South Korea's ruling party objects to 

cost-sharing deal for U.S. troops


South Korean Democratic Party lawmakers said they are not happy with a new defense-burden sharing deal with the United States after an agreement was reached earlier this month. File Photo by Yonhap

March 16 (UPI) -- South Korea is defending the terms reached in its cost-sharing deal for U.S. troops from critics in the ruling Democratic Party, who say they may not pass the legislation at the National Assembly, citing increasing costs that "unfairly" target the country, a key U.S. ally.

South Korean Defense Minister Suh Wook said Tuesday the 13.9% increase in Seoul's share of the defense burden was acceptable and a hard-won deal, Newsis and Korea Economic Daily reported.

In 2019 and 2020, tensions peaked between Seoul and Washington amid Trump's demand Seoul pay nearly $5 billion annually for 28,500 U.S. troops. The new multi-year deal reached on March 7 with the Biden administration is for about $1 billion.

"While there are some disappointments, the agreement was reached by following principles and settled at a reasonable level than in the Trump era," Suh said at a meeting of the National Assembly's defense committee. "In our own way we made efforts while following principles. It was negotiations with a partner, and we also had to demonstrate the spirit of the alliance."

South Korean lawmakers, including Rep. Hong Young-pyo, said Tuesday at the meeting the cost increase, which is in line with Seoul's original offer to the former Trump administration, was "undesirable." Hong suggested he may not vote for the deal at the National Assembly.

Hong, who did not publicly raise objections against Trump's demands last year, said the U.S.-South Korea alliance should "no longer be referred to as a value alliance."

"How much has [South Korea] invested in the transition of wartime operational control including the [U.S.] headquarters in Pyeongtaek?" Hong said, referring to South Korea's shouldering of building costs of the largest U.S. overseas military base in 2018.
RELATED North Korean vessels active in China, marine traffic data show



"The National Assembly is not a rubber-stamp parliament."

Hong's colleagues in the Democratic Party aired grievances about increased payments, citing U.S. dealings with Japan for comparison.

Rep. Kim Min-ki said while South Korea's defense costs for U.S. troops have steadily increased, Japan has not been asked to undertake a greater financial burden.

In 2020 under pressure from the Trump administration South Korea said it could agree to a maximum 13% increase from the previous Special Measures Agreement signed a year earlier, according to The Korea Times last year.

U.S. Secretary of State Antony Blinken and Secretary of Defense Lloyd Austin are to arrive in Seoul on Wednesday.

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Sen. Whitehouse calls for review of FBI's 'fake' Kavanaugh investigation

DO YOU LIKE BEER SENATOR?

Sen. Sheldon Whitehouse, D-R.I., said the FBI's investigation into Supreme Court Justice Brett Kavanaugh, pictured, may have been "politically constrained and perhaps fake" in a letter to the Justice Department. File Photo by Andrew Harnik/UPI | License Photo

March 16 (UPI) -- Sen. Sheldon Whitehouse, D-R.I., on Tuesday called for a congressional review of the FBI's investigation into sexual assault and misconduct allegations against Supreme Court Justice Brett Kavanaugh, saying the probe appears to have been "politically constrained and perhaps fake."

In a letter to U.S. Attorney General Merrick Garland, Whitehouse asked for the Justice Department to support a Senate review of the FBI investigation process. He said the agency failed to follow through on leads related to the allegations and did not provide transparency about the information it received through a "tip line" set up to aid the investigation.

"If standard procedures were violated and the bureau conducted a fake investigation rather than a sincere, thorough and professional one, that in my view merits congressional oversight to understand how, why and at whose behest and with whose knowledge or connivance this was done," wrote Whitehouse.

Prior to being confirmed in a 50-48 vote in 2018, Kavanaugh faced multiple allegations of sexual misconduct. Christine Blasey Ford testified before the Senate that he sexually assaulted her at a party when they were in high school.

Whitehouse said that while Kavanaugh disputed her accusations, Ford's testimony and other allegations "justified further investigation to seek corroborating or inconsistent evidence."

