A4 BAKER CITY HERALD • THURSDAY, MAY 19, 2022
BAKER CITY
Opinion
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Baker City, Oregon
EDITORIAL
City’s new
ambulance
database is
welcome
B
aker City Manager Jonathan Cannon has
made a valuable addition to the city’s web-
site, www.bakercity.com.
Th e new database has a considerable amount of
information about the city’s ambulance service. A
link to the ambulance service information page is
on the home page of the website.
Whether the city will continue to operate am-
bulances, or whether Baker County, which under
Oregon law is responsible for choosing ambulance
providers, will need to pick a replacement, is un-
certain.
On March 22 the Baker City Council, aft er
reviewing a report in which Cannon lists the
fi nancial challenges of operating ambulances and
expresses his belief that the city can’t aff ord to con-
tinue doing so, sent a notice to the Baker County
Board of Commissioners that the city intended to
curtail ambulance service on Sept. 30, 2022.
Th at prompted commissioners to write a re-
quest for proposals (RFP) for prospective ambu-
lance providers, with a June 3 deadline to respond.
Th e City Council decided May 10 to send a pro-
posal to the county. Cannon is preparing a draft
of the proposal for councilors to consider at their
May 24 meeting.
Th e new database includes detailed reports
showing changes over time in what percentage of
ambulance bills the city actually collects. Other
documents list ambulance calls where the patient
declined to be transferred or doesn’t need to be
taken to the hospital, and in some of those in-
stances the city doesn’t send a bill.
Another record shows the fi re department’s
monthly overtime costs. Th e total overtime tab
increased from $69,900 for the nine-month period
July 2020 through March 2021, to $135,600 for
the period July 2021 through March 2022. Th at’s
$65,700 more in overtime costs, a 94% increase.
Firefi ghter/paramedics who are members of the
Baker City Firefi ghters Association union blame
that increase on the city’s decision in the summer
of 2021 to have three division chiefs change from
working the 24 hours on, 48 hours off shift that
fi refi ghter/paramedics have, to a more standard
shift . Th at change, which reduced the number of
fi refi ghter/paramedics on call around the clock,
has made it more likely that off -duty staff will
need to come in, such as when there are multiple
calls simultaneously, union members say. Th e
union also fi led a grievance over that change.
Th e level of interest among local residents in
this issue is understandably high. Th e turnout at
the City Council’s May 10 meeting, with people
occupying all the chairs and many others stand-
ing, makes that obvious.
Th e situation is not limited to determining
which agency operates ambulances. If the city
ends its service, it would also have to lay off six
fi refi ghter/paramedics, a reduction in service that
many of those who spoke to the City Council on
May 10 opposed.
Given the circumstances, Cannon was wise to
make readily available so much information to
the public, rather than requiring that residents go
through the sometimes cumbersome process of
requesting documents, through Oregon’s Public
Records Law, that they’re entitled to anyway. Th e
new database gives citizens a more thorough per-
spective of the situation.
Although the new ambulance service database
doesn’t include the city’s current and past budgets,
those are also available elsewhere on the city’s
website. Th ose budgets show how the city has
been able to maintain its staffi ng levels, in both
the fi re department and police department, which
make up about 62% of the general fund, despite
the challenges of collecting ambulance bills.
— Jayson Jacoby, Baker City Herald editor
COLUMN
The fight against ‘superbugs’
tions originate outside of our hospitals
and within our communities.
Without effective antibiotics, run-of-
the-mill pneumonia or skin infections
can become life-threatening.
COVID-19 exacerbated the situation.
Amid the widespread uncertainty and
limited treatment options at the begin-
ning of the pandemic, doctors often used
antibiotics to treat COVID-19 patients as
they tried to help them. Patients may also
have been given antibiotics in instances
in which it was difficult to distinguish
between bacterial pneumonia, which re-
quires antibiotics, and COVID-19.
Hospital stewardship programs —
which manage the careful and optimal
use of antimicrobial treatments — also
had to redirect their limited resources
away from antibiotic use to focus on the
complex administration of COVID-19
therapeutics. And severely ill patients on
ventilators were at a higher risk of con-
tracting secondary infections, especially
while their immune system was weak-
ened.
These factors led to an increase in
drug-resistant infections acquired in
hospitals during the pandemic. Drug-re-
sistant staph infections, MRSA, jumped
34% for hospitalized patients in the last
quarter of 2020 compared with the same
period in 2019.
Proportionately, those numbers have
the biggest impact on California, which
has the most coronavirus cases of any
state. Los Angeles, San Diego, Riverside,
Orange, San Bernardino, and Santa Clara
counties have the highest number of
COVID-19 cases and deaths in the state.
Prior to COVID-19, we made initial
progress in the fight against antimicrobial
resistance. In 2014, California was the
first state to pass a law requiring antimi-
crobial stewardship programs in hospi-
tals. In 2019, Medicare began requiring
antibiotic stewardship programs.
Some modest federal investments have
also been made in antimicrobial research
and development, but not enough to
generate the pipeline patients need. We
must increase support for antimicrobial
stewardship practices, which were un-
der-resourced even before the pandemic.
Teaching practitioners to safely use and
monitor antimicrobial treatments is a sig-
nificant step.
We also need to develop novel antimi-
crobial medicines capable of defeating
the superbugs that have grown resistant
to previous generations of treatments.
But market incentives are misaligned. Be-
cause doctors prudently limit their use of
antimicrobials to avoid further resistance,
there isn’t high demand to sustain the de-
velopment of new products, which take
years of research and billions of dollars in
investments.
