In the spring of 1993, an unexplained illness spread through the Navajo Nation. Dozens of otherwise young and healthy people came down with flu-like symptoms — fever and fatigue — that spread into the lungs, where fluid pooled, suffocating victims from the inside. The sickness killed 27 people that year.

State experts were stumped. Federal health officials were flown into New Mexico, equipped with gas masks, fearing the unknown disease was infecting people in the Four Corners region through some airborne toxin, The Washington Post reported. It would be a month before epidemiologists linked the disease to mice carrying hantavirus.

More than two decades later, a new study warns that New Mexico might be among the states least prepared for such an epidemic, or another type of public health emergency, largely because of limited funding, gaps in public health staffing and the state’s failure to join an interstate nursing pact.

“It is important to view emergency preparedness as something we have to start to strengthen,” said John Auerbach, president and CEO of the Trust for America’s Health, a health policy nonprofit based in Washington, D.C., that released the study last week.

Federal funding for basic emergency preparedness and hospital emergency preparedness have been cut by more than 50 percent since 2002, and state and local funding across the nation has been cut by about a third in that time, according to the report.

Funding for public health in New Mexico has seen cuts for at least the last two years.

The Trust for America’s Health report looked at 10 indicators for a state’s health emergency preparedness. New Mexico, scoring well in just three out of 10 indicators, ranks among the bottom 11 states when it comes to being prepared for disaster.

The 10 indicators were based on broad public health measures that could be compared state by state. How New Mexico would handle a state-specific event, such as a radiological release from a national laboratory contaminating air, land, and water and food supplies, was not included in the report.

New Mexico received high marks for providing medical staff with biosafety training at state public health laboratories, for its ability to vaccinate more than 50 percent of the population against the flu virus in the last year and for passing a national public health accreditation.

“New Mexico, in fact, has strong leadership” in its Health Department, Auerbach said. “It has well-trained people in emergency preparedness.”

But the state lost points for a lack of paid sick leave laws for the private sector and a struggling public health budget, which, in recent years, has left lawmakers grappling with how to fund needed contract nurses.

New Mexico also lost marks for failing, so far, to join an interstate nursing compact. Since 2004, the state had participated in a compact that allowed licensed nurses to work in member states without the need for additional licensing. But a new compact will be implemented Jan. 19, and if New Mexico does not sign on by then, many nurses who have been crossing state lines to practice at medical facilities here will no longer be able to do that without a state license.

When hurricanes hit in Florida and Texas this year, Auerbach said, the compact allowed shelters to remain staffed with out-of-state nurses, providing overworked in-state nurses some relief, so they could rest between shifts and spend needed time with their own families amid the crisis.

The New Mexico Health Department, already wrangling with a 25 percent turnover rate for agency staff and elevated vacancy rate, also would benefit from an increase in salary for its nurses, according to the Legislative Finance Committee.

David Morgan, a Health Department spokesman, said the agency could not immediately respond to questions on the new emergency preparedness report.

The report also focused on a warming climate and its relationship to more severe natural disasters and drought, as well as the threat of more disease being spread by insects and other animals that thrive in heat.

“There is a growing body of evidence that there is significant global climate change that is occurring,” Auerbach said, “and that is creating a number of different ways that potentially threaten the public.”

Climate scientists in New Mexico say the Southwest is at the forefront of climate change and will see increasingly hot and dry temperatures, more severe forest fires and drought, and more drastic fluctuations between hot and wet seasons.

The 1993 hantavirus epidemic was an early example of the link between climate and disease.

Hantavirus was first documented in humans decades earlier, and a mice-borne illness was well-known within the Navajo Nation, which had developed its own medicinal treatment. But it was a drastic change in climate that caused the disease to surface and create an epidemic that year. Several years of drought were followed by heavy snowfall in the winter of 1993. In the spring, heavy vegetation allowed deer mice to reproduce rapidly, overpopulating piñon groves and sheep meadows. And disease spread.

When the weather varies drastically in New Mexico, with unprecedented moisture, hantavirus still strikes. There were 13 cases of the virus in the state between 2016 and 2017, and four deaths.

Contact Rebecca Moss at 505-986-3011 or

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