♪ Welcome to This Week in South Carolina.

I'm Gavin Jackson.

COVID numbers have dropped for the first time in months, but they remain high and health officials remain cautious as hospitals are still full and this week we saw the most deaths recorded in one day since the pandemic began.

We talked with infectious disease expert Dr Helmut Albrecht with the University of South Carolina and Prisma Health.

But, first Dr. Brannon Traxler public health director for DHEC gives us the latest.

Dr Traxler, thanks for joining us.

>> Thanks for having me again.

<Gavin> It's great to see you.

Can we just get a situation update from you?

It's been a few months since we caught up.

I just want to get idea how the state is doing during this latest surge.

It looks like some numbers have been dipping recently, but of course they're still very high.

What's the latest data looking like?

>> Certainly, so we saw 12 straight weeks of increasing - and case counts.

We've now seen one week that has not increased.

That is really too early to say whether this is a trend, whether we're plateauing or decreasing.

I certainly hope it is the start of both of those and that we are going to begin to decrease even faster.

At this time it is too early to know for sure, Certainly better than going up for a 13th straight week.

We are however still seeing very high case counts every day.

We're also seeing very high hospitalization numbers.

People in the ICU.

People on ventilators.

Certainly, most of those are not fully vaccinated.

We are also seeing children who are hospitalized, and we're seeing deaths that are still occurring.

We're well past ten thousand South Carolinians who have died related to COVID-19 now.

Our vaccination rates are very slowly increasing.

We are very close to 50% of eligible South Carolinians who are fully vaccinated.

So I certainly hope we'll pass that and continue increasing, but that has been a very slow increase throughout the summer.

>> Yeah, you mentioned the children being hospitalized the most recent data that I have is, about 35 kids in hospitals right now.

20 in critical care, seven on ventilators.

These numbers we didn't really see last year, and this is all because of the Delta variant right and the spread and obviously that surge that comes with it.

>> Right.

We're just seeing children that are spreading it so much more and are having - We're seeing more children that are being infected and therefore, as a result, seeing more that are being hospitalized.

As you noted, 20 kids needing intensive care in the state.

Some of those are on ventilators several even on the extracorporeal membrane oxygenation, which is similar to like a heart lung bypass which means that these individuals are critical.

We are seeing this in children.

<Gavin> When we talk about the children, just to keep focused on them, when we look at how we recover from this, do we have any idea how the recovery will look like?

Adults a little bit different story.

They're fully grown.

They've been developed.

Do we know what it's like for the road to recovery for these children when they're all these machines, which are very difficult even for grown adults?

>> We don't know.

We know that in general, children are very resilient.

They bounce back from difficult things usually much better than adults do.

They are still growing.

They are still developing, and so they have that ability to change and to adapt and recover.

However, for COVID-19 we just don't know specifically what that will look like, because we really just now are seeing increased numbers of children who are needing more intensive treatment for the disease.

Certainly the researchers in positions throughout the country will be following, there's children in the coming days, weeks, months, even years to certainly try to minimize any impact if it were to occur.

<Gavin> Like you said, we still don't know much about this virus.

We're still learning as we go, which is what's so scary about it, which is why you guys are pushing for vaccinations and masks, etcetera I want to talk to you about what we're seeing in hospitals.

We have seen some admission dip, but we're also seeing the National Guard helping out in the Grand Strand in one hospital system.

I've seen some cases across the country in northern Idaho exactly where they are under kind of a crisis standards of care, Triaging, essentially who can get the best care based on the likelihood of their survival.

Are we anywhere near that?

What's the status right now of our hospitals in terms of being of being able to offer acute care for these folks?

>> Certainly, our hospitals are feeling the impact of these high numbers of COVID-19 cases.

They are seeing high numbers of hospitalizations, however we are not at the point, and yet we are not implementing crisis standards of care.

However we would be prepared statewide, if we were to get to that, but I hope very much that we never do.

We are still seeing some bed availability, depending on the hospital in the state.

We hear reports of hospitals at times that have patients waiting in emergency department That's one thing to remind folks that if you were hospitalized for COVID-19 and the majority of people being hospitalized are still unvaccinated.

You are - they're taking the care, the resources, the time, that other people who have emergencies might need also.

<Gavin> We haven't really had too many reports of those I mean you hear about that man in Alabama who is trying to find a hospital for cardiac care and have died.

Have we had any reports of that you can speak to?

>> Not that I'm aware of, >> But we did have a grim day this week with DHEC reporting about 138 deaths in one day.

obviously some of those were retroactive but still a very large number for one day of reporting.

I look back at the 2019 - 2020 flu season data and we had about a 140 deaths, just from that one whole season right there and we had that report in one day in South Carolina.

Give us some perspective about that, especially when people continue to kind of compare this to the flu, when it's very obvious that it's not.

