Simple measures cut infections caught in hospitals

CHICAGO (AP) — Preventing surgery-linked infections is a major concern for hospitals and it turns out some simple measures can make a big difference.

A project at seven big hospitals reduced infections after colorectal surgeries by nearly one-third. It prevented an estimated 135 infections, saving almost $4 million, the Joint Commission hospital regulating group and the American College of Surgeons announced Wednesday. The two groups directed the 2 1/2-year project.

Solutions included having patients shower with special germ-fighting soap before surgery, and having surgery teams change gowns, gloves and instruments during operations to prevent spreading germs picked up during the procedures.

Some hospitals used special wound-protecting devices on surgery openings to keep intestine germs from reaching the skin.

The average rate of infections linked with colorectal operations at the seven hospitals dropped from about 16 percent of patients during a 10-month phase when hospitals started adopting changes to almost 11 percent once all the changes had been made.

Hospital stays for patients who got infections dropped from an average of 15 days to 13 days, which helped cut costs.

"The improvements translate into safer patient care," said Dr. Mark Chassin, president of the Joint Commission. "Now it's our job to spread these effective interventions to all hospitals."

Almost 2 million health care-related infections occur each year nationwide; more than 90,000 of these are fatal.

Besides wanting to keep patients healthy, hospitals have a monetary incentive to prevent these infections. Medicare cuts payments to hospitals that have lots of certain health care-related infections, and those cuts are expected to increase under the new health care law.

The project involved surgeries for cancer and other colorectal problems. Infections linked with colorectal surgery are particularly common because intestinal tract bacteria are so abundant.

To succeed at reducing infection rates requires hospitals to commit to changing habits, "to really look in the mirror and identify these things," said Dr. Clifford Ko of the American College of Surgeons.

The hospitals involved were Cedars-Sinai Medical Center in Los Angeles; Cleveland Clinic in Ohio; Mayo Clinic-Rochester Methodist Hospital in Rochester, Minn.; North Shore-Long Island Jewish Health System in Great Neck, NY; Northwestern Memorial Hospital in Chicago; OSF Saint Francis Medical Center in Peoria, Ill.; and Stanford Hospital & Clinics in Palo Alto, Calif.

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Online:

Joint Commission: http://www.jointcommission.org

American College of Surgeons: http://www.facs.org

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

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No more government contracts for BP

WASHINGTON (Reuters) - The U.S. government banned BP Plc on Wednesday from new federal contracts over its "lack of business integrity" in the 2010 Deepwater Horizon oil spill, possibly imperiling the company's role as a top U.S. offshore oil and gas producer and the No. 1 military fuel supplier.


The suspension, announced by the Environmental Protection Agency, comes on the heels of BP's November 15 agreement with the U.S. government to plead guilty to criminal misconduct in the Gulf of Mexico disaster, the worst offshore oil spill in U.S. history. The British energy giant agreed to pay $4.5 billion in penalties, including a record $1.256 billion criminal fine.


BP and its affiliates are barred from new federal contracts until they demonstrate they can meet federal business standards, the EPA said. The suspension is "standard practice" and BP's existing U.S. government contracts are not affected, it said.


The EPA acted hours before a government auction of offshore tracts in the Gulf of Mexico, a region where BP is the largest investor and lease-holder of deep-water tracts and hopes for further growth. BP is also the top fuel supplier to the U.S. military, the largest single buyer of oil in the world.


Suspension of contracts could give the government leverage to pressure BP to settle federal and state civil litigation that could top $20 billion if a court finds BP was grossly negligent in the Deepwater Horizon disaster.


An EPA official said government-wide suspensions generally do not exceed 18 months, but can continue longer if there are ongoing legal cases.


In a statement, BP said it has been in "regular dialogue" with the EPA, and that the agency has informed BP that it is preparing an agreement that "would effectively resolve and lift this temporary suspension." The EPA has notified BP that the draft agreement will be available soon, BP said.


