Time of transition in pandemic

March 09, 2021
Respiratory therapist Movita Singleton, right, and respiratory therapy coordinator Julie Wood check on a patient's chart in the COVID unit.
Respiratory therapy coordinator Julie Wood, left, and respiratory therapist Movita Singleton check on a patient's chart in the COVID-19 unit. Photo by Sarah Pack

As the number of new COVID-19 cases continues to drop, both nationally and in the Charleston Tri-county area, the leader of the MUSC COVID-19 Epidemiology Intelligence Project said it’s time to start talking about transition. “We have to be careful in this. We have to be patient.”

When he brings up the subject of transition, Michael Sweat, Ph.D., isn’t implying COVID is kaput. There’s still the threat of another surge due to variants. It’s also hay fever season, so people may mistake COVID symptoms for seasonal allergy issues, leading to undiagnosed infections that help the virus spread. 

Meanwhile, Sweat estimates the percentage of Charleston County residents who have immunity either from having been infected during the past three months or from vaccination is only around 40%. Statewide, it’s 37%.

Dr. Michael Sweat 
Dr. Michael Sweat

But by early May, depending on supply, all South Carolinians age 16 and up will be able to get a vaccine. “The worst is behind us, I think, in the realm of deaths and hospitalizations,” Sweat said. “We now need to think about the issue of transitioning, and that transition process is complicated and scary in some ways.”

For one thing, the coronavirus has lingering effects in some people. They may suffer from fatigue, shortness of breath, coughing, joint pain, chest pain, “brain fog,” depression, muscle pain, headaches and/or fevers. And in rarer cases, the coronavirus causes heart, lung, kidney, skin, neurological and serious psychiatric problems. 

“That's something we are going to have to deal with as a society –  there's going to be prolonged care needs and suffering,” Sweat said. “It has a lot of systemic problems that are really troubling.”

Another consideration: Not everyone who can get a vaccine will choose to get one. “We’ll have to navigate issues with people who are vaccinated versus those who aren’t vaccinated and what that's going to mean for all kinds of things,” Sweat said.

“It's already starting to be talked about a lot. There's talk about vaccination passports. Should you be able to travel or not? Can the workplace mandate a vaccine? Say you could have this one person who's a nonbeliever who could be walking around the office without a mask. How do we handle that?”

Sweat predicts legal challenges. “The Equal Employment Opportunity Commission has said that employers are allowed to mandate a vaccine. So as that starts happening, people will say they’re being discriminated against because of their anti-vaccine beliefs. It's really pushing something in public health that's been there from the beginning, which is this tension between individual and community rights.”

Society also will have to figure out how to balance our increased reliance on technology, for everything from work to shopping, with how we used to function in the Before Times. “There’s the question of how much we now do on video, versus live. It impacts all kinds of industries. It's accelerated a lot of social forces that were already happening to some degree, the decline of brick and mortar stores with the ascendance of online shopping and grocery delivery, video conferencing, working at home.”

Sweat said we’ll also have to think globally. Just because we’re able to talk about transition here, thanks to vaccines, doesn’t mean that’s happening around the world. “There are these things we've got to do as a human race. We need to set up really good genomic surveillance around the world so we can keep track of the variants. We're also going to need booster shots that are adapted to the variants. You need to get global vaccination, which is a huge thing, to keep more variants from spreading.”

For now, he encourages people to keep following COVID-19 guidelines, such as mask wearing and social distancing, to get us to the point where we can really ease up. “The policymakers are dying to loosen things up, but it's maybe just a little too early.”

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