As a result, many large biopharmaceu-
tical companies have stopped antimicro-
bial research entirely. And many smaller
startups have had success at first, only to
face bankruptcy. That’s part of the reason
why there have been few new classes of
antibiotics developed in the last 35 years.
This is a textbook case of a market fail-
ure, but government intervention can
help realign market incentives.
The PASTEUR Act is a bipartisan bill
in Congress that would establish a pay-
ment model for critically needed antimi-
crobials.
Currently, the government pays man-
ufacturers based on the volume of drugs
sold. But under PASTEUR, the govern-
ment would enter into contracts with
manufacturers and pay a predetermined
amount for access to their novel antimi-
crobials — allowing scientists to innovate
new treatments without fear of an insuf-
ficient return on investment due to low
sales volumes.
Essentially, the bill would switch the
government from a “pay-per-use” model
for antimicrobials to a subscription-style
model that pays for the value antimicro-
bials bring to society. By delinking pay-
ments to antimicrobial makers from sales
volumes, the measure would stimulate in-
vestment in new antibiotics.
The bill would also provide resources
to strengthen hospital antimicrobial stew-
ardship programs, which help clinicians
use antimicrobials prudently and help the
Centers for Disease Control and Preven-
tion closely monitor resistance. Hospitals
should join public health leaders in sup-
porting this legislation and invest more
of their resources in their antimicrobial
stewardship programs.
Unfortunately, superbugs aren’t an easy
enemy to defeat. We need to be fighting
them more vigorously to ensure that they
don’t get around our best defenses.
What I find disingenuous is that she
condemns other candidates by shedding
a negative light on it, while doing the
Baker County Republican Party Chair same thing.
Suzan Jones lectured here in this publi-
A couple other folks keep defending
cation against voting for a Republican
the action of campaign donations and
precinct party representative (PCP) for the suspension of bylaws at an improp-
your precinct that doesn’t live within
erly noticed meeting they held back in
your boundary. She says this isn’t neigh- November of last year. They had to sus-
borly. Nonsense. We all live in Baker
pend our party bylaws in order to break
County and we’re all friends, family,
the rules they wanted. Mr. Hughes and
and neighbors. We’re a small commu-
Mr. Langan are incorrect in their de-
nity. The state legislature changed to
fense of this action. They can only cite
allow for this rule in 2019. Chair Jones
that “some other county did it” while
knows this, because she was seen at the the evidence is ample within our county
courthouse prior to the filing dead-
rules as well as the Oregon Republican
line moving PCP candidates into vari-
Party rules that what they did is wrong.
ous precincts around the county at her
It’s happening again with robocalls
own discretion. And I’m fine with that. from this same group. They claim that
the Baker County Republican County
endorsed certain PCP candidates and
even posted it from the official Repub-
lican Facebook page. There was no en-
dorsement or recommendation by the
Republican Party. There was no meeting
or motion or vote for this effort as our
bylaws dictate under authorization of
Oregon Revised Statutes.
We all witnessed the greatest election
fraud in American history unfold in
2020. How can we ever fix the problem
when the leadership of our own party
is spreading misinformation, much like
the Democrats do, and it’s happening
right here in Baker County and congres-
sional district 2?
Jake Brown
Halfway
BY ANNABELLE DE ST. MAURICE
As parents, we inherently want to pro-
tect our children. We tell them stories
with happy endings and reassure them
that there aren’t monsters hiding under
the bed.
But there’s an enemy living among
us that poses a fatal threat to kids and
adults alike — and we’re simply not doing
enough to stop it.
These enemies are “superbugs” — bac-
teria and fungi that are resistant to an-
tibiotics and other medications. All mi-
crobes, from everyday bacteria to killer
superbugs, are constantly evolving. And
paradoxically, exposing microbes to anti-
microbials — whether a common antibi-
otic for strep throat or a potent antifun-
gal treatment given in the hospital — can
make them stronger in the long run.
While most of the microbes die when
treated, the ones that survive can repro-
duce. These new generations of microbes
can build up resistance to certain anti-
microbials, rendering some medications
less effective or ineffective over time.
Unfortunately, this natural evolution-
ary process is speeding up for several
reasons. We greatly overuse antibiot-
ics in patients with viruses, like the flu,
common colds and bronchitis — with-
out benefit. And modern medical care
has increased the demand for antibi-
otics. Advances in cancer care, organ
transplants and surgeries such as hip
and knee replacements have become
much more common. These proce-
dures can extend and improve life, but
patients often require antimicrobials
because they are at high risk of develop-
ing infections.
Bacteria are mutating at a speed that
outpaces the development of antibiotics.
Penicillin was discovered in 1941, but it
wasn’t until 1967 that penicillin-resistant
Streptococcus pneumococcus was first
identified. By contrast, consider an an-
tibiotic for multidrug-resistant bacteria
released in 2015, called ceftazidime-avi-
bactam. That same year a strain of bac-
teria emerged that was resistant to this
new antibiotic.
Drug-resistant pathogens are one of
the greatest healthcare threats of our
time — for everyone, everywhere, in-
cluding adults and children. More than
1.2 million people died worldwide from
antibiotic-resistant infections in 2019
alone. Multidrug-resistant infections are
on the rise in kids. More of these infec-
█
Annabelle de St. Maurice is an associate professor
of pediatric infectious diseases at the David
Geffen School of Medicine at UCLA, and head of
pediatric infection control and co-chief infection
prevention officer at UCLA Health.
YOUR VIEWS
Republican Party chair spreading
disinformation
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