'We can't keep chasing our tails' as COVID cases rise, expert says

July 29, 2021
Map showing COVID hotspots
This map from the CDC shows the risk of COVID transmission is high (red) or substantial (orange) for most of South Carolina.

While some people may be surprised by the renewed calls for masking and rising COVID case rates, Krutika Kuppalli, M.D., figured this would happen. “I don't think that people in the infectious disease or public health community ever thought that COVID was done.”

Kuppalli, an assistant professor in the College of Medicine at the Medical University of South Carolina who’s about to depart for a job with the World Health Organization’s Department of Emergency Preparedness to work on COVID-19, said we need to try to get the situation under control. She’s been part of the global response to COVID since the early days of the pandemic. And she’s seen what happened in other countries when the delta variant took over.

“We can’t keep chasing our tails when it comes to this. Part of that is going to be trying to get more people here vaccinated,” Kuppalli said.“And while we're doing that, we need to really try to get people to wear masks again, abstain from large events and maintain social distancing.”

Right now, there are more than 30 COVID-19 patients in MUSC Health hospitals across the state, including more than a dozen COVID patients in Charleston. And that Charleston total, 13, almost doubled the previous week’s number. Doctors say much of the blame lies with delta, which spreads more easily than any previous variant.

Dr. Krutika Kuppalli 
Dr. Krutika Cupola

“People need to understand that most of the patients we're seeing in the hospital right now are not vaccinated,” Kuppalli said. “I think a lot of times people think of COVID in terms of life and death. But I see a lot of patients who have long COVID and they are horribly debilitated and we can’t tell them when or if they will get better.”

She strongly encouraged people to listen to the Centers for Disease Control and Prevention’s updated mask guidelines. They call for even fully vaccinated people to wear masks in public indoor situations in areas where there’s substantial or high transmission — which includes much of South Carolina. 

Part of the reason for that recommendation is that a small number of fully vaccinated people are getting breakthrough infections thanks to the delta variant — and data indicates they have high viral loads and can spread the virus to other individuals.  

“Their viral loads are high, at the same level as you see in people who are infected who haven't been vaccinated. We’re trying to understand more about that. But that's different information than we found with the other variants, right? With the alpha variant, we did see breakthrough infections, but the people did not have a very high viral load and were not able to transmit to others. Delta is different.”

In people who do get breakthrough infections, Kuppalli said the vaccine offers protection from getting seriously sick, being hospitalized and dying. It also protects those around them. “I really hope people think about the fact that we don't want to infect our families or loved ones, particularly children less than 12 who are unable to get vaccinated.”

Right now in South Carolina, about 44% of state residents are fully vaccinated. That leaves a lot of people vulnerable. “When you have high levels of circulating virus, you're going to have more pressure on the virus which can lead to more viral mutations and emergence of more variants. And you're going to get more cases,” Kuppalli said.

“Last November, we were talking about the alpha variant. Today, we're talking about the delta variant. In three, four months, we could be talking about an even worse variant if we don't learn from this continuous cycle that we're in.”

Getting the virus under control could help prevent that, she said — and get us closer to a time when pandemic precautions become a thing of the past. For information about scheduling a vaccination or finding a community vaccine event, visit MUSC Health’s vaccination pages.

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