The state Department of Health announced a new public health order that allows its beleaguered health care facilities to transition to crisis standards of care, which provide for the rationing of treatment amid a double-whammy of COVID-19 cases and an ongoing shortage of hospital staff.

The order announced Monday creates what officials called a “standardized and equitable” process for determining patient priority for treatment when beds are limited.

“At the core of this is the lack of nurses to provide direct nursing care to patients in ICUs and general medical surge floors,” Dr. David Scrase, acting health secretary, said during a virtual news briefing.

But other factors are also at play, including a large number of patients flooding hospitals with non-COVID-related illnesses, he said

“We could talk for a long time about whether this very large number of very sick people who don’t have COVID is related to the pandemic or not,” Scrase said. “Most of us think it is. Most of us think that this unprecedented increase in how sick just the non-COVID patients are is related to delays in care.”

The state’s decision to enact crisis standards of care, the second time since the start of the pandemic, doesn’t mean every hospital will make the move.

“It isn’t every facility in the state [that] all at once goes into this,” Scrase said. “But a single hospital may invoke crisis standards of care for a period of time because they’re not able to handle the volume of patients or the complexity of patients.”

Dr. David Gonzales, chief medical officer at Christus St. Vincent Regional Medical Center, said the hospital is not at that point.

“Fortunately, we’ve been able to meet the needs of the community, both COVID and non-COVID, being very efficient in the care that we’ve given,” he said. “But we do realize that what the state has offered today is a tool for other institutions who are in a different situation than we are.”

Jennifer Vosburgh, associate chief nursing officer at the University of New Mexico Hospital, said while the number of COVID-19 cases and hospitalizations isn’t as high as they were in winter “thanks to the mask mandate and vaccines,” most hospitals never got a reprieve from previous spikes.

“During the winter surge … [the state call and transfer center] was always able to place the ICU-level patient,” she said. “Sometimes it took a little longer than others, but we always were able to say, ‘Yes, we will find you a bed.’ This surge is not like that. We are often finding ourselves saying, ‘No, we don’t have a bed. I’m so sorry. Please call back tomorrow.’ “

Sometimes, it’s too late.

Vosburgh said nurses at the call center try to follow up every 24 hours on calls they receive.



“Oftentimes, when they call and say, ‘Hey, were you ever able to find a bed?’ The answer is, ‘No.’ And often it is, ‘And the patient died,’ “ she said. “This is very, very distressing for our staff and for all of the health care workers in the facilities that can’t provide the care that they were trained to do.”

Vosburgh said New Mexico is in a “crisis.”

“We need to get control of our COVID cases immediately,” she said.

The Department of Health said the pandemic has placed an enormous and unsustainable strain on the state’s health care system.

“In particular, the volume of COVID-19 patients — almost all of whom are unvaccinated — have exacerbated existing staffing and other resource shortages,” the department said in a news release.

“Hospitals and providers are already faced with difficult choices about who gets care. Now, under [crisis standards of care], facilities statewide will use a more standardized and equitable procedure for making those decisions,” the department said, adding the state “will extend limited legal liability coverage to providers” using crisis standards of care.

Before a health care facility invokes crisis standards of care, it must temporarily suspend procedures that aren’t considered medically necessary.

Laura Parajón, deputy secretary for the Department of Health, said more than 81 percent of the state’s residents 18 and over and 62 percent of young people between the ages of 12 and 17 have received at least one dose of the vaccine.

“We continue to slowly but surely increase the number of New Mexicans fully vaccinated,” she said, adding 71.6 percent of adults and 53.5 percent of 12- to 17-year-olds are fully vaccinated and 5.3 percent of residents have received a booster dose.

“I think the next part of this pandemic is up to us as a community, as a state, as to how much we all decide to get vaccinated and try to end this pandemic,” she said. “We have the science now. We know how to fight this with the vaccine. So to me, it’s about how we think about as a community coming together and getting vaccinated to prevent more hospitalizations, more deaths, more difficulties in the hospitals.”

The state on Monday reported 1,895 new cases since Saturday and 12 additional deaths, for a total death toll of 4,942 residents.

“Sadly,” Scrase said, “this week we will in all likelihood surpass 5,000 deaths.”

Follow Daniel J. Chacón on Twitter @danieljchacon.

