[Editor's Note: The slide presentation PDF will be placed at the end of the article.]

By Mary Alice Murphy

Dr. David Scrase, New Mexico Human Services Department secretary, started out the meeting on Sept. 2, 2020.

"We will talk a lot about math and gating criteria," Scrase said. "At least three cases worldwide have been seen where the person has had two distinct COVID infections. The virus was genetically different the second time."

He noted that worldwide a person's chances of getting the coronavirus are much higher in lower income areas, such as Mumbai where the study took place. In New Mexico, the census tracks show that poverty groups catch the virus is five to six times higher, almost seven times, than in more affluent areas. He said the state is getting about 6 percent above the federal rate for COVID cases. New Mexico is the third lowest in the country for per capita income. Medicaid will see way more than its proportionate share of COVID cases.

Slide No. 7 shows the differences of spread by activity and numbers.
"That's why we are limiting occupancy in churches more than in hotels," Scrase said. "Poorly ventilated areas are the worst."

One of his slides showed different medications that are being used to treat COVID. "Why aren't we using some of these in New Mexico?"

He said that hydroxychloroquine is for parasites, not viruses. Azithromycin is used to treat bacterial infections, not viruses. Remdesivir, which is being used in New Mexico, is an antiviral, so it is what is appropriate to treat COVID-19. "We have seen good results with Remdesivir in New Mexico."

Scrase also talked about the need for people, even during COVID-19, to continue to seek routine and emergency health care. He said colon cancer is the second highest cause of death in the U.S. and is largely preventable through screening.

His graph showed a drastic drop in colonoscopies performed in major New Mexico hospital systems in March and April with an uptick starting in June and July, although the number is not back up to the usual rate. Scrase noted that about 23 million adults aged 50 to 75 are past due for screening and about 53,000 Americans will die from colorectal cancer this year. "It's much better to identify a small lesion before you get symptoms."

A questioner asked what point in the gating criteria could retail outlets open up further.

"COVID tends to enforce my opinion that people need to feel uncomfortable in public without masks on," Scrase said. "Yes, I know it's hard to enforce. Everyone wants to open up football games with full stands, but that will have to wait at least a year and maybe longer."

A Santa Fe Reporter reporter asked about plasma treatment.

Scrase said the FDA released emergency approval for its use. "Plasma can be donated every few weeks, but only 70 percent of recovered cases still have antibodies after three months, which may be an indication of how long the vaccine will last, too. Plasma is not very plentiful, as only one percent of the population has been infected and only a portion of those will have enough antibodies."

On his usual graph of cases among different age groups, he pointed out that the 20-29 year-olds are holding in first place at 20 percent.

He also noted that there has been a drop off in the amount of testing, because of less of a public demand. On testing positivity, New Mexico is in the top five or six of testing and getting the results out more quickly.

Scrase showed a chart that indicated that travel has stabilized. "Travel correlates best with case counts."

The state has put together a vaccine committee, which is looking at a plan. "We are asking people to get their flu shot this year in September or October. A COVID vaccine is expected in November and most people will require two injections of it."

Scrase introduced New Mexico Children, Youth and Families Department Secretary Brian Blalock. "He is one of the health secretaries in our morning huddle every day that continues to address items quickly. He is managing food and shelter."

Blalock said the collaboration among health secretaries has been great. "We in our department have a concern about child abuse. With the schools shutting down going into April, the number of child abuse reports dropped. Now they are coming back up to almost the same as in 2019 about this time. As school starts to reopen, we want to make sure teachers watch for child abuse."

He asked that anyone who sees signs of child abuse should call on their cell phone to #SAFE or to 855-333-SAFE (7233). "We can respond to make sure the child is safe, and the family has what it needs. A lot of what we've been doing during the COVID pandemic is making sure families have food, shelter and the cleaning supplies they need. We've talked about this before, but there is a growing concern about a behavioral health care crisis that will be following close on the heels of this pandemic, because of isolation, economic hardship and the sheer cost of this pandemic through death and the health crisis. We have the crisis line at 855-507-5509 or the NM Connect app, available on the Apple App Store or on Google Play. We have expanded telehealth for behavioral health issues."

Blalock said the food and shelter issue is rooted in department collaboration. "We respond to needs, especially in rural areas. We have delivered more than $2.34 million in emergency assistance that doesn't involve volunteers and schools. New Mexico has a strong food system, and we are no longer seeing incomplete deliveries. We have allowed online purchasing using SNAP and groceries delivered to your house. More than $1 million is spent a week online. We have ESF6 shelter operations for those who cannot safely isolate at home in non-congregate locations. The pandemic has acted differently from what we expected at the beginning. It had not overwhelmed hospitals. We have set up specialty shelters for detox and different medical shelters for those with co-morbidities. Most of the time, we've had 140-150 people sheltered, but the numbers are going down. The highest utilization was in Gallup and the next highest in Albuquerque. At the medical shelter, every single individual is connected with behavioral heath support for their well-being. We have also provided operational oversight and medical oversight."

