A surge of viral infections, including the novel coronavirus, respiratory syncytial virus — better known as RSV — and influenza, across the state is increasing admissions at Southern New Mexico hospitals’ emergency rooms, and ballooning wait times.
On Dec. 5, the New Mexico Department of Health issued a public health order allowing hospitals to increase capacity and transfers of patients because of rising RSV admissions in addition to COVID-19 and influenza. The order directed hospitals to return to a “hub and spoke model” that allows to facilitate more transfers, based on the severity of patients’ condition. This shifting of patients to facilities with the most capacity was a strategy during prior peaks of the coronavirus pandemic, which continues in its third year.
Many New Mexico hospitals are already operating at or above capacity in recent weeks, following a national trend attributed to what’s been dubbed the “triple-demic.”
“The emergency department has seen upwards of 120 to 140 visits per day,” said Dr. Dolores Gomez, chief medical officer at Memorial Medical Center in Las Cruces. “On average, they see between 80 to 100, so adding 20 to 40 more visits in a day with the same staffing can be very taxing on our system.”
Gomez said this has extended wait times by hours, as a “bottleneck” occurs in the emergency rooms.
MMC expands children’s unit
The recent state order also allows hospitals to submit waivers to the federal government, which removes their liability for certain billing practices and health and safety standards — such as adding beds above capacity, or setting up screening tents. The order is in effect until rescinded.
Memorial Medical Center is the only hospital in Las Cruces to provide inpatient care for children, Gomez said, making it a “hub” to receive transferred patients from across the region.
“We are called on a daily basis by some of the smaller hospitals who either don't have a pediatric unit or they know that this child will require admission,” Gomez said.
She said capacity limits at MMC and other hospitals in El Paso mean that sometimes the hospitals have to deny patient transfers, until a bed opens up.
The hospital filed a waiver, she said, and expanded its inpatient children’s care from eight beds to 20 beds, with the 12 expanded beds used as an overflow unit. She said typically 10 to 12 of the beds were in use at any given time, mostly for more severe cases of RSV.
“On average, we're probably admitting about four to eight new pediatric patients a day. The turnover is fairly quick, so you're also discharging about that number at the same time,” Gomez said. “It's definitely keeping us at capacity.”
RSV is a highly contagious virus spread through the air after an infected person coughs or sneezes, or touches infected surfaces. People of all ages can catch RSV, but serious infections of the respiratory system can harm infants, people with heart and lung disease, older adults or anyone with a weaker immune system.
While medical supplies are currently not an issue, she said, the hospital is “being judicious” with supplies on antiviral medication for flu and breathing treatments used for asthma, which are both in shortage nationwide.
Gomez said with the waivers the hospital hopes to hire additional staff that can care for children. The hospital is also preparing for a possible future increase in adults, most likely influenza admissions.
“We are still seeing upswings from COVID, as well,” Gomez said.
Residents can help slow the spread of viruses. Gomez urged masking indoors, good hand hygiene, staying home when sick, and getting the flu and COVID-19 vaccines.
“Masking can make a huge difference in terms of reducing the spread and also getting other people ill,” she said. “We’re not just worried about patients but also our workforce. Being able to do these things, not just for COVID-19, but now for flu and other viral illnesses can make a world of difference and take away some of the burden in our medical facilities.”
Three Crosses Regional Hospital and MountainView Regional Hospital in Las Cruces did not respond to repeated requests for comment.
New Mexico is experiencing “very high” levels of respiratory illness, a catch-all category encompassing COVID-19, RSV and other seasonal viruses, according to a Dec. 10 report from the state health department. South-central and southeastern counties’ levels tend to be “high” or “very high.”
Admissions rise in other Southern NM hospitals
In early December, the emergency room at Lincoln County Medical Center saw 77 patients daily, said CEO Todd Oberheu.
“We typically run 35 to 40 patients here in Ruidoso, so that’s double what we would consider a normal day,” Oberheu said.
The 25-bed, critical access hospital in Ruidoso also runs clinics in the surrounding communities of Capitan, Hondo, Corona and Carrizozo.
“We are right there, at our normal licensed capacity, but so far we’ve been able to handle most everything we need to,” Oberheu said.
Lincoln County Medical Center does not have any intensive care beds for children.
“If we end up having a patient that requires pediatric ICU, or even a situation of a 3-, 4-week-old child with RSV, we assess that position to determine if we’re capable of treating that,” Oberheu said, adding that the hospital will transfer children to Albuquerque, Las Cruces, El Paso or Roswell, depending on bed availability.
In Alamogordo, Gerald Champion Regional Medical Center had 10 COVID-19 patients admitted to the hospital as of Dec. 13, said Lillie Lewis, spokesperson at the hospital. The daily patient count has crept upward since earlier in the fall.
“We were down to having less than five to no COVID-19 patients in September and October,” Lewis said. “In November, we saw those numbers begin to go up. Today was the highest number since 2021, or early this year, with 10 patients with COVID-19 today.”
Gerald Champion Regional transfers young children requiring admission to Las Cruces.
Melissa Suggs, a spokesperson for Carlsbad Medical Center, said no one from hospital administration was available for an interview. The hospital, like others in the region, are seeing increases in RSV, COVID-19 hospitalizations and flu rates.
“We still have inpatient bed capacity and have been able to accept patients from other parts of the state and west Texas,” Suggs wrote in an emailed statement.
Statewide, an average of 185 patients are in the hospital each day because of COVID-19, according to The New York Times pandemic tracker. A total of 27 people are in ICU’s due to the illness, and an average of three people die per day.
Mimbres Memorial Hospital in Deming did not return requests for comment.
Medication shortages strain pharmacies
Caring for sick children has become more difficult as nationwide spot shortages of medications are straining pharmacies. Major chain pharmacies CVS and Walgreens announced Monday limits on children’s pain relievers and fever reducers.
Dale Tinker, executive director at the New Mexico Pharmacists Association, said state pharmacies were experiencing the “fairly dramatic shortage of medications such as amoxicillin and Tamiflu.”
Amoxicillin is a common antibiotic used to treat infections in lungs, such as bacterial pneumonia, but also middle ear, strep throat, ear or urinary tract infections. However, it's not a treatment for viral infections, like RSV, coronavirus and flu. Tamiflu is an antiviral medication to lessen the symptoms of influenza infections.
Pharmacists in Las Vegas and Carlsbad described long-standing shortages of medications, including antivirals and children’s fever reducers.
“It’s got to be a month now since we’ve had children’s fever medications,” said Pharmacist Brent Barrow at RioGrande Care Pharmacy in Las Cruces.
Most doctors and pharmacists are substituting amoxicillin for other antibiotics, but even that is reaching its limit, said Jack Volpato, a pharmacist for 35 years in Carlsbad.
“Just about any children’s antibiotic is in short supply,” Volpato said.
He said he is eking by on Tamiflu, getting very small shipments at a time, but said other pharmacies in the state are not so lucky.
“Pain and fever reducers – those are the ones that don’t seem to have any end in sight,” Volpato said of the shortages.
Many pharmacies offer both flu and COVID vaccinations. To find flu vaccine near you, visit Vaccines.gov. For COVID-19 vaccinations, visit ItsTimeNM.org. There is currently no approved vaccine for RSV.
Danielle Prokop is a freelance journalist working with the Southern New Mexico Journalism Collaborative, a partnership of local news organizations covering topics of importance to residents in the southern half of the state. The Collaborative’s current focus is COVID-19 recovery.