(16) comments

Lauren + Adam Whitehurst Rankin

84% of COVID hospitalizations are unvaccinated. https://cv.nmhealth.org/wp-content/uploads/2021/10/State-Report_healthsocial_10.04.21.pdf

Chris Mechels

Going unreported in this article, is that this edict lowers the bar for Credentials of those involved, and also makes them State Employees for protection from Tort Suits. Both of these moves seem questionable, yet the New Mexican didn't even bother reporting them. Check it out at the NM DOH website.

MLG and her crew have "managed", or "mismanaged" us into this "crisis" and now wants to lower the credentials required of the staff, and protect them from Tort Suits. A suggestion; lets use 16 year old students, like those now allowed by DOH under 7.8.2 and 7.9.2, as Direct Caregivers. Sets up a nice Covid transmission path; done in an Emergency Rule Making with NO public input.

If you still trust the DOH and the Governor, you haven't been watching.

Robert Fields

So you want to sue hospital workers overwhelmed by the folks who refuse to vaccinate and mask?

They have to ration care. That opens them up to people questioning their decisions. They absolutely need protection from lawsuits.

They are the same people who would be treating you otherwise so what’s the issue? Would you rather they all just walk off the job due to legal liabilities from patients who put themselves there through their own ignorance and militancy?

How many ways do you want it, Chris? DOH and MLG are trying to keep a system functioning that your anti-vax and anti-mask friends have undermined to the point that care has to be rationed.

I thought ivermectin and hydroxychloroquine was all you guys needed?

Robert Fields

Also, Chris, you blame MLG and DOH for what’s happening claiming they mismanaged this crisis. Sorry, but this situation is entirely the fault of the anti-vax and anti-mask crowd.

Anyone with even a barely functional brain and who paid attention knew that other states with less or no mask and vaxx restrictions were hitting these kinds of milestones. New Mexico already had a thin heath care system compared to other states. And MLG and DOH pushed mask and vax mandates that a lot of the state has defiantly resisted.

And you know what? The anti-vaxxers and anti-maskers have essentially been successful. They refused to help themselves, their coworkers, friends, neighbors, and communities, and instead held their protests, intentionally coughed on others, assaulted those who dared to tel them to mask, etc. There’s a whole laundry list of bad fringe right behavior in defiance of the steps that MLG and DOH were trying to take to contain the pandemic and keep our hospitals from being overtopped while also trying to save lives.

I’m having a hard time understanding why you think MLG/DOH mismanaged this while not blaming the ones who insisted on all the behaviors that only made it all so much worse? Why is that, Chris?

About the credentials bit — you do know our hospitals are short staffed, right? The onslaughts brought on by bad fringe-right behavior caused a lot of staff to resign. And, of course, some died themselves. To be fair, some also quit because of vaccine mandates, but that’s kind of what we’re talking about here, isn’t it? Those who refuse to vaccinate for no good reason are part of the problem and those staff would be in contact with other workers and patients like little agents of covid doom behind enemy lines. Is it mismanagement to remove those folks from the environment where they could infect the most vulnerable among us?

But back to reduced qualifications. The whole country is seeing shortages of hospital staff. So where does New Mexico get hospital staff? Reducing qualifications is not ideal by any means, but what is your solution to staffing shortages? Pay more is certainly a way to do it and get people fully qualified. Is that MLG’s/DOH’s responsibility? Most hospitals are now companies. What would you say if MLG/DOH started mandating pay scales? How would that go over, Chris? Just curious.

And I hopefully explained the liability shelter issue in my other reply. Let me know if you need more help.

Anyway, to kind of wrap this up, MLG/DOH tried to get people to wear masks, distance, and get vaccinated. The right refused. Some areas of the state filled their hospitals, other areas did not. Well, maybe until now. Regardless, the thing is if you accept that vaxxing, masking, and distancing reduce covid transmission, understand the previous relaxing of mandates was pushed for hard by the right but was still ok until delta hit and why that matters, and that the majority by far taxing our hospitals are the unvaccinated and only partially vaccinated, then how can you blame those that did their level best to get people to behave like sane adults in a deadly pandemic?

Everything MLG tried to do was met with defiant protests and public displays by the “muh raghts” crowd. Did MLG/DOH not act harshly enough for you? Should MLG reach into private businesses to tell them what salaries they can and can’t pay? I think your beef there is with the free enterprise hospital systems here for not doing enough to get and retain good employees.