Next Scrase went into the gating criteria update, where he said: "They are all in the green. The state, however, is still in the yellow because of the number of new cases per million. To go from red to yellow you have to have fewer than 80 news cases per million. We'll turn green when we get to 40 or the daily cases drop below 85. Quay and Lea counties are off the chart with about 10 percent new cases. We will use the 14-day averages to monitor to see if new cases are related to schools reopening or not. Our goal is to get the schools open and to keep them open. We have rigorous protocols for the schools. We will have cases and might have to close classes."

He mentioned the "fantastic innovation of transparent masks for the deaf and teachers of the deaf."

He and Blalock then entertained questions from the press.

The first questioner asked about the isolation centers and whether they would be long-term.

Blalock said they talk about that issue every day in the huddle. "We ask what a transition looks like. We don't want to have them open if they are not needed or closed if they are still needed. We won't pull out until the numbers are better." Scrase said the isolation centers are protecting other family members and cutting the spread.

A follow-up question asked about vaccine distribution centers. "Will New Mexico be ready for a potential rollout on Nov. 1?"

Scrase gave a "qualified no. We have public health offices in every county and more in the larger cities, so we think we can handle the distribution. But by Nov. 1, we won't know the side effects or longer-term effects. I could be wrong and there may be a bigger demand than I expect. I am telling people to get their flu shots in September and October."

Another press member asked about where to find county data on the cases. Scrase said it is on the data dashboard on the state COVID page. The test positivity rate is understated. "We don't double-count the positive tests." He noted that PED will have the information on its website. He referred to: https://www.covidexitstrategy.org.

Another questioner asked about the changes in policy in the public health orders. Scrase said: "Our bias is to reopen as much as we can safely, but not move too quickly." He cited camping for example and said the danger of camping in the wilderness is pretty safe, except from bears. However, camping with a larger group at a state park brings high risk. "We are looking for the public to cooperate with the public health orders."

The next press member asked two questions: How concerning is it to see the child abuse reports drop? And are you seeing signs of a behavioral health crisis?

Scrase said a study in June showed a 44 percent increase in anxiety and suicidal iteration. "In other countries with high rates of COVID, they have seen a major uptick in behavioral health issues. We made a quick change to telehealth and discovered that people may be willing to talk more about their problems over telehealth than in person." He said Dr. Neal Bowen gave a great presentation at a legislative sub-committee on the behavioral health issues.

Blalock said the virus is huge and at the forefront of most people's minds. "On the child abuse reporting issue, in March with higher numbers, we felt things were going well for communities. The dip in April was a huge concern. We have a similar concern about seeing numbers of domestic violence reports going down, too. If the overall reports went down, but we got the right reports, it would be better. First responders have done a great job at crisis reaction, but now they are exhausted. We're using predictive contact with those we have dealt with before. Youth suicide rates are lower, which is good news. The bad news is we had the highest rate in 2018. We've been in a behavioral health crisis for years."

Scrase reminded folks of the history of behavioral health services in the state. "They went away in 2013, out-of-state companies came in and only one survived. The 2013 issues also brought a lot of lawsuits, all of which have been settled. It's why we hired Dr. Bowen. We are trying to refigure behavioral health in New Mexico, so it works better for the providers and the patients. We show a greater number of people seeking care. We are putting a lot in place to face any surge in demand for services."

A reporter from KOB asked what specific data should be looked at for the 14-day quarantine of those coming into the state and what it will look like going forward.

Scrase said they are looking across America for more innovations on quarantines related to travel. Alaska tests people when they return. New York and Massachusetts monitor folks, and if a person comes from a "red state (meaning more Covid spread), they can't come in. We in New Mexico have exemptions for health-care workers, and if a person goes out of state to seek health care, and we are suggesting we may let non-custodial parents come to visit their children. If people treat Labor Day the same way they did July 4th, we're in trouble. Keep it small, keep it outside. We are asking you, the media, to help us get the word out. [Editor's Note: a poster toward the end of the slide presentation lays out the best way to prevent COVID spread over Labor Day.]"

Scrase said: "Some things we will have to give up for a year or more. And I think these large holiday gatherings are one of them. For Thanksgiving and Christmas, nothing will change with the virus. We will promote the same message as for Labor Day."

Another press member said an article in the New York Times indicated that although the number of positive cases in New Mexico is decreasing, the number of deaths is increasing and why that is the case.

Scrase said he has not seen that happening and doesn't think it is true. "The peak of deaths occurred on May 1, although there has been another uptick, but it's basically a plateau. It varies day-by-day. Hospitalizations, when necessary, come in about two weeks, and deaths at two to four weeks. We'll take a look at it and get back to you as well. We've done a lot of researching on excess deaths, which you brought to our attention and the number we have come up with is 730 more than in a normal year."

{pdf}mypdfs/FINAL_Press_Update_NMCOVID19_Day_1762020_09_02.pdf{/pdf}

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