New study shows impact of mask wearing on patient trust and perception of surgeon

This study is the first to examine the effect of a surgeon's mask on communication with patients in the clinic setting.

UNIVERSITY OF NORTH CAROLINA HEALTH CARE

Research News

 

IMAGE: NORMAL MASK VS. CLEAR MASK, DEMONSTRATED BY IAN KRATZKE, MD view more 

CREDIT: UNC SCHOOL OF MEDICINE

CHAPEL HILL, NC - A first-of-its-kind study out today in JAMA Surgery suggests that patients have a more difficult time understanding and building trust with their surgeons when they cannot see the surgeon's entire face due to masking requirements. These findings have major implications for not only how surgeons are viewed and rated by their patients, but also how well a patient does during and after a surgical procedure.

"At beginning of pandemic I had a patient say, 'Dr. Kapadia, it's odd you've taken out a big part of my colon and I don't even know what you look like,'" Muneera Kapadia, MD, the study's senior author said. "It made me realize we don't have much information on how masks are effecting surgeon-patient communication and relationships."

Kapadia, an associate professor of surgery in the UNC School of Medicine, found a way to study how the new masking protocols during pre-operative meetings are affecting patients' perception and trust of their surgeons. Study organizers utilized clear masks so that patients could see a surgeon's entire face, while still following safety protocols.

The randomized clinical trial included 200 patients that were recruited from 15 surgeon's clinics, spanning seven subspecialties. Surgeons were randomized to wearing clear masks versus covered masks for each new patient clinic visit. After the clinic encounter, patients completed a verbal survey including validated Clinician and Group Consumer Assessment of Healthcare Providers and Systems (CG-CAHPS) questions, and additional questions about surgeon empathy and trust, and the patient's impression of the surgeon's mask.

"When surgeons wore clear masks as opposed to traditional masks, patients rated their surgeon significantly higher in how well they provided an understandable explanation, knew the patient's history, demonstrated empathy, and built trust," said Ian Kratzke, MD, a resident in the department of Surgery at the UNC School of Medicine, and first author of the study.

Patients reported improved communication when surgeons donned a clear mask, suggesting that not seeing the surgeon's face may have negative consequences on the surgeon-patient relationship. And simply put, patients prefer to see their surgeon's face.

While donning clear masks for these interactions can be a solution, Kapadia says the study is more about raising awareness.

"Our face is how we connect with other people," Kapadia said. "We react to people with facial cues, which are being covered by the masks, and that's having a big impact on communication."

"We need to be cognizant that patients are having more difficulty connecting with us as providers. I think knowing that before interacting with them will help mitigate the issue by reminding us to spend more time getting to know our patients, and making sure they understand what we are trying to convey."

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This study was sponsored by the Department of Surgery in the UNC School of Medicine.

Invited Commentary

March 11, 2021

Benefits of Clear Masks in Communication With Patients

Margaret L. Schwarze, MD¹; Elle L. Kalbfell, MD¹

Author Affiliations Article Information

JAMA Surg. Published online March 11, 2021. doi:10.1001/jamasurg.2021.0848

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Adapting to new safety standards during COVID-19 has likely been easier for surgeons who are accustomed to wearing a mask. Although wearing masks outside the operating room has become the new normal, it may not be as easy for patients as it is for us. In this issue of JAMA Surgery, Kratzke et al¹ demonstrate that patients whose surgeon wore a clear mask were significantly more likely to give a top-box rating (4 on a Likert scale of 1-4) for providing easy-to-understand information, knowledge of patient information, displaying empathy, and generating trust.¹ Although there was no significant difference in patient-reported comfort with the surgeon operating on them, it is unclear whether this study was powered to detect such a difference.

This evidence should motivate us to consider why patients reported a striking difference in communication, particularly in a field (clinical communication research) that is chronically hamstrung by measurements with high ceiling effects. Because each surgeon served as their own control, the content of communication about disease and treatment, ie, information and knowledge, was presumably the same in each group. Thus, information transfer may not be as important as we think; technical details about illness or treatment may be less salient for patients than developing an interpersonal connection. Surgeons might view the surgical consultation as transactional, a time to exchange information, but patients may be inclined to see it as relational. Because human expressions are a critical component of emotional exchange, visual cues such as a smile, frown, or other facial gestures likely contributed to patient-perceived rapport and higher ratings despite similar informational content.

