A8 THE BULLETIN • WEDNESDAY, MARCH 17, 2021
EDITORIALS & OPINIONS
AN INDEPENDENT NEWSPAPER
Heidi Wright
Gerry O’Brien
Richard Coe
Publisher
Editor
Editorial Page Editor
Here’s a bill
we would be
glad to see die
O
ne of our favorite things that is happening in this
legislative session is something that appears to be not
happening: House Bill 2888.
That’s the bill introduced by State
ways. Is that really a problem?
Rep. Paul Evans, D-Monmouth. It
While most other colleges in Or-
seems to be set to die.
egon and across the country were
The bill would sever the relation-
struggling with enrollment even be-
ship between OSU-Cascades and
fore the pandemic, OSU-Cascades
OSU. OSU-Cascades would become was growing at a steady clip. If meet-
its own separate en-
ing student demand for
tity — Central Oregon If meeting student
higher education is a
University. Employees
goal for legislators and
demand for higher
and students would
students want to go to
be shifted to the new
OSU-Cascades, giving
education is a goal
school, apparently
more money to support
for legislators and
without any say in
the growth of the cam-
the matter. The new
pus is the right thing to
students want to go
school would also be
do. Evans should be of-
to OSU-Cascades,
prohibited from of-
fering ideas to improve
fering any programs
Oregon’s other institu-
giving more money
above a master’s de-
tions without the clear
gree. OSU-Cascades
to support the growth aim of undermining
had announced plans
OSU-Cascades’ success.
in 2020 to begin offer- of the campus is the
This week is a kind
ing a doctoral program right thing to do.
of do-or-die week for
in physical therapy in
legislation, as Gary
the fall of 2021.
Warner, who reports
Evans believes that OSU-Cascades for The Bulletin and EO Media
is growing at the expense of other in- Group, put it. If a bill has not had
stitutions in the state. That includes
a work session by Friday, it’s likely
Western Oregon University, located
dead. It’s not certainly dead. It’s likely
in the district Evans represents. And dead. There can be exceptions and
to some extent, he is likely right.
there are workarounds, but generally
The Legislature must makes deci-
no work session this week means no
sions about where to allocate dollars chance for a bill.
for higher education. It only has so
HB 2888 is in the House Education
much money to spend. OSU-Cas-
Committee. It has not had a work ses-
cades does benefit from its connec-
sion. It is not scheduled for one.
tion to OSU in no small number of
Hooray.
Surgical smoke can prove hazardous
BY BRENDA LARKIN
A
s a long-time operating room
clinical nurse specialist, I work
tirelessly for my patients and
in support of frontline caregivers.
Patients entrust their lives into our
hands as members of the team pro-
viding them with safe surgi-
cal care. Unfortunately, how-
ever, my life is also on the line
as I inhale the harmful surgi-
cal smoke prevalent in oper-
ating rooms across Oregon.
Surgical smoke is gener-
ated in the operating room
Larkin
when electrosurgical pencils
and lasers are used to cut or
cauterize tissue. In other words, it is
the smoke produced from burning
human flesh.
Like cigarette smoke, surgical
smoke can be seen and smelled. The
average impact of this smoke to the
surgical team is equivalent to inhal-
ing the smoke of 27-30 unfiltered cig-
arettes during each day spent in the
operating room. Secondhand smoke
exposure at this level is not acceptable
in our restaurants or bars. Surely, we
shouldn’t accept it in any of Oregon’s
healthcare settings.
In addition to causing respiratory
illness, asthma and allergy-like symp-
toms, surgical smoke can contain live
viruses such as human papilloma vi-
rus. In fact, there are documented
cases of HPV transmission from pa-
tients to providers via surgical smoke
inhalation.
GUEST COLUMN
Surgical smoke can also cause can-
cer cells to metastasize in the incision
site of patients undergoing the sur-
gical removal of a cancer. For babies
born by cesarean-section, their first
breath outside the womb
may be one filled with surgi-
cal smoke.
