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Six months into pandemic, hospital workers recover from ‘hopelessness’ of the COVID’s summer surge, set sights on fall

Hospital workers in Nevada this spring trained their eyes on New York and held their breath.

Facilities across the state dramatically reduced their hospital censuses, postponed elective surgeries and prepared overflow bed spaces, including, in one instance, in a hospital parking garage.

Health care workers watched the news reports of their counterparts across the country struggling to treat a deadly illness they knew little about as refrigerated trucks lined up outside hospitals to gather bodies of coronavirus victims.

Everyday Nevadans were ordered to stay home to prevent the spread of COVID-19. All non-essential business were shuttered across the state.

The hospital workers waited and waited, but the surge never came.

So, as spring started to turn into summer, salons, restaurants and retail businesses reopened, soon followed by bars, gyms and churches. People gathered with friends and family for Memorial Day and Fourth of July barbecues. Casinos reopened and tourists flocked back to Las Vegas. Public health officials at the state and local levels encouraged Nevadans to wear face masks but didn’t mandate it.

Then, cases began to rise. One hundred new cases a day at the beginning of June became 500 by the end of June and a thousand by the end of July. The number of COVID-19 patients in Nevada hospitals at a given time tripled from the end of May to the end of July.

Where there used to be one or two code blues — signaling hospital staff of a life-threatening medical emergency, like cardiac or respiratory arrest — in a 12-hour shift, there would be five or six, one nurse at a Las Vegas hospital said. Multiple doctors described feelings of “hopelessness” and “defeat.”

“We were losing multiple patients a day. The hospital was completely full. We were stretched very thin. A lot of our colleagues and health care workers were getting sick, some very severely sick,” said Dr. Matthew Stofferahn, chief of emergency medicine at Henderson Hospital, speaking on behalf of himself, not the hospital. “It seemed very dark.”

In response to the climbing cases and hospitalizations, the state implemented a mask mandate in late June, shuttered bars in some counties in early July and generally boosted enforcement of health and safety mandates at businesses throughout the summer instead of enacting more sweeping closures like the state saw in the spring. 

But what they couldn’t control was what people did outside of those businesses, whether people wore masks and practiced social distancing with friends and whether tourists chose to don or doff their masks while walking the Las Vegas Strip.

“There was sort of this public perception that the worst had passed because the lockdown was over when nothing could have been farther from the truth,” Stofferahn said.

More than a half dozen Nevada hospital workers, some of whom asked for anonymity to speak freely about their experiences, shared with The Nevada Independent what life was like this summer as hospitals battled a wave of COVID-19 coupled with a crush of patients who had delayed seeking medical care this spring and could wait no longer. 

Some say their hospitals were well prepared, having used their time this spring to secure personal protective equipment and ramp up their testing capacity. Others feel that while their hospitals have taken some steps in the right direction, they haven’t gone far enough.

Though all of the workers said that the situation in their hospitals has improved over the last month as COVID cases and hospitalizations have decreased statewide, they’re also already preparing for another surge this fall and winter as flu season layers on top of the coronavirus pandemic. Others are bracing for an increase sooner, as a result of gatherings over the Labor Day holiday.

“I went out to dinner on Saturday and the Strip was just packed,” said Erika Watanabe, an HCA health care worker, in an interview last week. “I think we look at it differently. We’re not even thinking flu season right now. We’re just thinking two to three weeks from right now.”

The July surge

The situation in the hospitals over the summer was a “mess,” Dr. Dean Polce, an anesthesiologist and partner with U.S. Anesthesia Partners, said.

Not only were hospitals battling an uptick in coronavirus cases, but they were struggling to treat other patients who delayed seeking medical care in the spring, afraid of contracting COVID-19.

“You had a spike in coronavirus cases and then you had a spike in people who hadn’t seen a doctor in six, seven, eight weeks when they should’ve,” Polce said. “At MountainView, you had patients lining the hallways everywhere, every night. It was a total mess.”

Stofferahn, the emergency medicine chief at Henderson Hospital, said it felt like they “literally couldn’t physically stuff another person into a hospital” this summer.

“There was a collision between elective surgeries and COVID patients,” Stofferahn said. “We had all these things colliding and we were overwhelmed. Morale was pretty low. We were defeated. Fortunately, it has gotten better, but July was kind of our New York moment, I feel like.”

When COVID-19 cases started climbing, hospitals, particularly in Southern Nevada, started taking steps to prepare. Dr. Dan McBride, chief medical officer of the Valley Health System, said that Henderson Hospital, for instance, opened an additional 25-bed observation unit in July to boost its bed capacity, while hospitals across the system increased their intensive care unit staffing and added additional negative pressure rooms to isolate COVID patients.

