A monthly online digital publication, The Business Review targets business leaders from the Rogue Valley and beyond. This means that your published articles and advertising message are being seen, read and remembered by those who are seeking your products or services in and around Jackson County and within more than 55 Oregon communities.
THE CHAMBER OF MEDFORD & JACKSON COUNTY THE BUSINESS REVIEW
FEBRUARY 2021
The Future of Healthcare
CONTENTS February 2021 | VOLUME 21 | ISSUE 2
4 LEADERSHIP MATTERS A Letter from Lydia Salvey, Editor In Chief
6 OREGON UPDATES Five Forces That Will Reshape The Future of Healthcare CDC’s COVID-19 Vaccine Rollout Recommendations 12 Companies Boosting Benefits To Employees 18 CREATING A STRONG ECONOMY Exercising While Wearing a Mask New Treatment Option for Covid-Positive Patients Business Reopening Guidance The Medical Debt Relief Act Groundbreaking Legislation to Boost Sustainability Bentz Appointed to the House Natural Resources Committee 27 PROMOTING THE COMMUNITY Rogue River Greenway Foundation 2021 Ride the Rogue $99,035 in Emergency Funding Disaster Relief and Recovery Efforts Retail is Alive and Well at The Village Medford Center 32 MEMBER NEWS Jackson County CoC Conducts Annual Homeless Count February 22: DNA Class Series, “X-DNA Inheritance Chart” Rogue Valley Genealogical Society Presents Exhibits & Creative Opportunities TouchPoint Leverages Clearfly 38 PROVIDING NETWORKING OPPORTUNITIES January Forum Review 41 RENEWING & NEW MEMBERS 42 MEMBERSHIP DIRECTORY
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A monthly online digital publication, The Business Review targets business leaders from the Rogue Valley and beyond. This means that your published articles and advertising message are being seen, read and remembered by those who are seeking your products or services in and around Jackson County and within more than 55 Oregon communities.
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Promote. Promoting the community. Create. Creating a strong local economy. Connect. Providing networking opportunities. Represent. Representing business issues. Our Strategic Objectives
Meet the Editorial Staff
Brad Hicks, CCE, IOM President & CEO brad@medfordchamber.com 541-608-8514
Lydia Salvey Editor in Chief/Vice President of Communications & Programs lydia@medfordchamber.com 541-608-8520
Kira Zavala Director of Sales
& Membership Development kira@medfordchamber.com 541-608-8522
Cathy Watt Office Administrator cathy@medfordchamber.com 541-608-8515
The Chamber of Medford & Jackson County 101 E 8th St, Medford, OR 97501 (541) 779-4847 • medfordchamber.com
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LEADERSHIP MATTERS A LETTER FROM LYDIA SALVEY, EDITOR IN CHIEF
W ith everything that has happened in the last year, the future of healthcare is something that has been on so many of our minds as we all watched the industry be overwhelmed and transformed, what felt like overnight. In this month’s issue of The Business Review we discuss the Future of Healthcare, what that looks like for jobs in the industry itself, and what it looks like for patients who are seeking treatment. At this month’s Forum, Regence BlueCross BlueShield of Oregon updated viewers on The Future of the Pandemic Response. Information was shared on vaccine availability and efficiency, mass vaccination events, and the distribution of vaccines. Other topics were discussed such as the increase of behavioral health issues during the pandemic, and the increase of telehealth appointments. To read more about the information shared during the program, check out “Now What? Discussing Next Steps in the Pandemic Response at the Chamber of Medford & Jackson County Forum.” Other articles in this issue include exercising while wearing a mask, treatment options for COVID positive patients, companies boosting mental health benefits , and the five forces that will reshape the future of healthcare . You will also find local updates on new businesses coming to Medford and winter activities to do here in the Rogue Valley. Next month we will be moving into cybersecurity and technology and will discuss what we all need to do to protect ourselves as our lives are shared online in a digital world. Thank you for reading The Business Review and we’ll see you again next month.
Lydia Salvey Editor in Chief/Vice President of Communications and Programs The Chamber of Medford & Jackson County
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OREGON UPDATES
FIVE FORCES THAT WILL RESHAPE The Future of Healthcare By Vibhas Ratanjee | November 2, 2020 | Gallup
The U.S. healthcare system is in a state of emergency. Gallup 2020 data show that only 19% of Americans are “very satisfied” with the quality of medical care in the U.S., a figure that has remained largely constant over the past two decades. And compared with other developed nations, the U.S. ranks highest on chronic disease burden, lowest on access to care and lowest on health system quality -- despite annual na- tional health spending of $3.6 trillion ($11,172 per person). These problems make post-COVID recovery strategies even more critical. To recover financially, healthcare leaders must unite, collaborate with leaders from other industries and re - evaluate traditional practices. There is no doubt that healthcare leaders have responded to the COVID-19 pandemic heroically, with many using this painful opportunity to embrace new learning and prepare for the next inevitable crisis. For example, COVID-19 has accelerated much-needed change, such as the digital and technological transforma - tion that many healthcare organizations were trying to ac - tualize before the crisis.
