How Gov. Michelle Lujan Grisham’s Big Bet on COVID-19 Testing Helped Curb the Outbreak in New Mexico
Michelle Lujan Grisham was ready for the coronavirus — or at least as ready as a governor can be for a once-in-several-generations pandemic to ravage every aspect of life in their state.
The former health secretary and U.S. representative from New Mexico who took over the state’s highest office in 2019 drew on her experience dealing with infectious diseases to get out in front of COVID-19. She declared a statewide health emergency on March 11th, when only four cases had been confirmed, and hospitals were offering free drive-through testing at hospitals just two days later. As of early June, New Mexico has administered more tests per capita than every state but Rhode Island and New York, a distinction that has helped prevent the virus from spiraling out of control in what is not only one of the nation’s poorest states, but one with an anemic hospital capacity.
As infection rates fell, some businesses in the state were allowed to reopen with restrictions on May 16th. “We’re going to demand in New Mexico that science guide every decision we make,” Lujan Grisham said during a press briefing in which she also stressed the importance of wearing masks. “We don’t want to go backwards and shut everything down.”
Just as crucial as early testing was Lujan Grisham’s early recognition that she couldn’t rely on the federal government. “I worked through the Trump administration as a member of Congress and was able to see the things that worked and the things that absolutely did not work, including the inconsistencies in getting valid information,” she explains over the phone to Rolling Stone. “I had that perspective.”
The interview was one of a series Rolling Stone conducted with governors during the month of May about the challenges of leading during the pandemic (including with Washington state Governor Jay Inslee and New Jersey Governor Phil Murphy.)
The interview was during a rare slice of free time for Lujan Grisham, immediately after one of her daily 2 p.m. coronavirus meetings. The conversation had been rescheduled from the previous weekend so that she could see her family for the first time in well over a month. “COVID-19 is 190 percent of what I do every day,” she says. “That’s why these large crises are really tough, because they’re on top of all the other things every human ought to be paying attention to in terms of improving quality of life and serving your constituents.”
How was the meeting?
I am — foolishly, some would say — trying to get these meetings down to a half hour. But I keep adding things that I want to know. They take about two hours. I get up to date, not just on the stuff that we look at every day, but we shift perspectives. What am I missing? How would I contain it differently? How does 7-day versus 14-day modeling compare? What about by county? I want to now look at average times of recovery by population segments. When you’re dealing with problem solving, you want to have as much information as possible.
In late February and early March, you didn’t have this wealth of data, and there were far more unknowns than there are now. What were you relying on back then when you were imposing a lot of these restrictions before the federal government and most of the rest of the country were even acknowledging the severity of the virus?
When I was secretary of health, we had a flu vaccine shortage and some very tough flu epidemic seasons. So I’m no stranger to the significance of any infectious disease, and I know the danger in a pandemic. You take an abundance of caution, even if you don’t know everything that you need to know. If there is no vaccine and no real treatment, then you better keep people from being in contact. I made quick and very broad, decisive actions, telling people to stay at home, closing schools, and narrowing essential businesses. We quarantined people coming across borders for 14 days. We were working on taking the temperatures of truckers coming in and out of the state and doing questionnaires about whether they were symptomatic. We really were aggressive on the front end, and I believe, unequivocally, it has paid off in where the state is today.
Are you worried about the degree to which the protests over the killing of George Floyd have pushed COVID-19 out of the news and will lead people to disregard taking the kinds of precautions you have been stressing for months?
People standing shoulder-to-shoulder in parks and streets and outside public buildings across the nation, even with scores of them wearing masks, presents an undeniable risk. I understand their anger and applaud their passion for justice. But I worry. We know how easily this virus can spread — and we know protesters could contract the virus and carry it unknowingly to their parents, grandparents, and other vulnerable populations. We have to remember we’re dealing with this urgent public health crisis even at this moment of national reckoning.
What was your response to Trump’s call with governors last week? What was going through your head as he stressed the need to “dominate” demonstrators?
All I could think was that he was dead wrong and steering the nation toward further anger, mayhem and violence. Dominance? That kind of implicit support for escalating force is what got us to this point. Dominance is a police officer’s knee on the neck of a citizen. Batons and tear gas and flash-bangs are not the tools to deflect the anger of peaceful protesters. Law enforcement’s role right now is to protect the peaceful protesters and prevent the small number of agitators from looting and escalating the situation. The president’s approach, that excessive force is the only way to address the anger and pain being expressed about excessive and unjust force, is wrong.
One of the things New Mexico was really out in front of was testing. Can you describe some of the ways making testing widely available early contributed to tamping down the spread of the virus and your ability to monitor it?