The findings may also point to what covered masks lack rather than what clear masks provide. When surgeons wear covered masks, patients may sense a lack of transparency, viewing the mask as a form of disguise or concealment. With limited visual cues, patients are left to determine how the surgeon is thinking or feeling. Many also noted it was easier to hear the surgeon, suggesting compensation for hearing loss or sensory preferences with visual cues. Study findings may also reflect pandemic fatigue. Masks are a reminder of innumerable hardships over the past year, and clear masks represent extra effort by surgeons to mitigate patient discomfort and increase engagement.

Alongside the disastrous effects of COVID-19 on everyday life, do clear masks really matter? They might. Trust is the cornerstone of surgical care. Without it, patients would not let us operate on them or trust our judgment to forgo surgery. And how we speak may be more important than what we say. As surgeons, we do many bold things because they improve patient care, and wearing a clear mask with new patients should be one of them.

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Article Information

Corresponding Author: Margaret L. Schwarze, MD, Department of Surgery, University of Wisconsin-Madison, K6/134 CSC, 600 Highland Ave, Madison, WI 53726 (schwarze@surgery.wisc.edu).

Published Online: March 11, 2021. doi:10.1001/jamasurg.2021.0848

Conflict of Interest Disclosures: Dr Schwarze reported grants from the National Institutes of Health and Greenwall Foundation and reports that her spouse has ownership interest outside the submitted work. No other disclosures were reported.

References

1.

Kratzke IM, Rosenbaum ME, Cox C, Ollila DW, Kapadia MR.  Effect of clear vs standard covered masks on communication with patients during surgical clinic encounters: a randomized clinical trial.   JAMA Surgery. Published online March 11, 2021. doi:10.1001/jamasurg.2021.0836
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Assessment of Use and Fit of Face Masks Among Individuals in Public During the COVID-19 Pandemic in China

Xiangbin Pan, MD^1,2; Xi Li, MD^2,3; Pengxu Kong, MD¹; et alLin Wang, MD⁴; Rundi Deng, MD¹; Bin Wen, MD¹; Luoxi Xiao, PhD^5,6; Honglin Song, PhD^5,6; Yi Sun, PhD⁵; Hongmei Zhou, PhD⁵; Jiang Lu, PhD⁵; Yang Wang, PhD¹; Qiuzhe Guo, MD⁵; Lin Duo, PhD⁵; Chengye Sun, PhD⁷

Author Affiliations Article Information

JAMA Netw Open. 2021;4(3):e212574. doi:10.1001/jamanetworkopen.2021.2574

Original Investigation 

Public Health

March 11, 2021

Key Points

Question  What proportion of people in public places are wearing face masks without proper airtight seals, what factors are associated with face mask protection efficacy, and can they be improved?

Findings  This cross-sectional study, including 6003 participants wearing face masks in public places, found that face mask airtightness was commonly suboptimal, mostly secondary to gaps at the upper face mask edge. Using simple and tolerable approach of sealing the upper face mask edge with an adhesive tape was associated with significant improvement of face mask airtightness.

Meaning  These findings suggest that compromised protection due to suboptimal face mask airtightness was common, and use of adhesive tape to seal the upper edge was associated with easily and quickly improving the airtightness of existing masks.

Abstract

Importance  Face masks are recommended to prevent transmission of coronavirus disease 2019 (COVID-19); however, there is scarce evidence on their protection efficacy and ways to improve it.

Objective  To determine the proportion of improper face mask use, the factors associated with face mask protection efficacy, and ways to improve efficacy.

Design, Setting, and Participants  This population-based cross-sectional study was conducted in China from July to August 2020 in 5 kinds of public places. Participants included convenience samples of individuals wearing face masks and able to taste the check solution.