He said the FBI failed to interview Max Stier, the president of the Partnership for Public Service and a college classmate of Kavanaugh's, who offered corroborating evidence while members of Congress were made aware of allegations from witnesses who "tried in vain to reach the FBI on their own" but found no one willing to accept testimony.

"When members made inquiries we faced the same experience: the FBI had assigned no person to accept or gather evidence," he said.

RELATED Lawmakers introduce bill to combat surge in anti-Asian hate crime amid pandemic

Whitehouse noted the FBI ultimately opened up a tip line to receive additional allegations or corroborating evidence but said Congress received "no explanation" of how or whether the allegations were processed and evaluated outside of 1-hour windows to review the materials gathered.

He added, however, that it did not appear the FBI had taken any measure to review the information that was sent through the tip line.

"This 'tip line' appears to have operated more like a garbage chute, with everything that came down the chute consigned without review to the figurative dumpster," he said.

RELATED Federal judge says CDC didn't have power to order national eviction ban

Whitehouse cited July 2019 testimony by FBI Director Christopher Wray before the Senate judiciary committee in which he assured the FBI's investigation was consistent with the agency's practices but refused to answer further questions, accusing the FBI of "stonewalling" lawmakers.

"It cannot and should not be the policy of the FBI to not follow up on serious allegations of misconduct during background check investigations," he said.

Study: U.S. COVID-19 cases underestimated by half, antibody testing suggests


Twice as many people may have been infected with COVID-19 than previously estimated by the U.S. Centers for Disease Control and Prevention, a new study suggests. File Photo by Jim Ruymen/UPI | License Photo

March 16 (UPI) -- Up to 16 million people in the United States may have had undiagnosed, asymptomatic COVID-19 as of September 2020 -- twice as many as previously estimated -- an analysis published Tuesday by JAMA Network Open reported.

Just under 7% of about 62,000 people in the United States with no symptoms of infection tested in the study had antibodies against the virus, the data showed.

Antibodies are cells produced by the immune system to fight off infection, and their presence in blood suggests that people either are battling the virus or were recently.

The nearly 16 million asymptomatic cases is more than twice the number of confirmed cases -- about 7.5 million -- reported in the United States by the Centers for Disease Control and Prevention at the end of September.

RELATED Pandemic's second wave less deadly than first in U.S., Europe, study finds

"As of September, the scope of the pandemic was about double the number of reported cases," study co-author Dr. Robert L. Stout told UPI in an email.

"The primary means of transmission of this virus is the asymptomatic population -- the patient [who] is unaware of their infectious status and is therefore at risk of unknowing spreading the virus," said Stout, a researcher with Lenexa, Kansas-based Clinical Reference Laboratory. The company that specializes in health testing for life insurance applicants.

Since the start of the pandemic last March, public health officials and researchers have suggested that the number of cases and deaths linked with the virus, both in the United States and globally, may be undercounted.

RELATED CDC finds issues with COVID-19 guidance by Trump administration

This is due to the number of infected people who may experience no symptoms, believed to be up to 80% of those with the virus, experts say.

For this study, Stout and his colleagues tested 61,190 life insurance applicants for antibodies to the coronavirus in September, using blood samples collected as part of the application process.

None of the applicants reported having symptoms of COVID-19. Just under 4,100, or 6.7%, tested positive for coronavirus antibodies, and about 56% of them were male, researchers said.

RELATED British COVID-19 variant to become dominant U.S. strain within weeks: CDC

Most of those who tested positive for antibodies were in their late 30s or early 40s, which researchers say is significant given that younger people are believed to be at lower risk for serious illness, or symptoms, from COVID-19.

These people may be unknowingly driving spread of the virus, the researchers said.

"Quite simply ... they think that everything is fine and continue to go about their normal activities," Stout said.

