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Creating a COVID-19 Hotel Isolation and Quarantine Program at the Gallup Service Unit

by Dr. Mia Lozada, Internal Medicine Physician, Gallup Service Unit, IHS Navajo Area

In early March 2020, here at the Gallup Indian Medical Center we knew that we had to plan ahead for the impact that COVID-19 would have on our communities. We began meeting with multiple local agencies, community groups and volunteers to assess what options we had for safe isolation spaces. We considered school gyms, recreation centers, churches, and outdoor tents with portable latrines and heating sources.

We also knew that social distancing would be challenging at shelters and detox facilities, and that our hospitals and emergency departments in town would be overburdened with patients with no safe place to go to isolate or quarantine. In addition, since many families live in multi-generational homes in close proximity, we had to plan for the likelihood that one family member would need a place to isolate away from others.

With the incredible collaboration of multiple organizations and individuals, including myself and IHS Internal Medicine Chief Clinical Consultant Dr. Jennie Wei, the Gallup Indian Medical Center, Rehoboth McKinley Christian Hospital, the Community Outreach and Patient Empowerment Program, the New Mexico Medical Reserve Corps, the City of Gallup and McKinley County, and with funding from the state of New Mexico and federal funds, the first patient was housed at a motel on March 24, 2020.

This was the first hotel isolation site to open up in New Mexico, which was shortly after the first COVID-19 case in McKinley County was identified on March 18, 2020. Over the course of the next few weeks, we quickly expanded the program to four motels, providing rooms for 140-160 individuals a day. 

The goal of the program was to provide anything that may be needed to ensure that patients could safely isolate without leaving their rooms. This included meals and 24/7 volunteers to help triage any needs of residents, ranging from snacks, clothing, toiletries, and other supplies. Each motel became a patient centered medical home of sorts, with its own team of providers and staff who did daily check-ins, along with a 24/7 physician telephone line that helped ensure that everyone got what they needed.

IHS Internal Medicine Chief Clinical Consultant Dr. Jennie Wei visiting patients at a hotel isolation site in Gallup, New Mexico

IHS Internal Medicine Chief Clinical Consultant Dr. Jennie Wei visiting patients at a hotel isolation site in Gallup, New Mexico

We were specifically concerned for the patients that might feel constrained in a room without the normal freedoms and healthy coping mechanisms, and how triggering this could be in the context of significant historical trauma. Behavioral health professionals, alcohol and substance abuse treatment counselors, certified peer support workers, social workers, and community health representatives were available and calling regularly. Chaplains and Navajo Interpreters also helped, and the Gallup Service Unit Office of Native Medicine provided healing herbs blessed by Native healers.

From March 24, 2020, through April 19, 2021, over 1,650 individuals have been housed at the hotel isolation program for at least one night. More than 45 volunteers from throughout the country donated over 8,500 hours from organizations.

There is no doubt that these efforts have helped to decrease the transmission of COVID-19, flatten the curve, and save lives. Not only have we been able to address people's acute medical issues, but we have helped many get sober for the first time in years, reconnect with family, and even stay engaged to the point where we have admitted over 45 individuals to inpatient rehab programs across New Mexico and Arizona. While in the hotel program, they have significantly decreased emergency department visits, run-ins with law enforcement, and nights spent in detox after being picked up under protective custody for alcohol intoxication. 

As a result of the partnerships and work on the hotel isolation program, other resources were established in the community and we continue to advocate for transitional and permanent supportive housing options to address homelessness in our community.

We also worked closely with the state and county to open up Four Corners Detox, a new sobering center and medical detox facility which is able to stabilize folks for up to seven days before transitioning them to inpatient rehab or other treatment and housing options. In their short time open, the detox center has transitioned over 30 people to inpatient rehab treatment options.

While the pandemic has hit our community incredibly hard, it has also shown what we can do when we work together to bring much needed resources to our community. While we want to take time to celebrate these victories, there is still much work to be done and we do not want to lose this incredible momentum.

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Dr. Mia Lozada, Internal Medicine Physician, Gallup Service Unit, IHS Navajo Area

Dr. Mia Lozada has worked at the Gallup Indian Medical Center in New Mexico as a general internist since August 2012. She leads the Internal Medicine Department's Quality/Performance Improvement initiatives, spearheads the Readmissions Task Force, and started the first Schwartz Center Rounds site in New Mexico at GIMC for staff well-being. She is board certified in addiction medicine and coordinates the medication assisted treatment prescriber group at GIMC.