle anything that could put their own re-elects in jeopardy.”

On that, at least, most everyone could agree.

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Apple's shares slide 4 percent to five-month low

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ABC's Diane Sawyer spurs jokes from Twitterverse

NEW YORK (AP) — Diane Sawyer's Election Night performance left some viewers asking if she had begun celebrating Tuesday's election a bit early.

Co-anchoring ABC News' coverage, the veteran journalist struck a different manner from her practiced, straight-news-delivering style.

Sawyer spoke more slowly than usual while seeming to prop herself on outstretched arms at the anchor desk she shared with George Stephanopoulos.

"OK," she said at one point around 10 p.m. EST, "I wanna — can we have our music, because this is another big one here? Minnesota, we're ready to project Minnesota, rrright now. ... Well, tonight we know that President Barack has won Minnesota," she rambled on, stumbling over the president's name.

Maybe Sawyer was just weary from the recent torrent of news.

In any case, the Twitterverse took quick notice and began cracking wise.

Her name was soon trending with unflattering posts, while a new Twitter handle, Drunk Diane Sawyer, collected hundreds of followers. An ABC spokesman did not comment.

"A bit tipsy," ''hammered" or "on pain killers, muscle relaxers, benzos or some combination" were among the jeering explanations. Another likened it to an episode of HBO's drama "The Newsroom," where Will McAvoy, the fictitious anchorman, had eaten a couple of pot brownies before unexpectedly being summoned to his anchor desk to report a news story.

Some tweeters joked that a more fun-loving Sawyer was a ploy by ABC to boost viewership. Several Twitter followers said they were drawn to the network by word that Sawyer was behaving, by one description, "a bit wacky."

"Bad night for Romney," one tweeter summed up. "Worse night for Diane Sawyer?"

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The Doctor’s World: Doctors Chased Clues to Identify Meningitis Outbreak

The e-mail Dr. Marion A. Kainer received on Sept. 18 suggested an investigation of a case of fungal meningitis and stroke in a man whose immune system was normal and whose only risk for the infection was a spinal injection of a steroid.

“Alarm bells went off” because of its rarity, Dr. Kainer, an epidemiologist at the Tennessee health department, said in an interview.

She immediately began what became a national investigation that has now identified 409 cases, including 30 deaths, from a fungus so unusual that it is not in medical textbooks. The fungus was transmitted through injections of a contaminated steroid drug prepared by the New England Compounding Center in Framingham, Mass.

Dr. Kainer’s investigation led Tennessee to take extraordinary measures to track down 1,009 people at risk of the fungal infection. The state is credited as the driving force in discovering one of the most shocking outbreaks in the annals of American medicine.

The discovery came in large part because of Dr. Kainer’s diligence and expertise in infectious diseases, neurology and public health. It came, too, from the clinical acumen of Dr. April C. Pettit, an infectious disease specialist at Vanderbilt University who sent the e-mail to the health department.

The still-evolving findings also illustrate the strengths of the government’s response to a public health crisis.

Dr. Kainer, like other physicians in hospitals and clinics, often detect the initial cases. But usually only health departments and other government agencies have the ability and authority to track down additional cases to document disease outbreaks and warn those at risk. It is work that private groups seldom can do, in part for lack of funds and the authority to examine patient records.

The national surveillance system for outbreaks of infectious and other communicable diseases relies on reports that physicians are required to send to local and state health departments and that are then relayed to the Centers for Disease Control and Prevention. At the federal agency in Atlanta, epidemiologists identify outbreaks by studying trends.

At the same time, the fungal meningitis cases have exposed weaknesses in government. A dispute surrounds the Food and Drug Administration’s failure to act earlier to prevent the outbreak. The federal agency has been attacked for failing to use its authority to protect the public from the dangerous practice of large-scale drug compounding that led to the outbreak. But the agency, whose top officials have remained relatively silent, says Congress has not given it the clear authority needed to have taken action.

Dr. Kainer’s investigation progressed in steps similar to peeling the layers of an onion.

Within two days of receiving Dr. Pettit’s e-mail, Dr. Kainer learned that the steroid had come from the New England Compounding Center.

“That got me very concerned,” Dr. Kainer said, because she had taken part in epidemiologic investigations involving different infections linked to compounding centers. Inquiries determined that the New England center had received no reports of infections linked to its steroid, and the C.D.C. knew of no additional recent cases of fungal meningitis and stroke.

An inspection by Dr. Kainer’s staff and from the clinic that administered the injection showed no obvious source of local fungal contamination, like recent construction or water leaks.

Then Dr. Kainer learned of three additional suspect cases of meningitis and stroke linked to the clinic. But fungi had not yet been identified in those patients’ spinal fluid. Also, her team could find no correlations in factors like time of day or week when the patients received the injections. One patient had a particular kind of stroke known as posterior circulation, which attracted Dr. Kainer’s attention because she had learned in neurology that fungal infections can cause such strokes.

“What didn’t make sense was that two patients appeared to be improving without antifungal treatment, and that didn’t fit the clinical picture,” Dr. Kainer said.

So she and her team took additional steps. One was to issue a statewide alert to identify similar cases; none were reported.

“We tell doctors and health workers we would rather have 15 false alarms than miss one case,” Dr. Kainer said.

Then she learned that the two patients who had been improving had taken a turn for the worse.

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