“These measures reduced the numbers of patients requiring ICU level of care and ventilator support by almost half from the levels noted in the early phase of the pandemic,” McBride said in a statement.

University Medical Center, the county-run hospital in Las Vegas, put teams in place to activate alternative surge space throughout the facility, including using extra space in a large recovery unit to care for non-COVID patients. Dignity Health, which runs three acute-care hospitals in Southern Nevada, reported making “internal adjustments” as needed.

Mike Forson, a pediatric critical care registered nurse at an HCA hospital in Las Vegas, said that his department slowed down over the summer as COVID cases increased, though staff floated over to help on the adult side. Forson, fortunately, said he was floated to the adult burn unit, not the adult COVID unit, as others were.

Watanabe, another HCA health care worker, voiced frustration at the fact that her hospital does not test all patients for COVID, as UMC does. She said not knowing whether a patient is COVID positive means that health care workers aren’t always wearing the appropriate level of personal protective equipment, known as PPE, when treating them.

“I will tell you that situation has happened to me, that after having contact with a patient it has been found out days later that the patient was COVID positive,” Watanabe said.

HCA did not answer specific questions from the Independent about which patients receive COVID-19 testing or in which situations PPE is available. Todd Sklamberg, CEO of Sunrise Hospital and Medical Center, one of HCA’s hospitals in Las Vegas, in a statement instead touted the hospital’s decision to “strategically” locate PPE distribution centers across its campus to more quickly deliver supplies and appoint a PPE steward to oversee “priority deployment” of equipment “when and where it is needed most.”

“We are confident in our inventories of personal protective equipment (PPE), including PAPRs, the highest level of COVID protection during aerosolizing procedures,” Sklamberg said. “We remain proactive in our preventive measures that follow regulatory agency protocols, including those for PAPRs.”

One doctor with patients in several Las Vegas hospitals still brings privately-purchased PPE on rounds inside facilities, not knowing what will be available on any given visit. For instance, the doctor said that PPE is available sitting out on the desk at the St. Rose Dominican Hospital, Siena Campus, a Dignity Health facility, but “in the HCA system, I still think we could do better.”

“To be honest with you, I bought my own personal protective equipment because I didn’t feel safe,” the doctor said. “I don’t feel secure that when going to the hospital that I’m going to find something that’s available.”

Stofferahn said that his hospital was “always able to keep pretty well equipped” with PPE.

“There were times when we were running pretty low on certain things, N95, masks, gowns,” he said. “But we were never in a crisis situation, and we were never unprotected. That was not something that we had to deal with.”

Another nurse at a Las Vegas hospital reported being “very blessed” to receive one new N95 mask per day.

The September stabilization

Fortunately, the situation in the hospitals is no longer as dire today as it was this summer. As of Friday, the most recent day for which hospitalization data is available, there were 443 people hospitalized with COVID-19 statewide, down from a high point of 1,165 at the end of July.

For some, it feels like COVID has again all but disappeared from the hospitals.

“At Southern Hills Hospital two weeks ago there was a census of 65 patients. Last Wednesday, it was seven,” Polce said. “There’s only three patients that they’re following at MountainView now. It used to be 20 something.”

Stofferahn said that his emergency department is seeing “far fewer sick COVID patients, or even COVID patients at all.”

“The big thing is that we’re definitely on a down slope,” he said. “The peak from July has definitely passed.”

McBride said not only are the levels of COVID-19 patients in Valley Health System hospitals about 50 percent what they were in late July and early August, but hospitals have also seen “marked reductions” in lengths of stays and “improved outcomes” for patients who do require hospitalization. 

Dr. Rodney Buzzas, Dignity Health’s chief medical officer, said in a statement that while the situation is “a bit calmer” than it was this summer “the intensity of our work remains.” Buzzas also noted that difficult protocols, such as continued visitation restrictions, are still in place and “something we will never become accustomed to.”

Six months into the pandemic, there’s also a sense among health care providers that while there are still many unknowns about COVID — including the long-term health challenges it may pose — it is much more of a known quantity today. 

For instance, doctors note that proning — putting patients in a swimmer’s position on their stomach — is now a common practice to help COVID patients breathe and keep them off of ventilators. They also know what isn’t effective, like treating patients with a combination of hydroxychloroquine and azithromycin.

There’s also less of a sense that they’re heading into a life-or-death situation at work every day treating COVID patients.

“We’ve all treated dozens if not 100 or more patients with COVID at this point, and we’re pretty comfortable being in the same room with them, giving them the appropriate treatment they need,” Stofferahn said. “We know when to start using different ventilatory techniques, which treatments are likely to work, which are not likely to work. There’s a feeling that it’s just like treating somebody with emphysema or asthma or pneumonia. It’s one of those things where we know what to do, and we feel comfortable doing it.”