U.S. operations accounted for more than 30 percent of BP's pre-tax profits in the third quarter, and the United States accounts for about a fifth of BP's global oil production.


The U.S. military has been a reliable customer of BP's jet fuel and other refined products. As recently as September, BP affiliates won two military fuel contracts worth as much as $1.37 billion, according to a website that tracks U.S. military contracts.


The EPA's action is a sign that all federal contractors will be held to high standards, said Scott Amey, general counsel for the Project on Government Oversight, a private watchdog group.


"BP had years to improve its business ethics and is paying the price for its inaction," Amey said.


On November 15, BP Finance Director Brian Gilvary told investors on a conference call that any blanket ban could force the company to rethink its entire U.S. business.


The Justice Department says it intends to prove in a court case set to get underway in February 2013 that BP was grossly negligent under the Clean Water Act, a claim the company has adamantly denied.


"The critical question is whether this a shot across BP's bows to get settlement, or a more sustained stance, in which case the importance of the context is underlined" by Gilvary's comments, said Peter Hutton, an analyst with RBC Capital Markets.


The EPA's suspension will not impair BP's ability to produce oil and gas from existing U.S. assets, said Pavel Molchanov, an analyst with Raymond James & Associates Inc in Houston.


"BP's supply contract of fuels to the Pentagon might be at risk, but of course BP could supply other customers if this supply contract is not renewed," Molchanov said in a research note.


BP and the U.S. government likely worked out a deal on the timing of the suspension before BP agreed to sign off on the November 15 criminal plea deal, said Samuel Buell, a Duke University Law School professor and former federal prosecutor.


"It's just inconceivable to me that BP's lawyers ... would have entered into that agreement last week without the issue of a suspension or debarment having been addressed," Buell said.


BP did not participate in Wednesday's federal auction of 20 million acres (8 million hectares) of drilling tracts in the Gulf of Mexico, one of BP's biggest oil production regions globally.


One long-time critic of BP applauded the decision.


"After pleading guilty to such reckless behavior that killed men and constituted a crime against the environment, suspending BP's access to contracts with our government is the right thing to do," U.S. Rep. Edward Markey, a Democrat from Massachusetts, said in a statement.


BP's U.S.-traded shares closed flat, while London-traded shares were down less than 1 percent at 427 pence.


(Additional reporting by Andrew Callus in London, Ayesha Rascoe in Washington, Joshua Schneyer in New York and Kristen Hays in Houston; Writing by Chris Baltimore; Editing by John Wallace, Grant McCool, Andrew Hay and Marguerita Choy)


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China's party paper falls for Onion joke about Kim

BEIJING (AP) — The online version of China's Communist Party newspaper has hailed a report by The Onion naming North Korean dictator Kim Jong Un as the "Sexiest Man Alive" — not realizing it is satire.

The People's Daily on Tuesday ran a 55-page photo spread on its website in a tribute to the round-faced leader, under the headline "North Korea's top leader named The Onion's Sexiest Man Alive for 2012."

Quoting The Onion's spoof report, the Chinese newspaper wrote, "With his devastatingly handsome, round face, his boyish charm, and his strong, sturdy frame, this Pyongyang-bred heartthrob is every woman's dream come true."

"Blessed with an air of power that masks an unmistakable cute, cuddly side, Kim made this newspaper's editorial board swoon with his impeccable fashion sense, chic short hairstyle, and, of course, that famous smile," the People's Daily cited The Onion as saying.

The photos the People's Daily selected include Kim on horseback squinting into the light and Kim waving toward a military parade. In other photos, he is wearing sunglasses and smiling, or touring a facility with his wife.

People's Daily could not immediately be reached for comment. A man who answered the phone at the newspaper's duty office said he did not know anything about the report and requested queries be directed to their newsroom on Wednesday morning.

It is not the first time a state-run Chinese newspaper has fallen for a fictional report by the just-for-laughs The Onion.

