April 1, 2020

Governor, administration prepare for coronavirus ‘surge’

In a press conference on Tuesday, Gov. Michelle Lujan Grisham and cabinet officials outlined the state’s preparations for the expected “surge” in cases of COVID-19 in the upcoming weeks and the resulting hospitalizations, which will strain and even overwhelm the state’s health care systems, as it has in other areas of the country and world.

And the state provided a stark update on how many New Mexicans could die, well above previous estimates.

She said the state will make preparations to expand its hospital bed capacity, medical equipment and COVID-19 testing, while urging the public to practice socially distancing to keep the peak of cases as low as possible.

Related: Guv’s public health order extended another month

What exactly that peak amount of cases looks like is something officials and experts have been considering as a way to prepare. 

A widely shared model from the University of Washington Institute for Health Metrics and Evaluation predicts that the state will hit its peak amount of COVID-19 cases on May 2, which would require 1,594 hospital beds and 239 beds in intensive care units. The model predicts a total amount of 529 deaths from COVID-19 in New Mexico, with a peak of 16 daily COVID-19 deaths on April 29.

Dr. David Scrase, the secretary of the New Mexico Human Services Department, said that the University of Washington model was a best-case scenario and based on old data. The New Mexico models are more of a “serious case scenario, because we need to plan for the most serious case scenario,” he said.

Models from the state predict the possibility of 210 people per 1 percent of the population that contracts COVID-19. With a projection of anywhere between 250,000 to 1.25 million, or roughly 12 percent to 60 percent of the state’s 2.095 million people, that would mean between 2,500 and 12,500 deaths.

“The problem with the peak, whenever it occurs, is it’s likely to overwhelm our delivery system,” Scrase said.

The model similarly projects 84,000 COVID-19 deaths nationwide. The White House, after weeks of downplaying the threat, predicts 100,000 to 240,000 deaths nationwide, even with social distancing.

As to when the peak will hit in New Mexico, Scrase said with a geographically diverse state, the peak will likely come at different times in different areas.

The area that state officials say will hit a peak first is the Four Corners area. Scrase said a peak could occur soon, “within weeks.” 

San Juan County has 32 confirmed cases of COVID-19, as of Tuesday’s release of numbers from the state Department of Health. The Navajo Nation, which spans through northwestern New Mexico, north-central and northeastern Arizona and parts of southwestern Utah, is currently battling an outbreak. As of Tuesday night, the Navajo Nation confirmed 174 positive COVID-19 cases and seven deaths. Of the positive cases, 26 are in counties in New Mexico, including 15 in San Juan County.

Adding hospital capacity

The state is also examining how many people will require hospitalization. The fear is that New Mexico’s hospital systems will be overrun by COVID-19 patients.

Scrase said the state model shows it could need 3,498 hospital beds at the peak of COVID-19, and the state currently has about 2,500 beds. And the state would require 2,175 intensive care unit beds—but the state currently only has 365. The model also predicts the need for 630 ventilators, but the state has just 471. 

“We’ve got work to do,” Scrase said.

Scrase said he believed the state could double its capacity, possibly more. But he said that even with that, it would take New Mexicans to do their part, and remain socially distanced, to reduce the need for hospitals by half. 

“I think we can make this work” if both happen, Scrase said.

Related: NM COVID-19 cases crosses 300; five have now died

Lujan Grisham said data showed that people who require hospitalization stay there on average “for about 21 hospital days for recovery, then discharge” before recovering at home.

Lujan Grisham outlined ways in which the state, along with the U.S. Army Corps of Engineers, is looking to expand hospital capacity. She said they are going to reopen an old Lovelace hospital on Gibson in Albuquerque, which will add around 200 beds for non-ICU patients. The state is also looking at places to add beds in other areas around the state, and mentioned Farmington, Gallup, Las Cruces, Roswell and Santa Fe.

