Living in a covid world

It’s been almost eight months since COVID-19 first descended on the Lowcountry. On March 9, there were just two confirmed cases of the virus in South Carolina, including one in Charleston County. Testing was not yet well established and there were many unanswered questions. 

 

Fast forward to last week and the numbers reveal just how menacing COVID has become. According to data posted on the state’s Department of Health and Environmental Control website, as of Oct. 29, the Palmetto State had seen a cumulative total of 173,491 positive cases, 10,345 hospitalizations, and 3,876 deaths. 

 

Those most at risk from COVID are those with pre-existing conditions – and seniors, who represent close to 87% of the deaths in South Carolina (for ages 61 and up).

 

Dr. Terry Steyer, chair of MUSC’s Department of Family Medicine, believes we are presently experiencing the “second wave” of the virus here in the Lowcountry.

 

“We kept our numbers really low and after July 4th we ramped up,” said Steyer, a Daniel Island resident. “…That was really our first peak…With Labor Day our numbers came down and now we’re beginning to see a trend up.”

 

As of Oct. 27, MUSC had conducted almost 190,000 COVID-19 tests in the Charleston area, and among those about 17,000 were positive. 

 

“We’re still hitting around that 10% positivity rate,” added Steyer. “As we look at data, people are saying. ‘well of course if we do more testing you’re gonna catch it more’ – that’s true. But it’s really percent positive that I really look at.”

 

According to the CDC, a positivity rate of 5% or lower indicates there is no longer widespread disease in a community.

 

In the early days of the pandemic, it might take up to a week to get test results back. Today, most patients getting the standard PCR test, which uses a nasal or throat swab to detect a genetic material from the virus, should hear back within 24-48 hours, said Steyer. There also is a rapid test available at some area health clinics that involves antigen testing, but it is not foolproof. 

 

“So the antigen testing is actually less sensitive, meaning it could be negative when you really still have the disease,” he said. “The PCR testing is about 99% accurate, but that rapid test is about 70% accurate. You trade off the accuracy by using a method that’s a little bit easier to obtain.”

 

According to Steyer, MUSC Health is working to offer point-of-care rapid testing in the near future.

 

When it comes to how health care is provided, the pandemic has definitely had an impact, noted Sean Nelson, MUSC’s director of ambulatory services for primary care. Patients can now decide between an in-person visit or a virtual visit. They also have the option of utilizing drive-up lab services if they don’t feel comfortable coming inside a practice. 

 

“COVID has changed our world from that perspective,” added Nelson. “…What we’ve noticed is, it’s very individualized…We’ve set up our environment to accommodate both types of patients.” 

 

Seniors have reportedly embraced the new virtual health opportunities. A recent study by healthinsurance.com noted a 300% increase in seniors using telemedicine during the pandemic.

 

As providers enter the fall and winter season, Steyer said their biggest concern is in differentiating between the flu and COVID, as symptoms for both often mirror each other. 

 

“Distinguishing between those two is pretty important,” he said. “Because the course of the disease, and honestly, the treatment itself, is very different depending on what you have. That’s the one thing, as we enter flu season, that we are a little nervous about.”

 

In addition to encouraging all to get flu shots this year, especially seniors, Steyer is also urging people to consider reimagining holiday celebrations. 

 

“The concept of what we do as the traditional Thanksgiving meal may be going away this year,” said Steyer. “…Small groups of 6 to 8 people make a lot of sense. If you do it outside, socially distanced with masks, I think you’re OK.”

 

And seniors need to be especially careful, he said, as the morbidity factor associated with COVID almost doubles by decade of age. 

 

“I think it’s just sort of being smart,” added Steyer. “I’ll be honest – I’ve seen older people go one of two directions. Some of them say ‘I’m older – if it gets me it gets me, that’s the way I am supposed to go.’ And I’ve seen other people literally become almost shut-ins, and there needs to be a healthy medium in there somewhere.”

 

As for whether or not all of us need to continue to take COVID-19 seriously, Steyer had this insight to share.

 

“I hear a lot of ‘I don’t know anyone who has died of COVID,’ or ‘I don’t know anyone who has been really sick with COVID,’ and I’m thankful for most people who haven’t seen that,” he said. “I’ve watched it. I’ve seen it. And when you literally see a person who is otherwise healthy go from breathing on room air to needing to be ventilated in less than 4 hours you see how tragic it can be.”

 

Steyer stressed the importance of continued prevention efforts like mask wearing, social distancing, and hand washing.

 

“Please listen to your public health experts, your physicians, your nurses and others who may be on the front lines and seeing what happens to people when they do get sick,” he continued. “Because we don’t want that to be you.”