In 2002, the Beijing Evening News, one of the capital city's biggest tabloids at the time, published as news the fictional account that the U.S. Congress wanted a new building and that it might leave Washington. The Onion article was a spoof of the way sports teams threaten to leave cities in order to get new stadiums.

Two months ago, Iran's semiofficial Fars news agency reprinted a story from The Onion about a supposed survey showing that most rural white Americans would rather vote for Iranian President Mahmoud Ahmadinejad than President Barack Obama. It included a quote from a fictional West Virginia resident saying he'd rather go to a baseball game with Ahmadinejad because "he takes national defense seriously."

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'Hobbit' director aims for magical film experience

WELLINGTON, New Zealand (AP) — Peter Jackson says he hopes technology he used on his "Hobbit" movie trilogy will help create a "magical" experience that will encourage people to return to theaters.

Jackson spoke at a news conference in Wellington hours before the Wednesday premiere of "The Hobbit: An Unexpected Journey." He shot at 48 frames per second instead of the traditional 24 to give the film greater clarity. He likened the technology to the leap from vinyl records to CDs.

He says younger people are happy to watch movies on their iPads, so filmmakers "have to make the cinema-going experience more magical and more spectacular."

Some observers who saw preview footage at a convention in April thought the images were too clear and that the realism detracted from the magic of film.

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CDC: HIV spread high in young gay males

NEW YORK (AP) — Health officials say 1 in 5 new HIV infections occur in a tiny segment of the population — young men who are gay or bisexual.

The government on Tuesday released new numbers that spotlight how the spread of the AIDS virus is heavily concentrated in young males who have sex with other males. Only about a quarter of new infections in the 13-to-24 age group are from injecting drugs or heterosexual sex.

The Centers for Disease Control and Prevention said blacks represented more than half of new infections in youths. The estimates are based on 2010 figures.

Overall, new U.S. HIV infections have held steady at around 50,000 annually. About 12,000 are in teens and young adults, and most youth with HIV haven't been tested.

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Online:

CDC report: http://www.cdc.gov/vitalsigns

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Protesters pack Tahrir Square, dispute Morsi

CAIRO (AP) — The same chants used against Hosni Mubarak were turned against his successor Tuesday as more than 200,000 people packed Egypt's Tahrir Square in the biggest challenge yet to Islamist President Mohammed Morsi.


The massive, flag-waving throng protesting Morsi's assertion of near-absolute powers rivaled some of the largest crowds that helped drive Mubarak from office last year.


"The people want to bring down the regime!" and "erhal, erhal" — Arabic for "leave, leave" — rang out across the plaza, this time directed at Egypt's first freely elected president.


The protests were sparked by edicts Morsi issued last week that effectively neutralize the judiciary, the last branch of government he does not control. But they turned into a broader outpouring of anger against Morsi and his Muslim Brotherhood, which opponents say have used election victories to monopolize power, squeeze out rivals and dictate a new, Islamist constitution, while doing little to solve Egypt's mounting economic and security woes.


Clashes broke out in several cities, with Morsi's opponents attacking Brotherhood offices, setting fire to at least one. Protesters and Brotherhood members pelted each other with stones and firebombs in the Nile Delta city of Mahalla el-Kobra, leaving at least 100 people injured.


"Power has exposed the Brotherhood. We discovered their true face," said Laila Salah, a housewife at the Tahrir protest who said she voted for Morsi in last summer's presidential election. After Mubarak, she said, Egyptians would no longer accept being ruled by an autocrat.


"It's like a wife whose husband was beating her and then she divorces him and becomes free," she said. "If she remarries she'll never accept another day of abuse."


Gehad el-Haddad, a senior adviser to the Brotherhood and its political party, said Morsi would not back down on his edicts. "We are not rescinding the declaration," he told The Associated Press.


That sets the stage for a drawn-out battle that could throw the nation into greater turmoil. Protest organizers have called for another mass rally Friday. If the Brotherhood responds with demonstrations of its own, as some of its leaders have hinted, it would raise the prospect of greater violence after a series of clashes between the two camps in recent days.


