Hospitals crack down on workers refusing flu shots

CHICAGO (AP) — Patients can refuse a flu shot. Should doctors and nurses have that right, too? That is the thorny question surfacing as U.S. hospitals increasingly crack down on employees who won't get flu shots, with some workers losing their jobs over their refusal.

"Where does it say that I am no longer a patient if I'm a nurse," wondered Carrie Calhoun, a longtime critical care nurse in suburban Chicago who was fired last month after she refused a flu shot.

Hospitals' get-tougher measures coincide with an earlier-than-usual flu season hitting harder than in recent mild seasons. Flu is widespread in most states, and at least 20 children have died.

Most doctors and nurses do get flu shots. But in the past two months, at least 15 nurses and other hospital staffers in four states have been fired for refusing, and several others have resigned, according to affected workers, hospital authorities and published reports.

In Rhode Island, one of three states with tough penalties behind a mandatory vaccine policy for health care workers, more than 1,000 workers recently signed a petition opposing the policy, according to a labor union that has filed suit to end the regulation.

Why would people whose job is to protect sick patients refuse a flu shot? The reasons vary: allergies to flu vaccine, which are rare; religious objections; and skepticism about whether vaccinating health workers will prevent flu in patients.

Dr. Carolyn Bridges, associate director for adult immunization at the federal Centers for Disease Control and Prevention, says the strongest evidence is from studies in nursing homes, linking flu vaccination among health care workers with fewer patient deaths from all causes.

"We would all like to see stronger data," she said. But other evidence shows flu vaccination "significantly decreases" flu cases, she said. "It should work the same in a health care worker versus somebody out in the community."

Cancer nurse Joyce Gingerich is among the skeptics and says her decision to avoid the shot is mostly "a personal thing." She's among seven employees at IU Health Goshen Hospital in northern Indiana who were recently fired for refusing flu shots. Gingerich said she gets other vaccinations but thinks it should be a choice. She opposes "the injustice of being forced to put something in my body."

Medical ethicist Art Caplan says health care workers' ethical obligation to protect patients trumps their individual rights.

"If you don't want to do it, you shouldn't work in that environment," said Caplan, medical ethics chief at New York University's Langone Medical Center. "Patients should demand that their health care provider gets flu shots — and they should ask them."

For some people, flu causes only mild symptoms. But it can also lead to pneumonia, and there are thousands of hospitalizations and deaths each year. The number of deaths has varied in recent decades from about 3,000 to 49,000.

A survey by CDC researchers found that in 2011, more than 400 U.S. hospitals required flu vaccinations for their employees and 29 hospitals fired unvaccinated employees.

At Calhoun's hospital, Alexian Brothers Medical Center in Elk Grove Village, Ill., unvaccinated workers granted exemptions must wear masks and tell patients, "I'm wearing the mask for your safety," Calhoun says. She says that's discriminatory and may make patients want to avoid "the dirty nurse" with the mask.

The hospital justified its vaccination policy in an email, citing the CDC's warning that this year's flu outbreak was "expected to be among the worst in a decade" and noted that Illinois has already been hit especially hard. The mandatory vaccine policy "is consistent with our health system's mission to provide the safest environment possible."

The government recommends flu shots for nearly everyone, starting at age 6 months. Vaccination rates among the general public are generally lower than among health care workers.

According to the most recent federal data, about 63 percent of U.S. health care workers had flu shots as of November. That's up from previous years, but the government wants 90 percent coverage of health care workers by 2020.

The highest rate, about 88 percent, was among pharmacists, followed by doctors at 84 percent, and nurses, 82 percent. Fewer than half of nursing assistants and aides are vaccinated, Bridges said.

Some hospitals have achieved 90 percent but many fall short. A government health advisory panel has urged those below 90 percent to consider a mandatory program.

Also, the accreditation body over hospitals requires them to offer flu vaccines to workers, and those failing to do that and improve vaccination rates could lose accreditation.

Starting this year, the government's Centers for Medicare & Medicaid Services is requiring hospitals to report employees' flu vaccination rates as a means to boost the rates, the CDC's Bridges said. Eventually the data will be posted on the agency's "Hospital Compare" website.

Several leading doctor groups support mandatory flu shots for workers. And the American Medical Association in November endorsed mandatory shots for those with direct patient contact in nursing homes; elderly patients are particularly vulnerable to flu-related complications. The American Nurses Association supports mandates if they're adopted at the state level and affect all hospitals, but also says exceptions should be allowed for medical or religious reasons.

Mandates for vaccinating health care workers against other diseases, including measles, mumps and hepatitis, are widely accepted. But some workers have less faith that flu shots work — partly because there are several types of flu virus that often differ each season and manufacturers must reformulate vaccines to try and match the circulating strains.

While not 100 percent effective, this year's vaccine is a good match, the CDC's Bridges said.

Several states have laws or regulations requiring flu vaccination for health care workers but only three — Arkansas, Maine and Rhode Island — spell out penalties for those who refuse, according to Alexandra Stewart, a George Washington University expert in immunization policy and co-author of a study appearing this month in the journal Vaccine.

Rhode Island's regulation, enacted in December, may be the toughest and is being challenged in court by a health workers union. The rule allows exemptions for religious or medical reasons, but requires unvaccinated workers in contact with patients to wear face masks during flu season. Employees who refuse the masks can be fined $100 and may face a complaint or reprimand for unprofessional conduct that could result in losing their professional license.

Some Rhode Island hospitals post signs announcing that workers wearing masks have not received flu shots. Opponents say the masks violate their health privacy.

"We really strongly support the goal of increasing vaccination rates among health care workers and among the population as a whole," but it should be voluntary, said SEIU Healthcare Employees Union spokesman Chas Walker.

