‘An Optional Pandemic’

A resurgence of COVID-19 spearheaded by the highly transmissible delta variant is sweeping across South Carolina, inflating daily COVID infections to levels that haven’t been seen since before vaccinations became widely available and leaving hospital staff fearing for a return to another emergency situation.

“We’re not there today,” Dr. Patrick Cawley, CEO of MUSC Health told the City Paper last week. “I certainly hope that does not happen, but we want to continue to watch this day by day, week by week … we have a chance today — if people get vaccinated this week … hopefully we never get into a situation like we ran into last year.”

But, the situation is already dire. Reports nationwide detail stories of those hospitalized with severe symptoms asking nurses and doctors for the vaccine only to be told it’s too late. One hospital in Louisiana is facing overwhelming influxes of patients, according to a CNN report, leading to ward closures and a skyrocketing ICU population.

The South Carolina Department of Health and Environmental Control (DHEC) statewide hospital bed capacity tracker shows 8,537 of 89 hospitals’ 11,165 inpatient beds were occupied as of July 27. Of those occupations, 453 were COVID-related, and 29.36% of those inpatients were in the ICU.

MUSC’s Epidemiology Intelligence Project shows that while hospitals are still well-equipped to handle the surge, climbing numbers will eventually threaten area hospitals. As of Aug. 2, 74% of MUSC inpatient hospital beds were occupied, and 72% of ICU beds in Charleston were occupied.

And even though hospitals are not facing extreme circumstances here yet, the rates of infection are still growing. 

“We need to look at two things: you need to look at the number of actual infections that have happened, and those do remain low, but then you really need to look at the leading indicator … the rate of change,” Cawley said. “The rate of change has had a very, very, very steep uptick in the last three or four weeks. It’s just a matter of time before the total number of cases will start increasing.” 

There is one key difference between this new wave of hospitalizations compared to last year’s — the ages are getting lower.

“Almost everybody we’re seeing in the hospitals are people that are unvaccinated, first of all,” Cawley said. “So if you look at who’s not vaccinated, it’s very, very little for the older age groups — it’s the middle age groups, and it’s trending lower.”

Mayor John Tecklenburg and Dr. Patrick Cawley encouraged masks and vaccination at a July 29 press conference | Provided

Cawley said while the likelihood of getting a severe infection had been lessening for younger people, the more-transmissible variants are closing the gap.

“You’ve seen the stories, these testimonials on the news,” Charleston Mayor John Tecklenburg said at a July 29 press conference. “You’ve seen those stories, and it’s real.”

Extra precautions advised to protect communities

The rapid spread of more infectious variants is prompting health officials to double-down on safety precautions that were thought to have run their course. 

New guidance from the federal Centers for Disease Control and Prevention are reminiscent of 2020 warnings, advising indoor masking, even for fully vaccinated individuals. This is because while fully vaccinated people are at low risk of infection themselves, they are still capable of transmitting the disease to others.

While some health experts are recommending local governments to impose mask mandates, Tecklenburg said that is off the table in Charleston.

“I don’t want to have to be fussing with folks about wearing a mask again or writing tickets again,” he said. “Let’s not go there. Let’s all go out and get vaccinated, then we won’t have to even deal with it.”

Cawley said that while it is well possible to prevent a second lockdown, he doesn’t think now is the time to rule it out. 

“It’s hard to predict these things and the impact they have,” he said. “At this point, there’s significantly more vaccines than demand. Even if everybody that has not been vaccinated wanted to get vaccinated tomorrow, we could easily handle that.” 

Hospitals throughout the state are taking extra precautions to protect staff. Charleston’s Medical University of South Carolina has mandated all of its employees get vaccinated. Now that vaccines are more widely available, these mandates are becoming more common.

And, the CDC has published extensive guidelines for schools, which are due to return to regular classes in the coming weeks. While school officials in South Carolina say they encourage masks and vaccines for all students attending school, they are unable to mandate it due to new laws passed by the legislature last year.

Vaccination remains best defense against COVID-19

Even with guidelines and mandates in place, the best defense against COVID-19 infection, including variants, remains vaccination. 

“Complete vaccination is the number one way to stifle the impact of the delta variant,” a DHEC spokesperson said. “Low statewide vaccination rates allow the virus to continue to mutate and new, more significant variants to spread.

“Just like vaccines have been overwhelmingly successful in saving populations from polio, tetanus, hepatitis, measles, whooping cough, the flu and many other diseases, we have life-saving vaccines that protect us from this new disease, including its variants, widely available,” the spokesperson said.

Tecklenburg said while COVID-19 has been a universal pandemic, one without a clear path out of, we’re now seeing an “optional pandemic” — one that the public can “opt out of” by getting vaccinated.

 Cawley said he couldn’t stress enough the safety and importance of getting vaccinated.

“You look at almost every health system in the country, the most vaccinated group, in the high 90%, is almost always doctors,” he said. “Physicians are trained to evaluate large amounts of clinical data and studies … they’ve looked at themselves and have decided to get vaccinated.”

Cawley denounced common “fables” he hears from those who show severe vaccine hesitancy, such as the speed with which they were developed and that the methods used by vaccines are experimental and unknown.

“The fable is that the vaccine is not safe and it’s not effective, and that is absolutely not true.”