A tweet by the Brotherhood warned that if the opposition was able to bring out 200,000 to 300,000, "they should brace for millions in support" of Morsi.


Another flashpoint could come Sunday, when the constitutional court is to rule on whether to dissolve the assembly writing the new constitution, which is dominated by the Brotherhood and its Islamist allies. Morsi's edicts ban the courts from disbanding the panel; if the court defies him and rules anyway, it would be a direct challenge that could spill over into the streets.


"Then we are in the face of the challenge between the supreme court and the presidency," said Nasser Amin, head of the Arab Center for the Independence of the Judiciary and the Legal Profession. "We are about to enter a serious conflict" on both the legal and street level, he said.


Morsi and his supporters say the decrees were necessary to prevent the judiciary from blocking the "revolution's goals" of a transition to democracy. The courts — where many Mubarak-era judges still hold powerful posts — have already disbanded the first post-Mubarak elected parliament, which was led by the Brotherhood. Now it could also take aim at the Islamist-led upper house of parliament.


Morsi's decrees ban the judiciary from doing so and grant his decisions immunity from judicial review. Morsi also gave himself sweeping powers to prevent threats to the revolution, stability or state institutions, which critics say are tantamount to emergency laws. These powers are to remain in effect until the constitution is approved and parliamentary elections are held, not likely before spring 2013.


Opponents say the decrees turn Morsi — who narrowly won last summer's election with just over 50 percent of the vote — into a new dictator, given that he holds not only executive but also legislative powers, after the lower house of parliament was dissolved.


Tuesday's turnout was an unprecedented show of strength by the mainly liberal and secular opposition, which has been divided and uncertain amid the rise to power of the Brotherhood over the past year. The crowds were of all stripes, including many first-time protesters.


"Suddenly Morsi is issuing laws and becoming the absolute ruler, holding all powers in his hands," said Mona Sadek, a 31-year-old engineering graduate who wears the Islamic veil, a hallmark of piety. "Our revolt against the decrees became a protest against the Brotherhood as well."


"The Brotherhood hijacked the revolution," agreed Raafat Magdi, an engineer who was among a crowd of some 10,000 marching from the Cairo district of Shubra to Tahrir to the beat of drums and chants against the Brotherhood. Reform leader Mohammed ElBaradei led the march.


"People woke up to (Morsi's) mistakes, and in any new elections they will get no votes," Magdi said.


Many in the crowd said they were determined to push ahead with the protests until Morsi retreats. A major concern was that Islamists would use the decree's protection of the constitutional assembly to drive through their vision for the next charter, with a heavy emphasis on implementing Shariah, or Islamic law. The assembly has been plagued with controversy, and more than two dozen of its 100 members have quit in recent days to protest Islamist control.


"Next Friday will be decisive," protester Islam Bayoumi said of the upcoming rally. "If people maintain the same pressure and come in large numbers, they could manage to press the president and rescue the constitution."


A fellow protester, Saad Salem Nada, said of Morsi: "I am a Muslim and he made me hate Muslims because of the dictatorship in the name of religion. In the past, we had one Mubarak. Now we have hundreds."


Even as the crowds swelled in Tahrir, clashes erupted nearby between several hundred protesters throwing stones and police firing tear gas on a street leading to the U.S. Embassy. Clouds of tear gas hung over the area, where clashes have broken out for several days, fueled by anger over police abuses.


A photographer working for the AP, Ahmed Gomaa, was beaten by stick-wielding police while covering the clashes. Police took his equipment and Gomaa was taken to a hospital for treatment.


Rival rallies by Morsi opponents and supporters turned into brief clashes in the Mediterranean city of Alexandria, where anti-Morsi protesters broke into the local office of the Muslim Brotherhood, throwing furniture out the windows and trying unsuccessfully to set fire to it. Protesters also set fire to Brotherhood offices in the city of Mansoura.