Supporters of health care worker mandates note that to protect public health, courts have endorsed forced vaccination laws affecting the general population during disease outbreaks, and have upheld vaccination requirements for schoolchildren.

Cases involving flu vaccine mandates for health workers have had less success. A 2009 New York state regulation mandating health care worker vaccinations for swine flu and seasonal flu was challenged in court but was later rescinded because of a vaccine shortage. And labor unions have challenged individual hospital mandates enacted without collective bargaining; an appeals court upheld that argument in 2007 in a widely cited case involving Virginia Mason Hospital in Seattle.

Calhoun, the Illinois nurse, says she is unsure of her options.

"Most of the hospitals in my area are all implementing these policies," she said. "This conflict could end the career I have dedicated myself to."

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Online:

R.I. union lawsuit against mandatory vaccines: http://www.seiu1199ne.org/files/2013/01/FluLawsuitRI.pdf

CDC: http://www.cdc.gov

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AP Medical Writer Lindsey Tanner can be reached at http://www.twitter.com/LindseyTanner

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France bombs Islamist strongholds in north Mali

BAMAKO/PARIS (Reuters) - French fighter jets pounded Islamist rebel strongholds deep in northern Mali on Sunday as Paris poured more troops into the capital Bamako, awaiting a West African force to dislodge al Qaeda-linked insurgents from the country's north.

The attacks on Islamist positions near the ancient desert trading town of Timbuktu and Gao, the largest city in the north, marked a decisive intensification on the third day of the French mission, striking at the heart of the vast area seized by rebels in April.

France is determined to end Islamist domination of northern Mali, which many fear could act as a base for attacks on the West and for links with al Qaeda in Yemen, Somalia and North Africa.

Defense Minister Jean-Yves Le Drian said France's sudden intervention on Friday had prevented the advancing rebels from seizing Bamako. He vowed that air strikes would continue.

"The president is totally determined that we must eradicate these terrorists who threaten the security of Mali, our own country and Europe," he told French television.

Residents and rebel leaders had reported air raids early on Sunday in the towns of Lere and Douentza in central Mali, forcing Islamists to withdraw. As the day progressed, French jets struck targets further to the north, including near the town of Kidal, the epicenter of the rebellion.

In Gao, a dusty town on the banks of the Niger river where Islamists have imposed an extreme form of sharia law, residents said French jets pounded the airport and rebel positions. A huge cloud of black smoke rose from the militants' camp in the city's north, and trucks ferried dead and wounded to hospital.

"The planes are so fast you can only hear their sound in the sky," resident Soumaila Maiga said by telephone. "We are happy, even though it is frightening. Soon we will be delivered."

Paris said four Rafale jets flew from France to strike rebel training camps, logistics depots and infrastructure around Gao with the aim of weakening the rebels and preventing them from returning southward.

"We blocked the terrorists' advance and from today what we've started to do is to destroy the terrorists' bases behind the front line," French Foreign Minister Laurent Fabius told LCI television.

France has deployed about 550 soldiers to Mali under "Operation Serval" -- named after an African wildcat -- split between Bamako and the town of Mopti, 500 km (300 miles) north.

In Bamako, a Reuters cameraman saw more than 100 French troops disembark on Sunday from a military cargo plane at the international airport, on the outskirts of the capital.

The city's streets were calm, with the sun streaking through the dusty air as the seasonal Harmattan wind blew from the Sahara. Many cars had French flags draped from the windows to celebrate Paris's intervention.

"We thank France for coming to our aid," said resident Mariam Sidibe. "We hope it continues till the north is free."

AFRICAN TROOPS EXPECTED

More than two decades of peaceful elections had earned Mali a reputation as a bulwark of democracy, but that image unraveled in a matter of weeks after a military coup in March which left a power vacuum for the Islamist rebellion.

France convened a U.N. Security Council meeting for Monday to discuss Mali. French President Francois Hollande's intervention has won plaudits from leaders in Europe, Africa and the United States but it is not without risks.

It raised the threat level for eight French hostages held by al Qaeda allies in the Sahara and for the 30,000 French expatriates living in neighboring, mostly Muslim states.

Concerned about reprisals, France has tightened security at public buildings and on public transport. It advised its 6,000 citizens to leave Mali as spokesmen for Ansar Dine and al Qaeda's north Africa wing AQIM promised to exact revenge.

In its first casualty of the campaign, Paris said a French pilot was killed on Friday when rebels shot down his helicopter.

Hours earlier, a French intelligence officer held hostage in Somalia by al Shabaab extremists linked to al Qaeda was killed in a failed commando raid to free him.

Hollande says France's aim is simply to support a mission by West African bloc ECOWAS to retake the north, as mandated by a U.N. Security Council resolution in December.

With Paris pressing West African nations to send their troops quickly, Ivory Coast President Alassane Ouattara, who holds the rotating ECOWAS chairmanship, kick-started the operation to deploy 3,300 African soldiers.

Ouattara, installed in power with French military backing in 2011, convened a summit of the 15-nation bloc for Saturday in Ivory Coast to discuss the mission.

"The troops will start arriving in Bamako today and tomorrow," said Ali Coulibaly, Ivory Coast's African Integration Minister. "They will be convoyed to the front."

The United States is providing transportation and communications support for the push against the Islamist rebels, a U.S. official told Reuters, speaking on condition of anonymity.

The U.S. support also includes intelligence sharing, the official said, without elaborating. Earlier on Sunday, another U.S. official said Washington was considering sending a small number of unarmed surveillance drones.

Britain and Canada have also promised logistical support.

Former French colonies Senegal, Niger and Burkina Faso have all pledged to deploy 500 troops within days. In contrast, regional powerhouse Nigeria, due to lead the ECOWAS force, has suggested it would take time to train and equip the troops.