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In 2020, 19% of Americans are very satisfied with the quality of medical care in the U.S. This percentage has remained stable throughout the past two decades.
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But healthcare leaders still find themselves in a precarious position due to considerable revenue loss. The American Hospital Association predicts that the financial strain on hospitals and health systems due to lower patient volumes “will continue through at least the end of 2020” -- a likely total loss of $323 billion in 2020. Gallup has conducted research in the field of healthcare for decades, including just before and during the pandemic. A recent review of this research uncovered five forces that are paramount for any healthcare organization’s survival -- through the current crisis and beyond. Gallup has conducted research in the field of healthcare for decades, including just before and during the pandemic. A recent review of this research uncovered five forces that are paramount for any healthcare organization’s survival -- Accountable care organizations (ACOs) have invested significantly in value-based care in recent years. It’s important to protect and even grow participation in this vital program. But healthcare organizations committed to value-based care must know that achieving key results in the future will require a shift away from conventional thinking and legacy ways of working. through the current crisis and beyond. Reimagine Value-Based Care.
The five forces that are paramount for healthcare organizations’ survival are: Reimagine value-based care; Prepare to be constantly disrupted; Embrace virtual healthcare; Manage mergers effectively; and Maximize the value of the ecosystem.
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To start, health systems need to enhance payer-provider collaboration and fine-tune value-based measures. But to optimize value-based care, hospitals also need to sharpen their efforts in building organizational agility -- in everything from processes to shared mindsets. Value-based care can no longer be separated from the quadruple aim; rather, it should drive patient experiences, population health, cost reduction and caring for the caregiver. Leaders’ aim to recuperate lost revenues might create an excessive focus on cost-cutting. This is bound to cause serious disruptions to employees and patients. The best hospitals will continue to prioritize an integrated strategy that promotes the quadruple aim through constant review and improvement of the patient and employee experiences. Prepare To Be Constantly Disrupted. COVID-19 has accelerated the healthcare industry’s erstwhile sluggish digital transformation journey. Even before the pandemic, technological and macroeconomic factors were steadily reshaping healthcare, from heightened venture capital interest in healthcare tech to organizations such as Amazon acquiring a supply license for pharmaceutical drugs. Post-pandemic, the evolution of healthcare delivery will increase -- far beyond the increase in virtual healthcare. Consider, for example, distributed healthcare -- urgent care clinics, free-standing emergency setups, retail clinics. Research has shown a higher return on invested capital (ROIC) for these alternatives compared with conventional hospital systems. But to effectively deal with disruption and stay on the cutting edge of innovation, healthcare must also invest in top talent. Recent Novartis research showed that 83% of technology professionals would consider working in the healthcare and pharmaceutical industries, with 72% more likely to consider it compared with six months ago. As these industries evolve -- both as a consequence of COVID-19 and other industry forces -- leaders need top talent to effectively integrate new delivery models and capture new market opportunities. The trouble is, in a dynamic time when talent has never been more crucial, retaining and acquiring talent that drives innovation is arguably more challenging than ever before. To secure their organization’s future, leaders need a proven, research-based talent attraction strategy. But acquiring the talent to accelerate innovation is just the beginning. Retaining and developing talent are equally important to performance and patient outcomes. An estimated 1.4 million health jobs were lost in March and April -- and there is likely to be further turnover due to the pandemic, especially among RNs and physicians. Healthcare providers need greater sophistication in management and leadership development for two reasons:
1.Managers are central to team engagement and retention, so retaining and developing great managers supports exceptional workplace performance. 2.With physicians playing a more central leadership and business role, physicians and nursing leaders must enhance
their capacity to thrive in uncertainty. Embrace Virtual Healthcare.
It is not surprising that the pandemic has ramped up virtual healthcare. The Centers for Medicare & Medicaid Services (CMS) loosened telehealth and HIPAA guidelines for Medicare, and commercial payers are following suit. The president recently issued an executive order to permanently expand some telehealth services in rural areas beyond the COVID-19 pandemic. Gallup recently published our perspective on virtual healthcare in American Journal of Managed Care. In a 2019 survey, we had found that only 14% of Americans said they had used telemedicine in the past year, and only 17% said they anticipated using it in 2020. But in March 2020, we found that 34% of Americans reported having used telemedicine, and nearly half (46%) said they are likely to use it in the future -- almost three times greater than approximately six months prior. And while telehealth usage rates may have declined from their peaks in the early
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months of the pandemic as many providers hastened back to in-person visits, public desire for telehealth has only continued to grow, with 50% saying they are likely to use it in the future as of September.
