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ALBUQUERQUE, N.M. (AP) — New Mexico on Monday cleared the way for hospitals to ration care if necessary, saying the state’s health care system has yet to see a reprieve as the nursing shortage continues and as many patients with non-COVID-19 illnesses and those who have delayed care over the last year are now filling hospital beds.

Health and Human Services Secretary Dr. David Scrase said hospitals already have been juggling patients with fewer resources since the pandemic began, and the order he signed sets up an “equitable procedure” for making tough decisions.

Hospitals can suspend procedures that aren’t medically necessary if they don’t have capacity, he said, explaining that some patients could see delays in care depending on which hospitals have to invoke crisis standards of care and for how long. Individual providers will be deciding what procedures are necessary.

Officials during a briefing shared maps that showed even the state’s most populated area had only two available intensive care beds.

“We’re in tough shape in New Mexico,” Scrase said, adding that enacting crisis standards doesn’t mean people should not seek care.

State officials also pushed for more people to either get vaccinated or get their booster shots, as the rate in New Mexico continues to hover just below 72%. About 5% of adults in the state have received booster shots.

There is a proposal being introduced in Albuquerque that would require the city’s police officers and first responders to be vaccinated or face termination. Those with exemptions would be required to show proof of negative COVID-19 testing every week.

Elected officials in New Mexico’s largest city already have acknowledged that the police force and the fire and rescue department have been overburdened even before the start of the pandemic with persistent violent crime, skyrocketing homelessness and other calls. Union members were expected to voice opposition to the measure.

The sponsor of the measure, Democratic City Councilor Isaac Benton, did not answer questions ahead of Monday’s council meeting about the potential effects or how the city could fill any gaps in emergency services that would likely result.

Mayor Tim Keller’s office issued a statement Monday, saying the city actively encourages vaccination for all who are eligible and has made getting tested and vaccinated as accessible as possible. The office also noted that a number of state and federal laws need to be considered when passing or implementing such a mandate and that the city’s legal department is reviewing it.

The push for mandatory vaccines among public safety workers in Albuquerque comes as police and firefighter unions as well as individual officers and first responders across the U.S. are fighting back by filing lawsuits to block mandates.

In Seattle, the police department was forced to send detectives and non-patrol officers to emergency calls last week because of a shortage of patrol officers that union leaders fear will become worse because of vaccine mandates. In Chicago, union officials said more than 3,000 officers were refusing that city’s mandate, with union leaders saying it was illegal because the city failed to negotiate the terms with the union.

There also have been protests by health care workers about mandates within their professions, and dozens of scientists, researchers and other workers at Los Alamos National Laboratory — the birthplace of the atomic bomb — also are suing over the lab’s vaccine mandate.

Albuquerque’s proposal would add the vaccine requirement to the city’s emergency declaration. The proposed amendment states that the pandemic is a unique crisis that continues to spread through New Mexico and that city employees who become sick can’t adequately perform their duties, which disrupts the orderly operation of the city government.

Many officers and first responders have questioned the purpose of the mandates, noting that they worked throughout the pandemic under the same conditions and shouldn’t be forced to get shots now.

The mandate for Albuquerque’s public safety workers would take effect no later than three weeks after approval. The council could vote as soon as mid-November.

A vaccine mandate was imposed by Democratic Gov. Michelle Lujan Grisham earlier this year for all state workers. Meanwhile, Bernalillo County officials have said they did not plan to require vaccines, pointing to staffing concerns.

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