HOUSE-TO-HOUSE SEARCHES

France, however, appeared to have assumed control of the operation on the ground. Its air strikes allowed Malian troops to drive the Islamists out of the strategic town of Konna, which they had briefly seized this week in their southward advance.

Calm returned to Konna after three nights of combat as the Malian army crushed any remaining rebel fighters. A senior army official said more than 100 rebels had been killed.

"Soldiers are patrolling the streets and have encircled the town," one resident, Madame Coulibaly, told Reuters by phone. "They are searching houses for arms or hidden Islamists."

Analysts expressed doubt, however, that African nations would be able to mount a swift operation to retake north Mali -- a harsh, sparsely populated terrain the size of France -- as neither the equipment nor ground troops were prepared.

"My first impression is that this is an emergency patch in a very dangerous situation," said Gregory Mann, associate professor of history at Columbia University, who specializes in francophone Africa and Mali in particular.

While France and its allies may be able to drive rebel fighters from large towns, they could struggle to prise them from mountain redoubts in the region of Kidal, 300 km (200 miles) northeast of Gao.

Human Rights Watch said at least 11 civilians, including three children, had been killed in the fighting. A spokesman for Doctors Without Borders in neighboring Mauritania said about 200 Malian refugees had fled across the border to a camp at Fassala and more were on their way.

In Bamako, civilians tried to contribute to the war effort.

"We are very proud and relieved that the army was able to drive the jihadists out of Konna. We hope it will not end there, that is why I'm helping in my own way," said civil servant Ibrahima Kalossi, 32, one of over 40 people who queued to donate blood for wounded soldiers.

(Additional reporting by Adama Diarra, Tiemoko Diallo and Rainer Schwenzfeier in Bamako, Pascal Fletcher in Johannesburg, Joe Bavier in Abidjan, Catherine Bremer, Leila Aboud and John Irish in Paris and Phil Stewart in Washington; Writing by Daniel Flynn; Editing by Will Waterman and Roger Atwood)

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Halimah Yacob is first female Speaker

SINGAPORE: Madam Halimah Yacob is Singapore's first woman Speaker of Parliament.

She took the Speaker's seat at the start of the sitting of the House on Monday afternoon.

Madam Halimah, who resigned on Sunday as Minister for State, fills the position vacated by former People's Action Party Member of Parliament, Mr Michael Palmer, who stepped down on 12 December 2012 due to an extramarital affair.

She was nominated by Prime Minister Lee Hsien Loong to be elected as Speaker.

- CNA/ck

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Fog disrupts schedule of over 40 flights at IGI airport

NEW DELHI: Dense fog on Monday returned to the Indira Gandhi International Airport here, badly affecting the schedule of over 40 flights, including diversions of eight to other cities.

Flight operations at the airport came to a standstill for around one-and-half hours, between 5am and 6.30am, as the runway visibility was less than 50 metres on both the runways, main (28/10) and third (29/11), airport sources said.

Eight flights coming to Delhi were diverted to Jaipur, Nagpur and Mumbai between 4am and 6am, when the runway visibility was less than 50 metres, which is the minimum required visibility for a flight to land using the most advanced Category III B of the instrument landing system.

The fog started to descend at the airport around 8pm on Monday night but it become dense from 11.30pm.

The general visibility and the runway visibility worsened after 2.30am when it reduced to less than 50 metres.

A Royal Dutch Airline flight (KLM 872) to Amsterdam was delayed by over eight hours due to fog and subsequent completion of flight duty time limitations (FDTL) of the crew.

The flight took off at 2.30am but had to return due to some technical reasons.In the meantime fog enveloped the airport and the visibility dropped to less than 100 metres, and flight was held up.

When visibility rose above the permissible limit, the FDTL of the crew ended and the flight was rescheduled for departure at 11.45, sources said, adding passengers have been accommodated in the hotels.

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Flu more widespread in US; eases off in some areas

NEW YORK (AP) — Flu is now widespread in all but three states as the nation grapples with an earlier-than-normal season. But there was one bit of good news Friday: The number of hard-hit areas declined.

The flu season in the U.S. got under way a month early, in December, driven by a strain that tends to make people sicker. That led to worries that it might be a bad season, following one of the mildest flu seasons in recent memory.

The latest numbers do show that the flu surpassed an "epidemic" threshold last week. That is based on deaths from pneumonia and influenza in 122 U.S. cities. However, it's not unusual — the epidemic level varies at different times of the year, and it was breached earlier this flu season, in October and November.

And there's a hint that the flu season may already have peaked in some spots, like in the South. Still, officials there and elsewhere are bracing for more sickness

In Ohio, administrators at Miami University are anxious that a bug that hit employees will spread to students when they return to the Oxford campus next week.

"Everybody's been sick. It's miserable," said Ritter Hoy, a spokeswoman for the 17,000-student school.

Despite the early start, health officials say it's not too late to get a flu shot. The vaccine is considered a good — though not perfect — protection against getting really sick from the flu.

Flu was widespread in 47 states last week, up from 41 the week before, the Centers for Disease Control and Prevention said on Friday. The only states without widespread flu were California, Mississippi and Hawaii.

The number of hard-hit states fell to 24 from 29, where larger numbers of people were treated for flu-like illness. Now off that list: Florida, Arkansas and South Carolina in the South, the first region hit this flu season.

Recent flu reports included holiday weeks when some doctor's offices were closed, so it will probably take a couple more weeks to get a better picture, CDC officials said Friday. Experts say so far say the season looks moderate.

"Only time will tell how moderate or severe this flu season will be," CDC Director Dr. Thomas Frieden said Friday in a teleconference with reporters.

The government doesn't keep a running tally of adult deaths from the flu, but estimates that it kills about 24,000 people in an average year. Nationally, 20 children have died from the flu this season.

