Serving the High Plains
Serving the High Plains
The New Mexico Department of Health issued new public health orders Thursday that include a temporary delay on non-essential surgeries because the COVID-19 pandemic is straining the state’s hospitals.
The orders came two days after state health officials said during a webinar that hospitals likely would begin rationing health care before the end of the month.
Human Service Secretary David Scrase said earlier in the week New Mexico’s hospitals contained a more than 1,000 COVID-19 patients, and hospital bed availability was “a very dynamic situation that changes by the hour.”
He added that rationing of care “could be very soon … maybe this month.”
New Mexico’s seven-day average of COVID-19 cases in recent weeks has been more than 1,600, nearly 10 times the gating criteria of 168. The test positivity rate has dropped from 24% on Nov. 24 to 13% on Dec. 6. The rate of spread also fell from 1.30 on Nov. 9 to 0.79 on Dec. 6.
Despite those encouraging signs, Scrase said he was concerned about a recent uptick in cases.
The ban on non-essential surgeries remains in effect through Jan. 4. Non-essential surgeries are defined to include procedures that may be delayed “without undue risk to the patient’s health.”
“Nothing in the emergency order applies to the provision of emergency medical care or any medical actions necessary to provide for urgent or emergency medical needs; or to any surgery or procedure that would result in the worsening of a serious condition, if not performed,” a news release from the DOH stated.
The second DOH order issued allows some physicians and other healthcare workers to treat COVID-19 patients even if they are outside their scope of practice, under limited circumstances.
During a webinar Dec. 8, Dr. Michael Richards, vice chancellor of clinical affairs at the University of New Mexico Health System, and Dr. Denise Gonzales, medical director at Presbyterian Health Services, detailed how hospitals likely would go to a “crisis” standard of care when demand for medical services outstrip hospital resources because of the pandemic.
Presbyterian, the state’s largest healthcare provider, manages Trigg Memorial Hospital in Tucumcari.
Richards said coordinated efforts between the state’s health systems and the DOH so far have transferred patients to less-crowded hospitals or move needed equipment, such as ventilators.
Gonzales said hospitals have prepared for the “third wave” of coronavirus cases by employing traveling nurses, redeploying healthcare workers, increasing hospital-room capacity, using old spaces in new ways and moving to more outpatient care.
Gonzales said rationing does not mean patients would not receive medical care. But if a hospital’s intensive-care unit is full, it would be forced to objectively evaluate whether a COVID-19 patient with other problems such as chronic kidney disease or advanced cancer likely would recover from treatment for the virus or whether the patient can be transferred to a less-crowded hospital.
“There’s no one bright line that we cross that says we’ll do this to every person and every circumstance,” Richards said.
During Thursday’s health briefing, a reporter asked Gov. Michelle Lujan Grisham whether hospitals crowded with COVID-19 patients would affect their ability to care for expectant mothers in labor. The governor said it not only would affect pregnant women, but people injured in accidents, suffer heart attacks or appendicitis and other situations were immediate care is needed. Because many hospitals everywhere are crowded, such patients often can’t be transferred out of state, she said.
“It is a dire situation around the country,” she said.
When asked about the state’s COVID-19 mitigation efforts this year, Scrase said they “certainly reduced death rates” and probably delayed the “crisis care” mode at hospitals by several months.
Lujan Grisham said Thursday that New Mexico would receive 17,550 doses of Pfizer’s COVID-19 vaccine as soon as this week after the U.S. Food and Drug Administration gave emergency approval Friday of its use. She said those doses would be given to frontline healthcare workers who have a high to medium risk of exposure to the virus.
Lujan Grisham said initial doses of the Moderna vaccine, which likely would receive FDA approval in the coming weeks, would be given to patients and staff at nursing homes.
When asked when a large enough proportion of New Mexico’s population would be immunized and have herd immunity from the virus, Scrase surmised it would be by the “end of summer” and not April or May as some have predicted.