outcomes will require heightened innovation, with leaders reevaluating legacy merger management tactics in pursuit of an approach that will drive outcomes in this new climate. For example, leaders
navigating M&A must relentlessly develop and engage talented RNs, physicians, physician leaders and nursing managers. Gallup research shows that during a merger, managers play a vital role -- but only 35% in the U.S. are engaged. M&A outcomes aren’t the only thing on the line: Engagement can mean the difference between retaining your top talent or losing it overnight in these
The best hospitals will continue to prioritize an integrated strategy that promotes the quadruple aim through constant review and improvement of the patient and employee experiences. Because patient needs and expectations will evolve continuously, hospitals need to constantly track patient insights across the continuum of care -- including the virtual space. Despite the current interest
in telehealth, the future of
healthcare delivery is likely to be
omnichannel -- combining telemedicine, retail clinics, on-demand
highly unpredictable times. During post-merger integration, to optimize performance and quality of care, leaders must prioritize the engagement of healthcare managers, physician leaders and nursing managers. Maximize The Value Of The Ecosystem. The healthcare system today is a complex web of interconnected stakeholders. And the ecosystem is expanding -- beyond the traditional players such as payers, providers, pharma and medical devices. In the post-pandemic world, the
care and more. Integrating these channels effectively will also require a significant change in leadership, as well as a more robust change management process to ensure that
new technology is utilized optimally. Manage Mergers Effectively.
Hospital M&A activity was at an all-time high in the years leading up to the pandemic. In 2019, nearly 100 healthcare mergers were announced -- but the COVID-19
crisis has put pressure on some of these deals. Post-pandemic, as the healthcare industry comes to terms with sustained losses, there might also be more significant pressure to consolidate. McKinsey research conducted before the pandemic showed that healthcare systems with more than 50% of the market share had 30% higher margins than those with less than 25% market share. And operating margins of systems that are investing in growth in distributed care settings outperform all other
ecosystem might look very different. For instance, service vendors have been experiencing more significant profit growth -- greater than 10% compared with other more traditional players. These service vendors, which include clinical services and financial services, are primarily growing because of advancements in analytics, big data and digital transformation. Proactive collaboration among players in this new ecosystem
The best hospitals will continue to prioritize an integrated strategy that promotes the quadruple aim through constant review and improvement of the patient and employee experiences.
will be critical for COVID-19 recovery. Further, real transformation in healthcare requires more significant linkages and synergy among these diverse players. Leaders in this ecosystem are all committed to the same goal -- transforming healthcare and improving accessibility -- yet make unique contributions and apply complementary strategies.
inorganic/M&A-type activity -- making them immediately more attractive. The hundred-odd mergers in 2019 were also unique because acquirers were not focused on obtaining “more of the same”; rather, they were looking for ways to expand their portfolios, market opportunities and service offerings. In a post-COVID world, maximizing merger
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Some partnerships are more important to get right, such as payer and provider synergy. Integrated healthcare delivery systems are uniquely positioned to maximize synergy between insurance and healthcare provision. Leveraging big data across multiple healthcare touchpoints is another key opportunity. More than ever, the speed of collaboration is vital -- for instance, PPE manufacturers need to proactively coordinate with hospitals to develop and deploy critical resources. The most urgent, of course, is vaccine development and advances in diagnostic testing -- not only for COVID-19 but for future outbreaks as well. These “high mission” initiatives require extreme levels of agile collaboration As a direct economic result of the pandemic, millions of Americans have lost their jobs -- and in turn, health insurance benefits. For everyone, the journey toward recovery will be arduous and protracted. Life ratings plummeted to a 12-year low in April 2020, according to Gallup Panel data, with Americans reporting severe stress and financial worry. And even before the pandemic, a West Health-Gallup survey in early 2019 among diverse healthcare industry players. An Evolution – Not a Revolution
revealed that 45% of Americans feared a major health event would leave them bankrupt. The much-touted digital and technological advances in healthcare are necessary but cannot singlehandedly solve these endemic issues in the short term. Rather, progress requires intense collaboration among leaders from government agencies, private enterprises and research institutes. These leaders must engage the collective talent, imagination and intellect of every employee and player in the industry. Maximizing the collective impact of the combined system will require a unified approach aimed at improving the quality of care and reducing costs. Beyond that, leaders across the industry must focus on enhancing holistic patient wellbeing -- going beyond physical health to improve financial, emotional and societal wellness. Leaders need to set their gaze on collaboration and cross- sectoral synergy. Indeed, healthcare leaders of the future must be boundaryless and acknowledge and appreciate the interdependence of all healthcare players. The future of healthcare in the U.S. depends on it. n
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OREGON UPDATES
CDC’s COVID-19 Vaccine Rollout Recommendations Updated February 3, 2021 B ecause the U.S. supply of COVID-19 vaccine is expected to be limited at first, CDC is providing recommendations to federal, state, and local workers, United States Postal
Service workers, manufacturing workers, grocery store workers, public transit workers, and those who work in the educational sector (teachers, support staff, and daycare workers.)