Some still, however, have fallen ill. One health care worker at MountainView Hospital, for instance, reported falling ill after being coughed on by a COVID-positive patient.

“I had everything — the fever, the shortness of breath, the bronchial spasm, the weakness, getting winded out — I had everything,” the health care worker said. “But I’m glad I didn’t have any underlying conditions.”

An approaching flu season

What remains uncertain is what kind of an impact the flu season is going to have on the pandemic. Talk to some hospital workers, and they’ll tell you that flu season could overwhelm the health care system as hospitals struggle to separate the flu patients from the COVID patients.

“As health care professionals, we do discuss it amongst ourselves, and we are bracing for a pretty bad winter with the flu and with COVID still with us,” Forson, the pediatric critical care nurse, said. “Most health care workers, when we have had the discussion, we’re bracing for a pretty bad winter.”

Others are hopeful that social distancing and mask-wearing protocols will not only continue to guard against COVID but will lessen the severity of the flu season this year as well. But there’s also a concern that pandemic fatigue may be setting in just as people need to start being the most vigilant.

“I’m reasonably optimistic that we might have a mild flu season,” Stofferahn said. “On the other hand if people are sick of doing those things or flagrantly disregarding those recommendations we could be in for a disaster.”

Hospital officials, in the meantime, say they are closely keeping an eye on case counts, continue to monitor their PPE levels and have plans in place should there be another surge. They are urging Nevadans to not only continue to wear masks, avoid large gatherings, practice social distancing and frequently wash their hands but also get the annual flu vaccine.

“These simple measures will save lives by helping to prevent new cases of COVID-19 and influenza in our community,” said Scott Kerbs, UMC spokesman, in an email.

Renown Health President and CEO Anthony Slonim, in a statement, said that attendance at drive-thru and walk-up flu shot events is already at an “all-time high.”

Some health care workers, like Polce, are matter of fact about what the flu season is likely to bring.

“The flu season is coming, and people die every year from the flu. I anticipate that’s going to happen again,” he said. “Patients come in and I’m like, ‘You just named eight problems, and any four of those are not compatible with life in a few months.’ The COVID was part of it, but that patient isn’t going to make it through 2020.”

But health care providers are, by and large, hoping that people continue to follow social distancing and mask-wearing protocols. Stofferahn said that the “most discouraging thing” to see as a health care provider is people “just completely disregarding mask wearing and social distancing.”

“They really are putting their lives at risk and the lives of their families and friends at risk,” Stofferahn said. “It’s almost like figuratively spitting in the face of health care workers who are trying to do everything they can to stay safe and save lives.”

NNBW Editor: Best In Business voting begins Wednesday; here’s what you need to know (Voices)

RENO, Nev. — As summer turns to fall (the first day of fall is Tuesday, Sept. 22), I wanted to remind all our readers that the voting period for the NNBW’s 2020 Best In Business contest kicks off first thing Wednesday, Sept. 23, and runs through the evening of Oct. 6.

BIB-2020

We held our nomination period from Aug. 19 through Sept. 9, during which we received hundreds of nominations of the best and brightest business leaders and companies throughout the greater Reno-Sparks region.

We can’t thank our readers and advertisers enough for such thoughtful and thorough nominations.

Now, it’s almost time to vote! To participate, simply go to nnbw.com/bestinbusiness2020 starting Sept. 23, click each of the three overarching categories, and then vote on your favorite person and/or company. You’ll be able to vote once per day for your favorite nominee in each of the 18 sub-categories.

Voting closes at 11:59 p.m. on Tuesday, Oct. 6, after which we’ll tally up the results and announce the finalists in a future edition of the NNBW and on our website at www.nnbw.com.

Depending on number of votes, we could have as many as 10 finalists in each category, which is very exciting.

To wrap it all up, we’ll announce the 18 winners (including second and third place) on Dec. 30, 2020, both on our website and within the 13th annual Northern Nevada Book of Lists, our marquee special section that’s scheduled to publish the same day to wrap up the year.

Questions about the contest or about the upcoming Book of Lists? Feel free email me at kmacmillan@nevadanewsgroup.com; or, reach out to NNBW Associate Publisher Melissa Saavedra at msaavedra@nevadanewsgroup.com. We’ll be happy to assist you.

Happy voting, Northern Nevada! As I’ve said before, after quite the tumultuous 2020 due to the COVID-19 pandemic, we’re beyond pleased to be able to celebrate our business community and provide them the grand recognition they deserve!

Kevin MacMillan is editor of the Northern Nevada Business Weekly. Reach him for comment at kmacmillan@nevadanewsgroup.com.

Michael Vallante: Supporting U.S. entrepreneurs’ resiliency (Voices)

One thing entrepreneurs know how to do is solve problems; they are resilient. COVID-19 is an unprecedented challenge, impacting every main street in America. 