Exposures  Demographic and socioeconomic characteristics, including sex, age, and education level; information on face mask model and the worn duration was recorded.

Main Outcomes and Measures  The main outcome as airtightness, assessed by detecting face-to-face mask gaps, movement of cotton fiber placed at the face mask edges, and using a qualitative fit test with a bitter solution spray. Masks were further assessed for whether sealing the upper face mask edge with an adhesive tape strip was associated with improved face mask airtightness.

Results  Among 6003 face mask wearers enrolled, the mean (SD) age of participants was 31.1 (13.7) years, and 3047 participants (50.8%) were female. The first qualitative fit test found air leakage in 2754 participants (45.9%; 95% CI, 44.6%-47.1%), which was mostly attributable to gaps at the upper face mask edge. After sealing the upper face mask edge with an adhesive tape strip, 69.7% (95% CI, 68.0%-71.5%) of masks that had exhibited leakage became airtight in the second qualitative fit test, and the rate of airtightness reached 96.2% (95% CI, 95.4%-96.8%) in a third qualitative fit test after new surgical face masks with tape on the upper edge were provided to those who had not converted initially. The tape was well tolerated; overall, 6 participants (1.2%) reported a rash and 24 participants (5.8%) reported significant discomfort.

Conclusions and Relevance  In this study of face mask fit among participants in China, although most people used face masks in public places, compromised protection due to suboptimal airtightness was common. The simple approach of sealing the upper edge of the face mask with an adhesive tape strip was associated with substantially improved its airtightness.

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Assessment of Use and Fit of Face Masks Among Individuals in Public During the COVID-19 Pandemic in China | Dermatology | JAMA Network Open | JAMA Network

NEITHER BEZO'S NOR BONO, GATES NOR GELDOF

Elite philanthropy does little to solve problems caused by rising social inequalities

Research shows giving by the super-wealthy in the United States and United Kingdom increases the sway of donors in society, education and politics

UNIVERSITY OF BATH

Research News

Giving at scale by the super-wealthy has done little to redistribute wealth from rich to poor, helping perpetuate social inequalities rather than remedying them, while paying considerable dividends to donors in the form of privilege and influence in society and politics, new research shows.

In the research paper 'Elite philanthropy in the United States and the United Kingdom in the new age of inequalities' researchers at the University of Bath School of Management and Newcastle University Business School also conclude that giving by the super-wealthy has failed significantly to benefit poor countries in the developing world, contrary to popular belief.

"This is a difficult area for many to come to terms with - it can be argued that any philanthropy is a good thing and that holds true if it is genuinely altruistic. But what we have identified is that elite philanthropy may actually be perpetuating inequality by favouring elite causes, by increasing the influence and power of the super-rich, and by increasing tolerance of inequalities by ordinary people," said Professor Mairi Maclean of the University of Bath School of Management.

Maclean said the research shows how elite philanthropy conspicuously increases the social standing of the super-wealthy, with donors receiving honours, distinctions and favourable media coverage. She said much elite philanthropy supports elite causes and institutions, a source of prestige for donors but a factor in sustaining or even increasing social inequality.

Maclean acknowledged that some very wealthy people have given away sizeable parts of their fortunes but said the research shows that most of their peers do not, with combined donations amounting to only a small percentage of the total wealth of the super-rich. "The fact is most super-wealthy people give very little relative to their means."

Her co-researcher at Newcastle University Business School, Professor Charles Harvey, said, "The greater part of funding stays at home in developed countries. The Bill and Melinda Gates Foundation is one of a handful of foundations to embrace international development, but even in this case much of the spend is on research and development in developed countries. Development funding by philanthropic foundations is in fact dwarfed by taxpayer funded spending on overseas development assistance."

The research shows that funding frequently comes with strings attached, with the super-rich able to pursue personal and political agendas through major charitable foundations. Some, by dint of their financial clout, are able to influence governments and the prestigious educational institutions that attract a major part of high-end donations.

"Universities like Harvard and Yale in the United States, and Oxford and Cambridge in the UK gobble up the lion's share of philanthropic funding, conferring on them a significant competitive advantage and arguably sustaining social inequality," Maclean added.

