‘There's always uncertainty, but every time I think it's over, we get another wave’

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Reported COVID cases in the Lowcountry and across the state are low right now. But Michael Sweat, Ph.D., leader of the Medical University of South Carolina’s COVID-19 tracking team, said that could change in the next few months. “There's always uncertainty, but every time I think it's over, we get another wave. I would guess it’s coming up in January.”

The reason: the potential for fast-spreading new variants. “I don't see any reason we're not going to have more variants coming down the pike at some point. I was doing some calculations of peaks and timeframes and it's about every 6.3 months on average that we get another variant that takes off. So we're due for it.”

 

Sweat, a professor in the College of Medicine at MUSC, an adjunct professor in the Johns Hopkins Bloomberg School of Public Health and a former research scientist at the Centers for Disease Control and Prevention, said that assessment comes against a backdrop of declining immunity.

“The science is pretty strong showing that the immunity wanes. Many people got vaccinated a long time ago now. And only about 40% of people who got two shots went on to get a third. That's at least 60% of people with pretty suboptimal vaccine immunity. There's a lot of infections that occurred, which will help. But even that wanes, and that wanes more inconsistently.”

With that in mind, he encouraged people to get the new bivalent vaccine. The shot protects against the dominant Omicron subvariants BA.4 and BA.5. MUSC Health offers it at Rutledge Tower on the Charleston campus, the Henderson Street Vaccine Clinic in Columbia and the MUSC Health pharmacies in Florence and Lancaster.

“I think has a lot of potential because it's specific to the BA.4 and BA.5 strains. But only about 4% of people so far have taken that. So the uptake's very low, and that's not good. I mean, really, people need to take it,” Sweat said.

He also encouraged people to get a flu shot. “We've had a couple years with very low flu prevalence, but this year, some of the indications coming out of the Southern Hemisphere are high flu prevalence. So that's another worry, given if these things kind of harmonize, you get a lot of people getting quite sick.”

Meanwhile, there are indications coming out of Europe that may give some idea of COVID’s trajectory. “Historically the pattern we tend to see is outbreaks in Europe, and then you'll see it in the northeastern U.S., particularly in the fall. And then it takes off here. If you look at the global map, Europe's really lit up. France, Germany Austria, all of Western Europe has pretty rapidly increasing rates right now. The U.K. is starting to go up as well, but not as dramatically. So when you start seeing that, that's usually a precursor to it happening here,” Sweat said.

 

“Right now, if you look across the U.S., most places are continuing to decline from this wave we've had, but there a few that aren't. Maine is increasing. So are Colorado, New Hampshire, New Mexico and Nevada.”

And COVID is still killing people. “We still have a pretty high rate of death happening in this country, about 350 people a day passing away from COVID,” Sweat said.

“I think we're way beyond the time when it was overwhelming the hospitals. And that changes the calculus for what people should be doing. But you don't want to get infected.”

Keep an eye on COVID numbers, he said, keeping in mind that the reported case numbers are only 10% to 17% of actual infections. Most people are testing at home, and those results aren’t included in official case counts. “I don't know that I would say there’s a strong recommendation that everybody ought to go back to masks. But I think people really do need to kind of consider their risk. I would make a strong recommendation that people get up to date on their booster shots. That's the weakest link.”