Now more than ever, there is widespread consumer awareness of how small businesses are the heartbeat of local economies. 

The Paycheck Protection Program provided over $500 billion to assist small businesses across the nation with retaining employees on payroll. The PPP has allowed small businesses the ability to keep their employees while they find solutions to today’s challenges. Solutions, such as creating outdoor dining and services, contactless door pick-up, door delivery, online orders, online events, and the list goes on.

Businesses are not only finding creative ways of surviving, but many are also creating means to support other businesses’ recovery, and in the process, they are creating new jobs to meet today’s business needs.

Businesses like eConnect, located in Nevada, received a PPP loan that allowed them not only to keep staff on payroll, but also develop a new product for the safe reopening of other businesses, and to hire new staff; eConnect pivoted its operations and shifted to developing “eClear,” a self-serve temperature check kiosk, allowing businesses and public spaces to begin opening up while observing local ordinances and keeping the public safe.

It is not surprising that the latest jobs report indicated nearly 1.4 million jobs added in August, making it the fourth month in a row of over 1 million jobs added.

A record 10.6 million jobs have been gained since April, bringing back about 50% of the jobs lost from the lockdowns.

The amount of jobs added to the U.S. economy over the past four months has surpassed expectations by a combined 12.2 million jobs. The August unemployment rate drop is the second largest decrease on record. The unemployment rate has already fallen below the peak unemployment rate from the great recession of 10.0%.

The unemployment rate has fallen to a level that some forecasters didn’t expect to reach even by the end of the year. This demonstrates the resiliency of entrepreneurs with the support of the PPP for their business and employees.

As the Regional Administrator for the Pacific Rim for SBA, and as Associate Administrator for the Office of Field Operations for our agency, SBA is ready to continue assisting, whether in-person, on the phone, or virtually through a webinar; we are here for small businesses and entrepreneurs.

Information about PPP forgiveness and other SBA resources are available online at SBA.gov.

Michael Vallante is the U.S. Small Business Administration’s Associate Administrator for the Office of Field Operations, overseeing the 68 district offices and nine Regional Administrators; and Regional Administrator for Region IX, overseeing the agency’s programs and services in California, Arizona, Nevada, Hawaii and Guam. Go to sba.gov/offices/regional/ix to learn more.

‘A weird market … a weird year’: COVID driving used car sales in Reno-Carson and beyond

RENO, Nev. — At Crawdaddy’s Used Cars in Reno, the car lot hasn’t looked the same since the coronavirus pandemic rolled into Northern Nevada.

Once filled with up to 40 used vehicles week after week, Crawdaddy’s has been averaging about 15 used cars on site over the past 6 months, said salesperson Gary Ferrick.

“We’ve been trying to keep up so that we don’t look like a parking lot instead of a car lot,” Ferrick said with a laugh.

Showcasing a stockpile of pre-owned vehicles rather than a smattering hasn’t been easy for any dealer across the country.

Consumers have been snatching up pre-owned vehicles at a historic rate during the coronavirus pandemic. In June, Edmunds.com found that franchised car dealers sold 1.2 million used cars and trucks, a 22% increase from June 2019.

All told, it was the highest monthly total since at least 2007. A month later, in July, there was a 22% drop in the number of used vehicles available at U.S. dealerships, according to Cox Automotive.

For dealers like Crawdaddy’s, the lack of supply on local lots has been compounded by not being able to go to live auto auctions in neighboring California, where auctions are strictly online due to COVID.

This, Ferrick said, is not ideal when bidding on pre-owned vehicles to add to their lot.

“We can go online and bid and take a chance on what you’re getting, but we haven’t inspected the vehicle to see what has to be done to it,” said Ferrick, noting that sales at Crawdaddy’s have experienced about a 30% drop-off over the past few months.

FLOODING THE MARKET

The used car boom is a culmination of multiple factors, according to dealers who spoke with the NNBW.

Perhaps the primary driver for the uptick in consumers racking up cars, old and new, is to avoid public transportation or Uber rides during the global health crisis, said Ryan Dolan, CEO of Reno-based Dolan Auto Group.

A Dolan Auto Group product specialist, right, helps a customer at Dolan Toyota at 2100 Kietzke Lane in Reno.
1-Car-Sales

“Ridesharing and mass transit, those things aren’t very well equipped for a virus or a pandemic of worldwide proportions,” Dolan said.

Ferrick agreed, saying that consumers are opting to invest in a used car rather than pumping money into a rideshare driver’s account.

“In our segment,” Ferrick said, “a lot of people that were taking Uber, they’re saving their money and buying a used car because they can make the same payment with what they were paying Uber.”

Others are simply trying to save money amid continued economic uncertainty, taking the frugal route with a used car payment in case a layoff, furlough or cutback in hours is around the corner, Ferrick noted.

