South Carolina is experiencing an unprecedented surge in respiratory illnesses that is overwhelming the healthcare system. This is an emerging crisis as COVID cases and hospitalizations tick up while South Carolina leads the nation in flu activity. Let’s take a deep look at what is driving this crisis and what needs to be done before infections spin out of control.
Flu Cases Reach ‘Very High’ Levels in South Carolina
The flu hit South Carolina early and hard this season, with state health officials reporting “very high” flu activity in December [1]. The South Carolina Department of Health and Environmental Control (DHEC) said flu cases reached “very high levels statewide.” Flu cases and hospitalizations started increasing early in the fall, and the state has outpaced the rest of the nation in flu activity for at least the past month [2].
Though flu cases are still very high, DHEC reported this week that flu hospitalizations have started to decrease. However, COVID-19 hospitalizations are rising at the same time, putting further strain on South Carolina hospitals.
| Flu and COVID Statistics in South Carolina | |
|---|---|
| Flu Activity Level | Very High |
| Flu Hospitalizations | Decreasing after reaching peak |
| COVID Hospitalizations | Increasing |
“While we’ve seen decreases in flu-related hospitalizations this week, the flu remains widespread throughout our state, and COVID-19 hospitalizations are rising,” said Dr. Brannon Traxler, DHEC Public Health Director [3].
COVID Cases Rebound After Holidays
The surge in flu cases is colliding with an uptick in COVID-19 cases and hospitalizations following the holiday season. COVID metrics had been declining in South Carolina through November and early December 2023. However, cases and hospitalizations started increasing again after Christmas.
Health experts believe holiday travel and gatherings caused COVID to spread more rapidly in recent weeks. The rise of new Omicron subvariants like XBB.1.5 are also likely contributing factors. Though many South Carolinians have protection from vaccinations and prior infections, immunity fades over time. We are headed into a perfect storm with high flu transmission and waning COVID immunity.
“We’ve got a double dose… of increased COVID cases as well as flu, combined with holidays and gatherings and kids being out of school, so we’ve definitely seen an increase in influenza-like illnesses in emergency departments,” said Dr. Jennifer Sullivan of MUSC Health [4].
Respiratory Infections Overwhelming South Carolina Hospitals
The tandem increases in flu and COVID cases are overloading hospitals already stressed from prior COVID surges and staffing shortages. Over 1,800 South Carolinians were hospitalized this week across flu, COVID, and other respiratory illnesses — a huge burden for hospital systems [5 [6].
Health experts say many hospitals already had to convert other units into makeshift ICUs this fall due to lack of space and staff. The massive influx of flu and COVID patients has created treatment delays and bed capacity issues. Doctors have resorted to treating patients in hallways and emergency rooms in some cases.
“Hospital systems certainly feeling the strain… we are seeing capacity issues again,” said Dr. Jonathan Knoche, medical director for hospitals in the Lowcountry [7]. This pressure on hospitals prompted South Carolina to re-activate its emergency operations center this week [8].
The shortage of healthcare staff in South Carolina exacerbates the capacity issues. Many hospitals had at least 20% of nursing positions vacant prior to the latest surge. Doctors and nurses are burning out from years of unrelenting COVID waves. More healthcare workers calling out sick with respiratory illnesses themselves further limits hospital capacity.
“Our staff are stretched very thin… we have a nursing shortage… people are getting tired,” said Dr. Traxler [9]. The exhausted healthcare workforce is struggling to keep up with this tsunami of infections.
Mitigation Efforts Needed as Crisis Worsens
More counties along the South Carolina coastline have moved into the “high” community level for COVID as designated by the CDC. This triggers recommendations for indoor masking and other precautions [10]. However, Governor Henry McMaster has not issued any new public health orders or reinstated an emergency declaration. Critics argue the hands-off approach has enabled infections to spiral higher.
With hospitals overwhelmed, health experts say individuals need to take action by getting boosted for COVID and flu, wearing masks indoors, avoiding large gatherings, and staying home when sick.
“All South Carolinians should take preventing illness seriously to protect themselves, their loved ones, and their communities,” said Dr. Traxler [3]. However voluntary measures have not been enough thus far. Stronger policy action like mask mandates may prove necessary if this crisis continues intensifying.
South Carolina leads the nation in flu activity and recently reactivated its emergency operations center due to overflowing hospitals. This underscores the need for both officials and residents to take the respiratory illness surge seriously. Otherwise, infections could spin further out of control, risking many lives. We all must act now to flatten the curve.
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