By Hallie Richwine

"I know that many Americans and many New Mexicans have been glued to their computer screens and televisions, watching every vote be counted," Governor Michelle Lujan Grisham said at the beginning of the press conference on November 5, 2020. "I really appreciate those that are able to tune in."

"Given the data you've seen, you would be correct that the data is not good. We are not trending anywhere in the right direction," Grisham said.

"It's a hard truth to hear and I think New Mexicans really need to understand the situation we're in."

Dr. Denise Gonzales, Medical Director of Presbyterian Healthcare Services and Dr. Jonathan Marinaro, Professor and Co-Chief of the UNM Center for Adult Critical Care joined Grisham and Dr. David Scrase.

"We've lowered our flags to mourn the statewide losses," Grisham continued. "We can't go to funerals. We can't celebrate lives like we would prefer to do. It doesn't make the losses less significant."

"November is going to be really rough," she said. "There's nothing we can do to change that trajectory. It's sad to be saying that today, but it's true."

The fate of the hospital system in New Mexico is directly related to the number of cases. "For every case we know, there are many more people that might not yet know they have it," Grisham said. "That leads to overwhelming hospital and healthcare system clinicians, and leads to unnecessary deaths." Grisham said we can control the rate of infection, but aren't.

"When we were doing really well, we were doing surveillance. When we were looking for it, we were ahead of it," she said. "Then we were behind the virus and responding to outbreaks. It's the worst possible outcome to be in."

"We get numb that these numbers grow," Grisham said. "We cannot get numb to that. We cannot, when people are infected with potentially deadly viruses. The reality of overwhelming the health care system relates to the economic health of the state."

With a 260% increase in hospitalizations, the current trajectory is unsustainable. "Even if there is a bed for the patient, there may not be a nurse," Grisham warned. "We are in a dramatic crisis situation, this is and has been a public health crisis like no other."

Grisham believes New Mexicans can break the cycle. "It is too late to reduce the number of deaths," she said. "It's too late to reduce the hospital capacity and the impact on staff." November, it seems, cannot be salvaged. "We, as a state, as a nation, were not vigilant. It's too late, but I'm hoping we can come together as a state so we don't have to continue through December."

In Scrase's presentation he referred to the daily case numbers. "There is no cause for celebration. We have had a few lower days, but there is an upward trend in all regions."

Following the exponential trend of this virus' progression, more than 10% of the total deaths have been in the past two weeks. 16 to 17 percent of hospitalized COVID-19 patients do not return to their families.

"Every area of the state is in short supply of staff and beds," Scrase said. "Surrounding states are facing the same serious staffing issues."

Current modeling predicts ICU beds will be full by November 11-12.

Marinaro said the state of New Mexico and UNM are doing their best to save lives. "Every hospital has opened their Emergency Operations Center," he said. "This is a different virus from the original plan, but it still allows for adjustment during surges."

Marinaro reminded New Mexicans that the frontline staff has been working hard since the beginning of the pandemic. "They haven't taken a break. They're giving all they can to save lives."

"Critical care nurses are hardworking, dedicated souls that have done everything they can to learn about the virus," Marinaro said. "They learned from March to May and they are even better now." He said there is incredible technology, too, including ways to help improve lung function.

All physicians have been called to help take care of the larger volume of cases. "There are long hours, uncomfortable PPE, and the cases that hit our hearts," he said. "We have even had nurses that lost family members, and they come back to work."

"Please wear a mask, avoid exposure, and wash your hands," he said. "Wearing a mask reduces the likelihood of getting the virus, which is more effective than the therapeutic efforts later."

Gonzales spoke about the preparedness actions New Mexico hospitals are taking. "We have been able to set standards, and stockpile PPE," she said. "Treatments were unknown, and now we have new treatments. Some are FDA approved and some are for emergency use. Now we have peer reviewed trials to guide when to use those treatments."

"Due to leadership and forethought, we have secured additional contract staff," Gonzales said. "Travel nurses help increase capacity and give nurses relief." As the impact is greater on the hospital staff, resources are being set up to to help maintain their well-being.

"Every one of you can be a healthcare hero," she said. Practicing social distancing, limiting gatherings, wearing masks, and practicing hygiene helps alleviate the strain on our healthcare professionals by helping mitigate the virus.

Many actions are being taken to help manage the capacity crisis. At least 400 travel nurses have been contracted to help in New Mexico hospitals. Scrase said recruitment of retired and inactive healthcare workers is also a way to increase staff, including matching unemployed healthcare workers with crucial positions.

"Nothing about the virus has changed," Scrase said. "It is hard to have patience when we know what it is that we can do."

"New Mexico is very fortunate," Grisham said. "We have had to leverage resources. Some of the research for deadly diseases is developed right here in New Mexico. We have great research institutions."

She wants New Mexicans to know that even though the state is a leader in research, the number of cases cannot be managed. "For expecting mothers, we don't have enough beds and staff. The state cannot manage this healthcare crisis in the way we desire."

"It's too late for November. Too many New Mexicans will lose their lives through November," Grisham warned. "Too many healthcare workers will be exhausted. It's too late to stop that." She reminds New Mexicans that the current system won't be able to rely on airlifting elsewhere, since beds are already taken in so many hospitals.

"You can do it. We can do it. Let's turn it around for December," Grisham said.

When asked if further restrictions will be added to the public health order, Grisham said she is prepared to take dramatic action like earlier in the pandemic. "If it's not better by December, we will have a terrible January. We want to be able to have an in-person legislative session," she said. Even then, the focus will be on emergency powers.

"New Mexicans know I am prepared to make decisions," Grisham said. She will watch modeling before making any decisions. "This will never disappear. If we manage to get a vaccine we won't have to shut down. We have to find better ways as a state and as a nation to manage [the virus.]" Grisham said it's unreasonable to think that everyone can stay at home until September. "I don't think anyone anywhere is thinking about sustaining that. We need to find the right mix of strategies that are manageable through next September."

Grisham said violations to the public health order are disrespectful to those that are doing their part. She said enforcement should do more, but also commended Ruidoso's first responders for putting together a video about wearing masks. Ruidoso, a village that relies heavily on tourism, has put out several "Ruidoso Safe" videos.

"These COVID briefings are fact- and science-based. They are not intended to scare New Mexicans," she said. "I hope you hear that in our approach. This is a crisis, on steroids, plus. We are in real trouble and there is no backpedaling." Grisham reminds New Mexicans of the tragic trajectory of Italy earlier in the pandemic, when cases rose so quickly that there was no room for even triage care.

"We don't have to go to Italy," Scrase said. "It is happening in El Paso. The rapid acceleration of cases, which produced a rapid deluge of patients needed hospital care, which led to using every possible space; then tragically a significantly higher number of deaths. There was a much higher death rate from not being able to care for patients, and then not enough people to take care of the deceased."

Gonzales said healthcare professionals will work hard to maximize the number of lives saved. "There are guidelines for who to treat versus not based on who may not survive," she said. "The numbers are showing us now that we might have to make decisions. It's a very extreme situation, and contrary to what Americans think of as health care."

"There's a rise in cases, then hosptilratizations, then deaths," Marinaro said. "It's not a mystery." He said the best thing the State can do is follow science.

"We need some data folks to really start to look at what the trends are in clusters, and outbreaks in zip codes," Grisham said. "Most New Mexicans are doing 20 things. Trying to link them all is complicated. If we're going to manage this until next fall we need to know which actions cause the highest risks."

You can see the entire slide presentation here.