Not to mention, after COVID slammed the brakes on the U.S. economy in mid-March, automakers stopped production of new cars for nearly two months. As a result, the demand for older cars was accelerated by the lack of new-vehicle inventory.

“The new-car market was pretty tough because they had shut down the factories for six or seven weeks,” Dolan said. “And there was a lag in the supply chain. So those months were pretty tough for the new cars as far as volume went, and used cars reaped the benefits of that. There was an uptick is used car buyers because the new cars weren’t readily available.”

Consequently, Dolan said, the values of used cars have “skyrocketed” — a shift in the market that typically sees listing prices decrease over time due to depreciation. As evidence, Edmunds data show the average price for all used vehicles climbed to $21,558 in July, a $708 increase compared to June.

‘PRE-COVID NUMBERS’

Some dealers are even seeing the price inflation of pre-owned vehicles push consumers toward buying a new car.

John Napoleon, dealer principal at Carson City Hyundai, says he’s seen an increase in new care sales due to the rising cost of used cars — making it more justifiable to go new.
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John Napoleon, dealer principal at Carson City Hyundai, said his used car sales are down about 10% compared to last year due to the market’s high prices and low inventory. New car sales, meanwhile, are up roughly 40%, he said.

“Because the used car prices are extremely high, it’s easier for someone to justify a new car,” Napoleon said. “If you have a one- or two-year-old used car that is a lot of money, you might be able to get into a new car for a couple thousand dollars more.”

Dolan, who told the NNBW back in the spring that April was the dealer’s “worst month on his watch,” said business overall has been an uphill climb since, thanks to its new-car inventory “beefing back up.”

“Last month, five out of our seven outlets sold more new cars than they did the previous August,” said Dolan, adding that September’s new-car sales are outpacing last year’s numbers. “We’re talking pre-COVID type numbers, so it’s pretty good for us.

“It’s been a weird market, it’s been a weird year. I wouldn’t have predicted the success we had over the summer.”

ON THE HORIZON

Heading into 2021, Napoleon expects sales to be “very flat” for a while, citing the impact of unemployment benefits drying up, and a lack of consumer confidence.

“I don’t see consumer confidence as being real strong — that’s more of a gut-feel,” he continued. “It seems like customer confidence is waning a little bit and I think this recovery is going to be longer than we think.”

Pausing, he added: “But it changes minute by minute. The trend is … there is no trend.”

Dolan, meanwhile, hopes the industry continues to trend upward as summer rolls into fall. But after experiencing the sales crash of spring 2020, he’s prepared for anything.

“I think if there’s some sort of a vaccine and sense of normalcy, I think we could ride this economy for another year or two if that happens,” he said. “But if we’re stuck in the doldrums again and we go through a flu season and there’s a bunch of sickness and death and jobs are lost, it could get ugly.

“So, I think it’s either going to continue to be really good or it’s going to drop off the map.”

As for used car lots like Crawdaddy’s, Ferrick says regional dealers are going to see an upswing in inventory by the end of the year. Why? He pointed to the unfortunate fact that creditors will eventually start to repo cars from people that haven’t made payments for 90 days or longer. 

“That’s going to be happening soon, and then the market will once again be flooded with used cars,” he said. “And the prices will drop to where we can buy them at a good enough price to sell them at a profit.”

Reno business owner to host first-ever mini golf fundraiser for 2 nonprofits

RENO, Nev. — West Muller, owner of downtown Reno businesses The Library Tap House and Hookah Lounge, announced last week that The Library is hosting its inaugural Mini-Golf Charity Tournament.

The fundraiser will take place at Magic Carpet Golf at 6925 S. Virginia St. in Reno on Sept. 26, with proceeds benefiting local nonprofits For The Kids Foundation and The Dean’s Future Scholars Program.

The event will include four different “tee times” to allow for social distancing. Slot availability per session will be limited to 27 teams.

Go to the fundraiser’s Eventbrite page here to buy tickets and learn more.

Vegas Chamber presses delegation for business liability protection

Concerned that a spate of COVID-19-related lawsuits could bankrupt businesses, members of the Las Vegas Metro Chamber of Commerce implored the state’s congressional delegation during the chamber’s annual D.C. retreat to pass a federal liability protection measure. 

“At no level do I defend people that don’t do what they’re supposed to do,” stressed Tom Burns, the Vegas chamber chairman, who said that employers want assurance that they will not be sued if they are following the federal, state and local safety guidelines.

Members of the Vegas chamber, which held its week-long D.C. outreach meeting virtually this year, also discussed establishing a federally backed disruption insurance program, the state of congressional negotiations on the next pandemic recovery package and infrastructure projects that would benefit the state. 

