♪ [opening music] ♪ Welcome to This Week in South Carolina .

I'm Gavin Jackson.

This week lawmakers returned to Columbia, and in the Senate, that meant focusing on the Fetal Heartbeat Bill.

Over in the House, lawmakers passed the Santee Cooper Reform Bill, and also focused on passing COVID relief for vaccine providers across the state.

This week we speak with Dr. Brannon Traxler of DHEC and MUSC's Dr. Danielle Bowen Scheurer.

Now for the latest from This Week.

While cases in hospitalizations are looking better in the state, news broke shortly after our taping Thursday, that South Carolina was the first state in the nation to detect the South African variant of COVID-19.

DHEC said that one case was detected in the PeeDee and one in the Lowcountry.

Experts agree that existing vaccines still work against this more contagious strain, and there's no evidence to suggest that the variant causes more severe illness.

Earlier this week, 7th Congressional District Republican Tom Rice, had a telephone Town Hall where he continued to defend his decision to vote to impeach President Donald Trump over inciting an Insurrection.

(Rep. Rice) I took an oath to protect our constitution, not to protect Donald Trump's job and not to protect the Republican Party.

I signed up to protect our constitution, and if you want a Congressman that is gonna Kowtow to bullies and to back down when people threaten, that they won't do the right thing, and will go along with the crowd, oh, everybody else, you know, on this side voted this way so I'd better vote that way, so people back home don't question me.

If that's the guy you want, then I'm not your guy.

[car horns honking] (Gavin) In the South Carolina Senate, the Fetal Heartbeat Bill which would ban abortions after roughly six weeks was debated all week and was approved Thursday.

The bill which makes exceptions for the life of the mother and fetal anomaly also allows for rape and incest exceptions, but requires medical providers to alert the County Sheriff of the accusation.

Republicans differed over the specifics multiple times.

Now, I just want to know whether you realize that we are not in a church.

We are in the South Carolina Senate where there's a separation between church and state.

Did you know that?

Everybody in here has a world view.

It's made up of various components including your religious faith, if you have religious faith.

You don't check your religious beliefs.

I'm not going to check mine.

I am your colleague in the Senate.

I am not a member of your flock.

Senator Marlon Kimpson summed up the debate over the controversial and likely unconstitutional bill this way: Upon hours, upon hours, upon hours that we're gonna spend debating the merits of an unconstitutional bill when we got people dying in the state of South Carolina due to COVID.

(Gavin) And in its quarterly call, Boeing announced its worst year ever, and CEO David Calhoun gave an update on Dreamliner issues.

(David Calhoun) We're conducting comprehensive inspections on undelivered airplanes, both in Everett and in South Carolina.

Since last quarter, we've expanded the scope of those inspections, including work done at our supplier partners.

Our assessment shows that none of the issues identified represent safety of flight concerns.

Nevertheless, we remain committed to taking the time to ensure each airplane meets our rigorous engineering specifications.

Joining me now to discuss the state's response to COVID-19 is DHEC's interim Public Health Director, Dr. Brannon Traxler.

Dr. Traxler, welcome back.

Thanks, thank you for having me.

Well, I want to lead out on some positive news.

I was on a call with you earlier this week, and you said that the state has seen somewhat of a plateau when we look at some key demographics when it comes to the pandemic.

Can you explain that and kind of give us an update on where we are as a state?

Certainly, so as everyone's aware, we saw a lot of high numbers a couple of weeks ago earlier in January, which likely reflected the holidays based on the timing, and so we have for the last couple of weeks been seeing really kind of a plateauing in terms of the number of cases if you look on a weekly basis.

Also you've been noticing probably our percent positivity has been down some.

However, I would like to see the plateauing becoming a steep downward trend, and I certainly would like to see that percent positivity which was in the lower 30 percent now is in the lower 20 percent, so I want to see it getting down to single digits.

We're still seeing some unfortunate numbers of folks dying from this as well in these cases.