"Some practice recommended CDC guidelines in public places while some may not," he said

Consumer groups urge Congress to protect stimulus payments from debt collectors


Without new legislation, Americans who are subject to garnishment would likely never see their $1,400 stimulus payment from the IRS. By law, banks are required to turn it over to debt collectors. File Photo by John Angelillo/UPI | License Photo

March 16 (UPI) -- Lawmakers in Congress are trying to pass a piece of legislation to protect the new round of stimulus payments for Americans who are subject to having the money taken by private debt collectors.

President Joe Biden's American Rescue Plan is sending $1,400 stimulus payments to all Americans who earned less than $75,000 in 2019 or 2020, and gradually reduced amounts to those making between $75,000 and $80,000.

The Internal Revenue Service began depositing the payments last weekend.

However, Americans who owe private debts that are collectible via court judgments could see their payments taken right out of their bank accounts. Lawmakers are trying to fix that.

RELATED Americans can check status, deposit date for new $1,400 stimulus payment

Sen. Ron Wyden, D-Ore., says he will introduce a bill this week to shield those Americans from having their relief aid taken away.

The $1.9 trillion relief bill passed by Congress and signed by Biden does not include special language that protects the stimulus payments from garnishment imposed by past fiscal judgments. The second payment of $600 in December had the protection, but the first $1,200 payment a year ago did not.

"We really wish this could have passed before the money started going out," National Consumer Law Center

"The protection would have been far more effective if the payment was coded in a way so that banks would automatically know to protect the money."

 Associate Director Lauren Saunders told CNN

.

The American Rescue Plan did not include the protection because it was passed in Congress under budget reconciliation, a procedural process that allowed Democrats in both chambers to pass the package without any Republican support. Not a single Republican in either chamber voted for the plan.

"Families that most need this money -- those struggling with debt and whose entire bank accounts may be frozen by garnishment orders -- will be not be able to access their funds," a group of consumer advocacy groups wrote in a letter to lawmakers last week.

"This group includes very low-income families with children, people who have been disconnected from work opportunities for along period and many low-income adults now raising children in their homes.

"Allowing economic impact payments to be garnished could impose significant burdens on some families, especially those in communities of color, facing unprecedented circumstances."

Without legislation to protect the payments, Americans who are subject to garnishment would likely never see their $1,400 check from the IRS. By law, banks are required to turn over money that is garnished and claimed by debt collectors.

"Unless Congress immediately passes the [change], they will be forced to pay some creditors who attempt to garnish and freeze bank accounts," the groups noted in their letter.

"We believe it is imperative that Congress ensure that these next stimulus payments are treated as 'benefits' subject to the federal exemption from garnishment."

The letter was cosigned by nearly 20 advocacy groups, including the NCLC, American Bankers Association, Consumer Bankers Association and National Bankers Association.

Monday, the IRS relaunched its "Get My Payment" tool that allows Americans to track the status of their stimulus payment.

Atlanta shootings: Police say gunman may have wanted to purge sex addiction

"[The gunman] made indicators that he has some issues, potentially sexual addiction," one investigator said Wednesday.

LITTLE MAN SUFFERS FROM EMOTIONAL PLAGUE 

OF MISOGYNY AND RACISM ALL ELSE IS EXCUSING HIMSELF

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Deputies with the Cherokee County Sheriff's Office are seen Tuesday evening at a massage parlor in Acworth, Ga., where four people were killed by a gunman who also attacked two similar businesses in the Atlanta area. Photo courtesy Cherokee County Sheriff's Office/Twitter


March 17 (UPI) -- Investigators said Wednesday that a man accused of shooting eight people dead at three massage parlors in Atlanta admitted a sex addiction and said he didn't specifically target Asian Americans at the businesses.

Police captured Georgia resident Robert Aaron Long after a manhunt on Tuesday night after the attacks at the massage parlors, which occurred within a short period of time and within close proximity. Eight people were killed and a few others were injured in the shootings.

Cherokee County Sheriff Frank Reynolds told reporters Wednesday that Long, 21, went on the shooting spree only hours after he obtained his 9mm handgun. He also said Long, who was arrested in Crisp County 150 miles south of Atlanta, has confessed to the attacks and said they were not racially motivated.

