As New Mexico confirmed its sixth case of COVID-19 on Thursday and the number of deaths caused by the pandemic approached 5,000 worldwide, a question emerged: How are the state’s hospitals preparing for a potential increase in patients?
State officials say each major hospital has its own “surge plan” that it would follow in the case of a sharp rise in patients due to coronavirus, and some facilities are already seeing an increase in people showing symptoms and requesting testing.
Lovelace Medical Center in Albuquerque, for instance, has already initiated the first step of its plan, instituting an “incident command team” that monitors staffing and supply levels.
“Currently, we are filling up our ICU — it’s a very busy day,” Dr. Vesta Sandoval, chief medical officer at Lovelace, told The New Mexican. “We’ve already gone into what we would consider a situation where we’re going to have to actively manage and be very alert and aware of what’s happening within the hospital.”
The crisis intensified in New Mexico on Thursday with head-snapping regularity:
- The state announced its fifth and sixth presumptive cases, including a second person in Santa Fe County.
- Health Secretary Kathy Kunkel issued an order prohibiting mass gatherings of 100 people or more.
- The state Public Education Department said public schools in New Mexico would close beginning Monday.
- In Santa Fe County, more conferences and events were canceled, senior centers announced closures starting Friday, and popular entertainment venue Meow Wolf temporarily suspended operations.
- The second case in Santa Fe County is a woman in her 50s who recently traveled to Italy, a hot spot for the outbreak, and is now at home in isolation.
Nationwide, the situation worsened considerably. Professional sports leagues announced they were ceasing play and college basketball’s March Madness was canceled. Broadway theaters and Disneyland and Disney World closed, and the Dow Jones Industrial Average recorded its biggest daily drop since the 1987 stock market crash.
In New Mexico, state and hospital officials have stressed the great majority of people diagnosed with COVID-19 — 80 percent, according to Presbyterian Healthcare Services — do not require hospitalization. And of those who are hospitalized, a small percentage need intensive care.
Still, Gov. Michelle Lujan Grisham has said she is prepared to use every resource at the state’s disposal should there be a rapid increase in the number of people who require care. That includes finding ways for hospitals to stretch their capacity and could even include calling on the National Guard to deliver supplies if necessary, Lujan Grisham said Wednesday.
“Every single tool we would need to treat, serve and protect New Mexicans will be made available,” the governor said.
State health officials also announced expanded testing for the virus Thursday, as TriCore Reference Laboratories began to offer a diagnostic test of respiratory specimens for COVID-19.
“The capacity to test in New Mexico is significantly increased to meet future demand with TriCore testing,” said Michael Edwards, director for the Department of Health’s Scientific Laboratory Division.
While that will make it easier for New Mexicans to get checked, it could also accelerate the pace of confirmed cases in the state by the very nature of more people being tested. And that could increase the workload at hospitals.
New Mexico has a total of 344 intensive care unit beds, with 54 open right now, according to the Department of Health.
Christus St. Vincent Regional Medical Center in Santa Fe said Wednesday its 200-bed facility was already at capacity. If the Department of Health inquires about admitting a COVID-19 patient, the hospital will care for the patient if it’s not at capacity, but it “will defer to the Department of Health” if it’s at capacity, said spokesman Arturo Delgado.
“In any mass casualty or patient surge situation, we would work to evaluate and discharge patients, if and when appropriate, to make room for more patients,” Delgado said. “So yes, we would absolutely do what we needed to do to provide care for our community.”
In the case of Lovelace, the hospital hasn’t hit capacity. But if it did, the facility already has a plan in place to expand the number of patients it can treat.
For instance, it could stop elective surgeries to free up more resources or transform other areas of the hospital to create more critical care units, Sandoval said.
Sandoval said Lovelace already has some experience carrying out a similar emergency plan, such as when its entire intensive care unit filled up during the H1N1 flu pandemic in 2009.
“You just have to have increased flexibility,” she said. “It’s a situation where you have to rely on the resources you have at hand and the people you have at hand, and everybody has to work as a team.”
Some hospitals could also transfer patients to other facilities in the state. Presbyterian Hospital in Albuquerque said it currently has capacity in its intensive care unit and could move patients elsewhere in the event of a rapid increase.
“Throughout the Presbyterian system, we would accommodate a surge in patients due to COVID-19 through triage and appropriate transfers to other facilities in New Mexico, in close coordination with the New Mexico Department of Health,” said Dr. Jeff Salvon-Harman, chief patient safety officer at Presbyterian Healthcare Services.
Presbyterian’s medical center in Santa Fe does not have an intensive care unit, but it could care for patients who need hospitalization at a level of care that the facility provides, Salvon-Harman said.
“Throughout the year, we conduct drills and exercises and have a standard plan in place so we are prepared for a possible widespread infection event,” he said.
Some facilities were less forthright about their surge plans. The University of New Mexico Hospital and UNM Health System said they were following their “pandemic influenza plan” and were “very prepared.”
But when asked for specifics on that plan, spokeswoman Alex Sanchez only sent a link to the Bureau of Health Emergency Management’s publications and resources page. A follow-up request to Sanchez for the UNM plan was not answered.
Sanchez did say that the hospital could set up “different triage areas” in the event of a patient surge.
“We have to have the ability to take patients, especially in a situation like this,” she said.
The Department of Health said it has been “working for weeks with the hospitals to identify alternative care sites” in a scenario in which certain hospitals reach capacity.
“If they say they are at capacity, DOH would contact our other partners,” said David Morgan, a spokesman for the department.
The agency said the names of the specific alternate care sites were “not being released at this time.”
“Alternate care sites would be activated as a crisis standard of care measure and the locations need to be protected until that time,” Morgan said.