Positive news? As COVID wave ebbs, experts eye what’s ahead

September 26, 2023
White rectangular COVID 19 test. It says COVID-19 antigen and has the letters C and T on the left side. There is a dark red line by the C and a fainter one by the T.
The faint line beside the letter T shows that the COVID-19 test taker still has the virus more than a week after her symptoms started. Photo provided

The COVID-19 test pictured at the top of this story was taken by a Charleston woman who came down with the virus right after a great vacation. More than a week later, she’s still testing positive.

She didn’t have to go to the hospital. But she did have to miss work and feel pretty rotten for a while. That’s the experience a lot of people who get COVID these days have. They don’t feel great for a few days, but then they recover.

Dr. Michael Sweat 
Dr. Michael Sweat

It’s a reminder that the COVID landscape has changed. Far fewer people who get the virus get dangerously ill from it than in the past. But lots of people are still getting it. And about 5% to 10% of them have lingering symptoms for three months or longer, which is known as long COVID.

There are also concerns that we may have a wave of respiratory illnesses as the weather cools off and people spend more time together inside, said Michael Sweat, Ph.D. He leads the Medical University of South Carolina’s COVID tracking team. “People are kind of on alert right now because last year, it hit in October with a dramatic increase in transmission occurring.”

“It” was an increase in influenza-like illnesses, based on people reporting symptoms, such as a fever and a cough or a sore throat. The wave occurred earlier than in previous years. “Some of it was COVID. Some of it was flu, some was RSV. Some of it could be something else, in fact. But that's why people are a little worried.”

COVID changes

However, there is positive news for now on the COVID front. First, case numbers are trending down in the Charleston area and across the country. About a dozen people are hospitalized with COVID in all of MUSC Health’s hospitals combined. And COVID-19 concentration in wastewater in the Charleston area dropped 22% in the latest weekly update from Sweat’s team.

Second, you can order COVID self-tests from the federal government again. Sweat said it’s a good idea to take advantage of that.

Two boxes. One says Clintest. The other says self-test at home. results in 15 minutes. Both are COVID test kits. 
Don't toss old COVID self-tests before checking to see if their expiration dates have been extended. Photo provided

“I think it's super important to have some on hand because it helps you know whether to isolate and not spread it to others. Also, if you're eligible, or if it's recommended, you should talk to your doctor if you test positive right away because the medication Paxlovid is very effective at stopping serious illness and mortality, but it has to be taken within five days of getting symptoms. And by the way, it’s also likely effective at stopping transmission.”

Third, your old COVID tests may still be good. Don’t toss them out before checking to see if their expiration dates have been extended, Sweat said. You can find that information on the Food and Drug Administration’s website.

And fourth: New COVID booster shots have hit the market. Sweat, a professor in the MUSC College of Medicine, adjunct professor at the Johns Hopkins Bloomberg School of Public Health and former research scientist with the Centers for Disease Control and Prevention, encouraged people to get them. “I think within short order, they're going to be widely available.”

Only about 20% of the people eligible got the previous COVID booster, Sweat said. “The new vaccine, I think, is really good. The data has shown that it's quite effective.”

He also said it can keep people from getting long COVID. There’s some interesting news on that aspect of the coronavirus. Scientists recently announced that they’ve found differences in the blood of people with long COVID compared with people who don’t have the condition. The hope is that their research will help lead to a test to diagnose long COVID in the future.

Other respiratory risks

Sweat and his fellow virus trackers are keeping an eye on some other viruses as well. That includes the flu and RSV.


Seven people were admitted to MUSC Health hospitals with the flu last week, up from one the previous week. You can get weekly updates on the flu from the South Carolina Department of Health and Environmental Control


Meanwhile, Sweat said RSV case numbers are flat – for now. “But RSV was unusually bad last year.” So bad, that at one point, the division chief of Pediatric Critical Care at MUSC Children’s Health said the state was “drowning in RSV.”

Will this year be different? That’s unclear. But a recent report from the CDC noted that in the Southeast, there have already been increases in RSV infections. 

There is one key difference from last year: We have new tools to fight RSV. The Food and Drug Administration and CDC recently approved RSV vaccines for people ages 60 and up and pregnant women between 32- and 36-weeks’ gestation.

There is also a new RSV monoclonal antibody for babies that can be lifesaving. Babies can have serious and sometimes deadly RSV infections. With the antibody, they get a single injection of a medication that provides antibodies to protect them for up to six months – enough to cover the RSV season.

Sweat hopes that everyone will have an RSV vaccine option soon. “I have a feeling eventually this will get more opened, more inclusive, in terms of its availability and approvals. I'm sure they did a complicated risk benefit analysis and cost. I think the cost probably has a lot to do with that. That'll probably come down over time.”