Morsi's supporters canceled a massive rally planned for Tuesday in Cairo, citing the need to "defuse tension." Morsi's supporters say more than a dozen of their offices have been ransacked or set ablaze since Friday. Some 5,000 demonstrated in the southern city of Assiut in support of Morsi's decrees, according to witnesses there.


So far, there has been little sign of a compromise. On Monday, Morsi met with the nation's top judges and tried to win their acceptance of his decrees. But the move was dismissed by many in the opposition and the judiciary as providing no real concessions.


Saad Emara, a senior Muslim Brotherhood member, said Morsi will not make any concessions, especially after the surge of violence and assaults on Brotherhood offices.


Emara accused the opposition "of resorting to violence with a political cover," claiming that former ruling party and Mubarak-era businessmen were hiring thugs to attack Brotherhood offices with the opposition's blessing.


"The story now is that the civilian forces are playing with fire. This is a dangerous scene."


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Associated Press writer Hamza Hendawi in Cairo contributed to this report.

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China praises engineer in aircraft carrier program

BEIJING (AP) — China's government gave hero's praise to a senior engineer on its aircraft carrier program who died of a heart attack after witnessing the first landing of a plane on the ship, underscoring the project's huge national prestige.

State broadcaster CCTV ran news of Luo Yang's death as its first item on Monday's noon news broadcast, a high profile for a scientist who was previously unknown outside of the carrier program. Luo, 51, oversaw the development of the J-15 fighter-bomber planes designated for the ship, which is called Liaoning after the province where it is based.

The coverage illustrates the priority Beijing has placed on the program, seen as representing China's rise from poverty to economic and political might over the past three decades. The carrier was built in the former Soviet Union and is seen as a test platform for future Chinese-built vessels.

Few details were available about Luo, who died Sunday. A man who answered the phone at his employer, the Shenyang Aircraft Corp., confirmed his death but declined to give details. The company produces the bulk of China's modern military jets — many of them, like the J-15, derived from Russian models.

The official China Daily newspaper said Luo had felt unwell while on board the ship but continued to monitor landings. He suffered a massive coronary after returning to his hotel and died on the way to hospital, the report said said.

Chinese academics assigned to signature government projects such as the carrier are often under enormous pressure, and stress is considered among the biggest killers of the country's intellectuals. China overcame major technical hurdles to make the carrier seaworthy after buying the half-completed hulk from the Ukraine and towing it to China, minus its engines, weaponry and navigation systems.

Most of that work was carried out in the northeastern port of Dalian, to which the carrier returned on Sunday following its latest round of sea trials.

Despite the breakthrough in air operations, the ship is still years away from being battle-worthy. China's navy still needs to show it can operate large numbers of planes at the same time and organize a carrier battle group that includes submarines and support ships.

"The first landing may be a milestone, but it's just the beginning," said Toshi Yoshihara, professor of Asia-Pacific studies at the U.S. Naval War College in Rhode Island. "How the Chinese will handle aircraft losses, which are inevitable, is a better indicator of Beijing's determination to become a carrier."

The J-15 is a Chinese adaptation of the naval version of Russia's Su-33.

In Washington, the State Department said the U.S. was continuing to monitor Chinese military developments carefully.

Spokeswoman Victoria Nuland urged Beijing to be as transparent as possible about its military capabilities and intentions and to use its capabilities, including the aircraft carrier, in a way conducive to supporting peace and stability in the Asia-Pacific region.

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Berry's ex says he was threatened before fight

LOS ANGELES (AP) — Halle Berry's ex-boyfriend claims the actress's fiance threatened to kill him during a Thanksgiving confrontation that left him with a broken rib, bruised face and under arrest.

Gabriel Aubry's claims are included in court filings that led a judge Monday to grant a restraining order against actor Olivier Martinez, who is engaged to the Oscar-winning actress.

