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Projections for virus starkly different

Copyright © 2020 Albuquerque Journal

SANTA FE – Just three weeks ago, state officials released projections showing New Mexico hospitals could face severe shortages of beds and ventilators at the peak of the coronavirus outbreak.

Their statistical model showed the state might have just 63% of the hospital beds it needed at the peak of the pandemic and just 38% of the ventilators – shortages of each exceeding 1,000.

But Gov. Michelle Lujan Grisham and her top executives shared a startlingly different picture last week. They no longer projected a shortage of general beds or ventilators.

In fact, they said, it was time to accelerate planning to reopen more of New Mexico’s economy.

The dramatically different projections illustrate the uncertainty policymakers face while trying to combat a newly discovered coronavirus that has proved highly contagious and deadly.

The differences have fueled skepticism about the state’s modeling, especially as frustration builds over the state’s stay-at-home instruction and closure of nonessential businesses.

State officials have shared numbers from the modeling sporadically – usually in public briefings broadcast from the Capitol. But skeptics have questioned why the projections aren’t published regularly online, like forecasts by the University of Washington and Los Alamos National Laboratory.

“Families all across our state have more questions than answers from leaders in Santa Fe, and they deserve better,” said Larry Behrens of Power the Future, an advocacy group for energy workers.

Power the Future and the libertarian-leaning Rio Grande Foundation have urged the state to share its disease modeling with the public.

State officials say they are preparing to post their projections online regularly and share more information about how the modeling works.

Just last week, they said, the state’s modeling team – which includes representatives from Sandia and Los Alamos national laboratories, the state Department of Health and Presbyterian Healthcare Services – agreed to publish weekly projections and explanatory material.

Jason Mitchell, a physician and chief medical officer for Presbyterian, said the projections have been incredibly helpful in day-to-day decisions for where to deploy resources, such as ambulances.

“It allows you to plan in a really meaningful way,” he said.

Health care leaders, Mitchell said, are using the near-term projections, for the most part, not looking at the longer-term projections for how many people might die over, say, the next 12 months. Such a forecast grabbed public attention April 3, when the state released a projection estimating that 2,100 to 4,700 New Mexicans might die, depending on the effects of social distancing.

Behavior praised

Mitchell and state Human Services Secretary David Scrase, also a physician, say New Mexicans’ own behavior is the driving force in the changed projections.

Even small changes in the transmission rate of the disease, they said, create enormously different projections because the math works exponentially.

It’s a much different outcome, for example, if each person with the coronavirus infects three other people, who in turn infect three other people and so on – rather than just a transmission rate in which 1.3 other people are infected.

And that’s the scope of the change health care leaders say they have seen in New Mexico.

Mitchell said New Mexicans appear to have reduced the transmission rate to just under 1.3, down from roughly 2.5 to 3.0 earlier in the outbreak.

“You’re talking about catastrophic life loss” hinging on small changes in the transmission rate, Mitchell told the Journal. “Every little bit you bring it down markedly reduces that.”

New Mexicans deserve credit, he said, for their commitment to staying home and engaging in social distancing.

Projected demand for medical beds, consequently, has fallen throughout the month while medical resources are increasing, Mitchell and Scrase said.

Hospitals have converted respiratory equipment into ventilators, they said, and health systems have retrained personnel to staff more beds.

And the old Lovelace hospital in Southeast Albuquerque is being prepared to add to the state’s bed capacity.

Patient surges likely

Scrase said some of the earlier projections – for substantial bed and equipment shortages – were based on higher transmission rates. They were always intended to be subject to change, he said, depending on how successful New Mexicans’ social isolation proved to be.

State officials, Scrase said, had to prepare for moderately bad scenarios rather than just hope for the best.

The 1.3 transmission rate, for example, was actually the lowest possibility that had been programmed into the model at one point as they built various “what if” forecasts.

Even so, Scrase said, the current transmission rate isn’t enough to end the pandemic. Hospitals still face the prospect of surges in patients, he said, until the transmission rate falls below 1.

Scrase didn’t commit to a particular date for putting the state model online. He said the state’s modeling team wants to publish weekly updates and share regular information going forward.

“We’re very proud of it,” Scrase said. “It’s very uniquely New Mexican.”


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