Generate an explanation for the given claim using the provided supporting material from the paragraph. Please consider the following points while generating an output. 1) The claim will always have supporting proof in the paragraph, and the paragraph will have a clear point of view supporting the claim. 2) There can be instances where direct correlation to the claim is not available. Make use of the sentences in the paragraph to provide a corresponding output supporting the claim. 3) The explanation should be at least one and at most twelve sentences long.

Ex Input:
Paragraph: The California deaths were caused by a strain of the influenza virus that is sending sufferers across the nation to the doctor for flu-like symptoms at rates that are 50 percent higher than normal, said Lyn Finelli, head of the influenza surveillance and outbreak response team at the Centers for Disease Control and Prevention. “That’s way above the norm for flu,” Finelli said. “It tells us we’re still in the middle of flu season, and in the Northeast and California it’s going up, up, up.”  The flu strain responsible for the California deaths, H1N1, also predominates nationwide this year. It hits people hardest between the ages of 25 and 64, partly because some older people are believed to have more immunity due to similar outbreaks many decades ago. In California, 52 people died last week alone, including one child, the state’s chief of communicable disease control told reporters on a conference call Friday. “This influenza season continues to be a severe one as the increasing number of influenza-related deaths indicates,” Ron Chapman, director of the California Department of Public Health, said in a statement, urging Californians to get vaccinated. In addition to the 147 confirmed California flu-related fatalities this season among people under age 65, another 44 suspected flu deaths remain under investigation, said Dr. James Watt, chief of the state’s Division of Communicable Disease Control. Most of those felled by the disease had other health conditions, but not all, he said. Last year at the same time, the state had recorded just 14 flu deaths among Californians under age 65. The death of a 47-year-old television advertising executive in the state’s capital city prompted a renewed call for residents to become vaccinated against flu. Sacramento County, with 21 deaths so far, leads the state in fatalities. “After reading the heartbreaking story of Nancy Pinnella, went to CVS and got my first flu shot ever,” California’s first lady, Anne Gust Brown, posted on Twitter. It is not fully clear whether California is an outlier in the severity of its cases, because states are not required to report flu deaths to the CDC, and data is collected differently from state to state and county to county, said CDC spokesman Jason McDonald. The fatality data that the public health agency does collect, on pediatric deaths, is not useful in studying H1N1, because the virus is more likely to attack adults, Finelli said. The public health agency does, however collect information on why people go to the doctor, and whether they are hospitalized for flu. Those signs, she said, show that this year’s flu is likely to continue to hit hard. Although the number of cases nationwide appears to have plateaued, she said, that does not take into account that California and the Northeast are lagging other areas with a late flu season. Meanwhile, CDC data does show that far more people under the age of 65 are being hospitalized with flu-like symptoms than last year. As of last week, for example, 76 percent of those hospitalized for flu were under age 65, compared to less than 50 percent last year. Nationwide, the data shows that somewhat fewer people have contracted flu so far this year than last year, Finelli said. This year’s strain, however, appears to be causing severe illness in a population that is more typically robust, she said. Claim: California sees high rate of flu deaths in unusually severe season.

Ex Output:
An unusually severe flu season has claimed the lives of at least 147 young and middle-aged people in California - 10 times the number killed by influenza viruses by the same time last year, public health officials said on Friday.


Ex Input:
Paragraph: A bill that would allow trained pharmacists to administer the influenza vaccine to children 12 years and older cleared the General Assembly’s Public Health Committee in a 17-7 vote this year, but it later died on the Senate calendar due to inaction. Bill supporter, Nathan Tinker, CEO of the Connecticut Pharmacists Association, said his organization doesn’t plan to push hard for it again in the next regular legislative session because he is worried the debate over the General Assembly’s efforts to scrap a religious exemption for some vaccines will ultimately spill over into discussions about the flu shot and likely doom the bill in the short, three-month session. “There is a community of people who are concerned about the impact or potential impact, whether real or perceived, about vaccines,” Tinker said. “And they get a lot of attention from legislators and that can make it difficult.” When the new legislative session opens in February, lawmakers are expected to consider ending the state’s longstanding religious exemption after newly released data showed a continued decline in immunization rates for measles, mumps and rubella among kindergarteners. That proposal has already met resistance and some of the concerns raised are like the ones voiced during this year’s discussion of the flu vaccine bill. Legislators were flooded with testimony earlier this year from parents with concerns about whether making the vaccine more convenient could lead to injuries that pharmacists might not be trained recognize. Others questioned the motives of the pharmaceutical industry and necessity of flu shots. Dr. Sandra Carbonari, a primary care pediatrician in Waterbury and the medical director of the Connecticut Chapter of the American Academy of Pediatrics, also opposed the bill, but for different reasons. She questioned whether state regulations for providing the flu vaccine to children who receive Medicaid benefits might ultimately make the shot too expensive, and whether DPH’s vaccine program can handle a large increase in the number of providers. She also noted that immunizing a child can be complicated. “Determining the appropriate vaccine for a pediatric age patient is not simple and requires accurate information about the medical history and current state of health,” she said in written testimony. Supporters of the flu shot bill argue that allowing parents to drop by a pharmacy, rather than make an appointment with a pediatrician, would ultimately lead to higher flu immunization rates. The bill had the support of the state’s Department of Public Health, which noted three children in Connecticut died from flu-related complications during the 2017-18 flu season. Pharmacists in Connecticut are currently allowed to vaccinate people 18 years or older. According to DPH, individuals under 18 can be administered the flu vaccine by advanced practice registered nurses at retail locations, such as a CVS MinuteClinic. Sen. Heather Somers, of Groton, the top Senate Republican on the Public Health Committee who co-sponsored this year’s bill, stressed that the legislation is voluntary and requires the consent of a parent or guardian. Somers contends the legislature just ran out of time to act on the bill earlier this year, and she plans to resurrect it when lawmakers convene again in February for the 2020 session. “This is something that saves lives,” said Somers, who helped to organize a mobile flu clinic in her district last year. “I think accessibility is key in our health care system.” Claim: Bill allowing pharmacists to give kids the flu shot at risk.