governments about who should be vaccinated first. CDC’s recommendations are based on those from the Advisory Committee on Immunization Practices (ACIP), an independent panel of medical and public health experts. The recommendations were made with these goals in mind: • Decrease death and serious disease as much as possible. • Preserve functioning of society. • Reduce the extra burden COVID-19 is having on people already facing disparities. While CDC makes recommendations for who should be offered COVID-19 vaccine first, each state has its own plan for deciding who will be vaccinated first and how they can receive vaccines. Please contact your local health department for more information on COVID-19 vaccination in your area. Healthcare personnel and residents of long- term care facilities should be offered the first doses of COVID-19 vaccines (1a) CDC recommends that initial supplies of COVID-19 vaccine be allocated to healthcare personnel and long-term care facility residents. This is referred to as Phase 1a. Phases may overlap. CDC made this recommendation on December 3, 2020. Healthcare Personnel - Learn more about why it’s important that healthcare personnel get vaccinated and who is included. Long-term Care Facility Residents - Learn more about why it’s important that residents of long-term care facilities get vaccinated and who is included. Groups who should be offered vaccination next (1b and 1c) CDC recommends that in Phase 1b and Phase 1c, which may overlap, vaccination should be offered to people in the following groups. CDC made this recommendation on December 22, 2020. Phase 1b • Frontline essential workers such as fire fighters, police officers, corrections officers, food and agricultural
• People aged 75 years and older because they are at high risk of hospitalization, illness, and death from COVID-19. People aged 75 years and older who are also residents of long-term care facilities should be offered vaccination in Phase 1a. Phase 1c • People aged 65—74 years because they are at high risk of hospitalization, illness, and death from COVID-19. People aged 65—74 years who are also residents of long-term care facilities should be offered vaccination in Phase 1a. • People aged 16—64 years with underlying medical conditions which increase the risk of serious, life- threatening complications from COVID-19. • Other essential workers, such as people who work in transportation and logistics, food service, housing construction and finance, information technology, communications, energy, law, media, public safety, and public health. As vaccine availability increases, vaccination recommendations will expand to include more groups The goal is for everyone to be able to easily get a COVID-19 vaccination as soon as large enough quantities of vaccine are available. As vaccine supply increases but remains limited, ACIP will expand the groups recommended for vaccination. n
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OREGON UPDATES
12 Companies Boosting Benefits So Employees Don’t Feel Isolated or Lonely During the Coronavirus Crisis
Marguerite Ward | September 10, 2020 | Business Insider T he coronavirus pandemic has upended life as we know it for millions of Americans, causing feelings of anxiety, depression, and grief. The silver lining is that companies are stepping up to help their employees by expanding their mental health benefits. A recent survey of 256 companies by the nonprofit employer group the National Alliance of Healthcare Purchaser Coalitions found that 53% of employers are providing special emotional and mental health programs for their workforce in the wake of the pandemic. These include changes in employee assistance programs, discounts on mental health apps, and more virtual service options like remote yoga classes. Here are 12 companies that have made changes to their wellness benefits in the wake of the coronavirus pandemic. Starbucks is giving employees and their family members 20 free counseling sessions a year.
Each employee and their family members will be able to access 20 sessions a year with a mental health therapist or coach through the provider Lyra Health, at no cost. The benefit rollout will impact more than 220,000 US workers and their family members, according to Ron Crawford, vice president of global benefits at Starbucks. Target is expanding its offering of online mental health resources. Target is offering its US employees access to free online
Employees can use the apps to improve sleep and deal with stress.
resources to support their mental, emotional, and physical health. Employees will receive a year of access to Daylight, a website and app designed to help users navigate stress and worry, and Sleepio, an app that provides self-help tools to improve sleep. For the month of April, employees will also be able to access free virtual fitness classes through the app Wellbeats. Before the pandemic, Target employees already had access to the company’s EAP program that, among other benefits, offers five free counseling sessions. PwC is offering employees access to well- being coaches. PwC recently introduced well-being coaching sessions where employees can reach out to a professional coach to
More than 220,000 US Starbucks workers will be able to access the counseling sessions.
Starbucks announced that beginning April 6, all of its employees (which the company calls “partners”) who work 20 hours or more per week will now be entitled to expanded mental health benefits through its employee assistance program (EAP).
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discuss anything that may be causing them stress. They also created an online community for workers to connect with one another to discuss challenges they’re facing surrounding coronavirus. The firm already offers employees and dependents six free therapy sessions, confidential emotional support via mobile app, and free apps on guided meditations, sleep, breathing, and relaxing music. SoFi is giving employees and select family members up to six therapy sessions.
In light of COVID-19, SoFi, a loan refinancing and personal finance company, has started providing employees, and up to three dependents over the age of 18, access to a mental health platform called Modern Health, in addition to in-network coverage of mental health providers included in their employee health plan. Modern Health offers employees up to six in-person or video therapy sessions and a range of digital resources like classes on meditation. Kickstand Communications is providing employees with a more flexible schedule. Kickstand Communications, a public relations, content marketing, and social media agency, already provides employees with a monthly wellness stipend that can be used to pay for mental or physical health. Because of coronavirus, the company recently began providing employees with a more flexible work schedule, and three hours per week to step away from the computer and recharge. Salesforce has started offering employees a series of articles and webinars on emotional health, as well as a meditation app, in addition to other benefits. In addition to its already existing employee assistance program that includes free face-to-face or video counseling
SoFi employees now have access to up to six in-person or video therapy sessions.