>> I think the comparison you just did is a perfect example.

We saw for an entire flu season for basically an entire year, the same number of deaths related to flu as we saw reported in one day for COVID-19 Yesterday we had a grim milestone nationwide with one in 500 Americans being impacted by COVID-19 and dying of it.

That is staggering.

That's a lot of lost lives, unfortunately.

>> I'm guessing you're also a little worried about the upcoming flu season, as well.

Compared to last year, too One, that was basically just nonexistent, because we were masking.

There was a lot more social distancing going on.

Now you have Delta.

Now you have kids back in schools without masks, because they can't enforce the mask mandate.

How worried are you about this upcoming flu season?

>> I'm concerned.

I really want to stress to everyone that just like we said last year, it is so important to get your flu shot this year.

Get your COVID vaccination.

Get your flu vaccination.

You can get them both at the same time.

It's in the early days of the COVID vaccines.

they weren't sure if it was safe to give another immunization at the same time.

They would tell you to space them by a couple of weeks apart.

Now we know, you can get the flu shot in one arm and your COVID shot in the other arm.

These folks we know, as you said we had a 140 die two years ago, during the flu season.

We have many more than that not even hospitalized due to the flu.

Our hospital systems are already getting stretched close to the maximum.

If we have a lot of flu related hospitalizations that's even more stretch on hospitals even more burden.

<Gavin> A worrisome thing to consider as we approach flu season and vaccination rates like you said, we're approaching 50%.

Have you seen any uptick in the trends and the rates for those vaccination numbers?

You know there's been different announcements from the administration and other requirements happening, but have we seen any substantiated uptick in these numbers?

>> We have seen increase.

We have seen, I think roughly almost twice as many people vaccinated in August as in July, however the numbers are still very low, the actual raw numbers.

I still wish that we were seeing that increase in rate, but with much higher magnitude of numbers.

I really want to stress to everyone to please get vaccinated.

This is the best, safest way to prevent yourself and those around you from getting seriously sick.

<Gavin> Dr. Traxler, what's the biggest myth or the biggest issue that you guys are running into with folks when it comes to vaccines?

There's a lot of hesitancy out there.

There's also a lot of misinformation, and complete misunderstanding about this - these vaccines, especially the Pfizer vaccine, which has full FDA approval.

What are you guys running into out there?

>> Sure, the one that I hear the most is people saying that it is not really a vaccine, and that is not effective, because you can still have break through cases.

We know that these vaccines were designed primarily to prevent serious illness.

So, they were designed to prevent hospitalizations and deaths, and so we know that breakthrough cases are going to occur unfortunately, but thankfully the vast majority of them are very mild at worst, moderate levels of disease and so even for that the rates of people who are fully vaccinated, who are developing breakthrough infections.

It's still very low.

I think in our state, we're looking certainly at less than one percent of people who are fully vaccinated who had a breakthrough infection.

I think more like one third of one percent.

<Gavin> So, you might be hearing about these breakthroughs, but it's really, really a small number?

>> It is.

It is.

And it doesn't mean that the vaccine is not effective.

The fact, that we're hearing about some of these, this vaccine still is very effective.

<Gavin> DHEC just released new data from August showing basically the breakdown about who's been hospitalized, who's been dying based on vaccination status.

This is out of 123 thousand cases for the month of August What was that data that you guys saw?

>> Certainly, we were seeing that 85% of the cases were not fully vaccinated.

Only 15% of cases were fully vaccinated.

When you looked at hospitalizations and the deaths, 71% of hospitalizations and 75% of deaths.

So, three out of every four deaths were people who were not fully vaccinated.

So, this disease is still primarily occurring in the unvaccinated population.

<Gavin> What do we know about boosters at this point?

Should we be considering boosters?

I know certain people can get a booster shot right now.

What about other folks who maybe are concerned, even those folks who got the Johnson and Johnson vaccine who feel like they maybe have been left behind a little bit in some of the reporting about the efficacy of the other vaccines.

Anything that they should know about or who can get a booster at this point?

>> At this time, the only people who really need to be getting a booster or it's really a third dose for them, are the people who are immunocompromised who have moderate or severe dysfunction with their immune system, where it can't mount that response needed.

We will be anticipating more information in the coming days about whether any other part of the general population who's fully vaccinated, needs to get a booster, in particular, the Pfizer people who are vaccinated with Pfizer.

The FDA is going to be their independent committee.

The VRBPAC is going to be meeting tomorrow to make their recommendations to the FDA about whether, an emergency use authorization should be given for the Pfizer vaccine for fully vaccinated folks to get a booster and then if they do recommend that, we would anticipate the CDC's advisory committee on immunization practices to meet again within days to make their recommendations to determine who does need a Pfizer booster.