Liability

But liability protection was the topic that brought up most often to each delegation member. While Democrats and Republicans are generally split over the liability protection issue, with Republicans supportive and and Democratic leaders wary, all members of the delegation signaled some degree of support. 

The push for a federal liability measure comes after the chamber helped pass a state bill in August that provided businesses protection against lawsuits unless a plaintiff can prove a violation of minimum health standards with “gross negligence.” A federal law would give additional certainty to businesses and make decision making easier for businesses that operate in more than one state, Burns said. 

Hospitals, health care facilities and public and charter schools are exempted under the state law, and Burns said the chamber would like them to be afforded protections under a federal law.

Sen. Catherine Cortez Masto echoed her Democratic colleagues by noting that the business concerns need to be weighed against the rights of workers and consumers. 

“I think we absolutely need some protections both for businesses and workers,” Cortez Masto told chamber members. “I think there’s a balance to be found. And I don’t support the extremes on either side. I’ve heard from our small businesses; it makes complete sense to me their concerns and they’re reasonable. But we can’t do too much, we can’t overreach.”

Liability protection was not included in a $3 trillion pandemic aid bill passed by the Democratic-run House in May. 

Rep. Dina Titus said that there is a chance the issue doesn’t end up in the next pandemic package. “It’s certainly something that’s on the table, but needs to be done in the right way,” she said. 

But Senate Majority Leader Mitch McConnell has said liability projection for business, health care providers and schools is his red line. 

Cortez Masto said she does not support the GOP’s liability bill introduced by Sen. John Cornyn of Texas and included in the GOP COVID-19 relief package introduced in July. Under that measure, businesses, schools and other organizations would only be liable if they demonstrated gross negligence or intentional misconduct, and could shift cases to federal court if they chose.

Democrats, such as Minority Leader Chuck Schumer, said the proposal is too business-friendly. Cortez Masto noted that it was never considered in committee and Democrats had no input. 

“It literally was drafted behind closed doors and dropped on the floor of the Senate,” Cortez Masto said. “That’s not how you get things done.” 

pared Senate GOP pandemic bill that included the liability language failed to win the 60 votes needed to advance last week. No Democrats supported the measure.

Rep. Steven Horsford and Titus both said that any federal law must not conflict with the state law. Federal law typically trumps state law. 

“We need to make sure that laws like the ones passed in Nevada are preserved,” Horsford said.

Disruption insurance

Businesses are also pushing for a new insurance program, backed by the federal government, on disruptions caused by the pandemic. Insurers currently don’t cover pandemic-related disruption following the 2002 outbreak of Severe Acute Respiratory Syndrome (SARS).  

“That’s because there’s no way to price for that or gather the money to put the coffers aside,” said Burns, who is president of the insurance firm Cragin & Pike in Las Vegas.

Insurers use premium payments from one group to pay for the insurance liabilities of another. But when all groups are affected, as in a pandemic, that model does not work.

The chamber supports a federally backstopped system as is used in terrorism risk and flood insurance. 

Horsford and Cortez Masto, who serve on the Ways and Means Committee and Finance Committee, respectively, said that is being considered by those tax-writing committees and other committees of jurisdiction.

“We need to design our legislation at the federal level to make that part of the economic recovery,” Horsford said. 

COVID relief

Members of the delegation also discussed the need to pass another pandemic relief bill, but all said that chances are slim that Congress can come to a consensus before the election. 

“Apparently the political geniuses-that-be think that nothing needs to get done in the next 45 days before the election,” said Rep. Mark Amodei, the state’s only congressional Republican. 

Amodei, along with Rep. Susie Lee, belongs to the Problem Solvers Caucus, which is a group of 50 House members, equally divided between Democrats and Republicans, who work on bipartisan legislative solutions. The group released a $1.5 trillion COVID-aid bill Tuesday that they hope can help restart negotiations, which broke down in early August.

While Democratic leaders, including Speaker Nancy Pelosi, said the bill is too small, Lee said she hopes “the pressure we’re putting on” will force a deal.

“This is CPR for the economy,” Lee said of the need for more aid. 

Infrastructure

The chamber also highlighted infrastructure projects that it wants to see completed and would help the state’s economy, including completing I-11 between Las Vegas and Phoenix and widening the I-15 corridor to California.

Sen. Jacky Rosen would like to see an expansive infrastructure package that along with transportation funding for I-11 also includes funding for broadband. 

“I think if we make those investments in broadband, then we’ll be poised for success,” Rosen said.

She added that she has a broad definition of infrastructure and that she foresees the possibility for agreement on bipartisan legislation 

“I consider education critical infrastructure too, so whether it’s education, whether it’s your freeways, highways, bridges, roads, ports, etc, etc. I think that there’s really good space for that, a bipartisan space, and that’s what I’m going to really push towards in the next session,” Rosen said.