Flu vaccinations are recommended for everyone 6 months or older. Since the swine flu epidemic in 2009, vaccination rates have increased in the U.S., but more than half of Americans haven't gotten this year's vaccine.

Nearly 130 million doses of flu vaccine were distributed this year, and at least 112 million have been used. Vaccine is still available, but supplies may have run low in some locations, officials said.

To find a shot, "you may have to call a couple places," said Dr. Patricia Quinlisk, who tracks the flu in Iowa.

In midtown Manhattan, Hyrmete Sciuto got a flu shot Friday at a drugstore. She skipped it in recent years, but news reports about the flu this week worried her.

During her commute from Edgewater, N.J., by ferry and bus, "I have people coughing in my face," she said. "I didn't want to risk it this year."

The vaccine is no guarantee, though, that you won't get sick. On Friday, CDC officials said a recent study of more than 1,100 people has concluded the current flu vaccine is 62 percent effective. That means the average vaccinated person is 62 percent less likely to get a case of flu that sends them to the doctor, compared to people who don't get the vaccine. That's in line with other years.

The vaccine is reformulated annually, and this year's is a good match to the viruses going around.

The flu's early arrival coincided with spikes in flu-like illnesses caused by other bugs, including a new norovirus that causes vomiting and diarrhea, or what is commonly known as "stomach flu." Those illnesses likely are part of the heavy traffic in hospital and clinic waiting rooms, CDC officials said.

Europeans also are suffering an early flu season, though a milder strain predominates there. China, Japan, the West Bank, the Gaza Strip, Algeria and the Republic of Congo have also reported increasing flu.

Flu usually peaks in midwinter. Symptoms can include fever, cough, runny nose, head and body aches and fatigue. Some people also suffer vomiting and diarrhea, and some develop pneumonia or other severe complications.

Most people with flu have a mild illness. But people with severe symptoms should see a doctor. They may be given antiviral drugs or other medications to ease symptoms.

Some shortages have been reported for children's liquid Tamiflu, a prescription medicine used to treat flu. But health officials say adult Tamiflu pills are available, and pharmacists can convert those to doses for children.

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Associated Press writers Dan Sewell in Cincinnati, Catherine Lucey in Des Moines, and Malcolm Ritter in New York contributed to this report.

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Online:

CDC flu: http://www.cdc.gov/flu/index.htm

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'Argo' Wins the Golden Globe for Best Movie Drama

Tina Fey and Amy Poehler: The women of the night. Credit: Paul Drinkwater/NBC/AP Photo.

11:06 p.m. ET: And finally, the Globes by the numbers: “Les Miserables” was the top winner, with three major trophies, followed by “Argo” and “Django Unchained, which each got two. On the TV side, “The Game Change” and “Homeland” scored three major awards, “Girls” got two.

11:00 p.m. ET: Fey and Poehler sign off: “Goodnight, we’re going home with Jodie Foster.” Can we get them next year, please?

10:58 p.m. ET: The final award of the night, best motion picture drama, goes to “Argo.” Sounds like we’ll be seeing a lot of Affleck, Clooney and the gang in the coming weeks.

PHOTOS: 2013 Golden Globe Winners

10:51 p.m. ET: And best actor in a drama award goes to … Daniel Day-Lewis for “Lincoln.” “Are you sure there’s room for another ex-president on the stage?” he jokes.

10:48 p.m. ET: Jessica Chastain wins for “Zero Dark Thirty.” She calls out director Kathryn Bigelow: “I can’t help but compare my character of Maya to you. … When you make a film that allows your film to allow your character to disobey the conventions of Hollywood, you’ve done more for women in cinema than you take credit for.”

PHOTOS: Golden Globes’ Hottest Couples

10:47 p.m. ET: It’s time for best actress in a drama — George Clooney’s presenting.

10:41 p.m. ET: Another win for “Les Miserables” — the movie wins the Globe for best comedy or musical.

10:31 p.m. ET: “Les Mis” star Hugh Jackman nabs the Globe for best actor in a movie musical or comedy. He saves his biggest thank you for his wife: “Baby, thank you for always being right.”

PHOTOS: Best and Worst Dressed at the Golden Globes

10:26 p.m. ET: So apparently Jodie Foster is not retiring. Backstage, when asked by reporters “Are you retiring?’, she said “no, not retiring.” What was she talking about then?

10:22 p.m. ET: Major night for “Girls” — second season premiere is tonight and the HBO hit just won best comedy. Dunham grabs the trophy and screams. “It took a village to raise this very demented child,” she says. “I also promised myself that if I ever got this chance, I would thank Chad Lowe.”

10:17 p.m. ET: Next major award of the night goes to Ben Affleck for “Argo” — best director. (Take that, Oscars.) Steven Spielberg does not look happy.

Credit: Jason Merritt/Getty Images

10:11 p.m. ET: And it sounds like Foster just retired from acting. She says she’s not returning to this stage or any stage: “It’s just that from now on, I may be holding a different talking stick.” People in the audience are wiping away tears, notably Kate Hudson.

RELATED: Jodie Foster Wows With Golden Globes Acceptance Speech

10:07 p.m. ET: Foster almost made a huge public statement about her sexuality. Instead, she said she’s single, and she “already did my coming out in the stone age.” “Now, apparently, I’m told that every celebrity is expected to honor the details of their private life with a press conference … You guys might be surprised, but I’m not Honey Boo Boo Child,” she said. “If you had been a public figure from the time that you were a toddler … then maybe you too might value privacy above all else. Privacy.” But she specifically thanked her partner Cydney Bernard, with whom she has two kids.

Credit: Obtained by ABC.

10:06 p.m. ET: Foster accepting her award: “Trust me, 47 years in the film business is a long time. … but tonight, I feel like the prom queen.”

10:02 p.m. ET: Robert Downey Jr. gives a somewhat incomprehensible intro for Jodie Foster, who’s being given the Cecil B. DeMille award for her decades in film.