Toxic surgical smoke,
which contains over 150
hazardous chemicals as well
as, carcinogenic and mu-
tagenic cells, can be safely
evacuated from the operating
room with the use of a sim-
ple hand-held device. No expensive
construction or HVAC changes are
needed. In fact, all operating rooms
already are equipped with suction
equipment that can be used to evac-
uate surgical smoke, and costs for the
filters are minimal.
For electrosurgical pencils, cost dif-
ferences between traditional pencils
and those with attached evacuators
can be as little as a few dollars per
pencil.
For decades, several health and
safety agencies have recognized the
hazards of surgical smoke and recom-
mended surgical smoke evacuation,
but there are no state or national en-
forceable requirements for such evac-
uation. Even though some Oregon
surgical facilities evacuate smoke vol-
untarily during some procedures, few
facilities evacuate consistently during
every procedure.
Nurses have little control over
whether we are assigned to a smok-
ing or nonsmoking operating room.
We are forced to argue for the use of
life-saving smoke evacuation equip-
ment at a time when we should all be
focused on the surgery at hand.
While hospital associations in Ken-
tucky and Colorado have supported
similar legislation in their states, the
Oregon hospital association has op-
posed the legislation here for three
years. They argue that voluntary com-
pliance is sufficient.
However, we on the front lines
know that voluntary compliance is
insufficient because operating room
staff in Oregon continue to work
in hazardous, smoke-filled operat-
ing rooms — even in the middle of a
deadly, viral pandemic.
This is why the Oregon Legisla-
ture must pass HB 2622 this year
and make Oregon a surgical smoke-
free state. HB 2622 would require
hospitals and outpatient surgery fa-
cilities to create and implement poli-
cies to evacuate surgical smoke. The
bill allows maximum flexibility for
surgical teams and facilities to se-
lect and use the equipment of their
choice.
Oregon must become surgical
smoke-free. My health depends on it.
e e
Brenda Larkin is a board member for the
Association for periOperative Registered Nurses
and an operating room clinical nurse specialist
in Bend.
123RF
A European mink, mustela lutreola.
Should Oregon tighten
rules for raising mink?
R
ecently it was beaver. And
now it is mink. The Center
for Biological Diversity has
aimed to reshape how Oregon treats
animals.
The group had filed a petition
with the Oregon Fish and Wildlife
Commission to get the state to move
to ending beaver trapping and hunt-
ing on federal land. The commis-
sion rejected that last year. This year,
the Center for Biological Diversity
filed a petition for the commission
to move to put mink on the list of
prohibited species. The commission
may make a decision on Friday.
Oregon has some 11 permitted
mink farms with more than 400,000
mink, according to The Capital
Press. Moving mink to the prohib-
ited species list would not mean all
those farms would have to close.
They would, though, be subject to
tighter regulation.
The immediate concern about
mink is that there is a threat that
mink can help spread COVID-19
to other animals and to humans.
There have been cases of mink in
this country and others catching the
disease. And of course, some people
do not want animals raised for their
pelts or meat. A bill in the Oregon
Legislature, Senate Bill 832, would
actually shut down all mink farms
in Oregon. That bill does not seem
likely to move this session because it
is not scheduled for a work session.
Commission staff have reviewed
the Center for Biological Diversity’s
request and recommend that it be
denied. It believes there are already
adequate protections in place. We
have only briefly summarized the is-
sue here, but what do you think the
state should do? Let us know. Letters
to the editor can be up to 250 words
and emailed to letters@bendbulle-
tin.com.
Editorials reflect the views of The Bulletin’s editorial board, Publisher Heidi Wright, Editor
Gerry O’Brien and Editorial Page Editor Richard Coe. They are written by Richard Coe.