I'm guessing that's because those numbers typically trail a few weeks behind those high case numbers that we saw this month.

Correct, so the high death numbers recently are reflecting those high case counts from a couple of weeks ago, so hopefully there's a plateau and decrease here very shortly too.

Now when we look at this plateau, do you think it's gonna be on the same scale we saw over the summer when we had our bad surge the first round?

Do you expect maybe, when we do start to plateau, we'll really go down further, and we're not gonna see another spike?

I mean, do you think there'd be any cause for another spike in the future, or do you think we would maybe get to some level of maintenance instead of these high spikes?

Sure, so I hope that we go down and don't just plateau really at this level.

We still have a very high amount of disease being spread, a high amount of virus being spread in the community.

Whether we see another spike is going to mostly be driven by people's behaviors, and certainly then, to some extent, vaccination and the rate of vaccination, the presence or absence of variants, you know, coming on board potentially.

But the biggest driver of that is going to be whether everybody can hang on that few more months that we need, you know, doing those actions that I know everyone's tired of hearing about but that we know make a difference.

And talking about vaccinations, over the past two weeks, you know, I know you've been busy for months, but it's been a really intense past few weeks talking about the vaccination rollout.

The Governor's been touring sites around the state.

There have been oversight meetings at the State House.

Are things ramping up to where they should have been, or now that we're more than a month into this?

Or how do you see the vaccine rollout going at this point?

Like I said we've been more than a month.

It seems like things are now really starting to hit their stride.

Is that where we should have been a month ago?

Well, I think that the word that we use so much that I think nobody's gonna want to use after this pandemic: unprecedented.

To rollout vaccines on this scale is unprecedented, from everything from the supply chain needs to the production and manufacturing by the pharmaceutical companies to the federal distribution within the state's distribution, and then even just the local vaccine providers using a new system this VAMS, dealing with complex vaccines that we've never had to deal with before.

So I don't think it could be unexpected that there would be a period of time where we would as you say, 'hit their stride.'

Certainly, it would have been fabulous to not have any of those, maybe growing pains as we did ramp up, but I am very pleased that it has quickly ramped up, and from what we're seeing and hearing in other parts of the country, everyone is experiencing the same thing.

South Carolina as of yesterday is ranked 10th by Becker's for utilization rate for how many vaccines we're getting and out of what we're receiving.

So I think that shows that South Carolina is doing a good job and I think it's only going to improve from here.

We just need more vaccines coming into the state.

Yeah, I think our vaccination rate at least for the Pfizer vaccine is around 74 percent as of our taping, and so probably even better than what that Becker's report pointed out, but there was some confusion.

There might still be some confusion for folks when they go to the DHEC website, they look at the vaccine allotment, and they see one large number of how many doses we've received versus how many have been administered.

Can you kind of break that down, and that is based upon the two different vaccines the state has received too.

Sure, and it is challenging because there are different allocations.

There's two different vaccines.

There's different federal programs we can allocate to, and how you define things like 'distributed', 'received', 'allocated' can make a difference, so one thing to look at is, like you said, look at the two different vaccines.

The Pfizer vaccine, all of the Pfizer has been coming directly into the state from the very beginning, and it's been going primarily to hospitals, a little bit to some other providers, but hospitals generally are who have the storage capabilities for it and so that's a very good one to look at in terms of utilization rate because we have not allocated Pfizer outside of any vaccine providers in the state.

The Moderna we chose to, right off the bat, allocate everything that would be needed to vaccinate all the residents and staff of all of the long term care facilities in the state to that federal pharmacy long term care program, and so they then, those two pharmacies, CVS and Walgreens, draw down, you know, basically take a withdrawal of doses when they need it from what we allocated to them, and so they are just finishing up, I think they have finished up, the first round of visits to nursing homes, and are very close to doing so with assisted livings, and so they will then continue for second doses.

That number that we put aside at the beginning includes second doses.

They'll continue to go to those facilities, so we'll see that number steadily going up.

