Crisis moment is here for hospitals | Editorials
State hospitals are facing the real possibility that “crisis care” standards will be put in
State hospitals are facing the real possibility that “crisis care” standards will be put in place, and soon.
It’s just the kind of news no one wanted to hear.
Crisis care, a term that’s exactly as foreboding as it sounds, is a standard that acknowledges the coronavirus pandemic is out of control, with hospital beds and intensive care units at or near capacity. As a result, resources will go to patients with a better chance of life, real-world rationing of treatment that will help decide who lives or dies.
Doctors from the Lovelace, Presbyterian and University of New Mexico health systems on Monday conducted an online news conference to again plead with the public to save the very institutions that may save their lives. On Tuesday, another news conference with Dr. David Scrase, secretary of the state Human Services Department, discussed just how crisis care standards could be implemented. It’s still not too late.
Sensible prevention strategies — masks, social distancing, no large gatherings — could help hospitals from reaching the point where standards better left to a battlefield are brought to civilian hospitals. A two-week shelter-in-place order is working as it is designed to — slowing cases. But we still don’t know what gatherings at Thanksgiving will do to numbers and how increases in COVID-19 cases will affect already-strained hospitals. And then, there’s the upcoming holiday season to consider and, sadly, fear.
When demand outpaces resources, the crisis care standard will be put in place. At that point, it’ll be up to local triage boards in place to make difficult decisions and allocate who gets what.
It is a nightmare scenario for overwhelmed hospitals and medical professionals, just one step from doomsday. But it’s the track we’ve been on since October, with the state and nation watching cases on an ever-upward trajectory.
The result: full hospitals.
If it were just about treating COVID-19 patients, that would be one thing. But a hospital is a one-facility-treats-all institution. Who wants to be a parent whose child has a burst appendix and needs emergency surgery? What about a car crash victim? Someone who needs cancer surgery? Weighing down the medical system to the breaking point hurts in countless ways, with the damage likely to stretch long past the pandemic. It’s not just hospitals, but up and down the system. Screening tests don’t happen. Vaccinations are delayed. Surgeries to fix minor problems are put off and major health issues result.
The surge of cases, leading to increased hospitalizations and to more deaths and long-term health concerns for survivors, has exposed the many frailties of our health care system.
As Gov. Michelle Lujan Grisham has made clear since the beginning, New Mexico needed to be more stringent when it came to lockdowns and mask mandates and other public health strategies because our system has little margin for error. We rank near the bottom in the United States for hospital beds per 1,000 people. We have an older population and one with more underlying conditions. We also are geographically spread out, with people lacking access to doctors and care. We don’t have enough doctors and nurses to take care of people in good times, much less in this crisis.
That’s why, on the other end of the pandemic, we need policies to rebuild individual wellness and the health care system from top to bottom. From shoring up rural hospitals and clinics so people receive better preventive and routine care, to adding the necessary beds in urban hospitals, to improving access to health care for all … we have much work to do. It’ll be a worthy question to ask those who someday will ask for your vote: What did you do to improve our health care system?
We can develop more programs such as the one at Capital High School to train future health care workers — build our own workforce, pay them and help them with housing so we have people to do the necessary care. Address underlying health issues — and this is no easy task — to make sure all New Mexicans have nutritious food, places to exercise and information about how to stay well.
Today, our health care system is nearing overload, but we will make it through this dark winter. Before the next pandemic hits, however, New Mexico must overhaul its structural problems and build a sturdier system that keeps people healthy, as opposed to meeting them only when they are sick.