10:00 p.m. ET: Despite her silence on her relationship status, Taylor Swift WILL NOT be spared: “You know what Taylor Swift, you stay away from Michael J. Fox’s son,” Fey slurs, ignoring Poehler’s objections. “She needs some me time to learn about herself.”

9:58 p.m. ET: Fey and Poehler come back to the mic (finally!) holding drinks. “Everybody’s getting a little lose now that we’re all losers,” Fey says. “Congratulations, Lena. Glad that we got you through middle school.” Poehler says, “Look how drunk Glenn Close is,” Close flails/dances in her chair. Fantastic.

9:52 p.m. ET: Lena Dunham wins best actress in a comedy for “Girls”! She calls Judd Apatow “the greatest honorary ’Girl.’” “This award is for everyone who feels like there wasn’t a place for her,” she says. “This show made a space for me.”

9:50 p.m. ET: Aziz Ansari is pretending the cast of “Downton Abbey” got him high. And Amy Poehler is in George Clooney’s lap. It’s great.

9:46 p.m. ET: “Brave” wins best animated movie.

9:45 p.m. ET: Oh, Sacha Baron Cohen. He’s subbing for Ricky Gervais with an insult-heavy presentation of the nominated animated movies. (Speaking of, where are Fey and Poehler?!)

9:38 p.m. ET: “Homeland” wins again. Claire Danes scores best actress in a TV drama. “I want to thank the other women in this category who are all so badass, so brilliant,” she says. She thanks her costume designer who apparently took her pants out every week while Danes was pregnant last season.

9:35 p.m. ET: The award goes to “Amour,” which picked up a slew of Oscar nominations too.

9:33 p.m. ET: Arnold Schwarzenegger and Sylvester Stallone look hilarious stuffed into suits. They’re presenting the award for best foreign film.

9:27 p.m. ET: It’s a good night for Don Cheadle. His Showtime show “House of Lies” returns for its second season tonight and he just won a Golden Globe for best actor in a TV comedy.

FULL LIST: 2013 Golden Globes Winners

9:23 p.m. ET: Globe for best original screenplay goes to Quentin Tarantino — that’s two trophies so far for “Django Unchained.” He calls the award a “damn surprise” and thanks his friends for listening to him read his scenes. “I don’t want input,” he says. “When I read it to you, I hear it through your ears.”

9:15 p.m. ET: Globe for best supporting actress in a movie (drama) goes to Anne Hathaway for “Les Miserables.” “Blergh,” she says, clearly flustered. “Thanks for that word, Tina.” She also pays tribute to fellow nominee Sally Field for inspiring her to stay in the industry.

Credit: Jordan Strauss/Invision/AP Photo.

9:12 p.m. ET: Best supporting actor in a TV series or movie goes to …  Ed Harris for “Game Change.”

9:06 p.m. ET: Jennifer Lawrence wins best actress in a movie (comedy or musical) for “Silver Linings Playbook.” “Oh what does it say?” she asks, looking at the trophy. “I beat Meryl.” She means Streep, of course.

9:05 p.m. ET: Camera pans to Tommy Lee Jones who is not at all amused by Wiig and Ferrell.

9:03 p.m. ET: Kristen Wiig and Will Ferrell are doing a hilarious bit about how they know absolutely nothing about any of the best actress movie nominees. Of Judy Dench in “Best Exotic Marigold Hotel”: “And she’s on that tractor with the marigolds everywhere.”

9:01 p.m. ET: Poehler gushes over “Hillary’s husband.” Fey is still in drag from her bit earlier. They’re amazing and we want to see more of them.

9:00 p.m. ET: Clinton’s presenting a clip of “Lincoln.” Now this makes sense. “We’re all here tonight because he did it,” he says of Lincoln’s battle to end slavery.

8:59 p.m. ET: What, Bill Clinton’s here?! He gets a standing ovation.

Credit: Obtained by ABC.

8:55 p.m. ET: Kevin Costner wins for best actor in a miniseries or movie for “Hatfields & McCoys.”

8:48 p.m. ET: Adele scoops up the Globe for best original song for the latest Bond theme, “Skyfall.” Her reaction: “Oh my God! … Honestly, I came for a night out, with my friend Ida, we’re new mums … I literally came for a night out.”

Credit: Jordan Strauss/Invision/AP Photo.

8:44 p.m. ET: “Life of Pi” wins for best original score … but J-Lo’s nude dress steals the spotlight. Just like her nipple almost did at last year’s Oscars.

8:41 p.m. ET: “Argo’s” real life inspiration, Tony Mendez, joined John Goodman to introduce a clip of the film, which is up for five Globes.

8:36 p.m. ET: Well that was awkward. Some sort of camera malfunction messed up Salma Hayek and Paul Rudd’s best TV drama intro. “Homeland” wins! Executive producer Alex Gansa: “Thanks to everyone who’s been watching ‘Homeland,’ and to those who haven’t, allow me to spoil it for you.”

8:33 p.m. ET: Best actor in a TV drama goes to … Damian Lewis for “Homeland.” Considering it’s a fan and critic favorite right now, not a huge surprise.

Credit: Jordan Strauss/Invision/AP Photo.

8:28 p.m. ET: Hollywood Foreign Press Association president Dr. Aida Takla-O’Reilly disses Jeffrey Katzenberg for never learning her name, asks Bradley Cooper to “call me maybe.” Amazing.

8:21 p.m. ET: And Julianne Moore wins for best actress in a miniseries or movie. “Oh my gosh, my children will be so relieved,” she says. She gives a shout out to Tina Fey and Katie Couric — “two people who made a difference in the 2008 election.”

Credit: Kevin WInter/Getty Images.