Then we did start about two weeks ago receiving Moderna, you know, after we had allocated everything we needed to that program it started coming into the state to all of our vaccine providers.

And so those are typically some of the smaller entities, some doctors offices, pharmacies, the federally qualified health centers, rural health clinics, and so I think that they are ramping up and are hitting their stride and we're gonna be seeing that utilization going up significantly.

So you have to look a little bit at the different pots of vaccine to really get a sense of truly what's being used.

(Gavin) Yeah, And when we're talking about the Moderna vaccine too, it's my understanding that we're gonna be seeing an increase in our allotment because of the federal government.

Can you explain that and and that'll be going, like you said, to the pharmacies and the Walmart's, the Publix's, other different providers besides just hospitals?

Correct, correct.

So we were notified late day before yesterday by the federal government that we would be receiving a 16 percent increase in our total allocation for the week, for at least three weeks starting next week, and that it would be in the form of Moderna, and so we will be seeing about 10,000 extra Moderna first doses beginning next week.

And yes, the hospitals are getting Pfizer.

A lot of these other places are getting Moderna, and so it's allowing us to bring on board some more vaccine providers in some of the rural and underserved areas, and get vaccines spread out throughout the state more.

And can you tell us about the follow through?

We're talking a lot about first doses, but when we look at second doses, are folks who are already looking for their second dose, are they getting priority over people trying to get their first dose?

How does that scheduling work and maybe tell us a little bit more about the plans that DHEC has in store for scheduling, since that is also been a huge bottleneck.

Certainly, and so I don't know that I'd say that one has priority over the other, though we certainly have been from the beginning, encouraging providers to make sure that they have the capacity to get people their second doses, you know, during the right time frame, assuming they gave them their first doses.

We've really been messaging to everyone that when you get your first dose, don't leave that first dose appointment without knowing when and where you're going to get your second dose, without having an appointment for your second dose.

And you should be going back to the place where you got your first dose to get your second one.

So the current system for scheduling appointments, VAMS, is a little bit more challenging in that regard in terms of scheduling secondary doses.

I will tell folks, if you have had your first one and you don't have an appointment for your second one, and you cannot find an appointment in VAMS, reach out directly to that provider, that facility where you got your first dose.

From what I'm hearing, they've been very good about working with people to get 'em in in a timely fashion to get that second dose, but we are, at DHEC, working on a statewide appointment system that would replace VAMS for the public to use, and where they would be able to book first and second dose appointments.

And that's expected pretty soon, we hear?

It is, it is, I'm hoping in a matter of days.

And then, Dr. Traxler, we have a few moments left, but I want to ask you a little about DHEC's board approving a new allocation plan that's based on per capita not based on other factors such as, you know, poverty levels or risk factors.

Can you elaborate on how this plan's gonna work and what's going to be implemented, and what people might be seeing going forward?

Certainly, so we are in the initial phases of putting together the plans to really operationalize this allocation method, that it will be on just a per capita based on population geographically and so our team is working with our planners, and logistics and operations folks are working with those from National Guard, EMD, the Hospital Association, quite a variety of folks coming together to determine what is the best method then to execute this, and so we, I think, the plan is to have a set up in place, the plans determined by the time the Board meets next, which I believe is February 11th, and review it then with them before executing.

Okay, so it's not in place yet.

They're still working on it, and that would be basically giving bigger counties a bit more doses, essentially?

Correct, correct, and one thing I will remind folks is, we have reminded the vaccine providers: people are not limited to only their county to get vaccinated, especially now or even more importantly, several weeks ago when it was mostly hospitals that were vaccinating, we do have eight counties without hospitals, and so we're all in this together.

We need everyone vaccinated.

So the doses will be sent there, but it's not going to limit people in terms of where they can get vaccinated, based on where they live.

And I guess that's not to folks in rural areas, but can you tell us a bit more about how y'all are focusing on making sure people in those rural counties can be a part of this?

Certainly, so we are focusing on making sure that we have vaccine providers in these rural communities.

