NM meets virus benchmarks in hospitals ICU capacity

ICU capacity, PPE and testing covered

In the early days of the pandemic with reports of overwhelmed hospitals in Italy, Spain and New York, running out of protective equipment for frontline workers and uncertainty about testing were real fears in New Mexico.

But 10 weeks after the state reported its first case of coronavirus, New Mexico has so far managed to avoid such perils. Data suggests that New Mexico is in good shape in three major categories for keeping the virus at bay: intensive care unit hospital beds, personal protective equipment and testing capacity.

Still, Human Services Secretary Dr. David Scrase cautioned against using the data to stop social distancing or other protective measures. He likened such a move to a skydiver taking off the parachute 1,000 feet from the ground.

“Remember that social distancing measures is really what is controlling the virus,” he said during the governor’s briefing on Wednesday. “We’re not ready to completely reopen everything. We have to go slow. We have to look at data. We have to give ourselves a couple weeks.”

State health officials said Thursday that 11 more New Mexicans have died from COVID-19, bringing the statewide death toll to 294. They also announced 163 additional cases of the virus, pushing the total to 6,472.

There were some foreboding data concerning hospital space in New Mexico, which has fewer hospital beds than many other states.

The Kaiser Family Foundation reported in 2018 that New Mexico had 1.8 beds per 1,000 people, well under the national average of 2.4. Several nationwide analyses, including one by the Harvard Global Health Institute, said New Mexico was particularly at risk of being overwhelmed by a virus spike.

With that in mind, public health officials started planning for a crisis in March. Balloon Fiesta Park and the old Lovelace hospital on Gibson were eyed as potential sites to treat patients, possibly in a sort of Army-field-hospital style.

“With the effective transmission rate in New Mexico coming

down so far with all the social and public interventions that have happened, we don’t project that being necessary in New Mexico at all,” said Clay Holderman, the chief operations officer of Presbyterian Healthcare Services and a member of the state’s Medical Advisory Team.

Seven major hospitals throughout New Mexico were designated as hub hospitals to treat most COVID patients. And those facilities greatly expanded their ICU availability. And so far those contingency plans have offered more than enough space.

On Wednesday, there were 283 ICU patients throughout those seven hospitals, which includes COVID-19 and other types of patients.

Though those hospitals usually only have 230 ICU beds, they have been able to expand their ICU capacity to 460. There are also plans that, should the hospitals need to go into crisis mode because of a surge of patients, could create up to 614 ICU beds.

So far, Holderman said hospitals have expanded ICU capacity through such measures as making pre- and post-surgery rooms into ICU rooms.

At one point last week, the ICU capacity at the seven hub hospitals around the state ranged from 95% of normal at Eastern New Mexico Medical Center in Roswell to 129% at San Juan Regional Medical Center in Farmington. University of New Mexico Hospital was at 111% of normal and Presbyterian was at 108%, according to state data.

“We’ve actually done really well,” said Patti Kelley, the chief nursing officer at UNMH.

A coordinated effort by hospital officials has allowed patients needing ICU beds to be spread out across the different facilities.

“So far, because of the balanced approach between UNM, Presbyterian, Lovelace Health System and other regional hubs … we have tried to balance how many patients we all take at once so we don’t overwhelm any particular facility,” said Troy Greer, the CEO of Lovelace Medical Center. “So that’s allowed us to manage ICUs pretty well.

“We have not come anywhere near crisis planning.”

PPE

In the early days of the pandemic, the price for some protective equipment that usually cost about 10 cents each jumped up to $5 apiece in some cases, Holderman said.

“You saw the supply chain act in some mercenary ways and we did pay premiums to secure stock for our staff,” he said.

Personal protective equipment, or PPE, includes supplies like masks, gloves and gowns worn by doctors, nurses and other hospital employees who come in close contact with patients.

Such supplies were in high demand all over the world.

In Albuquerque, nurses and others at UNMH held a protest outside the hospital one morning in mid-April because they didn’t know the size of the hospital’s stockpile of protective equipment.

Hospital officials said there were concerns supplies would run out.

“That was by far our biggest anxiety, our biggest fear,” Holderman said.

But currently, many hospitals are reporting deep stockpiles of the equipment.

For example, at Lovelace, Greer said the hospital this week had a more than 30-day supply of gloves, nearly 60 days of surgical gowns and a whopping 366day supply of N95 masks.

“Lovelace is in very, very good shape,” he said.

State officials reported on Wednesday that hospitals across the state are meeting their supply goals of protective gear.

The stockpiles were created through several initiatives.

Hospitals were careful about organizing patients to lengthen how long an employee could wear the equipment. Different vendors were found, along with ways to extend the life of the equipment. And hospitals delayed procedures so they wouldn’t burn through supplies.

At UNMH, a PPE committee meets daily and has created guidelines to manage the equipment. Actions like wearing a surgical mask over an N95 mask are done to extend the life of the equipment.

“You have to be flexible with COVID being so new across the world,” said Kelley at UNMH. “We’re learning every day about how it’s transmitted and how we should keep people safe. So every day the PPE committee is looking at our usage and if there’s a better way to do it.”

Testing

New Mexico has the fifth highest per-capita coronavirus testing rate in the country, according to the Kaiser Family Foundation.

The state, including public and private labs, is able to process about 4,400 tests per day, according to the governor’s briefing. The state has set a goal of 5,000 tests a day.

Presbyterian and Lovelace in Albuquerque rolled out drive-through testing in mid-March.

Holderman said Presbyterian was initially taking about 200 samples to be tested for the virus per day. The hospital is now taking about 1,200, including mobile and in-patient testing.

“New Mexico gets an A for testing,” he said.

That said, there could be issues as the economy begins to reopen, he said. Testing can play a key role in monitoring the spread of the disease.

“There’s some fear … that there may not be sufficient test kits or lab capacity depending on how the public responds. So there is some worry about backup and delay,” he said. “But clearly we’re in the top 10 states in the country for testing per capita and we are ramping up at a rate that’s better than most.”