8:18 p.m. ET: “Game Change” scores best miniseries or movie. Somewhere, Sarah Palin is probably shaking her fist.

8:14 p.m. ET: We’ll use the commercial break to declare that Poehler and Fey had an absolutely amazing opening bit. Bravo.

8:12 p.m. ET: Second award of the night, best supporting actress in TV: Maggie Smith for “Downton Abbey.” According to Poehler and Fey’s drinking game, you should drink take off a piece of clothing now.

RELATED: Poehler and Fey Reveal Their Golden Globes Drinking Game

8:10 p.m. ET: And the award for best supporting actor in a movie goes to … Christoph Waltz for “Django Unchained.” Hint that he’ll win the Oscar for that part too?

8:07 p.m. ET: Fey almost reprised her Sarah Palin impression while into-ing Julianne Moore but appears to have lost it. Dang.

8:05 p.m. ET: Poehler: “Meryl Streep is not here tonight, she has the flu. And I hear she’s amazing in it.”

8:04 p.m. ET: Fey had a great one for Anne Hathaway and “Les Mis”: “I have not seen someone so totally alone and abandoned like that since you were on stage with James Franco at the Oscars.”

8:03 p.m. ET: Poehler on Kathryn Bigelow and the “Zero Dark Thirty” torture controversy: “When it comes to torture, I trust the lady who spend three years married to James Cameron.” WOW.

8:02 p.m. ET: Oh and they’re not going to be offensive like past host Ricky Gervais. Poehler: ”When you run afoul of the Hollywood Foreign Press, they make you host this show two more times.”

8:00 p.m. ET: Fey and Poehler did an outfit change before stepping up to the mic. Poehler threw the first jab of the night: “You can smell the pills from here. ”

7:44 p.m. ET: “Scandal” and “Django Unchained” star Kerry Washington never Googles herself. She feels like it’s bad for her health. Now you know. Also, she looks gorgeous in Miu Miu.

7:40 p.m. ET: @AngiesRightLeg has met its match: Halle Berry struck a leggy pose on the red carpet in an unfortunate one-shoulder gown.

Angie's Right Leg, meet Halle's. Credit: Steve Granitz/Getty Images.

7:33 p.m. ET: It’s an “ER” reunion! George Clooney and Julianna Margulies just hugged on the red carpet.

7:28 p.m. ET: Best song nominee Adele revealed that she actually had to be convinced to write the theme for “Skyfall.” “It’s a big responsibility doing a Bond song,” she said. “I didn’t want to let everybody down by doing it.”

7:19 p.m. ET: Julianne Moore looks stunning in black and white Tom Ford. She’s up for best actress in a TV movie for “Game Change.”

7:18 p.m. ET: “Mad Men” star Jon Hamm on the best part of playing Don Draper: “Well it’s always fun to play drunk, because if you forget your lines you’re just like, ‘Uh, well, I’m in character.’”

PHOTOS: The 2013 Golden Globes Red Carpet

7:15 p.m. ET: Taylor Swift wore a mermaid-cut eggplant gown … and did not at all talk about what happened with her latest boyfriend, Harry Styles. Sigh.

Credit: Credit: Steve Granitz/Getty Images.

7:14 p.m. ET: Hugh Jackman revealed the “horrible” way he shed weight quickly before filming “Les Mis”: “I lost about 35 pounds in 36 hours before the first scene. I didn’t drink any liquids whatsoever.”

7:07 p.m. ET: Another fashion miss: Jennifer Lawrence. It looks like she stole Madonna’s cone bra and cut off the straps.

Credit: Steve Granitz/Getty Images.

7:02 p.m. ET: “Zero Dark Thirty” star Jessica Chastain diverged from the major trends of the night — nude, black and white, and red — in a powder blue Calvin Klein Collection gown. The plunging bodice looks a bit like a sack.

Credit: Steve Granitz/Getty Images.

6:57 p.m. ET: E!’s mani-cam has become a source of contention. While some actresses happily showed off their nails on the tiny red carpet, Aziz Ansari refused to stick his hand in the diorama-like box.

FULL COVERAGE: The 2013 Awards Season

6:56 p.m. ET: Olivia Munn has a new perspective on newsrooms now that she’s on Aaron Sorkin’s “The Newsroom.” “I think [our show] makes other newsrooms seem pretty easygoing,” she said.

6:42 p.m. ET: Julia Louis-Dreyfus said she had a “little tiny piece of cake” to celebrate her birthday. “Look, this is a corset,” she said, pointing to her Vera Wang dress. “I can’t mess around.” Though she’s up for best actress in a TV comedy, she thinks she’ll lose. “I hope that Lena Dunham or Amy Poehler have their speech ready,” she said.

6:38 p.m. ET: Hosts Tina Fey and Amy Poehler are encouraging their guests to get liquored up. “It’s a party and we want it to remain a party,” Fey said. Both have awesome outfits — a strapless black and white gown for Fey and a low cut tuxedo for Poehler.

6:31 p.m. ET: “Girls” star and Globes nominee Lena Dunham said her stylist gave her very specific instructions about adjusting her dress because “my breasts have a tendency to shove my dress to the right.” She looks lovely in chocolate brown, off-the-shoulder gown.

Lena Dunham. Credit: Steve Granitz/Getty Images.

6:28 p.m. ET: Best actress in a TV comedy nominee Zooey Deschanel showed off her film strip nail art on the red carpet. Very Hollywood.

Zooey Deschanel. Credit: Steve Granitz/Getty Images.

6:22 p.m. ET: Another stunning new mom: Megan Fox. She admitted that husband Brian Austin Green picks most of her dresses.

6:16 p.m. ET: The first surprise of Golden Globes: How utterly amazing Claire Danes looks. She gave birth a month ago and has a flat, practically concave stomach. She tried on her red Versace dress for the first time last night but admitted she’s “been in sweatpants for quite a while.” She added, “I hope I don’t leak.”

