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As New Mexico reopens, how safe are you?

Copyright © 2020 Albuquerque Journal

Information regarding coronavirus in New Mexico can be dizzying.

New Mexico made national news last week as one of 14 states with their highest seven-day average of new COVID-19 cases. The same day, state officials announced the lowest increase since April: just 47 cases.

The latest data from Johns Hopkins University shows that the highly contagious virus has been detected in just 3.4% of all people tested in New Mexico. But state highway message boards are warning New Mexicans the risk “remains high.”

New Mexico’s per capita COVID-19 death rate is second-highest in an eight-state Southwestern region. But eliminate the “hot spots” – such as the outbreak in the northwestern part of the state, mostly in Native American communities, and people who have died in long-term care facilities – and the number of deaths would be cut by more than half.

The sometimes confusing information comes at a time when New Mexicans are starting to emerge from weeks of government-imposed restrictions. With new freedom to dine out, go to state parks, get a haircut or manicure and shop for nonessentials, the question remains: What’s the risk of getting the virus, especially if you have no connection to any of the hot spots?

There are no good answers.

“It’s all relative,” said Dr. David Scrase, Gov. Michelle Lujan Grisham’s top medical adviser on the coronavirus. “You don’t want to take any unnecessary risks. At the same time, I would ask the question, is this something I can live without for 18 months (until a vaccine is developed)?”

The hope is that with New Mexico’s high level of testing for the virus – more than twice that of most neighboring states – officials can get a better handle on the prevalence of the disease.

“If you took out the hot spots, we’d be looking really good,” Scrase said.

And random tests of essential workers, such as those who work in grocery stores, have been “pretty low” for COVID-19, he said. “It’s been a really big deal, and a lot of people have died from it, but it’s a very, very low prevalence, that we know of.”

Yet last week, after the state permitted new partial openings of certain nonessential businesses and parks, the website to help states reopen safely reported a 24% increase in New Mexico’s positive cases over a 14-day period.

On May 27, the state moved into the green category on the exit strategy website, signifying “trending better.”

Now New Mexico is in the “bright red,” for “trending poorly,” Scrase said in a public update Thursday.

Scrase said most of the dramatic jump in the average number of daily cases is driven by the outbreak at the Otero County prison facilities in Chaparral. But he said the uptick could also be partly due to the partial reopening of the state, which has led to increased human interactions.

“We need to put the foot on the brake and encourage all of you to stay at home,” he said. “Don’t expand activities.”

Risk reduction

Public health experts typically focus on how to reduce risk, such as wearing a mask or face covering, avoiding crowds and keeping 6 feet away from others.

“I still like to think of it that we’re all equally susceptible to getting the virus and those of us with more risk factors (such as being over 60 or having chronic health conditions) have a much higher chance of having a bad time with the virus,” said Scrase, a physician who also is state human services secretary.

Health Secretary Kathy Kunkel has said the increased testing by the state, which now includes people with no symptoms who are workers or who have come into close contact with those with the virus, is focusing on certain higher-risk groups, such as child care workers, prison inmates and those who work in grocery stores.

“We want to find out where it is and where it isn’t,” she said recently.

Nationwide, New Mexico ranks third-highest for the number of COVID-19 tests administered per capita, with New York second-highest and Rhode Island first, according to Johns Hopkins.

Kunkel said the Department of Health has a rapid response team for cases of the coronavirus in the workplace. Since May 11, the team has responded to 119 positive cases in 27 industries in the state, including grocery stores, dental offices, nursing homes and child care facilities.

“When we learn in the morning there’s been a positive, we will contact the business to let them know,” she said. The team then helps the business with testing of employees, she said, and assists in closing the affected area.

‘Leaving the bubble’

Leslie Alderman, a psychotherapist practicing in New York City, told the Journal last week that her clients have had evolving reactions to “leaving the bubble of quarantine.”

At first they asked, “When is this going to be over?” she said. Then, as states around the country started to lift their restrictions, her clients “started to get a little panicky, because the reality of going to work or going to meet friends for dinner was just a minefield of decisions and potentially frightening scenarios.”

“Are the elevators safe? Bathrooms? Are babysitters safe? We’d gotten used to a very close set of rules, almost like being let out of prison, and you’re, like, ‘yikes,’ ” Alderman said.

She said the public has more personal responsibility now and “not very clear guidelines” from state and local public officials.

“Meanwhile, the information that we’re getting about this novel coronavirus seems to change every week. Do wear masks. Don’t wear masks. It’s a little dizzying and hard to keep up with. And some of the things we had to learn and had been told at the very beginning of the pandemic were changing too. So it’s like, hmmm, who do I trust?”

Scrase said he thought it was “unfortunate” that an official with the World Health Organization suggested last week that the transmission of COVID-19 by people with asymptomatic cases is “very rare.” WHO officials later clarified that statement, saying scientists have not determined how frequently it is spread by asymptomatic cases.

In New Mexico, according to the state DOH, about 24% of people who test positive for the virus do not have symptoms. And, Kunkel has attributed the spread of the virus among assisted living and nursing home patients as having come from staffers who showed no symptoms. A Health Department spokesman said last week that 893 positive tests have come from such long-term care facilities.

Scrase said in a pandemic, and with a new virus, there is a rush to get information out to doctors and the public.

“We’re going through a rocky period with the medical literature, too,” he said. “We don’t tolerate uncertainty well.”

Risks unknown

So how risky is it to resume some of your outings if you don’t live in a hot spot or are connected with anyone who is? There’s no data to predict that, Scrase said.

If past testing is considered, the number of COVID-19 tests conducted in New Mexico divided by the positives has been close to 4.5%, he said. In San Juan and McKinley counties, about 14.5% of tests have been positive, he said.

For the rest of the state, “it was more like 3%,” Scrase added.

The U.S. seven-day rolling average of positive tests as of Friday was 4.5%, according to Johns Hopkins.

The percentage of positive tests is typically considered to assess whether a state is testing enough, Scrase said, and he said the governor believes more is needed here.

In her COVID-19 update last week, Lujan Grisham addressed the issue of New Mexico’s fluctuating case counts.

She cautioned New Mexicans that data has to be collected and assessed “over a much longer period of time to understand what it really means.”

“Having lower cases today feels good, but it is not an indication that we are free of COVID,” she said.

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