November 17, 2020

COVID-19 hospitalizations grow, hospitals utilizing surge plans

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Leaders from Albuquerque hospitals provided an update on the COVID-19 pandemic in their facilities, saying resources are stretched but not yet broken, and said the systems are working together to help patients.

Lovelace Chief Medical Officer Dr. Vesta Sandoval said hospitals around the state are seeing an increased number of COVID-19 patients. 

As of Monday, the state of New Mexico reported that over 738 people are being treated for COVID-19 in hospitals statewide.

“Everyone’s surge plans are activated,” Sandoval said. “Everybody is evaluating multiple times a day, our status, our bed status, our availability, communicating with everyone within our system, as well as the other facilities within the city and state, trying to have access for the patients that are coming in.”

Dr. Denise Gonzales, the medical director at Presbyterian, said she believed that the two-week shelter-in-place order that began Monday would have a positive impact on the number of hospitalizations. She said Presbyterian facilities are “filled well beyond what is our typical capacity.”

The three healthcare leaders also spoke about the toll the pandemic has taken on healthcare workers as they work to take care of the skyrocketing numbers of COVID-19 patients.” 

All hospitals have already taken measures to expand capacity as part of their surge plans.

Sandoval said this included repurposing and expanding areas to treat patients, and “taking staff and utilizing them in different sorts of ways and sort of a team sort of approach and being able to expand your capacity beyond the normal walls of your normal units within the facilities.”

University of New Mexico Chief Quality and Safety Officer Dr. Rohini McKee said they have also converted areas that were previously used for outpatient care to inpatient care, “redeployed” nurses and physicians to aid in patient care and postponed elective surgeries that could wait for six to eight weeks without danger of worsened outcomes.

All of this was learned from the first wave, Gonzales said, including planning on expanding ICU capacity and being licensed to have more areas than one patient in a room if necessary.

Gonzales said that while the exact numbers change daily, and even on an hourly basis, “the trend has been towards 50-50 in terms of COVID to non-COVID conditions” among patients.

It can take more effort to treat COVID patients, in part because of the need for healthcare workers to ensure PPE is properly equipped.

McKee noted that they are seeing more who require ICU treatment, which takes more resources.

“They’re just very sick when they’re in the ICU,” she said. “And they need a lot of nursing attention. And I think it leads to a lot of both physical and emotional fatigue at the end of the day for our nursing staff.”

The hospital systems have all supplemented staff with traveling nurses, but Sandoval noted that they are competing with hospitals nationwide for traveling nurses.

The lack of staffing is one reason cited why the Gibson facility, which was readied by the U.S. Army Corps of Engineers early this year, isn’t a current option, and even if it was an option,it would likely not be used for treating COVID-19 patients.

“Even if there are extra beds at Gibson, I think the staffing would be the rate limiting step there,” McKee said. “And Gibson might be better used for folks that don’t actually need to be in an acute care setting.”

Patients themselves are also impacted by the inability to have traditional support systems in place, as families are not allowed to be in the room because of the nature of the contagious disease.

They also echoed Gov. Michelle Lujan Grisham and state Human Services Department Secretary Dr. David Scrase when it came to holiday plans for families in the state.

McKee urged New Mexicans to reconsider any in-person celebrations over the holidays, as these can spread COVID-19, acknowledging that it would be difficult.

“It is absolutely essential that we pull together to think about how we can be safe over the holidays, so that we can protect not just our families and the ones we love, but the most vulnerable in our community and our healthcare workers,” McKee said.

She also urged caution when making decisions for holiday gatherings.

“I would urge our community to think about who they want at the Thanksgiving dinner table next year as they make these decisions,” she said.