Ex Output:
The contentious debate about whether Connecticut lawmakers should scrap a religious exemption for certain childhood vaccinations could inadvertently end up sinking efforts to make the flu vaccine more accessible to children.


Ex Input:
Paragraph: The story should have stated how much CAD costs per mammogram, and how that compares to the costs of a radiologist or technician providing a second reading of the images. The story quotes a researcher saying cost-effectiveness needs to be studied. This should have triggered additional reporting comparing costs. The story says Medicare pays $15 per CAD reading, but this does not indicate whether this covers costs. The story does a good job of describing the methodology and the outcomes in terms readers can understand. The study results showed that the recall rates–the percentage of women brought back for a second mammogram–was signficantly higher with CAD than with double readings (3.9 percent vs. 3.5 percent). Yet CAD discovered no more cancers. These additional mammograms without more accurate diagnosis can produce increased anxiety and potentially more biopsies. The report should have mentioned this. This news report is based on a peer-reviewed study published in a top-tier medical journal. The underlying study itself is a randomized, blinded trial involving about 30,000 women. The story does nothing to exaggerate either the prevalence or severity of breast cancer, or the benefits of CAD. The reporter quotes the article itself, the lead author, a breast cancer clinician at a major teaching hospital, a medical society’s breast cancer expert, and a clinician who uses CAD in his practice. This is excellent sourcing. The story reports the study’s funding, as well as two of the researchers’ links to CAD makers. The story clearly compares the options of having two human readers of mammograms against one reader using CAD. Yet the reporter fails to compare the value of these methods with those when a single human reader is used, which remains the common practice in the U.S. The study reports that double readings have been shown to be 4 to 14 percent more effective in detecting cancers than single readings, with a recent meta-analysis showing a 10 percent advantage to double reading. This context would have been very valuable, to demonstrate that U.S. diagnostic practices miss a lot of cancers. The story states that computer-aided dectection (CAD) of breast cancer is used for about a third of mammograms in the U.S. This implies availability at more specialized facilities and teaching hospitals. A more direct statement of this would have been useful. But the story meets minimum standards under this criterion. The story says CAD is used for about one-third of mammograms in the U.S. and is likely to be used more as digital imaging becomes more widespread. The report does not appear to draw on the press release. Claim: Computers help docs spot breast cancer on X-rays

Ex Output:

This well-reported story on a study of computer-aided detection (CAD) of problems found in mammograms follows most health journalism best practices. But two related flaws, and one contextual issue, prevent it from providing a higher level of reader service. As the ratings above show, the reporter provides necessary information about evidence and outcomes, and does an excellent job with sourcing. It communicates very clearly the conclusion that one radiologist using CAD appears to be as effective in identifying cancers as two radiologists reading the same images. The flaw is that the story fails to compare the benefit of these practices to the most common method of diagnosis used in the U.S.–a single reading by one radiologist. The published study itself reveals that double readings have been shown to be 4 to 14 percent more effective at detection than single readings, with a meta-analysis showing a 10 percent advantage. Combined with the report’s failure to directly compare costs of single-reader, double-reader and single-reader-with-CAD methods, the reader isn’t able to understand the real trade-offs facing the U.S. medical system: the cost of missed cancers vs. the cost of additional technology. And finally, when dealing with mammography it’s important for reporters to understand the underlying challenge is not simply to identify cancers, but to identify the cancers that matter. It has not been demonstrated that diagnosing more cases of breast cancer reduces mortality or incidence of invasive cancers. This fact is always worth mentioning in stories about the benefits of cancer detection.