So apparently we’re stuck between a rock and a hard place, Chris. It can happen here and the anti-vax/anti-mask crowd put us here. You might want to look deeper into why things are like they are. You are blaming the wrong people.

Instead, look at the right wing pundits and an orange ulcer who pushed conspiracy theories, the people who believe facebook strangers instead of trusted and respected heads of government agencies who fought things like ebola, or whatever. The fringe and far right made this bed. Now we all get to lay in it.

LeRoy Sanchez

👍👍👍

Robert Fields

Hey Chris, just in case you still are missing the point, here’s an article from Newsweek about an unvaccinated Virginia couple who died of covid two weeks apart and left 5 children behind. The father was hospitalized the day his wife died and he ended up begging staff for the vaccine but they had to tell him it was already too late:

https://www.newsweek.com/unvaccinated-couple-dies-covid-2-weeks-apart-leaving-5-kids-orphaned-1640446

Both of them tied up ICU beds and hospital staff who now get to deal with the added emotional toll of a family decimated by bad covid decisions fed by right wing misinformation. If you can call it a consolation, they did this to themselves. But that is the crux of this - they did this to themselves.

It’s tragic. About as tragic as it gets. But as we have hospitals rationing care here, why on earth do you blame the people who have done their best to prevent things like this, and done it in the face of all the republican anger and grandstanding, even waving guns because they don’t like being told what to do, and well microchips, hoaxes, and all the other nonsense the right embraced. Back to New Mexico, why do you try to wave your arms and blame the people who tried hard here, and did quite well to have held this off this long, while the right used every trick in the book to negate and block anything MLG/DOH tried to do?

No problem with the various sheriffs who refused to enforce covid mandates (one running for ABQ mayor), the Silver City restauranteur who kept his restaurant open in defiance of the lockdown or any of the other businesses that did the same, or the school board who refused to enforce a mask mandate to protect the children in their community? No blame for them? Why?

Come on, Chris. Why do you blame this mess on the people who tried to stop it and are trying desperately to keep our hospitals functioning, instead of all the people who acted like idiots, put themselves and everyone else around them at risk, and are the ones by far filling hospitals, morgues, and graves directly as a result of their own militant refusals to follow guidance with proven efficacy?

If you still blame the DOH and the Governor, you haven’t been paying attention.

LeRoy Sanchez

👍👍👍

Barbara Harrelson

I did not see a response from/about Presbyterian Hospital here in Santa Fe. Would be good to know the status and prospects for all local hospitals.

Joe Brownrigg

[thumbup][thumbup][thumbup]

Robert Fields

[thumbup][thumbup][thumbup]

Steve Boyles

Every unvaccinated person increases the risk on my child getting Covid. And it's an unnecessary risk.

Robert Fields

It truly is upsetting. These people are militantly ignorant and somehow they justify not caring about their fellow humans. They are about as selfish and ignorant as you can get.

It’s a totally unnecessary risk.

BARRY SILVER

will the unvaccinated now get vaxed and put on their masks?

or have they no shame? will this focus their attention on our obligation to our neighbors? or will they strut down the path of proud ignorance to negligent manslaughter?

Jonathan Owen

They are shameless for the most part. My big concern is for the undocumented who may be afraid to get the vaccine due to fear of deportation or lack of English language skills.

Robert Fields

[thumbup]

Robert Fields

I don’t think it’s lack of shame. I think they are literally brainwashed into thinking the vaccinations are deadly and dangerous. The far right media has been overrun with commentary citing VAERS risks (which is the totally wrong thing to cite), stories of microchips, vaccine ineffectiveness, and so on.

Most laypersons don’t know how to interpret that kind of information and for whatever reason the ignore the proof in the pudding results with relative hospitalizations and death rates between fully vaccinated and partial or unvaccinated.

We have a significant portion of the population that simply can’t process anything but do and don’t and are incapable of thinking critically. Even people on their own death beds, pleading for others to get the vaccines they didn’t, can’t break the stranglehold the college dropouts like Tucker Carlson and Sean Hannity have on them.

It took decades to cause this as people decided it was some kind of badge of honor to be ignorant. It will take decades to correct it.

And personally, I think they may have been helped along somewhat by an unholy de facto partnership between our Russian “friends” and facebook. That’s biting them back, though, as Russia’s own hospitals are being overrun.

What a world.

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