As Tri-county COVID numbers fall from July peak, expert outlines concerns for autumn

The latest update from the MUSC COVID-19 Epidemiology Intelligence Project shows the growth rate is still going down. The seven-day average in growth of new confirmed cases is now just 0.6%

Michael Sweat, Ph.D., leads the COVID tracking effort. “People should feel good that things have come down so much since early July. The decline we’ve seen is evidence that individual behaviors are working,” he said. But he added, “in the past week the Charleston area has seen some increases in the number of cases being diagnosed every day, so it is definitely not the time to go back to things like it was pre-COVID times.” 

As summer winds down, he sees four risks for the fall season: holidays, school, prevention fatigue and our tendency to let down our guard when conditions improve — something Sweat called the paradox of prevention.

Holidays 

Holidays are a time when people typically travel, see family and gather in groups. Will COVID curtail that — or join the celebrations as an unwanted guest? Sweat isn’t sure.

“We have Labor Day coming around. Then Thanksgiving is not too far off, and eventually, Christmas. Those are big holidays,” he said.

At this point, he’s most concerned about Thanksgiving. “It’s such a big holiday for families to get together, so it’s going to be really culturally challenging not to get together in big groups. That could be a real risk. We just don’t know.”

School

While most schools are at least partly online, Sweat said we’re likely to see a slow reopening. That could reopen the door to the coronavirus if people aren’t careful. 

“The science is not 100% clear, but with university students, it’s not looking good. There have been multiple outbreaks. The University of North Carolina opened up, and the same week, they had to close down again.”

Fatigue

Those students, like many other people, may be tired of worrying about the coronavirus all the time. Sweat said that fatigue is a risk factor for COVID if it leads them to put away their masks and stop social distancing and start gathering in large groups. 

It’s happened in other places. “In Spain, you saw a huge outbreak, then they got it way down in a couple of months. But then, about two-and-a-half months later, it went back up again,” Sweat said. “If you look at our trends, you see the same thing here.”

 

Here’s what he’s talking about. South Carolina started to shut down in mid-March to prevent the spread of the coronavirus. For the most part, people stayed home. But by the time Memorial Day rolled around, restrictions had been eased and a lot of folks went out again to bars, restaurants, beaches and elsewhere. That allowed the virus to spread.

By the Fourth of July, cases hit a new peak. Since then, the numbers have gone down as people take the virus seriously. Will that last? Sweat hopes so.

“Two-and-a-half, three months — that seems to be how long you can get people to really be vigilant. If that’s true, and I hope it’s not —  I hope we’ve learned what we have to do to keep cases down —we could see an uptick sometime in October. I think that’s a potential risk. People can’t stick with it and start testing the limits.”

Paradox of prevention

Another challenge heading into the fall is what Sweat called the paradox of prevention. “When things are really good, you need prevention to stop them from getting bad. But people are more willing to do them once they’re bad. You sort of wait for the problems to develop,” Sweat said.

“We could live with this epidemic indefinitely if we keep up the precautions. People are waiting on a vaccine, but we have tools that work right now: masking and distancing.”