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Clearcover is hosting a digital roundtable session with a mental health counselor.
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sessions, Salesforce has begun offering employees access to Thriving Mind, a series of articles and webinars on emotional health created in partnership with Stanford Medical and Thrive Global. The company has also launched a live webinar series called B-Well Together with figures like Arianna Huffington and Deepak Chopra, a daily well- being survey to track employees’ mental health, as well as access to Plum Village’s Zen Meditation app. Power Home Remodeling, a remodeling company, reduced the copay charge for therapy visits. Power Home Remodeling partnered with a few virtual therapy apps to give employees free access. Power HQ To help employees access more affordable care, Power Home Remodeling changed its copay for employees seeking in-network therapy from $50 per visit to $20. It also offered employees free premium access to mental health coaching app Sanvello and virtual therapy app Talkspace. TransferWise is giving employees a 50% discount on mindfulness apps like Headspace.
The company is offering a digital session with a counselor through its EAP program.
The company is offering a digital session with a counselor through its EAP program. Courtney Hale/Getty Images Auto insurance company Clearcover is hosting a digital session with a counselor through its EAP to discuss mental health during social distancing and quarantine. The company has also set up a slack channel on mental health and productivity to encourage conversation around the topic. Prior to the pandemic, the company offered employees three free sessions with a counselor, regardless of whether they were enrolled in medical benefits, along with unlimited PTO days. EY is offering its employees 24/7 resources through its program EY Assists, which connects employees to healthcare professionals.
The company is increasing its offerings of wellness-related Zoom events, from yoga and salsa dancing to meditation and a book club.
Global technology company TransferWise already offered its 2,000 employees counseling sessions with mental health professionals through its EAP. Because of the pandemic, however, the company is offering employees discounts on various well-being services, such as 50% off Headspace, a mindfulness and meditation for stress and sleep. TransferWise is also increasing its offerings of wellness-related Zoom events, from yoga and salsa dancing to meditation and a book club.
The professional services firm is expanding it’s EY Assist program.
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The professional services firm is offering 24/7 resources through its program EY Assist, which connects employees to healthcare professionals. In addition, the company is offering small discussion groups to employees on mental health, webinars on managing stress, and virtual coaching sessions. Merit, a platform for digital credentials, is offering workers access to a service that lets employees talk with wellness coaches.
Merit, a platform for digital credentials, is offering its employees and their spouses free access to 24/7 mental wellness coaching through Sibly, a service where people can text with wellness coaches about a variety of mental health topics. Sibly is currently offering organizations three months of the service free of charge or commitment. Benecard, a prescription benefit company, is offering employees free access to a mindfulness app for three months. Benecard, a prescription benefit company, is partnering with Free Form Minds, a mindfulness app and website, to allow for 400 enrollees from the company to receive free access for three months. Each day, participants receive a short video on a specific theme, like gratitude or relaxation. “We are living in unprecedented times with heightened anxieties, fears, and frustrations,” COO Kevin Kroll said in a press release. “With the partnership and help of Free Form Minds, we hope this free service will alleviate some of the pressures on our members, clients, and brokers — both professionally and personally.” n
The wellness coaches on Sibly can help an employee navigate stress related to the coronavirus pandemic, relationship issues, and more.
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CREATING A STRONG ECONOMY
Exercising While Wearing a Mask Some types of masks are better than others when exercising in crowded spaces.
By Gretchen Reynolds | June 17, 2020 | New York Times W earing a mask during exercise reduces the risk that we will infect someone else with the novel coronavirus if we unwittingly carry the disease. But wearing a mask also affects how the exercise affects us, according to exercise scientists who have begun to look into the effects of covering your face while working out. Their research and insights, some of them based on self- experimentation, raise practical questions about whether some types of masks might be better than others for exercise, how often masks should be swapped out during prolonged exertions and just how much we should expect our heart rates to soar if we attempt to interval train with a mask on. Almost all of us know by now that the Centers for Disease Control and Prevention recommends we cover our faces when we are in crowded public spaces, such as parks or pathways, and in shared, indoor locations, including gyms, to help block the transmission of the novel coronavirus through respiration. These recommendations — which are requirements in some communities and businesses — become particularly pressing when we exercise, since past studies show that our breathing rates can double or even quadruple then, sending out higher numbers of potentially infectious respiratory droplets. But while there is growing evidence that masks can affect breathing in general, as my colleague Jane Brody wrote about this week, little is yet known scientifically about if and how face coverings change the subjective experience and physical impacts of exercise — although many exercisers will tell you that they do. A commentary published this month on the website of the British Journal of Sports Medicine points out that covering your face during exercise “comes with issues of potential breathing restriction and discomfort” and requires “balancing benefits versus possible adverse events.” To find out more about those benefits and adversities, I contacted several scientists who have begun analyzing masks and exercise, including the primary author of the new commentary. Because university closures and other pandemic restrictions prevent large-scale, lab- based experiments now, these scientists’ research efforts primarily have involved wearing masks themselves during workouts or asking a few close colleagues to do the
A woman practices yoga outdoors while maintaining social distancing and wearing a face mask.
