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NM races to stay ahead of coronavirus curve

Medical personnel wait for potential patients at a mobile unit for coronavirus testing across the street from Lovelace Hospital Friday afternoon. (Roberto E. Rosales/Albuquerque Journal)

Copyright © 2020 Albuquerque Journal

SANTA FE – Gov. Michelle Lujan Grisham and top public health officials said Friday that it’s critical for New Mexico to slow the spread of coronavirus infections – “flattening the curve,” they called it – to avoid overwhelming the state’s health care system.

Their comments came as four new COVID-19 cases emerged in Bernalillo and Santa Fe counties, bringing the total to 10 infected adults in the state.

At least two of the patients were hospitalized, with one in intensive care.

The state earlier this week had about 54 open beds in intensive care units – out of 344 altogether – underscoring the need for New Mexicans to avoid large gatherings, wash their hands frequently and limit contact with other people.

“The more we do to minimize spread, the more lives we save,” Lujan Grisham, a former state health secretary, told a news conference Friday.

The goal, officials said, isn’t just to reduce the total number of people who get sick, but also to avoid an initial spike in cases that overwhelms hospitals and health care workers.

The state has enough COVID-19 testing capacity at this point, officials said, but New Mexico is already lodging requests with the national stockpile to ensure enough protective equipment is available. Health officials are also working to ensure that nurses licensed elsewhere are cleared to work in New Mexico.

Most important, the state is encouraging people to call their health care provider – or a state hotline – if they exhibit symptoms of COVID-19, such as fever, cough or trouble breathing. They should also self-isolate and follow their doctor’s instructions.

To encourage people to seek help if they need it, Insurance Superintendent Russell Toal issued emergency rules Friday that will prohibit New Mexico health insurers from charging copays or imposing similar costs on COVID-19 patients for testing and treatment.

Lovelace Medical Center created an outdoor clinic for drive-up COVID-19 testing on Friday. The hospital is offering testing outside of its hospital near Downtown. (Roberto E. Rosales/Albuquerque Journal)

New cases

Three of the four cases confirmed Friday are in the same Bernalillo County household, where someone had earlier tested positive after traveling. They are a man in his mid-50s, a woman in her mid-70s and a man in his 80s.

The fourth case is a Santa Fe County woman in her 20s who recently traveled to New York.

All are either in isolation at home or in hospitals.

Dr. Chad Smelser, medical epidemiologist for the state Department of Health, said New Mexico’s first 10 cases appear related to travel – either directly or indirectly. In other words, he said, they have a clear explanation and are not an example of broader “community spread.”

Nonetheless, Smelser said, the department’s investigators are engaging in extensive contact tracing, or going back to get in touch with anyone who has come into contact with an infected New Mexican to check on their symptoms.

Smelser said there has been at least some contact between schools and residents who tested positive for COVID-19, although he didn’t reveal details. The state is taking precautions and working with those schools, officials said.

Earlier this week, Albuquerque Academy closed its campus, announcing that a member of its community had been in close contact with someone who had tested positive.

The curve

Dr. David Scrase, secretary of the state Human Services Department, said the aggressive protective measures New Mexico is taking – including the temporary closure of schools – have a proven record of slowing infection rates.

But to succeed, he said, families must take the protective measures seriously, avoiding playgrounds and other gathering places, not just schools.

He showed a graph based on information from the U.S. Centers for Disease Control and Prevention. It showed that the number of cases would spike quickly beyond the capacity of the health care system if no protective measures were taken.

But with protective measures, the growth in cases is a gentler curve, spread out over a longer period of time and staying within the health system’s capacity.

“Without any protective measures,” Scrase said, “the delivery system is immediately overwhelmed.”

Hospitals themselves, he said, follow strict protocols for handling infectious diseases. People suspected of having an infection may be directed to a drive-through site for evaluation or testing, Scrase said.

Presbyterian Healthcare Services, for example, is asking patients with respiratory symptoms to wear a mask when entering the hospital or doctor’s office. Patients “with identified COVID-19 risks” are being put in isolation rooms during assessments, a Presbyterian spokeswoman said.

Socorro General Hospital, meanwhile, has erected a tent outside as a precaution in case it’s needed for additional patients.

A sign points to the COVID-19 testing site at Lovelace hospital near Downtown.

‘Difficult decisions’

Lujan Grisham said Friday that there’s no way to know how long New Mexico will maintain its ban on public gatherings and other protective measures. But taking steps early, she said, should shorten the period of time they’re necessary.

“These are very difficult decisions,” Lujan Grisham said. “The decision to restrict gatherings is hard on businesses, hard on New Mexicans, hard on families.”

The state Department of Health is also encouraging people to avoid travel and self-isolate for 14 days if they’ve been out of New Mexico.

Lujan Grisham herself suggested people just stay home for spring break.

“Every travel contact creates risk so we want to minimize that,” the governor said.

More positive cases of COVID-19 are inevitable, Lujan Grisham said.

The state has significantly expanded its testing capacity this week.

For many people, of course, COVID-19 symptoms are mild and don’t require hospitalization. But those most at risk are older adults and people with another chronic illness.

Keeping distances

“Social distancing” has been part of the Centers for Disease Control playbook for more than 30 years in trying to slow the spread of viruses like the flu.

It covers a lot of territory – from keeping your distance from coworkers to closing schools and any large gathering of people.

Social distancing according to the CDC involves “remaining out of congregate settings, avoiding mass gatherings, and maintaining distance.”

If there is no vaccine available, social distancing is a way for health officials to slow the spread of the virus.

The coronavirus spreads between people through respiratory droplets from coughing, sneezing and personal contact with an infected person, such as being within 6 feet of the person.

There is evidence that the virus can live on surfaces for several hours. That means a person can self-infect by touching an infected surface, then the mouth, nose or eyes.

People are thought to be most contagious when demonstrating flu-like symptoms, which include cough, fever, fatigue and difficulty breathing. There have been a few reports that people can be contagious without symptoms, but there isn’t clarity yet on whether this is correct.

According to Feb. 14 statements by CDC’s head of vaccine and respiratory diseases center, Nancy Messonnier, the incubation period lasts up to 14 days. Someone exposed to the virus may not show symptoms for many days and may have negative test results but later be shown to be infected. The reason is that it takes the virus more time to replicate in some people than in others.

Journal staff writer Jessica Dyer contributed to this article.

• For questions about schools, child care, unemployment benefits and other topics, call 1-833-551-0518.

• Visit newmexico.gov or cv.nmhealth.org for updates.

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