Maclean said the research team identified several incentives for elite philanthropists, including the amassing of 'social and cultural capital', such as receiving honours like as knighthoods in the United Kingdom for their services to charity. Viewed in this light, donors can effectively buy their way into circles of influence and networks. Tax advantages also play a part.

"In both the US and UK, philanthropists have their giving power boosted by being able to offset their donations against their tax bills. This looks, on the face of it, like a good thing to encourage giving. But it means those funds can be diverted into areas in which they have an interest or wish to exert influence or gain prestige. They, rather than governments, are effectively deciding how and where their taxes should be spent," Harvey said.

Maclean said attempts to reform this tax issue - most notably an initiative by former British Chancellor George Osborne to put a cap on tax relief on donations - had failed in the recent past. Philanthropists had almost universally opposed any changes to a system that many critics believe is an unjustifiable form of state conferred elite privilege.

"It is easy to be cynical about this. We do accept that many elite philanthropists act sincerely to improve the lives of others and that there are many generous and outstanding philanthropists, but we suggest that altruism alone does not explain their actions. It is far more likely that philanthropy yields substantive rewards beyond the emotional satisfactions of beneficence - and our research bears this out," Maclean said.

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The study by Mairi Maclean, Charles Harvey and Ruomei Yang of the Centre for Research on Entrepreneurship, Wealth and Philanthropy (REWP) at Newcastle University, and Frank Mueller of Durham University Business School, can be accessed at https://onlinelibrary.wiley.com/doi/full/10.1111/ijmr.12247

Notes to editors

For further information please contact Tony Roddam at the University of Bath press office on +44 7971 500460 or press@bath.ac.uk or Dawn Tudge at the Newcastle University press office on +44 7971 115495 or dawn.tudge@newcastle.ac.uk

University of Bath

The University of Bath is one of the UK's leading universities both in terms of research and our reputation for excellence in teaching, learning and graduate prospects.

The University is rated Gold in the Teaching Excellence Framework (TEF), the Government's assessment of teaching quality in universities, meaning its teaching is of the highest quality in the UK.

In the Research Excellence Framework (REF) 2014 research assessment 87 per cent of our research was defined as 'world-leading' or 'internationally excellent'. From developing fuel efficient cars of the future, to identifying infectious diseases more quickly, or working to improve the lives of female farmers in West Africa, research from Bath is making a difference around the world. Find out more: http://www.bath.ac.uk/research/

Well established as a nurturing environment for enterprising minds, Bath is ranked highly in all national league tables. We are ranked 6th in the UK by The Guardian University Guide 2021, and 9th in both The Times & Sunday Times Good University Guide 2021 and the Complete University Guide 2021. Our sports offering was rated as being in the world's top 10 in the QS World University Rankings by Subject in 2021.

Newcastle University

Newcastle University, UK, is a thriving international community of more than 29,000 students from over 130 countries worldwide. A member of the Russell Group of research-intensive universities in the UK, Newcastle has a world-class reputation for research excellence in the fields of medicine, science and engineering, social sciences and the humanities. Our academics are sharply focused on responding to the major challenges facing society today. Our research and teaching are world-leading in areas as diverse as health, culture, technology and the environment. The Research Excellence Framework 2014 (REF) placed Newcastle University 16th in the UK for Research Power and the vast majority of our research (78%) was assessed to be world-leading or internationally excellent. Newcastle University is committed to providing our students with excellent, research-led teaching delivered by dedicated and passionate teachers. This is reaffirmed by achieving the best possible outcome - a Gold Award - in the Teaching Excellence Framework (TEF) and is placed in the top 10 in Europe for teaching excellence in the Times Higher Education Europe Teaching Rankings. See http://www.ncl.ac.uk/press/about/keyfacts/ for more.