The Moderna data is slightly behind in terms of time wise the Pfizer so that'll be coming and I anticipate in the near future, and same with Johnson and Johnson or Janssen.

It was the third of their vaccines that was authorized originally and began getting used.

So, it makes sense that it would take longer than to, it would be later collecting the data before we know.

So, for right now everybody just needs to sit tight and continue to listen and await word from the public health officials.

>> We're also expecting maybe some new data, the end of October, when it comes to vaccines for younger children too.

Is that something that, I guess is pretty promising at this point.

>> Right, so we're very hopeful.

We just like everyone else very much want to make as many people as possible eligible for vaccination, as long as we know it's going to be safe and effective.

We're hearing good positive things about the data for the Pfizer vaccine for that next age group down, down to age five or six through eleven year olds.

So hopefully that will be coming certainly within the next couple or few months.

>> Dr. Traxler, with just a few moments left, I want to ask you about mandatory vaccinations for school aged children.

I asked the superintendent of education about this and she said this is a DHEC decision.

Obviously, there's only a certain number of kids that can get vaccinated right now, but when does DHEC make a decision when it comes to mandatory vaccinations for kids going to school?

>> So, we would not begin even entertaining really that discussion until a vaccine was widely available for all of the children that we were looking at in school and approved by the FDA, not just having an authorization.

So, we're not going to be looking at that for this school year or likely even next school year.

Going forward, I think a lot of it will depend on what we see in terms of the disease and the virus and how much of it is out there, in our community and such, and how much of a problem this is, in future years.

>> Just one last question here, what is your message to parents who are sending their kids to schools?

And you're seeing these numbers of kids getting sick in these faculty members who are also getting sick too, and even some children dying and others getting hospitalized.

What's your message to parents?

What they can do to help protect their children?

But first and foremost, if your child is 12 years or older, please get them vaccinated.

It is absolutely safe and effective, and we know it's the best prevention method It also will keep them in school the best because they want me to quarantine if they're exposed, and they're fully vaccinated.

And we know that the best place for kids to be is safely in person and in person learning.

For all children, I strongly recommend I cannot recommend strongly enough masking when they're in public and around other people which includes at school when they're indoors at school and so - it is very easily done by children.

They're very adaptable.

Many children who wear masks and tolerate it.

We know it's safe and we know it's effective.

So, vaccination and masks are the best ways to protect your children.

<Gavin> Great advice, right there from Dr Brannon Traxler.

She's the DHEC, Director of Public Health.

Thank you so much for your time, Thank you for all you are doing over there at DHEC.

>> Thank you stay safe.

>> Thanks.

Joining me now is Dr Helmut Albrecht.

He's the medical director for the Prisma Health and the University of South Carolina Center for Infectious Disease Research.

Dr. Albrecht, welcome back to the show.

>> Thanks for having me.

<Gavin> I want to get your thoughts on what we're seeing on the front lines, what you're hearing, and seeing on the front lines of hospitals, across the state specifically, Prisma Health.

What's it like out there right now?

>> I was actually on call, last week for Infectious Diseases here at Richland, and that's very common because we used to run the service here in the Midlands with two people.

Now, we're running with six and barely getting it done.

We have enough people to do it.

It's just not a healthy way to do it and I've done this now, for quite some time.

I've never had in one week, so many people, relatively or really young fighting for their lives.

I've run clinics in Africa.

I've worked on bone marrow transplant units.

I was around for the early age, days when treatment really weren't available, but this is unprecedented.

<Gavin> This sounds pretty discerning too.

What are you seeing exactly?

It's all anecdotes, but Thursday and Friday I think our service alone saw six pregnant women with COVID, whether one is going to make it or not is unclear and it's just talking to a 27 year olds about intubation and those kind of things.

It's not good for anyone, neither for the patient, nor for the providers.

It's - the numbers are just overwhelming.

when you're supposed to see ten patients in an afternoon, trying to see 30, it's just hard to do.

It's almost impossible to do it right, at least for your internal standard.

So, everybody is frustrated about this everybody is in this for a living this all day, every day.

I had a nurse walk out on us on the morning huddle.

She said, I can't take anymore we at six deaths overnight in one unit.

Took care of this guy for four weeks, and I need a break.

I know I'm on, but I just need out.

It's not - you can't even fault anybody for that, right?

It's hard and it's emotionally draining and it's physically demanding, these 16 hour days - I'm too old for this stuff.

<Gavin> Is there any light coming forward at this point.

I just said that we saw some drops in numbers, just one week, of course, after 12 weeks of straight increases there.

Obviously, deaths still lag.

That's something you guys are dealing with in an intensive way, and when it comes to hospitalizations, is there anything encouraging, right now?

Or is it still just pretty bleak is what it sounds like.

<Helmut> No, it's an incredible break that we're not seeing this increase.