"During his interview, he gave no indicators that this was racially motivated," Reynolds said in a report by the Atlanta Journal Constitution. "We asked him that specifically and the answer was no."

Sex addiction played a role in the shootings, authorities added, because Long often frequented massage parlors and wanted to eradicate a behavioral habit he was trying to break.

"Yesterday was a really bad day for him and this is what he did," Cherokee County Capt. Jay Baker said in the AJC report.

"He made indicators that he has some issues, potentially sexual addiction, and may have frequented some of these places in the past. We still have a lot of things to process."

Long is scheduled to be arraigned on murder charges Thursday. It wasn't immediately known whether the handgun used in the crimes was obtained legally.

ANOTHER PROUD BOY

Investigators say Robert Aaron Long has confessed to the shootings at all three massage parlors, which killed eight people. Photo by Crisp County Sheriff's Office/EPA-EFE

BY ANY OTHER NAME

The Cherokee County Sheriff's Office identified four of the victims Wednesday who were shot at the parlor in Acworth, Ga. -- Delaina Ashley Yaun, 33; Xiaojie Yan, 49; Daoyou Feng, 44; and Paul Andre Michels, 54. Another person who was injured in the shooting there was listed in stable condition.


Six of the eight victims were of Asian descent and seven were women, details that spurred speculation that the attacks may be related to a wave of violence against Asian Americans in the United States over the past year related to the COVID-19 pandemic. Former President Donald Trump often refers to the coronavirus as the "China virus," and has even called it "Kung Flu," simply because it was first observed in Wuhan, China.

President Joe Biden has been in contact Wednesday with U.S. Attorney General Merrick Garland and FBI Director Christopher Wray about the attacks. The bureau is involved in the investigation, as it may represent a hate crime.

White House press secretary Jen Psaki said Wednesday Biden was being briefed on the shootings and the president said he would address the attacks publicly on Wednesday afternoon.

"It is tragic. Our country, the president and I and all of us, we grieve for those lost," Vice President Kamala Harris told reporters Wednesday. "This speaks to a larger issue, which is the issue of violence in our country and what we must do to never tolerate it and to always speak out against it.

"But I do want to say to our Asian American community that we stand with you and understand how this has frightened and shocked and outraged all people."

At a ministerial security conference in South Korea on Wednesday, Secretary of State Antony Blinken denounced the shootings and said that such attacks have no place in the United States or any other nation.

Atlanta Mayor Keisha Lance Bottoms told reporters Wednesday that investigators believe Long may have been on his way to Florida to carry out more attacks when he was captured.

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ALCHEMY OF NATURE

Cave-harvested Turkish honey dubbed world's most expensive

Centauri Honey, which is harvested from a Turkish cave 8,000 feet above sea level, was declared the world's most expensive honey by Guinness World Records.

 Photo courtesy of Guinness World Records

March 16 (UPI) -- A Turkish company set a Guinness World Record for the world's most expensive honey with a cave-harvested variety priced at over $5,400 per pound.

$338.06 PER OZ
Guinness said Centauri Honey, which is harvested from a cave more than 8,000 feet above sea level, is priced at $5,409 per pound, making it the most expensive honey in the world.

The honey is dark in color and is said to have a bitter flavor. It is prized for its medicinal value, being high in magnesium, potassium, phenols, flavonoids and antioxidants.

Centauri said the honey can only be harvested once a year, as opposed to two to three times a year for most commercial honeys, to ensure the bees that make the nectar are not disturbed.

The company said samples of the honey are sent after harvest to the Turkish Scientific Council/Food Institute to verify its quality

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Strawberries, spinach, kale top 2021 'Dirty Dozen' contamination list


Workers are seen picking strawberries at a farm in Marina, Calif., on April 28, 2020. File Photo by Terry Schmitt/UPI | License Photo

March 17 (UPI) -- Strawberries, spinach and kale topped an annual list released on Wednesday that details products that contain the most pesticide residue on the fruits and vegetables market.