The Nevada Independent is a 501(c)3 nonprofit news organization. The following people or entities mentioned in this article are financial supporters: Steven Horsford – $1,000.00; Susie Lee – $1,120.00; and Titus for Congress – $1,000.00.

Backed by $1.1 million grant, UNR Med researcher studying root of Alzheimer’s, Parkinson’s diseases

RENO, Nev. — Every person carries around a 3-pound universe filled with billions of cells that communicate and orchestrate everything we do — from thinking to moving to sensing.

It makes sense that such a busy planet of activity can get stressed or damaged as we age.

For some, this can potentially lead to neurodegenerative diseases of the brain, such as Alzheimer’s, a type of dementia that slowly destroys memory skills, thinking skills and, eventually, the ability to carry out daily activities.

In 2018, Nevada saw 874 people die from Alzheimer’s disease, making it the sixth-leading cause of death in the state, according to the Alzheimer’s Association. All told, that year the total number of Nevadans aged 65 and older with Alzheimer’s was 45,000, a number projected to jump to 64,000 by 2025.

Yet, despite decades of neuroscience research, scientists don’t yet fully understand what causes neurodegenerative diseases of the brain — like Alzheimer’s and Parkinson’s — and how to treat them. 

One researcher at the University of Nevada, Reno School of Medicine, with the help of a federal grant, is on a mission to help change that.

Dr. Robert Renden, assistant professor in the department of physiology and cell biology at UNR Med and the UNR Neuroscience Institute, this summer was awarded a five-year, $1.1 million grant from the National Science Foundation (NSF).

Specifically, Renden will explore how brain cells maintain the energy needed to communicate at contact sites — synapses — which play a critical role in a variety of cognitive processes, learning and memory. Moreover, synapses play a crucial role in many brain diseases and disorders. 

“This project answers the NSF mission of really understanding the most basic biology of how synapses function,” Renden said in a video interview with Peak NV. “And also provide a component to help educate the next generation of researchers, which is part of the NSF mission. This will help UNR Med by providing research opportunities for med school students, physician assistants, postdocs … that’s the immediate payoff.

“The longer-term payoff will be having the basic knowledge of how these synapses function. And then that will inform us what could probably be going wrong when we have disease states.”

To that end, Renden said that his study aims to advance new approaches in the study of Alzheimer’s, Parkinson’s and dementia, among others. These neurodegenerative diseases, he said, result from a loss of energy production, homeostasis and reduced mitochondria function. 

Dr. Ruben Dagda is assisting Dr. Renden in the neuroscience research.
Photo: UNR Med

“That delivery of energy and utilization of energy is fundamentally and acutely important,” Renden said. “One of the goals of this research is to try to tie that together at a really fundamental level. And so the hope is that we can make really basic observations about how energy is utilized, generated and distributed at synapses.” 

Renden is collaborating with Dr. Ruben Dagda, associate professor in pharmacology at UNR Med, who is looking at brain disease models. Dagda said Alzheimer’s research is lagging behind “severely” in Nevada due to a lack of state funding, making Renden’s research grant all the more important.

“Our hope is that whatever we publish, our observations can lead us to a better understanding of Alzheimer’s,” Dagda told Peak NV. “It’s very important because in Nevada, 15% of its population is over 65. And by 2025, it’s going to be over 20%.”

And people over 65 have a two-fold increase — or 200% — for developing Alzheimer’s, according to Dagda. In addition, they have an 80% increase in developing Parkinson’s, he added.

“Why?” Dagda continued. “We don’t really know … but the destruction and energy production and the utilization of energy and the brain makes the neurons very sensitive to dying. We know in those two diseases, there’s an increase in stress and inflammation in the brain.”

With that in mind, Renden said if research can lead to identifying the potential for these neurodegenerative problems early — before clinical symptoms surface — they could then be treated early with self-care, proper nutrition and exercise. 

After all, Parkinson’s and Alzheimer’s symptoms do now show up until significant damage in the brain has already been done, according to Renden. 

“You don’t see Parkinson’s disease motor symptoms until something like 80% of your dopaminergic neurons are dead,” he explained. “And for Alzheimer’s disease, you’ve got to see profound structural loss — literally chunks of the brain dying off — before you see the clinical manifestation.”

Simply put, Renden and Dagda are using techniques to identify changes in synaptic function or cellular function far in advance of cellular death. 

“In the (petri) dish, we can see the cells as they’re starting to get stressed or just starting to get damaged,” Renden said. “And then the idea is that at that point you’d want to go in and do some of these really early, noninvasive nutritional-type interventions, which have been shown to be really effective.”

Go to unr.edu/neuroscience to learn more about the Institute for Neuroscience at the University of Nevada, Reno.

