Home News COVID-19 Situation State enacts crisis standards of care for hospitals

State enacts crisis standards of care for hospitals

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New Mexico enacted crisis standards of care for the state’s hospitals for the second time during the pandemic in a revised health order issued Monday afternoon.

The health order recognizes what has been going on in New Mexico for about six weeks and offers hospitals across the state standardized procedures for making decisions about providing care and resources, said Dr. David Scrase, acting secretary for the New Mexico Department of Health. The health order will be in effect for four weeks.

“What’s really going on is that there has been a substantial change in universal health care operation,” Scrase said in a livestreamed press conference Monday afternoon.

Unlike December 2020, when the crisis standards of care were first enacted, there are fewer patients being treated for COVID-19, Scrase said. However, a combination of a shortage of nurses and people seeking delayed care for other conditions has filled hospital beds, especially intensive care units, to overflowing, he said.

“Right now this week, at the core of this is the lack of nurses to provide direct nursing care to patients in ICUs and general medical floors,” he said.

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The state is working on a contract to bring nurses into New Mexico, but the shortage is nationwide, he said.

Scrase said those who have sought delayed care are also sicker than they would be if they sought care earlier.

“Most of us think that the unprecedented increase in how sick the non-COVID patients are is related to delays in care,” he said.

The state is enacting the standards of care now, rather than weeks ago, because modeling showed the number of new cases would start to decline. However, that has not been the case, Scrase said.

“It just stayed steady and with the burden of illness that we’re seeing in our hospitals statewide — urban, rural, everyone in between — it’s just becoming harder and harder to deliver the highest level of care to everybody,” he said.

There is another further difference between this health order and December. Local hospitals will be able to decide when they enter crisis standards, rather than the standard applying statewide.

“A single hospital may invoke crisis standards of care for a period of time, just because they’re not able to handle the volume of patients or the complexity of patients,” Scrase said.

Before a hospital gets to that point, however, it will have to suspend non-medically necessary procedures. Physicians will be able to decide what is medically necessary, however.

“The state is not closing down medically necessary procedures,” Scrase said. “The treating provider is the one that decides if something is medically necessary,” he said.

If a cancer screening such as a mammogram or colon cancer screening shows a suspicion of cancer, then a needle biopsy or colonoscopy would be medically necessary, he said. Elective procedures such as a knee replacement might be delayed, Scrase said.

“I want to make it really clear, this doesn’t mean New Mexicans should wait to seek care. If you’re needing care, if you have an abnormal test, don’t put it off any longer,” he said.

In the daily case update, NMDOH reported 1,895 new COVID-19 cases in the state for Saturday, Sunday and Monday in 32 counties and three correctional facilities.

The report included 73 new cases in Chaves County, the most in southeast New Mexico. Curry County had 29 cases, De Baca County had two, Eddy County had 39, Lea County 36, Lincoln County 39, Quay County had four and Roosevelt County had 20.

Across the state, San Juan County had 384, Bernalillo County had 379, Doña Ana County had 148, Otero County had 131 and Sandoval had 118.

The total number of cases in the state is now 265,632 since March 2020, including 12,479 in Chaves County.

A dozen deaths related to COVID-19 were reported in Monday’s update. Three were in Curry County. Bernalillo, Quay and San Juan counties each reported two, and Eddy, McKinley and Sandoval counties each reported one death.

The ages of the deceased ranged from a man in his 30s from Bernalillo County to a man in his 80s from Sandoval County. Nine were hospitalized and eight had underlying health conditions.

The total number of deaths in the state related to COVID-19 is 4,942, including 196 in Chaves County.

As of Monday, 300 people were hospitalized for COVID-19 in the state.

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