The list compiled by the Environmental Working Group, called the "Dirty Dozen," outlines which fruits and vegetables are most contaminated.

The EWG also produces a "Clean 15" list, which describes which fruits and vegetables have the least amount of pesticide residue. Both lists are based on data from the U.S. Agriculture Department.

On the 2021 Dirty Dozen list are strawberries, spinach, kale, collard and mustard greens, nectarines, apples, grapes, cherries, peaches, pears, bell and hot peppers, celery and tomatoes.

RELATED FDA provides path for authorization of at-home COVID-19 tests

Topping the Clean 15 are avocados, followed by sweet corn, pineapples, onions, papaya, frozen sweet peas, eggplants, asparagus, broccoli, cabbage, kiwi, cauliflower, mushrooms, honeydew melon and cantaloupes.

"We urge consumers who are concerned about their pesticide intake to consider, when possible, purchasing organically grown versions of the foods on EWG's Dirty Dozen, or conventional produce from our Clean 15," EWG toxicologist Dr. Thomas Galligan said in a statement.

The group said tests done by the Agriculture Department found residues of potentially harmful chemical pesticides on almost 70% of the non-organic fresh U.S. produce. The department performed common washing, scrubbing and peeling of the items before testing.

The EWG noted that most of the pesticide residues fell under federally mandated limits, but that doesn't mean they're always safe.

"The EPA's tolerances are often far higher than what many scientists believe is safe -- particularly for pregnant women, babies and young children," EWG President Ken Cook said.

CORPORATE SHILLS CALL IT FEARMONGERING

Tamika Sims, senior director of food technology at the International Food Informational Council, said the main impact of lists like the Dirty Dozen is that they frighten consumers.

RELATED FDA: No evidence COVID-19 spreads through food, food packaging

"This list should have no impact on your shopping habits," Sims said in a report by USA Today. "[The USDA and EPA] work conservatively to make sure all these fruits and vegetables are safe for consumption."
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Japan court rules that gov't ban on same-sex marriage is illegal


Activists participate in a march supporting lesbian, gay, bisexual and transgender rights at the "Tokyo Rainbow Pride" in Tokyo, Japan, on April 28, 2019. File Photo by Keizo Mori/UPI | License Photo

March 17 (UPI) -- In a historic ruling on Wednesday, a Japanese court decided that the government's ban against same-sex marriage is unconstitutional.

The Sapporo District Court in its ruling sided with three same-sex couples in Hokkaido who argued their inability to marry legally amounts to a denial of freedoms and equality granted them by Japan's constitution.

The court ruling came at a time several similar cases challenging the ban are being considered in Tokyo, Osaka, Nagoya and Fukuoka.

"Sexual orientation is not something that a person can choose and change at their own will," Judge Tomoko Takebe wrote in his ruling, according to Asahi Shimbun.

"It is discriminatory treatment that gay people are being denied even part of the legal benefits resulting from marriage, and it goes beyond legislative discretionary powers."

The three couples who are party to the suit, two male couples and one female couple, filed their original complaint in February 2019 after officials ruled they filed their marriage papers illegally.

The court's ruling on Wednesday, however, did not award the couples financial compensation.

The Japanese government has defended the same-sex marriage ban, saying it provides legal protection for husbands and wives who live together and produce children.

Though House has passed Equality Act, 

anti-LGBT efforts persist in U.S.

Activists hold rainbow flags during the People's March for Roxanne Moore in Times Square along New York City's Seventh Avenue on October 2, 2020. Moore, a 29-year-old Black transgender woman from Reading, Pa., was shot 16 times by police officers. File Photo by John Angelillo/UPI | License Photo

WASHINGTON, March 17 (UPI) -- While the House passed the Equality Act that would expand the federal Civil Rights Act to protect members of the LGBT community last month, Democrats' Senate majority means it's unlikely to reach President Joe Biden's desk.