You need to know where the virus is presenting itself so you can get people isolated immediately and reduce overall transmission. When you reduce transmission, you also reduce what we call the density of prevalence of the virus in a community, and then you can take other actions. If you can’t do testing, you’re flying blind. Too many people are infected by the time you know you’ve got a problem. And though no state has an adequate health care system to deal with a pandemic, New Mexico, per capita, has half as much [infrastructure] as any other state. If we get this wrong, people will die because they can’t get health care. So I was really clear about that.
The federal government was not clear about the strategies they were going to undertake, so I became the testing expert. I basically did an inventory of lab assets. I knew exactly how many instruments we had. I learned what it took to get them calibrated to run the COVID test. I was clear about which COVID tests were the most viable and reliable. I went to every single manufacturer directly. I literally called the CEOs and the government relations people every single day until I got in the queue to get orders coming into New Mexico. We could keep expanding testing because I knew where my labs were, I knew where the instruments were, I knew what it takes to get it done, and it put us in a much better position.
How has your inability to rely on consistent federal support affected your ability to combat the pandemic?
I knew it was going to be challenging. A lot of the federal secretaries have no government experience, and many of them have no experience in the area that they’re asked to lead. The White House can be responsive, but the problem is that it’s hit and miss because they don’t have a strong federal design. They’ve got 50 different things they’re working on at a time for 50 different governors, which is why constituents aren’t getting what they need. It’s something they’ve arguably gotten worse on, at a time when we need more data, more information, and more confidence because we are reopening and introducing risk back into our communities. This is when the federal government really has to be consistent. The fact that they’re not is really a travesty. Frankly, I don’t see it getting better anytime soon.
New Mexico is one of the poorest states in the nation. To what extent have economic concerns factored into your decision making?
It’s a really hard balance. The national noise is that you have to choose between public health and safety, and the economy. I don’t believe that. I believe in prudent decision making, because closing the economy can be worse over the long haul. People are desperate. People have lost their businesses and lost economic security. When somebody will text me or call me and say, “Throw a bone to this industry and open up a little early,” that’s a political decision, and I don’t make any political decisions about this virus. This virus is nonpartisan. It will attack you no matter where you are or who you are. But people really pressure me, and I get it. I don’t dismiss that. The way people are all feeling is credible. But I have to look at the data to make those decisions.
The Navajo Nation has been hit particularly hard. Why has the outbreak been so bad there? What are some of the challenges in preventing it from getting worse in these parts of the state you don’t really have the same kind of jurisdiction over?
I have no control over a sovereign nation. I don’t think that I should. I had a call with every tribal leader in the state in early March when we were making all of these decisions. I got on the phone and said, “You have to shut down. You have to close the casinos. You have to close your hotels.” There’s a lot of risk because of their chapter government with layers of really complex organizational systems. In their families, what is incredible in terms of caregiving — support, pride, and faith — has become their Achilles Heel, because they have multiple generations living in one household. There are too many households without running water or electricity. They have to travel in order to get those basic supplies. They don’t have adequate health care. Their testing was taking weeks to get returned.
I alerted the White House that the risk was high and they need to do something differently. The federal government is in charge of their testing, in charge of their supplies, in charge of their hospitals. It’s all federal. [In New Mexico,] 50 percent and above — depending upon whether you look at mortality rates, of positive [COVID-19] case rates, or hospital rates — are Native American cases. If you took out the Native American positive cases in New Mexico, we would have the lowest rate of transmission per capita in the country, by far. This was a complete failure of the federal government.
What is being done to insulate the Navajo Nation and other vulnerable communities throughout the state against the effects of the pandemic in the long term, especially considering the lack of federal support?
We have isolation centers where we use available resources and can move you and your family, separate you into hotel rooms, and make sure that you’ve got food, water, security, and health care support — and move you if you get sick. What we tell people is that you need to self-isolate until you get your test results back. If you live in an urban area, you can go right home and you’ve got water and electricity and shelter — all the things that you need. You’re going to get an answer in 24 hours at the most. If you’re in Navajo Nation, you might not get an answer for a week, and you need to go out and get other supplies. You might have a dialysis appointment or any number of things you have to go to, yet you don’t have any information. Neither do we, so we can’t do the contact tracing. It’s terrible.
But I’ll tell you what: We’re going to get a hold of it. The Navajo Nation has been incredible, and we’ve got a rapid response team with some of the best scientific and medical docs in the country, all working together to think about how we can contain it faster. If the federal government can step up its game, that’s great. But I have to operate as if they’re not going to. We have to have all of these things in place because we can’t tolerate losing one more life. Not one. We can’t have one more person get sick. We can’t have one more family be decimated by this virus. It is cruel, and unfair, and unjust. And we will do everything in our power to fix this.