RELATED: Claire Danes Flaunts Post-Baby Body at the Golden Globes

Claire Danes dressed her insane post-baby body in Versace. Credit: Steve Granitz/Getty Images.

6:14 p.m. ET: Amy Adams, up for best supporting actress for “The Master,” looks angelic in a Marchesa in a color she called ballet pink. “This is mommy at work,” she said to her daughter back at home.

Amy Adams in Marchesa. Credit: Steve Granitz/Getty Images.

6:12 p.m. ET: Julianne Hough opted for a creepy crawly accessory — her earrings are made out of actual beetles.

6:02 p.m. ET: For Julia Louis-Dreyfus, this Globes is extra special — today is her 52nd birthday and she’s up for best actress in a TV comedy for “Veep.” “Today I’m either a year older & I’m gonna lose a Golden Globe OR at least I’m nominated & I’m not dead yet,” she wrote on her WhoSay page.

6:00 p.m. ET: It’s here, the night that Hollywood has been steeling its liver for: The Golden Globe Awards, which are almost always a raucous time because the Hollywood Foreign Press keeps the bar open throughout the ceremony. We’ll be chronicling all the jokes, insults, red carpet highlights — and of course, the winners — right here. Keep refreshing for the latest updates.

PHOTOS: 2013 Golden Globe Nominees

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Russia rejects Assad exit as precondition for Syria deal

MOSCOW/BEIRUT (Reuters) - Russia voiced support on Saturday for international peace envoy Lakhdar Brahimi but insisted Syrian President Bashar al-Assad's exit cannot be a precondition for a deal to end the country's conflict.

Some 60,000 Syrians have been killed during the 21-month-old revolt and world powers are divided over how to stop the escalating bloodshed. Government aircraft bombed outer districts of Damascus on Saturday after being grounded for a week by stormy weather, opposition activists in the capital said.

A Russian Foreign Ministry statement following talks on Friday in Geneva with the United States and Brahimi reiterated calls for an end to violence in Syria, but there was no sign of a breakthrough.

Brahimi said the issue of Assad, who the United States, European powers and Gulf-led Arab states insist must step down to end the civil war, appeared to be a sticking point.

Russia's Foreign Ministry said: "As before, we firmly uphold the thesis that questions about Syria's future must be decided by the Syrians themselves, without interference from outside or the imposition of prepared recipes for development."

Russia has been Assad's most powerful international backer, joining with China to block three Western- and Arab-backed U.N. Security Council resolutions aimed to pressure him or push him from power. Assad can also rely on regional powerhouse Iran.

Russia called for "a political transition process" based on an agreement by foreign powers last June.

Brahimi, who is trying to build on that agreement, has met three times with senior Russian and U.S. diplomats since early December and met Assad in Damascus.

Russia and the United States disagreed over what the June agreement meant for Assad, with Washington saying it sent a clear signal he must go and Russia contending it did not.

Qatar on Saturday made a fresh call for an Arab force to end bloodshed in Syria if Brahimi's efforts fail, according to the Doha-based al Jazeera television.

"It is not a question of intervention in Syria in favor of one party against the other, but rather a force to preserve security," Qatar's Prime Minister and Foreign Minister, Sheikh Hamad bin Jassim al-Thani, said in an al Jazeera broadcast.

CONFLICT INTENSIFIES

Moscow has been reluctant to endorse the "Arab Spring" popular revolts of the last two years, saying they have increased instability in the Middle East and created a risk of radical Islamists seizing power.

Although Russia sells arms to Syria and rents one of its naval bases, the economic benefit of its support for Assad is minimal. Analysts say President Vladimir Putin wants to prevent the United States from using military force or support from the U.N. Security Council to bring down governments it opposes.

However, as rebels gain ground in the war, Russia has given indications it is preparing for Assad's possible exit, while continuing to insist he must not be forced out by foreign powers.

Opposition activists say a military escalation and the hardship of winter have accelerated the death toll.

Rebel forces have acquired more powerful anti-tank and anti-aircraft weapons during attacks on Assad's military bases.

Assad's forces have employed increasing amounts of military hardware including Scud-type ballistic missiles in the past two months. New York-based Human Rights Watch said they had also used incendiary cluster bombs that are banned by most nations.

STALEMATE IN CITIES

The weeklong respite from aerial strikes has been marred by snow and thunderstorms that affected millions displaced by the conflict, which has now reached every region of Syria.

On Saturday, the skies were clear and jets and helicopters fired missiles and dropped bombs on a line of towns to the east of Damascus, where rebels have pushed out Assad's ground forces, the Syrian Observatory for Human Rights said.

The British-based group, which is linked to the opposition, said it had no immediate information on casualties from the strikes on districts including Maleiha and farmland areas.

Rebels control large swathes of rural land around Syria but are stuck in a stalemate with Assad's forces in cities, where the army has reinforced positions.

State TV said government forces had repelled an attack by terrorists - a term it uses for the armed opposition - on Aleppo's international airport, now used as a helicopter base.

Reuters cannot independently confirm reports due to severe reporting restrictions imposed by the Syrian authorities and security constraints.

On Friday, rebels seized control of one of Syria's largest helicopter bases, Taftanaz in Idlib province, their first capture of a military airfield.

Eight-six people were killed on Friday, including 30 civilians, the Syrian Observatory said.

(Writing by Oliver Holmes; Editing by Tom Pfeiffer and Doina Chiacu)

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Some leads in cat mutilation case: K Shanmugam

SINGAPORE: Law and Foreign Affairs Minister K Shanmugam said there has been some leads on the recent case of cat mutilation.

Two weeks ago, on 30 December 2012, two kittens were found dismembered outside a HDB flat in Chong Pang Division in Yishun.