Broadbent & Associates expanding to open new office in Elko

ELKO, Nev. — Civil engineering firm Broadbent & Associates, Inc., is expanding by opening a new Northern Nevada office location in Elko on Sept. 28.

The office at 845 Railroad St. will provide on-site workplaces for staff members relocating from the firm’s Reno office to better serve clients in the Elko area, according to a Sept. 9 press release from the firm.

“We are proud to expand to meet the growing needs and clientele that we service in and around the Elko community,” Randy Miller, vice president and principal engineer of Broadbent, said in a statement. “This location allows us to better support the local community and increase the personal attention dedicated to each project.

“We are excited to continue providing the services that we have offered to the area for the past 30 years in addition to expanded services that our stationed staff can now provide.”

Miller will oversee the new location and staff that includes Ryle Yopps, a project engineer who grew up in Elko who will serve as lead project manager for the new location.

“Ryle is an outstanding project manager and great leader to establish and build our new office,” Miller said.

Broadbent is offering the following services in Elko and the surrounding area: air quality permitting and stack testing, civil engineering and permitting, emergency response, environmental assessment and remediation, environmental field services, industrial hygiene, petroleum contaminated soil (PCS) management, water and wastewater facility operations, and water resources.

Carson City’s Miles Construction donates $5,000 to local Boys & Girls club

CARSON CITY, Nev. — Carson City-based Miles Construction recently presented the Boys & Girls Clubs of Western Nevada with a $5,000 check in support of nonprofit’s Luau 2020 event and fundraiser, which was held virtually on Sept. 12.

According to a press release, the money supports general operating costs for the Club and was provided in advance of the organization’s annual fundraiser.

“Miles Construction has been giving to the Club for 16 years,” Katie Leao, executive director for The Boys & Girls Clubs of Western Nevada, said in a statement. “They have given $38,000 over the last decade and we are so appreciative of Miles for all they have done for the Club. From donating to coming in and working on the Club itself, they are so generous.

“We are lucky that they are a community partner and love the youth of Carson City and Carson Valley.”

All Nevada bars to reopen next week as Clark, Elko counties granted permission to open

Bars and taverns statewide will be open for business next week after Nevada’s COVID-19 Mitigation and Management Task Force voted Thursday to open such establishments in Clark and Elko counties amid improving coronavirus metrics.

The task force’s decision comes more than two months after state officials shuttered bars in seven counties statewide as the number of coronavirus cases spiked this summer and represents the culmination of a weeks-long campaign by counties to allow such establishments to reopen, including, most recently, in Washoe County.

Clark and Elko counties are the final two counties to be allowed to reopen their bars, taverns, wineries, breweries and distilleries effective 11:59 p.m. on Sunday.

Though Clark and Elko counties remain on the task force’s list of counties at elevated risk for the spread of COVID-19, Caleb Cage, Nevada’s COVID-19 response director and the task force’s chair, said that both counties have made significant progress. 

As of Monday, Clark County’s average daily case rate per 100,000 residents was down to 390.2 from a high of 1,006.8 in early August, while Elko’s was down to 232.8 from a high of 518.3 in late July. Counties are considered at risk if their case rate is greater than 200.

Cage lauded the fact that local jurisdictions across Clark County had committed to enforcing COVID-19 health and safety protocols at bars, something he had voiced concern over at a previous meeting. In fact, Clark County submitted a series of letters from bar owners and local jurisdictions voicing their commitment to safety should bars be allowed to open.

“The two items that I think are really helpful to me are the letters, the letters from your bar owners and bar employees as well as from the jurisdictions within Clark County, so Clark County, city of North Las Vegas, city of Las Vegas, Henderson, Boulder City and Mesquite,” Cage said. “I think they’re all positive changes or positive steps.”

The task force did not, however, consider a request from Clark County on Thursday to allow conventions and churches to operate at 50 percent capacity instead of being subject to the state’s 50-person limit on public gatherings and permit youth sports to resume. Those decisions, Cage said, would have to come from Gov. Steve Sisolak in the form of a new emergency directive.

During a press call on Wednesday, Sisolak said that his administration is continuing to review capacity and gathering limits.

“Any of the changes or new plan related to those would have to be rolled out in the future,” Cage said.

While Clark and Elko counties remain on the task force’s list of at-risk counties this week, Washoe County for the first week was not flagged as having elevated risk of disease transmission after 11 straight weeks of meeting the task force’s risk criteria. Churchill and Eureka counties were also removed from the state’s list this week, while Lyon and Mineral counties were newly added to it.

If Lyon and Mineral counties remain at risk next week, they will be required to present a county action plan to the task force at its meeting next week.

The Nevada Independent is a 501(c)3 nonprofit news organization. The following people or entities mentioned in this article are financial supporters of our work:Caleb Cage – $200.00; and Steve Sisolak – $3,200.00.