In a California hospital, patients who could barely breathe were crowded in a hallway because there was no room for them anywhere else. \u00a0This was in a TV news report in mid-December. That\u2019s what it looks like, I thought.<\/p>\n
Around the same time, New Mexico\u2019s healthcare system went over the line into crisis mode.\u00a0 It has swung back. It will probably go back and forth again, especially if we have the anticipated surge resulting from people who did not take the holiday warning seriously.<\/p>\n
New Mexico does not have enough hospital beds to cope with a surge of COVID-19. We\u2019ve known that since the beginning.<\/p>\n
We don\u2019t have enough doctors or nurses to serve those patients, if the case numbers continue to rise.<\/p>\n
Panels of experts have been organized, to make the decisions about\u00a0 who gets the ventilator and who doesn\u2019t, if those decisions have to be made.<\/p>\n
The governor cautioned, last spring, that New Mexico\u2019s healthcare system is not robust enough to respond to an explosive spread of the virus. She warned New Mexicans to follow the guidelines, including wearing masks and staying out of large gatherings.<\/p>\n
We heard from health care leaders. A few of these discussions were online and public. The CEOs of the major hospital systems described their plans for cooperation and sharing of resources. They talked about medical ethics issues and how New Mexico could be forced to ration health care. They did not want physicians to bear the burden of life or death decisions \u2013 who does not get the hospital bed or the ventilator — while standing in the hallway of the emergency room.<\/p>\n
There was talk of a statewide panel of medical ethicists who would create guidelines that doctors could follow.<\/p>\n
The science has progressed in the last several months. Ventilators are no longer quite as critical as they were back then. Treatments now exist that were not known in the spring. Those treatments are available only if there are doctors, nurses, therapists and hospital beds.<\/p>\n
New Mexico has been over the line. \u00a0Though I cannot predict our status on the day you read this, we have spent some days in crisis mode.<\/p>\n
The governor\u2019s executive order 2020-083 orders a new COVID-19 credential for physicians, nurse practitioners and other advanced health care providers treating patients with the virus or believed to have the virus. With this credential, they are considered public employees for the purposes of the state\u2019s Tort Claims Act. That ensures doctors treating COVID-19 patients have some of their liability exposure absorbed by the state.<\/p>\n
This order takes effect when the state reaches the point where \u201ccrisis care\u201d is necessary because there aren\u2019t enough resources for every patient. \u00a0At that point, the health care system switches from the standard of the best interest of every individual patient to the best interest of the state\u2019s public health.<\/p>\n
The governor didn\u2019t get us here.\u00a0 People who ignored the public health guidelines did.<\/p>\n
The executive order is on the governor\u2019s website. It\u2019s worth reading in detail.<\/p>\n
I also recommend a longer document titled \u201cNew Mexico Triage Protocol for the Allocation of Scarce Resources Under COVID-19 Crisis Standards of Care.\u201d \u00a0I especially recommend this document to you if you think your individual judgment is smarter than the science and you don\u2019t have to social distance or wear a mask.<\/p>\n
The protocol document is on the Health Department website. With almost mathematical specificity, it explains the statewide and local advisory boards and the standards for decisions that have to be made under crisis standards of care.<\/p>\n
As the policy documents explain, if someone in your family is the one denied a ventilator, it will not be the governor but a member of your community who will make that tragic decision.<\/p>\n
\u00a9 2021 NEW MEXICO NEWS SERVICES<\/p>\n","protected":false},"excerpt":{"rendered":"
In a California hospital, patients who could barely breathe were crowded in a hallway because there was no room for them anywhere else. \u00a0This was in a TV news report in mid-December. That\u2019s what it looks like, I thought. Around … Continue reading