In the parking lot of Regional Medical Center in Orangeburg, South Carolina, construction workers have been working around the clock to erect a series of inflatable white and blue medical tents as doctors inside scramble to contain the wave of coronavirus patients.
The rural hospital, which serves a population twice the size of Rhode Island, is nearly full, forcing officials to ask the National Guard to erect the state’s first field hospital, comprising four tents to provide overflow capacity for at least a dozen virus patients at a time.
While the alternative care site won’t be usable for up to three weeks, Regional Medical Center President and CEO Charles Williams said the precautionary measure is necessary as the state continues to see a surge of COVID-19 cases that could overwhelm the public health system.
“At some point, we must do something, because there’s only so many beds, so many staff, we must do something,” Williams said in a Monday press conference, noting that there were only eight beds available in the hospital. “We must do everything we can to actively plan to care for our patients.”
The dire situation in Orangeburg is a microcosm for the state, which has continued to shatter COVID-19 records. As one of the earliest states to loosen coronavirus restrictions, South Carolina is now struggling to address a brewing COVID-19 crisis.
Meanwhile, Gov. Henry McMaster this week announced a slew of businesses could reopen. Festivals, concerts, movie theaters, stadiums, gymnasiums, concert halls, performing arts centers, parks, and racetracks can reopen at 50 percent capacity.
“Hollywood is knocking and movie theaters will be ready to open,” McMaster said Wednesday. “They will have to follow these rules. Go see your favorite movie, have some distancing, you’ll have to wear a mask.”
At least 1,551 people have died and 85,423 more have been infected with the coronavirus in South Carolina—with one in five tests returning a positive result. On Wednesday, the state had a roughly 20 percent increase in the number of new cases overnight, with 1,666 cases. The South Carolina Department of Health and Environmental Control announced Wednesday that 79 percent of ICU beds were occupied—with 404 of them being used by COVID-19 patients.
Dr. Helmut Albrecht, chairman of the Department of Internal Medicine at the University of South Carolina in Columbia and Prisma Health, told The Daily Beast the uptick in coronavirus cases “was inevitable” because the state’s reopening occurred far too soon.
“I understand that we need to open up but I am not sure that I’m seeing any logic in opening up with these numbers,” Albrecht said. “It’s just too high. We have not peaked in the hospitals yet and we have not peaked in the mortality yet. There was always going to be a delay—and all of us in the medical community are feeling this impending situation. We were stretched in March and now we are dealing with several-fold of those numbers now. I am very concerned.”
South Carolina’s coronavirus case count has been on a steady rise since June, when hospitals were dealing with about 450 virus patients. In a New York Times study of the number of daily infections between June 28 and July 5, Arizona and Florida were the two most affected areas in the world—followed by South Carolina, Bahrain, and Louisiana.
The number has tripled in the past two months, overwhelming emergency departments and their staff who are seemingly unable to keep up with a wave of new cases surging daily as government officials put a band-aid on the problem. Last week, the South Carolina National Guard announced they would provide staffing support to five hospitals along the Grand Strand, sending in at least 40 medics to “expand their ability to care for patients in need.”
According to one Charleston ER doctor, the surge of cases also means hospital staffing is a problem as more employees have fallen ill with the virus. The lack of staff, he said, has forced hospitals to send virus patients to other facilities—sometimes hours away.
“Charleston is a big city, so residents with COVID-19 don’t have to go far to get treatment when we can’t handle them,” the doctor said. “But this uptick in cases is only going to get worse, and in more rural cities, like Orangeburg, residents might not have anywhere else to go. We’re on the brink of a crisis if we don’t get our numbers down, or get more hospital space immediately.”
Albrecht also stressed the catastrophic effects of a lack of personnel, stating that while Columbia, the state capital, has “arenas we can open” if hospitals run out of space, “if we don’t have the doctors and nurses it doesn’t matter.”
“We’re seeing more staff members with COVID-19 than ever before, and we have more patients to deal with,” he said. “It’s a bad scenario. Right now we are handling the virus, and we are handling whatever it throws at us and would very much appreciate to not be further overwhelmed.
“But once you have to look at your resource allocation, and decide who gets what, then mortality goes up dramatically. Certainly, we are all feeling the pressure right now.”
Some doctors insist the surge in South Carolina was inevitable, given state officials’ response to the virus. Aside from closing schools in the first month of the pandemic, there was very little statewide effort to slow the spread. As late as the end of March, the Republican-led state government was actively discouraging local public-health efforts.
Facing pressure from local Democratic lawmakers, McMaster, a Republican, has allowed cities to implement public-health measures like closing some businesses.
But many South Carolinians were instantly outraged by even the smallest restrictions. The first major public protest against social-distancing measures was in Columbia on April 24. A few hundred people, many of them from out of town, marched or demonstrated from their cars.
On April 24, McMaster was one of the first governors to begin loosening coronavirus restrictions, issuing an executive order that allowed most retail and department stores to reopen with social distancing. And as McMaster has continued to expand the number of available businesses to reopen—so has the rate of COVID-19 cases.
The Wednesday announcement that large venues like concert halls and arenas could reopen—albeit at 50 percent occupancy or 250 people—will mean large group activities resume. It will inevitably result in “an additional uptick” that will strain an already limited healthcare reserve, Albrecht said.
Noting that McMaster also signed an executive order on Wednesday mandating face masks for all restaurant employees and patrons, Albrecht said masks are just one measure that will curtail the virus.
“We’re way too high in our numbers for testing and tracing to make a real impact,” he said. “All the other measures need to work together—and while face coverings might mitigate the spread, the numbers are just too high. If we don’t bring our numbers down, another strong uptick could overwhelm our healthcare system.”
Albrecht added that while some large cities in the Palmetto State have already taken steps to curtail the spread, there is still a “knowledge gap” between residents and the medical community.
Myrtle Beach, a popular tourist destination with a large elderly community, seems to be one of the biggest problem zones in the state. A 71-year-old Virginia resident died from the virus just four weeks after his vacation there.
An internal state report obtained by ABC News foreshadowed that South Carolina’s COVID-19 outbreak has no end in sight. The July 4 report, which highlighted hot-spot zones particularly in coastal counties, said that in Horry County, where Myrtle Beach is located, “cases continue to sharply rise” with “widespread travel to the area contributing to cases.” In Charleston, there is “no sign of cases slowing down,” according to the report.
For the Charleston ER doctor, the ongoing flocks of tourists and residents to Myrtle Beach and other hotspots proves that “people still are not taking this seriously.” Noting that the peak for the state may have already passed, he stressed that “some residents need a wake-up call—this is a pandemic that isn’t going away.”
While the state government has all but surrendered to the virus, cities are continuing to fight. Columbia, Charleston, Myrtle Beach, and more than two dozen other municipalities have, since late June, passed ordinances requiring people to wear masks while in public.
But to date, South Carolina doesn’t have a mask mandate despite recommendations from the Centers for Disease Control and Prevention. McMaster’s office did not respond to The Daily Beast’s request for comment about the COVID-19 increase in South Carolina, but the governor has previously bashed some preventive measures, calling mask mandates “impractical” and “ineffective” last month.
“People are talking about perfect storms and I don’t like that idea—you can’t avoid a perfect storm,” Albrecht said. “But this is avoidable. We can make this situation better if we just buckle down. Other places have shown that opening early without data support is really dangerous. We have to do that smarter.”