Aubry, 37, was arrested on suspicion of misdemeanor battery after his confrontation with Martinez on Thursday, but he states in the civil court filings that he was not the aggressor and that he was threatened and attacked without provocation. Martinez told police that Aubry had attacked first, the filings state.

A representative for Martinez could not be immediately reached for comment.

Aubry's filing claims Martinez threatened him the day before the fight at an event at his daughter's school that he and the actors attended. Aubry, a model, has a 4-year-old daughter with Berry and the former couple have been engaged in a lengthy custody battle.

The proceedings have been confidential, but Aubry states a major aspect of the case was Berry's wish to move to Paris and take her daughter with her. The request was denied Nov. 9, Berry's court filings state, and Aubry shares joint custody of the young girl.

Aubry claims Martinez told him, "You cost us $3 million," while he was punched and kicked him in the driveway of Berry's home. Aubry had gone to the home to allow his daughter to spend Thanksgiving with her mother, the filings state. Aubry claims Martinez threatened to kill him if Aubry didn't move to Paris.

Berry was not in the driveway during the confrontation and neither was their daughter, the documents state.

Photos of Aubry's face with cuts and a black eye were included in his court filing.

A judge set a hearing for Dec. 17 to consider whether a three-year restraining order should be granted. Aubry has a Dec. 13 court date for the possible battery case, which has not yet been filed by prosecutors.

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

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Bounce houses a party hit but kids' injuries soar

CHICAGO (AP) — They may be a big hit at kids' birthday parties, but inflatable bounce houses can be dangerous, with the number of injuries soaring in recent years, a nationwide study found.

Kids often crowd into bounce houses, and jumping up and down can send other children flying into the air, too.

The numbers suggest 30 U.S. children a day are treated in emergency rooms for broken bones, sprains, cuts and concussions from bounce house accidents. Most involve children falling inside or out of the inflated playthings, and many children get hurt when they collide with other bouncing kids.

The number of children aged 17 and younger who got emergency-room treatment for bounce house injuries has climbed along with the popularity of bounce houses — from fewer than 1,000 in 1995 to nearly 11,000 in 2010. That's a 15-fold increase, and a doubling just since 2008.

"I was surprised by the number, especially by the rapid increase in the number of injuries," said lead author Dr. Gary Smith, director of the Center for Injury Research and Policy at Nationwide Children's Hospital in Columbus, Ohio.

Amusement parks and fairs have bounce houses, and the playthings can also be rented or purchased for home use.

Smith and colleagues analyzed national surveillance data on ER treatment for nonfatal injuries linked with bounce houses, maintained by the U.S. Consumer Product Safety Commission. Their study was published online Monday in the journal Pediatrics.

Only about 3 percent of children were hospitalized, mostly for broken bones.

More than one-third of the injuries were in children aged 5 and younger. The safety commission recommends against letting children younger than 6 use full-size trampolines, and Smith said barring kids that young from even smaller, home-use bounce houses would make sense.

"There is no evidence that the size or location of an inflatable bouncer affects the injury risk," he said.

Other recommendations, often listed in manufacturers' instruction pamphlets, include not overloading bounce houses with too many kids and not allowing young children to bounce with much older, heavier kids or adults, said Laura Woodburn, a spokeswoman for the National Association of Amusement Ride Safety Officials.

The study didn't include deaths, but some accidents are fatal. Separate data from the product safety commission show four bounce house deaths from 2003 to 2007, all involving children striking their heads on a hard surface.

Several nonfatal accidents occurred last year when bounce houses collapsed or were lifted by high winds.

A group that issues voluntary industry standards says bounce houses should be supervised by trained operators and recommends that bouncers be prohibited from doing flips and purposefully colliding with others, the study authors noted.

Bounce house injuries are similar to those linked with trampolines, and the American Academy of Pediatrics has recommended against using trampolines at home. Policymakers should consider whether bounce houses warrant similar precautions, the authors said.