Mr Shanmugam, who's the MP for Nee Soon GRC, said some people had come forward with information related to the case. He said he has passed the information on to the police.

He called the case "cruel" and "abominable". "I'll be checking with the police again on what is happening. But we also don't want to put the pictures up too much because I worry about copy cat incidents. It's terrible."

- CNA/ck

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Anju Ilyasi's death: HC stays medical board proceedings

NEW DELHI: In a relief to TV serial producer Suhaib Ilyasi, the Delhi high court has stayed the proceedings of a medical board constituted to examine afresh the reasons of his wife Anju Ilyasi's death in 2000.

Ilyasi, also the editor-in-chief of Bureaucracy Today magazine, has been facing trial as an accused for last 12 years in dowry death case of his wife Anju Ilyasi.

She had been rushed to a hospital on January 11, 2000 with fatal stab wounds allegedly received by her at her East Delhi residence.

"Issue notice to respondent department (Delhi police) for March 14. Meanwhile, the (medical) board proceedings have been stayed," Justice Kailash Gambhir said.

Ilyasi, who had shot into limelight after hosting TV serial on crime, 'India's Most Wanted,' alleged even after the lapse of over 12 years when the trial is at its fag end, police, without getting sanction from the lower court, constituted a medical board to examine afresh the reasons of his wife's death.

The previous medical board had given split opinion on her death, Ilyasi's counsel said, adding that "the formation of another board was an act of contempt."

Ilyasi also alleged that a police officer, who was one of the investigating officers in the case, still "interferes" with the judicial and enquiry processes despite the fact that he is deployed as DCP in the Prime Minister's security contingent.

The trial court would shortly start hearing final arguments in the case in which penal provisions relating to dowry death and subjecting a woman to cruelty have been invoked against Ilyasi.

Earlier, a trial court had rejected Anju's mother Rukma Singh's plea to invoke additional murder charge against her son-in-law Ilyasi, saying no fresh evidence has emerged against him.

The court had also noted that there was no proof to support the allegation that Ilyasi had tampered with evidence.

Prior to this also, the court had rejected a similar plea. Ilyasi was arrested on March 28, 2000 and later, charges were framed against him in the case after his sister-in-law and mother-in-law alleged that he used to torture his wife for dowry.

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Q&A: Scramble for vaccine as flu season heats up

WASHINGTON (AP) — Missed flu-shot day at the office last fall? And all those "get vaccinated" ads? A scramble for shots is under way as late-comers seek protection from a miserable flu strain already spreading through much of the country.

Federal health officials said Friday that there is still some flu vaccine available and it's not too late to benefit from it. But people may have to call around to find a clinic with shots still on the shelf, or wait a few days for a new shipment.

"We're hearing of spot shortages," said Dr. Thomas Frieden, director of the Centers for Disease Control and Prevention.

Colorado offers an example. Kaiser Permanente, which has 535,000 members in the state, stopped giving flu shots this week. But it expected to resume vaccinations when new shipments arrive, expected this weekend.

Some questions and answers about flu vaccines:

Q: Are we running out of vaccine?

A: It's January — we shouldn't have a lot left. The traditional time to get vaccinated is in the fall, so that people are protected before influenza starts spreading.

Indeed, manufacturers already have shipped nearly 130 million doses to doctors' offices, drugstores and wholesalers, out of the 135 million doses they had planned to make for this year's flu season. At least 112 million have been used so far.

The nation's largest manufacturer, Sanofi Pasteur, said Friday that it still has supplies of two specialty vaccines, a high-dose shot for seniors, and an under-the-skin shot for certain adults, available for immediate shipment. But it also is working to eke out a limited supply of its traditional shots — some doses that it initially hadn't packaged into syringes, said spokesman Michael Szumera. They should be available late this month.

And MedImmune, the maker of the nasal spray vaccine FluMist, said it has 620,000 extra doses available.

Q: Can't they just make more?

A: No. Flu vaccine is complicated to brew, with supplies for each winter made months in advance and at the numbers expected to sell. Although health officials recommend a yearly flu vaccination for nearly everybody, last year 52 percent of children and just 39 percent of adults were immunized. Most years, leftover doses have to be thrown out.

Q: Should I still hunt for a vaccine?

A: It does take two weeks for full protection to kick in. Still, health officials say it's a good idea to be vaccinated even this late, especially for older people, young children and anyone with medical conditions such as heart or lung diseases that put them at high risk of dangerous flu complications. Flu season does tend to be worst in January and February, but it can run through March.

Q: I heard that a new flu strain is spreading. Does the vaccine really work?

A: Flu strains constantly evolve, the reason that people need an updated vaccine every year. But the CDC says this year's is a good match to the types that are circulating, including a new kind of the tough H3N2 strain. That family tends to be harsher than other flu types — and health officials warned last fall that it was coming, and meant this winter would likely be tougher than last year's flu season, the mildest on record.

Q: But don't some people get vaccinated and still get sick?

A: Flu vaccine never is 100 percent effective, and unfortunately it tends to protect younger people better than older ones. But the CDC released a study Friday showing that so far this year, the vaccine appears 62 percent effective, meaning it's working about as well as it has in past flu seasons.

While that may strike some people as low, Frieden said it's the best protection available. "It's a glass 62 percent full," he said. "It's well worth the effort."

Q: What else can I do?

A: Wash your hands often, and avoid touching your eyes, nose and mouth. Viruses can spread by hand, not just through the air. Also, cough in your elbow, not your hand. When you're sick, protect others by staying home.

And people who are in those high-risk groups should call a doctor if they develop symptoms, added CDC spokesman Tom Skinner. They might be prescribed antiviral medication, which works best if given within the first 48 hours of symptoms.

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AP Medical Writers Lindsey Tanner and Mike Stobbe contributed to this report.

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