I mean we're used to this kind of stuff but now in the last couple of weeks, we have never seen an increase that quickly, but it's also focal.

Our colleagues in the upstate are still in the very thick of it.

You'll have one local outbreak.

You'll have one gain.

You have one set up where bad things happen and you are dealing with an extra couple hundred patients.

That's clearly not done yet.

So, we are looking at these numbers now twice a day in order to shift resources.

The good news for Prisma is we can shift resources.

We can bring ventilators upstate.

We can bring theoretically patients down if we need to.

We have a lot of possibilities to switch up things.

Everyone is still really in an overwhelmed mode right now and I don't see it stopping going up this is not good enough.

We need clearly a break before we see the next wave of things happening >> Can you, again Doctor, speak to a specific group here.

We talked about pregnant women.

You even mentioned that one of them might not make it from the ones you saw.

What's your message to women, especially women who are maybe getting pregnant or are pregnant, when it comes to getting the vaccine and the research that's out there, right now?

>> The research has shown that it's not only recommend, it's strongly recommend.

Pregnancy is an immune deficiency.

It's very clear that it doesn't affect fertility for men or women.

COVID does.

You may never be the same as far as fertility goes if you go through COVID, that can actually infect for instance your testicles like mumps can and leave significant damage there, but for women it's really highly recommended.

COVID increases the rate off dying 25 fold almost in pregnancy.

It's not a trivial increase.

It's a life or death situation for a pregnant woman with serious COVID, for her and for her baby.

There's two people you need to consider.

Really we haven't seen it this bad even with other diseases that sort of affect pregnancy I'm a new granddad to two beautiful baby boys.

I vaccinated my daughter in law before the data were so clear.

Now they are absolutely clear that you need a vaccine when you're pregnant; but they're doing great.

Seeing that over there while I'm holding my healthy grand babies is hard.

>> Definitely.

Definitely, very much so, Sir.

When it comes to booster shots too, we're talking about a lot of back and forth within the medical community, especially this week looking at research out there, right now.

Pfizer looking into shots.

Moderna's looking into potential booster shots, too.

Where do you fall on this debate right now?

Obviously people that are immunocompromised can get a booster shot, but what about others?

Where do you stand on this research right now?

>> So, it's a booster shot and a third shot for immuno- compromised.

They're not the same.

The third shot for immuno compromised, that completes your initial series.

That shouldn't be called a booster shot.

99% of people who would line up for the third shot do want a booster shot.

They are not in one of those groups that are immunocompromised, but it's a very different thing.

The data that we have on the third shot is mostly from transplant and a lot of that's stipulation, but I think that's pretty clear four weeks after your second shot you can get a third shot if you fall into one of these groups.

The booster shot is - it's difficult.

There's really no data for Moderna and J & J right now For Pfizer, we have a data set from Israel.

That's a very unique data set.

It's over 60 year olds.

it's much more in the total Delta society.

It's a very different situation, but it decreases your rates of breakthrough by over 80%, so I think that's going to be enough for Pfizer to recommend this.

What they're going to do in the U.S., they are actually debating that on Friday on the FDA level and then the CDC actually has to put the parameters around this.

Are we going to go with six months?

like Israel?

Are we going to go in an older population or everyone?

It's clear that the antibodies fall, but that's actually doesn't matter it's clear that neutralizing falls, but we need to show is that the shot can decrease something, Re-admissions, hospitalizations.

It's actually none of the vaccines are failing there yet.

We are still seeing the vast majority that get critically ill or die in the hospitals.

I mean over 98% of those are unvaccinated.

So it's much more important to get a first and a second shot into people and even to discuss a third shot, but I think it will come.

I think it makes some sense, and we have to reduce the virus burden in our community.

It can't go on like this.

So, this is one way to do it, but it's probably not the most promising way.

<Gavin> Dr Albrecht, with just 30 seconds left, I want to ask you about the state reaching the 50% milestone right now for fully vaccinated folks.

What's your message right now, really quickly to the other 50% of eligible South Carolinians when it comes to getting vaccinated.

>> You need to help us get back to some sort of normalcy in the healthcare system and as a society.

We can't afford this.

The concerns are clearly not valid reasons, so to get a vaccine, help us out.

Help your community here and get on with it.

>> Gotcha.

Very good advice.

Thank you, Doctor for all you do and your colleagues out there at Prisma Health and all those on the front lines That's Dr. Helmut Albrecht.

He's the Medical Director for the Prisma Health and University of South Carolina Center for Infectious Disease Research.

Thank you again.

>> Thank you.

<Gavin> To stay up to date, with the latest news throughout the week, check out the South Carolina Lede.

It's a podcast that I host twice a week, and can be found on SouthCarolinapublicradio.org or wherever you find podcasts.

For South Carolina ETV, I'm Gavin Jackson Be well, South Carolina.