With the coronavirus surge overwhelming many hospitals in New Mexico, the state’s Department of Health on Thursday issued a “crisis care” order and a suspension of “non-essential surgeries.”
The order permits hospitals, if it becomes necessary, to prioritize their resources for COVID-19 patients that have the best chance of survival. In practice, it will mean that COVID-19 patients whose organ systems are failing and have comorbidities, such as heart disease or kidney disease, will be less likely to receive treatment than healthier patients.
“We’ve been preparing for this since April,” said David Gonzales, chief medical officer at Christus St. Vincent hospital in Santa Fe. “Our hospitals are at capacity now. But because the hospitals in New Mexico have been so closely aligned, the big institutions have been able to support the smaller ones, and that has worked very well … I hope we’ll be able to avoid that situation where we have to ration care.”
At present, Christus St. Vincent has about 40 COVID-19 patients, nine of whom are in the intensive care unit. Gonzales said the ICU unit was at 111% capacity, meaning that the hospital had to expand it from its usual 18 beds to 20.
Coronavirus-related hospitalizations have risen precipitously in the Southwestern state since mid-November, increasing from 506 on Nov. 15 to 916 on Thursday.
At Presbyterian Healthcare Systems in Albuquerque, 271 patients are hospitalized for COVID-19, including 57 in an intensive care unit, according to spokeswoman Alyssa Armijo. In total, 675 patients are hospitalized at Presbyterian, which is an increase of 30% from the same time last year.
“Presbyterian continues to exhaust every possible avenue, through expanding clinical spaces and increasing staffing, to care for more COVID-19 patients during the pandemic,” Armijo said.
Philip Baker, a paramedic and director of the rapid response team at the University of New Mexico Hospital, warned about how crisis care could play out.
“I don’t envy the providers who have to make the plans for if and when we have to determine who gets care and who doesn’t,” Baker said. “How would you feel if your grandmother was coming to the hospital, and they said, ‘Sorry, we have a patient who is A, B, and C versus your grandmother’s D, E, and F. So [that patient] is gonna get the care and the machines and the medicine they need, and your grandmother will have to go without.'”
Although UNM didn’t give out numbers on how many patients are hospitalized with COVID-19 or how many beds are in use, a spokesperson did say, “As the number of COVID patients continues to increase, we are adapting our plan to levels we have not seen before. We are now caring for patients in areas that previously had been clinics or other types of space.”
In addition to ordering crisis care, the Department of Health issued an order stopping nonessential surgeries in New Mexico hospitals from Friday until Jan 4.
The situation has taken an emotional toll on staff.
“Our numbers have gone up … and it is scary,” said Maria Paiz, a registered nurse supervisor and part of the COVID-19 unit at UNM. “It’s scary for me, it’s scary for my staff, it’s scary for anyone who has family, and it’s scary for our patients.”
Baker warned that the worst may be yet to come as rationing could eventually involve more than just COVID-19 patients.
“It’s not just affecting COVID patients,” he said. “How would you feel if you got in a car accident and you weren’t able to be seen in the emergency room? We take it for granted that we can show up to the hospital and receive care. With COVID and the influx of patients that we are seeing, there’s a real possibility that you show up to the hospital to get care, and they’ll tell you, ‘Sorry, we can’t help you.'”