same and taking copious notes. But although anecdotal and unpublished, their analyses provide useful tips and cautions for mask wearing during workouts. Perhaps most important, they show that masks do alter exercise, says Cedric X. Bryant, the president and chief science officer of the American Council on Exercise, a nonprofit organization that funds exercise research and certifies fitness professionals. “In my personal experience,” he says, “heart rates are higher at the same relative intensity when you wear a mask.” In other words, if you don a mask before running or cycling at your usual pace, your heart rate will be more elevated than before. “You should anticipate that it will be about eight to 10 beats higher per minute” when you wear a mask than when you do not, Dr. Bryant says. This exaggerated rise in heart rate will be most pronounced during intense efforts, he says, such as hill repeats or intervals. Some people also could experience lightheadedness during familiar workouts while masked, says Len Kravitz, a professor of exercise science at the University of New
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Mexico. He is in the early stages of planning a large study of masks and exercise with funding from A.C.E. that will begin when pandemic restrictions allow, he says. But already he has conducted an informal experiment with two of his students, both experienced athletes. One ran, masked, without breathing difficulties, he says. The other, wearing the same type of cloth mask, felt dizzy after only a few minutes of exertion. Thankfully, such discomforts likely can be minimized by judicious mask choice and fitting, says Christa Janse van Rensburg, a professor of exercise science at the University of Pretoria in South Africa, who wrote the commentary about masks with her graduate student, Jessica Hamuy Blanco. Avoid paper, surgical masks altogether during exercise, she says, since they rapidly become wet when we breathe into them vigorously and lose some of their ability to block outgoing germs. Cotton cloth masks likewise dampen easily. Cloth masks made from breathable, synthetic materials should lessen moisture buildup. Choose models, though, that “have two layers of fabric or less,” she says, to avoid facial overheating and any bunching of the cloth that might constrict breathing. Some exercisers may prefer neck gaiters (also called buffs), which can be pulled up over the mouth and nose but remain open at the bottom, increasing air flow. “This can be good from a comfort point of view,” Dr. van Rensburg says, “but perhaps with the trade-off of less-effective infection control.” Look for gaiters in summer-weight fabrics, not those designed for use during skiing. Plan, too, to carry extras of your preferred mask if you will be exercising for more than about 30 minutes, Dr. Bryant says. Even breathable fabrics become drenched at that point and should be replaced. Try not to touch the front of the used mask, since any viral particles you came into contact with could have accumulated there, he says, and after removal, pack or dispose of it carefully. Some athletic clothing companies, including Under Armour, Koral, Zensah and others have begun to manufacture masks for use during exercise. You may need to try several models to find the one that most comfortably fits your face and exercise routine, Dr. Bryant says. But do not be deterred in the interim from wearing a mask if you will be exercising around other people, he continues. Wearing a mask can be particularly important if you are exercising indoors at a gym, where air circulation is less likely to dissipate the virus. “I know some people find them unpleasant” while running or cycling “and there are controversies” about whether they should be mandatory. “But I look on masks as an opportunity to be a good citizen and show that you care about the well-being of others,” he says, even as you bolster your own well-being with a workout. n
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CREATING A STRONG ECONOMY
New Treatment Option for Covid- Positive Patients Now Available at Asante Ashland Community Hospital With the FDA’s approval for the emergency use of monoclonal antibody treatment for COVID-19, Asante is one of four health care providers in Oregon offering this potentially life-saving care to people in our community. N ow available at Asante Ashland Community Hospital, the monoclonal antibody treatment bamlanivimab (made by Eli Lilly and Company) and the therapeutic cocktail casirivimab/imdevimab (made by Regeneron) are the first outpatient, non-vaccine treatments for COVID-19.
They offer an experimental treatment option for people newly diagnosed with COVID-19 and who meet certain medical criteria as determined by the FDA. The treatment is appropriate for about 12% of people with mild to moderate COVID-19 symptoms. “The treatment can have a significant impact on the severity of symptoms people experience as well as help reduce the need for more intense hospital-related interventions,” said Lee Shapley, MD, administrator at Asante Ashland Community Hospital. “By treating people at the early onset of their COVID diagnosis, this therapy can help people recover faster with fewer lingering effects of the disease and keep more people out of the hospital.” The drugs are administered via intravenous infusion to people with an early diagnosis for COVID-19 and who are in a high- risk category. This includes, but is not limited to, people with cardiovascular disease, hypertension, respiratory disease, chronic kidney disease, diabetes, immunosuppressive disease or have a body mass index over 35. “People diagnosed with COVID need to ask their doctor right away if they’re a candidate for monoclonal antibody treatment,” said Dr. Shapley. “It’s important to start treatment immediately after a diagnosis for the best outcome.” The infusion treatment lasts about an hour, with an additional hour of observation after the treatment. “Asante is following recommendations from the FDA to provide the highest quality care and meet the highest safety standards possible for this therapy,” said Kristi Blackhurst, vice president of Operations at Asante Ashland and Asante Rogue Regional Medical Center. “Treatment can be considered for any person in Asante’s nine-county service area in Southern Oregon and Northern California who has a referral from their doctor.”