CANADA

Access to Cancer Surgery in a Universal Health Care System During the COVID-19 Pandemic

Antoine Eskander, MD, ScM^1,2,3; Qing Li, MMath¹; Julie Hallet, MD, MSc^1,2,4; et alNatalie Coburn, MD, MSc^1,2,4; Timothy P. Hanna, MD, PhD^1,5,6; Jonathan Irish, MD, MSc³; Rinku Sutradhar, PhD^1,2

Author Affiliations Article Information

JAMA Netw Open. 2021;4(3):e211104. doi:10.1001/jamanetworkopen.2021.1104

March 11, 2021

Introduction

For many cancers, surgery is central to diagnosis and treatment and is the only curative modality. Treatment delay can result in a missed opportunity for cure and can worsen outcomes.^1-3 Postponing cancer surgery may cost more lives than can be saved by diverting surgical resources and services to managing coronavirus disease 2019 (COVID-19) infection.^1,2 Delays in surgical care and a backlog of new cancer diagnoses will place unprecedented pressures on health care systems, particularly those with a limited ability to increase throughput.⁴ Data are lacking on the effect of pandemic deferral policies on cancer surgery case volumes and whether specific subgroups have been disproportionately affected. These data are required to inform surgical policies during future waves of the COVID-19 pandemic, ensuring optimal outcomes and equitable care.⁴ Although sociodemographic factors (such as belonging to a minority racial or ethnic group, having low income, and having a nonrural residence) have been associated with increased COVID-19 infection rates and less access to treatment,^5,6 little is known about whether these factors were also associated with access to cancer surgery during the pandemic. Therefore, we sought to quantify the cancer surgical backlog and determine whether there were differences in sociodemographic and hospital characteristics among patients undergoing cancer surgery in the pre– and peri–COVID-19 periods.

Methods

This was a population-based retrospective cohort study in Ontario, Canada, that was approved by the Sunnybrook Health Sciences Centre research ethics board. This study followed the Strengthening the Reporting of Observational Studies in Epidemiology (STROBE) reporting guideline. Informed consent was waived because this was a population-based retrospective study. The weekly volume of a comprehensive and well-defined list of cancer-directed hospital-based surgical procedures was determined using Canadian Institute for Health Information procedure codes between January 7, 2018, and June 27, 2020. Only institutions that provided complete data during this period were included in the study.

Segmented regression models were constructed to quantify (1) the surgical volume trend pre–COVID-19 (January 7, 2018, to March 14, 2020; preperiod slope), (2) the immediate decrease in surgical volume at the start of the pandemic (March 15, 2020; change in intercept), and (3) the surgical volume trend during the peri–COVID-19 period (periperiod slope, March 15 to June 27, 2020). In comparing patient characteristics from the pre–COVID-19 period with the peri–COVID-19 period, a standardized difference of greater than 0.1 was used to indicate a meaningful difference between groups. Statistical analysis was performed using SAS Enterprise Guide 7.15 (SAS Institute).

Results

We included 543 751 patients (mean [SD] age, 56.9 [16.9] years; 332 156 [61.1%] women) from 112 of 120 hospitals (93.3%) eligible for analysis. There was an immediate 60% decrease in the mean surgical volume on March 15, 2020, compared with the mean surgical volume in the pre–COVID-19 period. This decrease was followed by a 6% increase in mean surgical volume each subsequent week. Surgical volumes did not return to pre–COVID-19 numbers by June 27, 2020 (Figure), resulting in 35 671 fewer completed surgical procedures in the peri–COVID-19 period than the pre–COVID-19 period.

There were few sociodemographic differences between the patients who received surgery in the pre– or peri–COVID-19 period (Table). Measures, such as material deprivation, rurality, immigration, and region, did not differ between patients treated in the pre– or peri–COVID-19 period. However, compared with the pre-COVID-19 period, cancer surgery in the peri–COVID-19 period was more often considered urgent (78 263 [15.4%] vs 9365 [27.6%]; standardized difference, 0.30) and performed more frequently at teaching hospitals (360 807 [29.2%] vs 11 628 [34.2%]; standardized difference, 0.11) and in inpatient settings (233 522 [45.8] vs 20 700 [60.9]; standardized difference, 0.31).