As I said we, in planning for next week and these 10,000 extra doses of Moderna that we're getting, it's allowing us to look at the map and see where there were gaps in some of these rural and underserved areas for providers and bring on board some providers to receive doses, those extra doses to help increase the coverage in all of the areas.

We also have, you know, about three weeks ago, I think, started vaccinating a couple of weeks ago, brought onboard the federally qualified health centers, and then last week the rural health centers, the rural health clinics.

The number of DHEC clinics and sites, they're not all at our health departments, but the number of DHEC sites continues to increase week after week and some of those are mobile and will be going out into areas also without potentially brick and mortar sites.

And just as we leave, Dr. Traxter, any information, websites, phone numbers you can give people really quickly so they can find out more about vaccines or scheduling?

Certainly, so our overall vaccine website that's a wealth of information is scdhec.gov/vaxfacts.

And then if you go to scdhec.gov/locator, that takes you to that map that'll show you the sights that are accepting appointments currently for vaccinations.

If you don't have internet access, you can call our Care Line, which is 1-855-4SC-DHEC.

Right, and that's Dr. Brannon Traxler with DHEC.

Thank you so much for joining us.

Thank you for having me.

We continue our COVID-19 conversation with Dr. Danielle Bowen Scheurer.

She's the Chief Quality Officer at MUSC Health.

Dr. Scheurer, thanks for joining us.

My pleasure, thanks for having me.

I just want to start off and ask you about the vaccine rollout.

We're six weeks into this.

MUSC's played a huge part in it.

Tell us, has the hospital system started to hit its stride, would you say, or are there still challenges facing the system?

Tell us what's going on with you all.

Yeah, I know.

That's a great question.

I think we're obviously better off than we were five weeks ago when we started, but yes, we're still trying to get the cadence of matching what I refer to as our roving bottleneck.

So you've got to match vaccine supply with patient demand, with staffing.

And while that sounds easy to match all three every single day, that's really what we're trying to smooth out, not always knowing how much vaccine we're gonna get, not always knowing which patients are gonna show up or not show up.

So it's a constant evolution, but that's what we're trying to strive for is to get all three of those things to match.

And when we look at the utilization rate for MUSC, tell me a little bit about that.

It seems a little bit low.

It's around 52 percent the last time I checked.

Can you elaborate on that situation?

I know you're talking about bottlenecks and things like that, but maybe why that rate is still so low when you have vaccine on the shelf.

Yes, we do have significant discrepancies in those data sources between DHEC and MUSC and I've commented on that in other places.

We are meeting with DHEC on a regular basis and trying to resolve those discrepancies.

Our internal numbers are in the mid 80's which is very similar to other health systems in and outside the state.

DHEC also did release a statement yesterday which was very inspiring, that the state of South Carolina is in the top ten as far as doses administered in the country, so I think overall we're still having some data discrepancy woes, but that's not reflective of our performance at MUSC.

Gotcha, yes.

So again, hitting that stride that we're talking about there with 80 percent utilization is good.

What about second dose shots?

Is that any concern?

Are you guys pretty good about keeping up with folks?

When they get the first one, they make sure they get that second scheduled?

Absolutely, we absolutely guarantee a second dose.

As you all know, the absolute ideal day is at day 21.

The manufacturer recommends 19 to 23.

No one recommends earlier than 19 and the CDC actually has relaxed it a bit, and said even up to six weeks out is pretty reasonable, so up to 42 days.

If people are scheduling, we do track that, and if people are scheduling over five or six weeks out we do call them and make sure that that was not a mistake and try to get them in again within that window, which has relaxed a bit but again, ideally at day 21.

You know, we are, like we were saying, six weeks into this.

We're seeing a little more of a boost of the vaccine coming from Moderna, coming to the states.

I'm just wondering where do you see...

I know we talk about the now.

We're all focused on the first roll out, but where do you see us being as a state, maybe as MUSC, in the next six weeks?

I mean how far are you looking forward to where we will be then?

Yeah, I mean, I think we have a lot to look forward to.

