One focus of New Mexico’s response to the COVID-19 pandemic is the “surge.” That’s the time that hospitalizations will stretch hospital resources to their maximum, and potentially overwhelm, as has happened in other areas around the country and world.

In a remote press conference by Gov. Michelle Lujan Grisham and two of her cabinet-level secretaries, the governor said a number of times that the number one thing New Mexicans can do to push that surge further into the future and lessen its impact is to remain socially distanced.

“We should just treat it like we all have this virus and we have an extra responsibility to prevent the spread,” she said.

Lujan Grisham said the state also advised, but did not require, that residents wear masks when in public for essential business—but said that medical-grade masks including N95 masks should be left for first responders or healthcare workers.

The reason to slow the spread is to lessen the impact on the state’s hospital system. 

Dr. David Scrase, the Secretary of the state Human Services Department, said that with “high intervention,” state models project more than 2,100 people would die with COVID-19 over the next 12 months. But without any sort of social distancing from the public, the projections say over 4,700 people would die. 

As for the surge, Scrase said it would take place at different times in different areas of the state. The first areas to be hit appear to be Western and Northwestern New Mexico. 

“I think their surge will happen in Gallup over the weekend, we’ve already sent out ten more ventilators to Gallup, so it’s happening right now, and then in Farmington very soon,” Scrase said.

Lujan Grisham said the state is working with the U.S. Army Corps of Engineers to convert parts of Gallup High School into a hospital to treat non-COVID-19 patients and allow the hospital to focus on the more serious cases. The Corps will do construction and engineering work, she said.

Scrase said this would add another 50 hospital beds to the area’s capacity. 

San Juan County is also seeing the need for additional help. Scrase said that Presbyterian Healthcare Services workers on Friday were driving equipment to Farmington to help with telemedicine and allow doctors with expertise in Albuquerque to provide guidance to those at the San Juan Regional Medical Center in Farmington.

And in Albuquerque, in addition to the previously announced reopening of the old Lovelace Hospital on Gibson, Lujan Grisham said the state was working on getting approval to use the Veteran’s Administration hospital in Albuquerque to treat non-veterans during the crisis.

Stretched thin

Statewide, the peak number of hospital beds, ICU beds and ventilators fall short of what the state would need during the surge in patients, even when serving at “maximal” capacity, which would involve drastic measures like patients being served in hallways, multiple people per ICU room and potentially multiple people on a single ventilator. 

The state projects that at “maximal” capacity, the state will have 2,217 general hospital beds, 589 ICU beds and 625 ventilators. But what would be needed at its peak per the model are nearly 3,500 general hospital beds, 2,175 ICU beds and over 1,600 ventilators. 

“Do I have all the equipment that we need today?” Lujan Grisham said, when referring to ventilators from the national stockpile. “I don’t.”

And Lujan Grisham said no matter what New Mexico receives out of the national stockpile, it won’t be enough for a respiratory pandemic, and some equipment being given to states isn’t in working order.

As for other medical equipment, including personal protection equipment (PPE), the state is doing all it can to get more, Lujan Grisham said, despite the challenges the state faces. 

She said that N95 masks that once cost 80 cents are now going for $8 to $10 each.

“Can I promise every healthcare worker and every New Mexican that we’re going to have enough of these?” she asked. “I can’t.”

This is why she asked that people not buy N95 or surgical masks for their personal use.

Still, there is some positive news. Scrase said in his decades working in the healthcare sector in New Mexico he has “never seen anything like the level of cooperation we have right now. Leaders coming together right now and dropping any sense of competitiveness they might have had in the past.”

And he mentioned that the FDA approved the emergency use of CPAP machines, commonly used for those with sleep apnea, for some cases, which would allow the state to stretch its supply of ventilators.

President Donald Trump invoked the Defense Production Act to ease the manufacture of ventilators and other protection equipment this week, after weeks of calls from governors throughout the country.

And Lujan Grisham said that local companies were manufacturing PPE, mentioning N95 respirators, plastic face shields and sterilized gloves. 

She also said that the state is “actively recruiting” nurses from Canada, and are close to getting federal approval to use the nurses in hospitals in the state. The nurses would need to self-quarantine for 14 days after arrival, but then would be able to help the state’s medical workforce

Testing update

The state announced its largest amount of new positive COVID-19 tests in one day, 92. That brought the state’s total amount of positive tests to 495. 

This came days after the state announced it relaxed the standards for those seeking tests. 

And Secretary of Health Kathyleen Kunkel said the same day the state announced the new standards, DOH sent collection kits to 75 nursing homes. Nursing homes are particularly at risk because older people and those with preexisting conditions, including liver disease, asthma and diabetes, are also extra vulnerable to COVID-19.

Still, Lujan Grisham said even the relaxed criteria does not allow the states to do “surveillance” work to track the spread.

The overriding call from the press conference was that to avoid the most serious problems with the spread of COVID-19, New Mexicans need to socially distance.

That’s why she said the state would be announcing “metering” for those going to big box stores like Target or Wal-Mart, to ensure too many people aren’t together in one space.

But ultimately, she said it’s up to New Mexicans to realize the seriousness and to remain socially distanced.

“The second you let up, it’s an invitation to this virus,” Lujan Grisham said.