There is no one-size-fits-all when it comes to preventing and treating something as complex as a pandemic occurring within a severe economic downturn in a state like New Mexico.
Yet, armed with science and a deep understanding of local history and politics, county stakeholders can make huge strides in preventing infection to avoid the high cost of treating it and fatalities. And businesses can safely start up again.
Ensure local vital services to demonstrate we care : For eight months, we have asked the public to wear masks, social distance and be vigilant about ending transmission. We have also asked local small-businesspeople to accept that their enterprises may be over. We have said to those who lost jobs to be patient and get by. Add to this parents juggling home school even if they work outside the home full time.
Complicating matters for those local residents who were struggling to access such vital services as health care, child care and job training before the pandemic, we have historically said, “Figure out how to fix yourselves. And obey us.”
And we wonder why 100% of our county residents don’t follow all public health guidelines. People are angry, scared, cynical and confused. What is required are the reassuring messages of local respected leaders coupled with a commitment that no one goes homeless or hungry during this era of colliding crises.
We have, in seven counties, begun forming coalitions to do just this – working to ensure vital services that say to people, “You matter.” If we, county by county, create a sense of care and provide actual care, residents will be far more likely to comply, reduce transmission and be part of the solution.
Ensure robust health care is accessible: We must ensure the funding for quality medical care, including testing and treatment. This includes the funding for protective gear for all providers, along with well-resourced clinics and hospitals to accommodate current and future levels of infection. This means we must assess in each county access to medical care and how to fix gaps.
Our county system of care also needs the resources to support contact tracing. We need to know, once a person is identified as infected, with whom they were in contact. We know the research on effective contract tracing, and the ratio between tracers and the population size (which could be 15-30 tracers per 100,000 people). We can learn from other countries what works and how to do contract tracing to infection rates decrease.
Guided by great care
As you can see, Step 1 goes way upstream to prevent infection before it starts. If we do this step effectively, the public will join in prevention efforts, the costs of Step 2 can be reduced, the pandemic ends and local economies can start up.
We won’t be able to shame or coerce people into complying – at least not as a long-term strategy through rural and urban New Mexico. People need to know they are cared for before they will follow all rules blindly (even rules that can save their lives). The pandemic is teaching us that the phrase “we are all in this together” has never been more true, and it needs to be acted upon in ways that all residents can see and benefit from.
We have a long hard storm ahead and we need to make sure everyone knows a lifeboat, in the form of access to the vital services for surviving and thriving, will be made available to them. Only with a true sense of community and accessible services will the public want to follow public health guidelines in order to end our crisis.
The bottom line: If local leadership ensures “great care” in the form of access to vital services for survival, people who are scared and angry will be far more likely to become part of COVID-19 prevention.
Matt Probst of Las Vegas, N.M., is medical director of El Centro Family Health in northern New Mexico and founder of the 100% San Miguel County initiative to ensure 10 vital services for surviving and thriving.