Discussion

An immediate 60% decrease in cancer-directed surgery was associated with measures aimed at creating capacity for COVID-19 admissions. This decrease led to major disruptions in cancer care with a large deficit of completed cases in the peri–COVID-19 period compared with the pre–COVID-19 period. Importantly, in a universal publicly funded health care environment, sociodemographic factors were not associated with receipt of surgery in the early peri–COVID-19 period. This suggests equally equitable access to surgical care for patients treated in the early peri–COVID-19 period compared with the pre–COVID-19 period. This study is limited by the lack of timely access to the provincial cancer registry data, which decreased cancer specificity (due to data lag). However, these cancer-directed procedures, whether specifically performed for cancer or not, provide insight to cancer surgical services. Further work is needed to ensure patients experiencing material deprivation are not disadvantaged as cancer diagnostic services increase. The Canadian universal health care context is uniquely positioned to answer cancer outcome questions with an equity lens during the COVID-19 pandemic.

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Access to Cancer Surgery in a Universal Health Care System During the COVID-19 Pandemic | Oncology | JAMA Network Open | JAMA Network

Nova Scotia judge grants injunction against protesters blockading logging road

A Nova Scotia Supreme Court judge has issued a permanent injunction against a blockade of logging roads in southwestern Nova Scotia

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© Provided by The Canadian Press

Justice Kevin Coady says in a written decision issued Thursday that Westfor Management Inc. established a strong case against Extinction Rebellion, and that the forestry group would suffer irreparable harm if the blockades were permitted to resume.

The protesters set up camps on logging roads near the Caribou River on Oct. 21, saying they were protecting the habitat of endangered mainland moose.

On Dec. 10, an interim injunction was granted ordering them to stop the blockades, and five days after that, the RCMP arrested nine people and the two roads were reopened.

In granting the permanent injunction, Coady noted Extinction Rebellion never sought a judicial review of the minister's original decisions permitting the logging to proceed.

HE CAN'T ITS APPROVED PRACTICE UNDER ARBITRATED LABOUR LAW SECONDARY PICKETING 
However, the judge refused to grant a wider, more sweeping injunction that would have prohibited the protesters from blockading other forestry operations run by Westfor.

Coady also declined to order the advocacy group to cover legal costs of the forestry company, noting, "this organization, and similar public interest groups, are well-intentioned and play a role in our modern-day democracy."

Marcus Zwicker, general manager of Westfor, said in a release that the company was pleased, as "the judge found that laws must be followed."

"The families that depend on forestry have a right to earn a living and the protesters illegal blockades were stopping people from going to work,” Zwicker said.

However, Extinction Rebellion member Nina Newington said her group was delighted by the decision, because Coady refused the wider injunction.

"Given how heavily the case law around injunctions favours resource extraction companies, this was quite a win for us," she said in a news release.

"Now if the government will do its job as promised, protecting the habitat of endangered species and reforming barbaric forestry practices, Nova Scotians won’t have to put themselves at risk again."

This report by The Canadian Press was first published March 11, 2021.

The Canadian Press

SEPARATIST IDEA, DANGEROUS AND LESS VALUE THAN CPP
Next step on Alberta pension plan in spring, but no change without referendum: Kenney
STEALING OUR PENSION MONEY TO GIVE TO BIG OIL

EDMONTON — Premier Jason Kenney says his government will make a decision this spring on whether to pursue pulling Alberta out of the Canada Pension Plan

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BANDIT KENNEY LEADER OF THE UCP GANG

MORE REFORM PARTY FIREALL ALBERTA BULLSHIT

 FROM THE NINTIES RETURNS 

© Provided by The Canadian Press

But Kenney says even if the United Conservative government proceeds, Albertans will have the final say through a referendum on whether to create an Alberta Pension Plan.

Treasury Department officials are currently studying the feasibility of Alberta going it alone on a provincial plan.

The move follows a report released last summer from the province’s Fair Deal Panel.

The panel reported that given Alberta’s young population a separate pension plan could be a multibillion-dollar net benefit.

However, the panel noted that it heard a lot of reaction both for and against a separate plan and that Albertans want assurance that the money will be there when they retire.