The infusion center at Asante Ashland was made possible by the community. Through donations to Asante Foundation, the space for this specialized treatment includes infusion chairs, IV pumps, new flooring, fresh paint and other furnishings. “Offering this innovative treatment is a testament to the power of philanthropy in our community,” said Andrea Reeder, Asante Foundation campaign director. “Not only has the community responded beautifully to help meet the most urgent needs related to COVID, it has turned to Asante as a trusted health care partner. Donor generosity made this infusion unit a reality, and it continues to help patients and health care workers through the pandemic and beyond.” The monoclonal antibody treatment bamlanivimab (made by Eli Lilly and Company) and the therapeutic cocktail casirivimab/ imdevimab (made by Regeneron)
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The Business Review | February 2021
Asante Ashland Community Hospital
Go to asantefoundation. org for more information about the COVID-19 Compassion Fund. The other three Oregon hospitals offering monoclonal antibody treatment are St. Alphonsus Medical Center in Baker City, Pioneer Memorial Hospital in Heppner and Bay Area Hospital in Coos Bay. About Monoclonal Antibody Treatment Antibodies are proteins that people’s bodies make to fight viruses, such as the virus that causes COVID-19. Antibodies made in a laboratory act a lot like natural antibodies to limit the amount of virus in your body. They are called monoclonal antibodies. These antibodies may help reduce the amount of COVID-19 virus in the body, which could give the body more time to learn how to
make its own antibodies. Studies have shown these experimental therapies lessen the severity of symptoms of SARS-CoV-2 infection and prevent hospitalization. Monoclonal antibody treatment with bamlanivimab or with casirivimab and imdevimab are for people who have tested positive for COVID-19 and have mild to moderate symptoms and meet FDA high-risk criteria. Casirivimab and imdevimab must be given together. Bamlanivimab is given alone. Medical providers must follow guidelines from the FDA Fact Sheet for Bamlanivimab and the FDA Fact Sheet for Regeneron to assess and refer their patients appropriately. n
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February 2021 | The Business Review
CREATING A STRONG ECONOMY
State-by-State Business Reopening Guidance
U.S. Chamber Staff | May 4, 2020 A cross America, business leaders are restarting our nation’s economic engines and employees are returning to work. However, this process is taking place gradually and non-uniformly across the country depending on regional differences in the prevalence of COVID-19. required; in others, they’re suggested. In some states, mask requirements apply only to employees, while in others, customers must wear them, too. In some states, employers are required to screen employees before shifts begin; in others, it’s required after each shift. In still others, it’s not required at all. Meanwhile, some states are leaning on questionnaires, but even then, the questions and retention rules vary. To help track the differences across each state and provide the latest guidance and information to America’s employers, we have launched the following interactive state map and state guides. Below, you will find the latest guidelines, timelines and other critical information for businesses aiming to restart In some states, for example, masks are
State By State Business Reopening Guidance Click here to see interactive map explaining guidelines and timelines for employers. Last Updated: February 2, 2021
safely and sustainably amid the pandemic, as well as (at the bottom of each state profile) a link to the latest information for employers in that state. We will update this resource as new state plans take effect and new information becomes available. Please note that this tracker captures plans in effect for reopening of non-essential businesses. It does not include guidance for essential workers or protocols for when an
employee or patron is diagnosed with COVID-19. Future phases of reopening in a given state will be updated at the start date. This map and the state profiles may not be exhaustive and should not be construed as legal advice. Please click on the links to further information for each respective state (at the bottom of each state profile) for the latest guidance and information for employers in that state. n
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The Business Review | February 2021
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February 2021 | The Business Review
REPRESENTING BUSINESS ISSUES
TMheedical DReelbietf Act Merkley, Porter Introduce Critical Legislation to Protect Patients with Medical Debt from Long- Term Financial Harm Washington, D.C. O regon’s U.S. Senator Jeff Merkley teamed up with Representative Katie Porter (D-CA-45) today to lead three Senators and 46 Representatives in the introduction of the Medical Debt Relief Act—legislation that would remove paid-off or settled medical debt from a patient’s credit report and institute a year-long waiting period before new medical debt can be reported. “There is nothing more outrageous than the fact that after a family has paid their medical debt, their credit is still destroyed as if that debt remains unpaid,” said Merkley. “Credit agencies are repeatedly kicking families when they’re down and struggling to get back up, and in the middle of this devastating pandemic, it’s long past time we fix that.” Even before the coronavirus crisis hit, tens of millions of Americans had a past-due health care bill on their credit report, and medical debt was a leading reason why Americans filed