Meanwhile, legislative proposals to limit lesbian, gay, bisexual and transgender rights -- especially transgender rights -- are being debated in at least 30 states like Alabama, Texas and Montana. In Mississippi, a bill forbidding transgender athletes from joining women and girls' sports teams was signed by Gov. Tate Reeves last week.

"This is telling trans kids that they don't belong, that they're not welcome in our society, we don't want them to play sports, we don't want them to be a part of our community at all," said Jarvis Dortch, executive director for the Mississippi American Civil Liberties Union.

Such bills, he said, send a message of ostracization to transgender students.

RELATED House passes Equality Act in move to expand LGBTQ protections

Daye Pope, organizing director for Trans United, said Senate approval of the Equality Act is important because it would block passage of the state-level bills.

"It would say and enforce that you can't actually discriminate against trans youth in school. And in sports, you can't actually discriminate against queer and trans people in public restrooms and in restaurants," she said.

While laws such as Mississippi's sports ban bill also go directly against Biden's Jan. 20 executive order barring gender identity-based discrimination, it does not have the force of law that only Congress can enact.

RELATED Miss. governor signs bill banning transgender students from women's sports

"What's really important for LGBT people is sex discrimination," said Luis Vasquez of the UCLA School of Law. "The problem is that the Civil Rights Act explicitly says sex, but it doesn't explicitly say sexual orientation or gender identity."

The Equality Act would include those categories.

With Biden's executive orders, however, federal agencies under the president's control are directed to read legislation that mentions "sex discrimination," such as the Civil Rights Act, to include sexual orientation and gender identity.

RELATED Elliot Page 'really excited' about acting after coming out as transgender

"What the Equality Act is trying to do is take all of that guesswork out, take all of the inconsistencies out so that now whenever an LGBT person feels that they've been discriminated against in violation of those laws, they'll be able to make their case and point to language that will explicitly say, 'Title Seven says that you can't discriminate in employment on the basis of sexual orientation and gender identity,'" Vasquez said.

Gallup found recently that more than 5% of Americans identify as a member of the LGBT community, with most identifying as bisexual. Also, one in six Generation Z adults consider themselves LGBT.

As people grow more comfortable sharing their sexuality and gender identity, hate crimes against LGBT members are increasing.

Demonstrators protest outside the U.S. Supreme Court as justices hear oral arguments in three cases on LGBT discrimination protections, in Washington, D.C., on October 8, 2019. The cases involve accusations of discrimination based on sexual orientation and one on whether discrimination laws apply to transgender workers. File Photo by Kevin Dietsch/UPI

The Human Rights Campaign, a leading rights group, reported that at least 44 transgender or gender non-conforming people were killed by violence in 2020, mostly Black and Latinx transgender women.

Pope says it's "a really scary time" because of so many state bills that target trans and non-binary youth.

"Being a kid and being a teen is hard enough," she said. "You're trying to find yourself, you're trying to make sense of school and peer groups and your home life, and trans youth are already more likely to attempt suicide or self-harm."

According to the National Alliance on Mental Health, transgender youth are twice as likely as their cisgender peers to "seriously consider suicide." This pattern follows into adulthood, where transgender adults are nearly four times as likely as to have a mental health condition than cisgender adults.

Gaining Senate approval of the House-passed Equality Act would provide legal protections against intolerance toward the LGBT community. But Senate Democrats need to keep all 50 of their voters on board and get 10 Republicans to join them in preventing a filibuster that would block consideration of the proposal.

Since Biden took office, Pope said, a majority of the president's time has been spent "undoing the damage" of former President Donald Trump -- including repealing the transgender military ban, initiating legislation to stop housing discrimination and promising more to come.

"Under the new administration, we want to be bold, we want to be proactive and aggressive about ... equal rights for queer and trans people in this country," Pope said.

THE COST OF ANTI-VAXXERS

Study: Measles outbreak in 2019 cost one county $3.4M
By Amy Norton, HealthDay News
MARCH 13, 2021 / 1:05 AM

A single measles outbreak cost one U.S. county $3.4 million, a new government study estimates, underscoring the societal burden of inadequate vaccination rates.