Kenney made the comment Wednesday when asked by Opposition NDP Leader Rachel Notley about the pension plan project during committee discussions on the 2021 Alberta budget.

“We are awaiting results of a technical study being led by Treasury Board and Finance in co-operation with external experts to look at the costs, the benefits, and the potential structure of an Alberta Pension Plan, similar to the Quebec Pension Plan,” said Kenney.

“If the conclusion is that it would be a net benefit to Alberta and our economy while strengthening our province, then we may proceed with that referendum.

“Final decisions on that will be made later this spring.”

Alberta is already proceeding with a referendum in October on whether it should try to seek a more beneficial deal on equalization payments.

This report by The Canadian Press was first published March 10, 2021.

The Canadian Press

Geothermal project moves forth with new drilling partner

Alberta No. 1, located south of Grande Prairie and set to become the first commercial-scale geothermal facility in the province, has a new drilling provider.

The No. 1 Geothermal Limited Partnership entered into an agreement with the Calgary-based Akita Drilling for the exploration well of the geothermal project, according to Alberta No. 1.

“We have always stewarded Alberta No. 1 as a geothermal project ‘built in Alberta by Albertans,’” said Catherine Hickson, Alberta No. 1 CEO.

In 2019 Terrapin and Municipal District of Greenview council announced the intention to develop a geothermal energy facility in the Gold Creek area.

The Edmonton-based company Terrapin Geothermics developed Alberta No. 1, which is partly funded by Natural Resources Canada’s emerging renewable power program.

The project is budgeted at $90 million and is projected for completion in the first quarter of 2024, according to Hickson.

Alberta No. 1 is expected to produce at least five megawatts electric (MWe) net of electricity and 300 terajoules of thermal energy per year for local industry, Hickson said.

This energy is expected to benefit the forestry, manufacturing and agriculture industries.

Alberta No. 1 is further expected to create more than 300 direct and indirect jobs, according to Hickson.

Brad Quarin, Local Journalism Initiative Reporter, Town & Country News

As climate fight shifts to oil, Biden faces a formidable foe

CASPER, Wyo. — President Joe Biden’s bid to tackle climate change is running straight through the heart of the U.S. oil and gas industry -- a much bigger, more influential foe than Democrats faced when they took on the coal industry during the Obama years.

© Provided by The Canadian Press

Coal dominated U.S. power generation for decades, with the bulk of that fuel coming from the massive strip mines of Wyoming’s Powder River Basin — a market that collapsed in recent years as utilities switched to natural gas.

Fast forward to 2021 — and oil and gas have eclipsed coal to become the biggest source of greenhouse emissions from public lands and waters, federal production data indicates. That’s made government fuel sales an irresistible target for Democrats as they try to rein in climate change.

Biden’s election has put big oil companies on the defensive after largely having their way in Washington under President Donald Trump. But in taking on petroleum companies with a moratorium on oil and gas lease sales, Biden picked a foe that spent lavishly over decades to secure allegiance from Republican lawmakers.

The industry is also deeply enmeshed in local economies -- from Alaska and the Gulf Coast to the Rocky Mountain drilling hub of Casper, Wyoming -- posing a challenge to the Democrat as he tries to navigate between strong action on the climate and recovering from the pandemic's financial devastation.

“You’re not hurting the big guys that are doing all the development. You’re hurting these little guys that are dreaming up where no one else thought there was any oil and gas,” said Steve Degenfelder, land manager for family-owned Kirkwood Oil & Gas in Casper, a community of about 60,000 known as The Oil City.

Trump’s final months in office saw a huge spike in new drilling permits after his administration sped up approvals. As a result, some companies with the biggest presence on public lands have announced that they are ready to weather changes under Biden.

An executive from Devon Energy told investors last month that the company was “ready to roll with the punches” and has about 500 drilling permits in hand. That will last the company for years in Wyoming and New Mexico.

“They expected this....They prepared for it,” said University of Oklahoma Associate Professor Robert Lifset, who teaches history of the U.S. energy industry. “But the difference now is going to be stark. (Oil and gas companies) don’t get to run energy and environmental policy in the way they once did.”