Editor’s note
The policy of this page is to al-
low people to have their say in let-
ters and guest columns but we don’t
want people to attack other people
personally — just their ideas. We re-
cently ran a guest column that took
aim at a frequent guest columnist,
Rich Belzer, for his lack of creden-
tials. We have never asked Belzer to
provide us with a broader explana-
tion of his background and so that
was our fault. Belzer’s tagline has
typically read: Rich Belzer lives in
Bend. There is more to Belzer than
that. Belzer served as director of
federal marketing for a NYSE-listed
computer company and was subse-
quently a senior executive with two
Nasdaq-listed high-tech companies.
He moved to Bend to join Columbia
Aircraft where he became vice pres-
ident of worldwide sales. We wanted
to set the record straight.
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How to make sure people still get tested
BY JESSICA COHEN AND JOSEPH ALLEN
Special to The Washington Post
P
ublic health officials are rightly
concerned about the rapid de-
cline in coronavirus testing.
Maintaining adequate testing — in-
cluding among asymptomatic people
— will be key to navigating to the end
of the pandemic and rebuilding confi-
dence that going to work, to school, to
a Broadway show or on international
travel is safe. The vaccine rollout is go-
ing well, but not everyone will be vac-
cinated, and we are still many months
away from vaccine approval for chil-
dren. Testing will remain a pillar of
our overall public health strategy.
But getting people to take those
tests will become increasingly diffi-
cult. Health officials too often resort
to fear or shame to encourage peo-
ple to do things, but repeating tired
refrains such as, “COVID-19 is a
threat!” and, “Get tested!” won’t cut it.
Instead, we need fresh approaches in-
formed by behavioral economics.
People are responding exactly as
we would expect as infection rates de-
cline and vaccinations accelerate. Let’s
say a person with a cough is decid-
ing whether to get a coronavirus test.
We could characterize this choice as
weighing expected costs against ex-
pected benefits. The expected costs
include out-of-pocket costs, travel
time and waiting time, as well as con-
cerns about discomfort or about the
potential need to quarantine if the re-
sults are positive. Expected benefits
include getting treatment sooner if the
test is positive and preventing loved
ones from getting sick.
But here is where declining
COVID-19 rates come in: The less
likely people are to test positive and
accrue benefits from testing, the less
likely they will be willing to take on
the costs. This is a particularly im-
portant problem for many essential
and low-income workers, who, be-
cause of lack of paid sick leave, are
further disincentivized to get tested.
To increase testing, we need to dra-
matically reduce the costs to testing —
for example, offer free, rapid tests that
are comfortable, easy to use and avail-
able at home. Increasing the benefits
to testing is harder, but we can em-
phasize the benefits in public health
messaging of keeping one’s commu-
nity, schools and local economy open.
However, we should not rely exclu-
sively on feelings of altruism.
Of course, our decision-making
isn’t always so rational and carefully
considered. One thing we know from
behavioral economics, a field that
integrates economics and psychol-
ogy, is that small “nudges” can have
outsize effects on behavior. Nudges
are small changes in how choices are
framed. The classic example comes
from defaults. People tend to stick
with whatever option they start with.
Simply making organ donation and
retirement savings opt-out instead of
opt-in often leads to huge increases
in take-up. Asymptomatic testing
programs might find that take-up is
substantially higher if the default is to
participate. Bundling free, at-home
rapid tests with reservations for sport-
ing and entertainment events and dis-
tributing them to parents at all well-
child visits are other small nudges that
could reinforce participation.
On the other side is “sludge.” Sludge
is the idea that minor costs or inconve-
niences — such as paperwork and wait-
ing in line — can dramatically discour-
age participation. Our primary mode of
testing — lab-based polymerase chain
reaction testing — while important and
valuable, is full of sludge.
At-home rapid tests can potentially
remove this sludge. Let’s meet people
where they are: At their home, with
plenty of nudges and as little sludge as
possible.
e e
Jessica Cohen and Joseph Allen are associate
professors at the Harvard T.H. Chan School of
Public Health.