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Online:

Pediatrics: http://www.pediatrics.org

Trade group: http://www.naarso.com

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

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Sandy cost New York $32 billion

ALBANY, N.Y. (AP) — Top political leaders in New York put their heads together Monday on big requests for federal disaster aid as Gov. Andrew Cuomo announced that Superstorm Sandy ran up a bill of $32 billion in the state and the nation's largest city.

The cost is for repairs and restoration and does not include an additional accounting of over $9 billion to head off damage in the next disastrous storm, including steps to protect the power grid and cellphone network.

"It's common sense; it's intelligent," Cuomo said. "Why don't you spend some money now to save money in the future? And that's what prevention and mitigation is."

New York Mayor Michael Bloomberg had announced earlier in the day that Sandy caused $19 billion in losses in New York City — part of the $32 billion estimate Cuomo used.

New York taxpayers, Cuomo said, can't foot the bill.

"It would incapacitate the state. ... Tax increases are always a last, last, last resort."

Cuomo met with New York's congressional delegation to discuss the new figures and present "less than a wish list." The delegation, Cuomo and Bloomberg will now draw up a request for federal disaster aid.

States typically get 75 percent reimbursement for the cost of governments to restore mass transit and other services after a disaster.

The most basic recovery costs for roads, water systems, schools, parks, individual assistance and more total $15 billion in New York City; $7 billion for state agencies; $6.6 billion in Nassau County and $1.7 billion in Suffolk County, both on suburban Long Island; and $527 million in Westchester County and $143 million in Rockland County, both north of New York City, according to a state document used in the private briefing of the delegation and obtained by The Associated Press.

Hard times were already facing the state and city governments that were staring at deficits of more than $1 billion before Sandy hit in late October. State tax receipts have also missed projections, showing a continued slow recovery from a recession that could hit taxpayers in the governments' budgets this spring. And there's the looming fiscal cliff, the combination of expiring federal tax cuts and major spending cuts that could rattle the economy.

"Make no mistake, this will not be an easy task, particularly given the impending fiscal cliff, and a Congress that has been much less friendly to disaster relief than in the past," Schumer said. "We will work with the (Obama) administration on supplemental legislation, to be introduced in the upcoming December session of Congress, that will set us on the road to meeting New York's needs. This will be an effort that lasts not weeks, but many months, and we will not rest until the federal response meets New York's deep and extensive needs."

Rep. Peter King, a Long Island Republican who, like Schumer, is a powerful member of his chamber, said he is seeking cooperation from House leaders to find enough disaster aid.

"It really is survival," King said. "This is an emergency. This should be separate of all the debate about the fiscal cliff and everything else."

The Cuomo administration has gained the public support of President Barack Obama and FEMA in New York's proposal for full reimbursement for storm damage, but state officials have privately worried about how much the state can get now.

In the city, Bloomberg is asking federal lawmakers to put up nearly $10 billion to reimburse government agencies and private businesses. That would be additional funding on an expedited basis over the $5.4 billion in standard disaster aid that the city projects it will receive from the Federal Emergency Management Agency.

That FEMA money and private insurance won't cover all the public and private expenses from the storm, which included damaged streets and restaurants closed because of flooding, Bloomberg said.

"While the impact of the storm will be felt for some time and the challenges are great, I am confident that the city will rebound and emerge stronger than ever," Bloomberg wrote to the congressional delegation.

Reinsurance company Swiss Re showed the extent of private sector pain. It estimates that claims stemming from Sandy will cost the company about $900 million and that total losses from insured damage will be between $20 billion and $25 billion.

Reinsurance firms provide coverage to insurance companies for great losses stemming from events like natural disasters.

Other states are seeking federal assistance, too. FEMA has already paid out nearly $250 million in New Jersey, where Gov. Chris Christie says the preliminary damage estimate is $29.4 billion and could rise.

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Associated Press writers Jennifer Peltz and Meghan Barr in New York City contributed to this report.

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