Gone from power in Washington are former industry lobbyists including Trump’s Interior Department secretary, David Bernhardt, who oversaw a loosening of rules for drilling. They’ve been replaced in many instances with environmentalists and industry critics. Biden’s nominee for Interior secretary, New Mexico Rep. Deb Haaland, has a history of anti-oil activism.

Just a week after his inauguration, Biden announced the sales moratorium while officials review potential climate impacts and whether energy companies are paying enough. He's following a familiar template -- a 2016 Obama-era moratorium on federal coal sales that Trump and other Republicans seized on as evidence of a “war on coal” by Democrats.

That last “war” was against a retreating army: Coal production in Wyoming peaked in 2008 — and by the time of the moratorium, most major coal companies had gone bankrupt and scuttled plans for major expansions.

The oil industry stumbled last year during the coronavirus pandemic and a price war, but now companies such as Devon, EOG Resources and Occidental Petroleum are poised to expand their presence on public lands, including in the Powder River Basin.

Less insulated against the policy changes are smaller companies such as Kirkwood Oil & Gas, operating in downtown Casper since it was founded by William Kirkwood in 1965. It's now run by his sons with about 40 employees and drilling in several western states.

A company like Kirkwood can spend years piecing together federal leases like a jigsaw puzzle and assessing the profitability of oil and gas deposits as market conditions and oilfield technologies evolve, said land manager Degenfelder.

But after last year's price drop and now the leasing moratorium, its plans to further develop areas such as western Wyoming’s Upper Green River Basin — home to two of the most productive U.S. onshore gas fields — are on hold.

While some countries move away from fossil fuels, brothers Steve and Bob Kirkwood are on the lookout for places that aren't, such as Colombia, They're also considering private lands in west Texas and exploring other options such as mining metals used in electric car batteries.

Oil from federal and tribal lands makes up about about a quarter of U.S. production.

Oil and gas companies and their supporters gave about $136 million in the last election cycle, mainly to Republicans, according to the Center for Responsive Politics. Kirkwood's owners and their wives donated more than $15,000 to Trump’s re-election campaign and other GOP causes, records show.

Trump supported the U.S. oil business, Steve Kirkwood said. “Biden will support it in Saudi Arabia, Iran — everywhere else.”

Taxes on energy production and infrastructure in Wyoming help bankroll schools, roads and public services. In the Powder River Basin, petroleum operations now provide most of the property tax base in some counties.

Last year, the government sent $457 million to Wyoming from lease sales and energy production on U.S. lands in the state — second only to New Mexico.

Even with Trump gone, the oil and gas industry still has formidable allies in Congress, who say the moratorium would cost tens of thousands of jobs. Republican Sens. Steve Daines of Montana and Cynthia Lummis of Wyoming blocked immediate consideration of Haaland’s nomination on Thursday, citing her past statements against the oil industry. A final vote is expected Monday.

Benefits to the climate from a ban on new oil and gas leases could take years to realize, according to economic analysts.

Like Kirkwood Oil & Gas, companies could respond by shifting some of their activities onto private lands in the U.S., and more oil would likely come in from overseas, said economist Brian Prest, who examined effects of a long-term leasing ban for the research group Resources for the Future.

As a result, almost three-quarters of the greenhouse gas emission reductions from a ban could be offset by oil and gas from other sources, said Prest. The net reduction would be about 100 millions tons (91 million metric tons) of carbon dioxide annually.

Pressures on the oil and gas industry are growing along with concern over climate change, said Lifset, the Oklahoma history professor. Foremost are recent plans by major vehicle makers including Volvo and GM to transition to electric vehicles from gasoline, which takes up almost half the U.S. crude oil on the market.

“The real threat is not the government limiting production,'' Lifset said. “It’s the economy and the culture moving away from consuming oil and shrinking the market.”

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Brown reported from Billings, Mont.

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On Twitter follow Mead Gruver: @meadgruver and Matthew Brown: @MatthewBrownAP
Mead Gruver And Matthew Brown, The Associated Press