'Increasing rapidly': COVID case numbers small but rising

For the first time in a while, the words “increasing rapidly” appear on a weekly update from the Medical University of South Carolina’s COVID-19 Epidemiology Intelligence Project. COVID cases in the Charleston area rose 80% compared with the previous week. In Florence, the growth rate hit 191%. And the Midlands saw a 289% increase.

But the numbers those percentages represent are small. The Charleston area had seven cases per day per 100,000 people. Florence: just two per day per 100,000. The Midlands: eight.

“I think there’s a real chance, to a large degree, that we’re kind of flying into the dark,” said Michael Sweat, Ph.D. He leads MUSC’s COVID tracking team. He’s also a professor in the College of Medicine at MUSC, an adjunct professor at the Johns Hopkins Bloomberg School of Public Health and a former research scientist with the Centers for Disease Control and Prevention.

“I can’t stress enough that these are clearly radical undercounts that we’re looking at nowadays. The vast majority of people are testing with home test kits. But I really feel like the growth rate continues to tell you a lot. Some people go on to get a PCR to confirm the home test or if they’re having symptoms. It’s probably a fairly consistent rate. So if the growth rate is up, it tells you something is happening,” Sweat said.

 

A polymerase chain reaction test, or PCR, is what you get if you go to a COVID testing site and your sample is sent to a lab. Your result becomes part of the state’s official tally. If you test for COVID at home, of course, state health officials don’t know about it.

So Sweat is advocating for an additional way of monitoring COVID. “I do think the one thing that we should be doing is wastewater testing for the COVID-19 virus. It would give us early detection, but it’s got to be done regularly, and the data has to be released.”

A spokesman for the South Carolina Department of Health and Environmental Control said in an email that the agency has been working on building the capacity for wastewater testing and analysis at the Public Health Laboratory and within the Division of Acute Disease Epidemiology as part of the National Wastewater Surveillance System. He also noted that severe cases of COVID-19 — those that result in hospitalizations and deaths — remain on the decline.

In the meantime, Sweat continues to predict another surge this summer.“I just don’t know how big it’s going to be. I’d say at worst, it may be similar to what Delta looked like in terms of the number of infections, but we will likely have fewer people being hospitalized than we saw with the Delta wave.” That Delta wave hit last September. Its peak, while the highest of the pandemic at the time, was much smaller than the Omicron wave that would follow and peak in mid-January 2022.

At best, Sweat said the current uptick could peter out. “That has happened in the past. But normally, with a new variant, that doesn’t happen. You tend to see it play out. And there are a lot of people not boosted, so their immunity is kind of weak. So it’s complicated.”

Omicron subvariants have caused cases to rise across most of the United States. But the national COVID death rate is falling. “I think it’s likely it won’t overwhelm the hospitals like before,” Sweat said. “I think most people are going to have mild cases. There’s a lot of immunity out there.”

But immunity wanes, even from vaccination. “About 60% of people who got two doses did not go on to get the third, which produces a profound improvement in your ability to not get seriously ill. Getting the booster is really important. I would not wait to do that. Now’s the time."