The state and U.S. Army Corps of Engineers are also looking at locations for an Army field hospital, which President Donald Trump promised to provide to the state. The exact size of the hospital is not yet known.

“We’re going to locate the hospital, which will have ICU beds, where we think we are going to have surges,” Lujan Grisham said.

The hospital would take about a week to set up before it can start seeing patients.

Major General Kenneth Nava, the Adjutant General of the New Mexico National Guard, said he is working with FEMA on the placement of the hospital.

“The placement of that hospital is going to be based on data,” Nava said. “Where do we need it?”

The state is also, like all other areas in the country, looking to expand its stockpile of personal protection equipment, or PPE. 

Lujan Grisham said that the state has now received 75 percent of its allotment from the federal stockpile. But beyond that, the state has placed orders for “hundreds of thousands” of N95 masks and thousands of orders for other protective equipment, from plastic gowns to gloves to surgical masks.

She said that the computer chip manufacturer Intel donated PPE, while the national labs gave PPE to the national stockpile and were working to get it allocated to New Mexico.

Nava said that the state’s stockpile is sufficient “for now.”

“The push really is when the surge comes, making sure we have PPE on hand,” he said.

Lujan Grisham agreed and said she and her administration are doing what they can to procure more PPE.

“I’m pushing the federal government hard. And no apologies for that,” Lujan Grisham said. “And I’m pushing the private sector hard. And no apologies for that.”

Testing expansion

New Mexico Department of Health Secretary Kathy Kunkel announced that the state is increasing testing capacity to detect COVID-19 in residents who are asymptomatic. Until now, a resident could get tested only if they showed symptoms of the virus, which are a fever, a cough and shortness of breath.

The new criteria includes those who may be asymptomatic but have had close contact with someone who has tested positive for the virus; household members of someone who tested positive for COVID-19 and the state is recommending those who may be asymptomatic in nursing homes or other places where people are in close settings be considered for testing.  

Kunkel said the state now has over 60 testing sites. Of those, 45 were open in 24 different counties on Tuesday, she said. Kunkel said residents can find out which testing sites are open each day by visiting the state’s website.

Kunkel also said the state is removing the need for a referral to get tested. She said some private hospitals may still require it but the state will not and a resident who needs to get tested can call the public health office to request an appointment.

The state is also further expanding its testing capacity. Kunkel said the state’s labs can currently run 250 tests per night and TriCore Reference Laboratories can run about 1,100. But with new instruments being installed at the DOH labs, that will add the capacity for another 500 tests, and TriCore may add another 500-800 tests to its daily capacity.

Through Tuesday, New Mexico has processed 13,240 tests, which is about the same as states with larger populations like Indiana (13,373 tests for nearly 6.7 million residents) and Virginia (13,401 tests for 8.5 million residents) according to the COVID Tracking Project and most recent U.S. Census Bureau population estimates

If all goes right, Lujan Grisham said the state would be able to process between 4,500 and 5,000 tests per day by the end of April. That includes expanding testing capacity and getting enough supplies for the tests.

“We’ll be the only state that I’m aware of in the country that can do that with this kind of a population center which gets us closer to that kind of really robust surveillance. That opportunity will save us, protect us, and give us the necessary data to do modelling that most states won’t be able to do until after their surge and incredible emergencies,” she said. 

Lujan Grisham said she would like for everyone to be able to get tested. But she said the state doesn’t have enough testing supplies to do that. She called the way in which states and the federal government have been competing with one another for testing and other equipment “draconian” and “unnecessary.”

“But we can relax the criteria (for testing). We can expand in that regard,” she said.

New Mexico gets a “C”

Lujan Grisham referenced the Unicast map that uses anonymized cell phone location data to track, in aggregate, how much residents move. The state has received a “C-,” indicating residents are still traveling instead of staying at home. Lujan Grisham said she wants the state to get to an “A.”

“The less transmission the more lives we save,” she said. “We have a social contract and we must take this seriously.”