for bankruptcy. Unlike credit card debt or loans that consumers take on willingly, medical debt results from an unexpected accident or illness outside of one’s control before causing significant long-term damage to a person’s credit score. That’s because once unpaid medical bills are assigned to collections, they result in derogatory marks that scar credit scores for years, even after the debts have been paid off. The Medical Debt Relief Act would undo that injustice by deferring derogatory marks on credit scores for medical debt collection by one year, giving patients time to pay their medical bills before their records are affected. During this one year-year period, a consumer may communicate with an insurance company to determine coverage for the debt, and apply for financial assistance. In addition, the bill will prohibit consumer reporting agencies from reporting an individual’s medical debt for one year, and requires all paid-off or settled medical debt to be removed from consumers’ credit reports and credit scores. The legislation is cosponsored by U.S. Senators Robert Menendez (D-NJ), Richard Blumenthal (D-CT), and Chris Van Hollen (D-MD), and is supported by the National Patient Advocate Foundation, National Consumer Law Center, Americans for Financial Reform, and Consumer Federation of America. n
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The Business Review | February 2021
REPRESENTING BUSINESS ISSUES
Groundbreaking Legislation to Boost Sustainability Among America’s Ports Legislation would address environmental disparities in port communities, cut greenhouse gas pollution, and create good-paying jobs Washington, D.C. O regon’s U.S. Senator Jeff Merkley is leading five of his Senate colleagues—including U.S. Senator Ron Wyden—in introducing the Climate Smart Ports Act—legislation that would create a $1 billion per year federal program dedicated to improving sustainability
To ensure that money in this program finds its way to communities that need it the most, the bill sets aside a minimum of 25% of funding for areas in non-attainment with Clean Air Act criteria pollutants. In addition, applications for grant funding are scored in part on how they will reduce public health disparities in communities and reduce toxic air pollution. The bill also includes provisions to ensure that the upgrades create good jobs, by requiring payment of a local prevailing wage for work performed with federal funds, encourage project labor agreements and local hiring, give preference to equipment produced in the United States, and includes language protecting dock workers from automation. “We are pleased by Senator Merkley’s ongoing efforts to promote the success of our nation’s ports, while prioritizing environmentally sound legislation to minimize the impacts of greenhouse gas emissions,” said John Burns, CEO of the Oregon International Port of Coos Bay. “Ports are economic drivers in the communities and regions where they operate. It is critical that they continue to facilitate the flow of commerce while investing in a greener tomorrow.” The Climate Smart Ports Act is endorsed by International Longshore and Warehouse Union (ILWU), National Electrical Contractors Association (NECA), Pacific Northwest Waterways Association (PNWA), Washington Public Ports Association (WPPA), Moving Forward Network, Earthjustice, Natural Resources Defense Council, Sierra Club, League of Conservation Voters, Environmental Defense Fund, Food & Water Action, Greenpeace, Eastyard Communities for Environmental Justice, Friends of the Earth, Jobs to Move America CA, the American Lung Association, Indivisible San Pedro, the San Pedro & Peninsula Homeowners Coalition, Green For All, Union of Concerned Scientists, by Humankind, Oregon Public Ports Association (OPPA), International Port of Coos Bay, Port of Portland. In addition to Merkley and Wyden, the legislation is cosponsored by U.S. Senators Elizabeth Warren (D-MA), Kirsten Gillibrand (D-NY), Dianne Feinstein (D-CA), and Martin Heinrich (D-NM). A summary of the bill is available here. n
measures at America’s ports. The legislation was also introduced in the U.S. House of Representatives by Congresswoman Nanette Diaz Barragan. Greenhouse gas pollution from mobile sources at ports is on the rise. The Climate Smart Ports Act would assist ports and port users in reducing harmful pollution by replacing cargo handling equipment, port harbor craft, cargo delivery trucks, and more with zero-emissions equipment and technology. In addition, the legislation would help ports develop onsite clean energy microgrids to power their facilities and equipment, and authorizes an additional $50 million per year for the Diesel Emissions Reduction Act (DERA) to be spent specifically on reducing port emissions. “Nearly 40 percent of Americans live within 3 miles of a port—meaning these investments will not only improve port facilities, but also dramatically reduce the pollution that has long affected port-adjacent communities, which are home to millions of low-income families and communities of color,” said Merkley, who serves on the Senate Environment and Public Works Committee and is a member of the Senate Environmental Justice Caucus. “Every American deserves to breathe clean air that’s free of harmful chemicals from port equipment and trucks. The Climate Smart Ports Act lays out a commonsense plan to help turn that principle into a reality, while also creating good-paying, reliable jobs.” “Oregon’s ports are the lifeblood of the coastal economies that keep our communities happy and healthy. But we cannot continue to operate 21st-century ports with 20th- century tools,” said Wyden, who is a senior member of the Energy and Natural Resources Committee and a member of the Senate Environmental Justice Caucus. “The Climate Smart Ports Act is key to continuing to nurture the quality of life for Oregonians who live and work in port communities – from clean water and breathable air to permanent, reliable jobs with a liveable wage.”
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February 2021 | The Business Review
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