The outbreak occurred in Clark County, Wash., in early 2019, and ultimately infected 71 people -- mostly children younger than 10 who hadn't received the measles-mumps-rubella, or MMR, vaccine.

The county's low MMR coverage is believed to have left it vulnerable, according to Jamison Pike, a researcher at the U.S. Centers for Disease Control and Prevention who led the study.

Around the time of the outbreak, 81% of 1- to 5-year-olds in the county had received one MMR dose, and 78% of older kids had received both doses.

RELATED Study: Vaccines have saved 37M lives, mostly children, since 2000

In contrast, an average of 94% of kindergarteners nationwide had received both MMR doses.

The misery -- and danger -- of measles is well documented. The viral infection causes a high fever, cough, runny nose and rash. In some cases it leads to complications like pneumonia and swelling of the brain.

According to the CDC, about 20% of Americans who contract measles end up in the hospital, while 1 to 3 in every 1,000 die.

RELATED 1 in 5 in U.S. doesn't believe in vaccines, survey shows

AMERICA IS A VERY RELIGIOUS PROTESTANT NATION

But there is also an economic toll, Pike said. When an outbreak strikes, public health agencies jump into action, performing testing, contact tracing and vaccination of susceptible people.

Then, Pike said, there is the lost productivity when people exposed to measles have to quarantine, or stay home to care for a sick family member. During the Clark County outbreak, 839 people went into quarantine -- with three weeks being the recommended duration.

Pike and her colleagues estimate that the public health response alone cost about $2.3 million. Productivity losses, meanwhile, added up to just over $1 million. Direct medical costs tacked on another $76,000.

RELATED More than one-third of U.S. pediatricians dismiss families for vaccine refusal

While the number of measles cases was not huge, at 71, each case cost the county more than $47,000, the CDC team estimates.

Yet those figures do not capture the full bill, according to Pike. For one, the Clark County outbreak was linked to additional measles cases, in Oregon and faraway Georgia.

It's also hard to account for all the societal costs, Pike said. As one example, a measles outbreak can divert resources from routine public health services, such as nutrition programs and surveillance of other diseases.

"There are ripple effects," Pike said. "It's not only the infectious disease that spreads."

Dr. Jessica Cataldi wrote an editorial published with the study on Friday in Pediatrics. She agreed it's important to understand the economic fallout of measles outbreaks.

"It really does reflect the shared impact in the community," said Cataldi, a pediatric infectious disease specialist at Children's Hospital Colorado and University of Colorado Anschutz Medical Campus in Aurora.

Due to the pandemic, she said, many people now grasp the burden of quarantining and needing time off from work to recover from illness or care for a family member.

But the broader public health response to disease outbreaks, which are publicly funded, also affects the community, Cataldi said.

The year of the Clark County outbreak, 2019, was a bad measles year for the United States. The country saw its highest number of cases since 1992, according to the CDC. The largest outbreak occurred in New York, primarily affecting a Brooklyn Orthodox Jewish community with low vaccination rates.

In the United States, the CDC says, measles outbreaks generally happen when a traveler brings the virus into the country, and it then spreads among clusters of unvaccinated people -- often fostered by "anti-vaxxer" sentiment among some parents.

Cataldi said measles is highly contagious -- much more so than COVID-19, in fact. So even a small decline in MMR coverage can make a community vulnerable.

"This is why we vaccinate," Cataldi said.

During the pandemic, when many U.S. children were not getting routine checkups, vaccination rates plummeted.

If your child fell behind on the recommended vaccine schedule, Cataldi said, "now is the time to get caught up."

Parents can make the mistake of believing they do not need to vaccinate their child because other people are vaccinated. But, Pike said, when enough people take that position, herd protection wanes.

One difficulty, she noted, is actually locating the "under-vaccinated pockets" that dot the United States, to better understand what is going on in those places. Those pockets may not become apparent until a disease outbreak hits.More information

The American Academy of Pediatrics has more on measles.

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