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Coronavirus spike: ‘Like nothing else we’ve seen’

Copyright © 2020 Albuquerque Journal

Human Services Secretary David Scrase is joined by Dr. Jason Mitchell, chief medical officer at Presbyterian, and Dr. David Gonzales, chief medical officer at Christus St. Vincent, to provide an update Thursday on the COVID-19 pandemic. (N.M. Human Services Department)

SANTA FE – New Mexico hospitals could be caring for patients in MASH-style units by December if the pace of new coronavirus infections continues unchanged, health care leaders said Thursday.

The warning came as the state obliterated its old record for new virus cases in a day – set just last week – and reached another high in the number of COVID-19 patients in hospitals statewide.

New Mexico reported 1,082 new coronavirus cases Thursday, clearing its previous high by 24%. The state has averaged 790 cases a day this week, or 3.9 times higher than the average Oct. 1.

“The velocity of that spike is like nothing else we’ve seen in this pandemic,” Dr. Jason Mitchell, chief medical officer at Presbyterian Healthcare Services, said in an online press briefing. “This is a serious call to action for us as a community.”

He said Thursday that if the state’s virus trends continue, hospitals are likely to engage their “crisis standards of care” sometime next month.

In December, Mitchell said, they could be calling in every doctor available, retraining them and setting up MASH-style tents.

Human Services Secretary David Scrase said health care leaders are also closely watching the number of ventilators used by COVID-19 patients.

But crisis standards of care aren’t inevitable, Mitchell said. New Mexico hasn’t yet passed the tipping point, he said, if residents rigorously wear masks, avoid gatherings and limit the transmission of COVID-19.

“We are at a pivotal point,” Mitchell said.

Coronavirus hospitalizations reached a state record on Thursday – 323 patients, or more than three times as many as at the beginning of the month. The number may include out-of-state residents hospitalized in New Mexico, but health officials say the state isn’t a net importer of patients because other states take New Mexico patients, offsetting any visitors hospitalized here.

Dr. David Gonzales, chief medical officer at Christus St. Vincent Health System, said admission from other causes – not COVID-19 – is also increasing the strain on hospitals.

“This is leading to full houses across the organizations in our state,” Gonzales said. “As we increase, we may have beds, but we may not have staffing for those beds.”

Drastic measures needed?

New Mexico’s seven hub hospitals had 288 intensive care beds occupied Thursday. The state’s baseline capacity is 290 ICU beds for coronavirus patients.

Moving to contingency standards – postponing elective surgeries, closing down other units – could boost the capacity to 439 ICU beds.

In a crisis, capacity could reach 623 beds “through drastic measures,” health officials said.

Statistical modeling by state health care leaders shows that, if the current trend continues, New Mexico would exceed its contingency standard in mid-November and push past even the crisis capacity in early December.

A possible strategy, Mitchell said, would be setting up tents to accommodate patients, with units similar to mobile army surgical hospitals.

The state has also considered sending patients to the old Lovelace hospital on Gibson SE in Albuquerque, but Scrase said finding enough health care workers to staff the facility is a barrier, among other challenges. Just staffing the state’s existing hospitals may be difficult, he said, depending on how many coronavirus patients need care amid the surge.

COVID bubble

New Mexico is also nearing 1,000 coronavirus deaths.

Health officials reported three more fatalities Thursday, including the death of a woman in her 20s from Sandoval County. She had underlying health conditions.

Men in their 70s and 90s also died.

The death toll now stands at 994 state residents since COVID-19 arrived in March, according to state figures.

New Mexico is seeing an increasing number of coronavirus infections in people of all age groups and parts of the state, Scrase said.

The case increase comes as New Mexico sharply expands testing. The state has conducted about 8,983 tests a day over the last week, or about twice as many as it was doing just after Labor Day.

But the number of new infections isn’t only a result of increased testing. The share of tests that come back positive has also climbed, reaching about 9.5% over the last week, up from 3.4% at the beginning of the month.

New Mexicans, Mitchell said, have succeeded in the past at slowing down sharp growth in cases. The key, he said, is wearing masks, washing your hands and keeping a safe distance from other people.

“It is time to stay in your COVID bubble and keep it as small as possible,” Mitchell said.

Scrase had one more suggestion: Stay home on Halloween.

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