Weeks of distancing remain, but MUSC leaders say 5 steps needed to protect public health before rules are relaxed 

Charleston has kept cases relatively low, but officials urge caution

click to enlarge MUSC is preparing for a surge of coronavirus patients in late April

Sam Spence

MUSC is preparing for a surge of coronavirus patients in late April

The rate of new cases is declining and Charleston's COVID-19 outbreak is less severe than other places, but MUSC leaders say we'll need to maintain social distancing for at least another month. That gives us time, they say, to develop a plan to reopen the economy.

Epidemiologists at the Medical University of South Carolina say key indicators show that hospital resources are prepared, despite Charleston residents lagging behind major metropolitan areas in their efforts to social distance.

"The peak is highly likely to be more manageable based on the collective action of South Carolina's elected officials," MUSC President David Cole said during a press update Wednesday morning.

click to enlarge Cole - COURTESY MUSC
  • Courtesy MUSC
  • Cole
According to Cole, hospitals' abilities to treat COVID-19 patients will need to be sustained and new cases will need to remain low before social distancing restrictions can be phased out.

"If the current models hold true, these conditions will likely exist in approximately 4-6 weeks," Cole says. "This provides the timeframe to develop the plans and infrastructure needed to have a successful economic recovery."

To prevent a "crippling" second wave of cases that could undo potential economic recovery, Cole outlined five "key moves" he described as essential:

1. Staged revitalization of the economy: Develop a plan for a gradual re-opening of businesses, prioritizing those with high economic impact that pose a low risk of COVID-19 transmission
2. Continued disease testing
3. Immunity testing: Rolling out widespread immunity testing to track those who may not be susceptible to the disease
4. Contact tracing: Establishment of a system to identify people who come in contact with COVID-19 patients
5. Protecting the vulnerable: Making sure that those especially prone to COVID-19, such as elderly, immunosuppressed, and minority communities, have necessary protection, testing, and treatment
So far, Charleston has not developed an excessive concentration of COVID-19 cases as a proportion of its population, researchers have found. Compared to New York, which has seen nearly 11 cases per 1,000 people, the Charleston area has seen just 0.68 confirmed cases per 1,000, according to MUSC. The South Carolina Department of Health and Environmental Control puts that figure closer to 0.88 cases per 1,000 people, still well below American hotspots. Statewide, DHEC estimates the rate is 1.70 positive cases per 1,000 people.

State officials caution, however, that the total number of cases is likely much higher, with many COVID-19-positive people experiencing mild symptoms never getting tested. MUSC has plans in motion to accommodate overflow capacity for coronavirus patients, should the need arise.
click to enlarge Projected impact of COVID-19 patients at MUSC (data published April 15) - MUSC
  • MUSC
  • Projected impact of COVID-19 patients at MUSC (data published April 15)
MUSC forecasts project weekly hospital admissions for COVID-19 at least doubling over the next two weeks, peaking at the end of April. Projected admissions decrease after that, but continue into late June. For reference, the projected number of new case admissions in mid-June are roughly equal to admissions in early April.

While cases in the area have remained relatively low so far, Charleston-area residents have not heeded stay-home orders to the extent that their peers in other areas have. According to data published Wednesday by MUSC, Charleston County residents have cut their travel by an average of 20 percent, peaking at around 50 percent on weekends.
click to enlarge (published April 15) - MUSC
  • MUSC
  • (published April 15)
click to enlarge (published April 15) - MUSC
  • MUSC
  • (published April 15)
In Seattle and Los Angeles, where COVID-19 patient counts are high and more strict lockdowns are in place, residents have cut travel by as much as 90 percent by the end of March, according to MUSC graphs aggregated from Cuebiq, which analyzes anonymized mobile phone location data.

MUSC's analysis echoes reports across Southern states that had not adopted strict stay-at-home orders where people continue to move throughout the state despite risks of spreading the virus.

South Carolina Gov. Henry McMaster began limiting businesses that could operate in mid-March, but waited to issue a more restrictive "home or work" order until April 6.

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