Just like you said, I think the federal allocation distribution is definitely gonna go up with negotiating with both Pfizer and Moderna as well.

Johnson and Johnson data does look very promising, and at least according to Fauci, who is obviously a reputable source, there's belief that Johnson and Johnson vaccine may go for review as early as mid to late February and be in circulation by early spring, so that's a great vaccine as well.

Some of the data hasn't been published, obviously, but the safety and efficacy do look good.

It's a one dose vaccine, which you can imagine just the logistics of the two dose.

It's much more difficult, and it only has to be refrigerated, which is also a remaining difficulty with the Pfizer vaccine, so I think we have a lot to look forward to.

I know our supply is inevitably going to go up substantially in the next couple of weeks or months.

I want to focus now on looking at the hospital system.

We just saw 6000 confirmed deaths this week from COVID-19.

We've had more than that unconfirmed, of course, but we also heard from Dr. Brannon Traxler with DHEC saying that we've reached somewhat of a slight plateau, some optimism there.

Tell me about what y'all are seeing in your hospital system, how the surge is handling there, and what's going on within the hospitals.

Yeah, I agree.

We're experiencing the same thing.

I think we have a little bit of light at the end of the tunnel.

We seem to have hit a plateau as well, both in percent positive tests, as well as number of admissions, so we are very much looking forward to that plateau turning into a decrease in total cases, and in particular hospitalization.

Most of our care team members who have been vaccinated, our care team member rates have plummeted, which is so wonderful to see, which again, I think helps people feel safer coming to get care and coming to the hospital or our clinics, knowing that the vast majority of our care team members have also been vaccinated and therefore dramatically reduces the risk of COVID transmission.

Is staffing still an issue, though, at this point?

I mean, it's never easy.

I would say it's not in a critical status as we have seen periodically here and there, and our need for outsourcing staffing has gone down, so staffing is never easy.

It's always a bit of a struggle to get that perfect number of people, the qualified people in.

But that has also hit a bit of a relief valve as well.

And Doctor, we have about two minutes left.

I want to ask you about vaccine hesitancy.

I've even heard about those in the medical field as well, having some hesitancy around the vaccine.

I was wondering if you're seeing that in the numbers in vaccines with this phase one, a situation with these doctors and medical professionals.

Do you hear about that?

Do you hear medical professionials expressing some concern, as well as others about the vaccine, and what would you have to say about that?

We do, we do indeed.

I think most of the concern is the rapidity with which the vaccines were released, and there's still some concern of 'how could it possibly be that safe and effective.'

Some other concerns I think are more sort of medical myth, more than legitimate concerns and things around 'does it alter my DNA' or 'does it make me infertile.'

There's no evidence to support any of those concerns, and so we have spent a ton of time combatting vaccine hesitancy both within our team members as well as within the community.

So we've again just tried to battle it with facts, and advertising the folks that have gotten the vaccine and that 'I'm still here.

I'm still vertical.'

'The side effects weren't that bad.'

I think the further out we go, the easier vaccine hesitancy is gonna become.

As people personally know people who have gotten the vaccine and have done well.

Yeah, and with that I know I've heard from DHEC.

We have not heard of any major reactions to this, and again those major reactions happen with, I think, about 11 out of 1,000,000 people, so they're pretty rare.

Exceedingly rare.

Exactly.

And COVID is not exceedingly rare, so if you're gonna pick COVID or the vaccine, I really hope people would pick the vaccine over getting COVID.

Strong words right there, Doctor.

We appreciate catching up with you.

That's Dr. Danielle Bowen Scheurer.

She's a Chief Quality Officer at MUSC Health.

Thanks for joining us.

My pleasure, thank you so much.

To stay up to date throughout the week, check out the South Carolina Lead .

It's a podcast that I host multiple times a week.

You can find it on South Carolina Public Radio dot org or wherever you find podcasts.

For South Carolina ETV, I'm Gavin Jackson.

Be well, South Carolina.

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