COLUMBIA — The number of COVID-19 cases in South Carolina is expected to climb to more than 8,000 by early May, nearly 20 times the confirmed cases so far, according to a forecast released Wednesday by the state's public health agency.
That projection could decrease significantly if residents practice social distancing as requested. When cases could peak in the state and, consequently, when restrictions on work and activities could start to be lifted are unknown, agency officials said.
"It’s hard to predict the future because the future is going to be determined on how we follow the key instructions to help flatten the curve," Rick Toomey, director of the state Department of Health and Environmental Control, said.
Asked about the likelihood of South Carolinians being back at work by April 12, as President Donald Trump has set as a goal, Toomey said, "It would certainly be a wonderful occurrence for us to have a wonderful Easter Sunday, but it’s hard to predict."
As of Wednesday afternoon, there were 424 known cases of COVID-19 in 39 of South Carolina's 46 counties, including seven coronavirus-related deaths. Kershaw County remains the hardest hit, with 63 confirmed cases, according to DHEC.
Based on the spread so far, the agency projects there will be about 2,700 total cases by April 2 and 8,050 by May 2, though Toomey stressed those are cumulative cases that include patients already recovered.
Residents should not expect to be notified if they're exposed to a case, said Dr. Linda Bell, the state epidemiologist, who again urged people to stay home, keep 6 feet away from each other if you must go out and wash your hands frequently.
A nationally renowned researcher with the University of South Carolina predicts much high numbers.
That forecast by James Morris, a USC biology professor, predicts that by March 31, South Carolina will have about 2,500 people who have tested positive. By April 10, though, that number skyrockets to about 40,000.
"Right around the first of April, it's going to get dicey. From that point on, it really explodes," said Morris, who has done groundbreaking work on the impacts of rising sea level on marshlands.
Morris, who usually studies changes over decades, began tracking South Carolina's cases in mid-March and plugging numbers into a mathematical model he likened to a high school algebra problem.
That's the problem with an exponential projection, Bell said.
It's based on dramatic rises in confirmed cases from one day to the next, but some of those jumps were due to delayed reports to the state agency from labs processing the tests, not actual day-to-day increases, she said.
She noted that Morris' forecast for South Carolina is higher than the current cases in New York, where millions of people live much closer to each other than here, she said.
But Morris said he plotted the model's accuracy over the coming days, and the actual rise in cases came close to his forecast. If anything, he said, the model underestimated the pace. Initially, the number of cases in South Carolina doubled every three days. Now it's down to 2.5 days.
He wrote a letter to Gov. Henry McMaster earlier this week urging the governor to take stronger actions to prepare for an upcoming flood of sick patients. He believes the state and its universities should consider setting up temporary hospitals in arenas and other large spaces.
About 20 percent of people who get the virus are expected to need hospitalization.
McMaster has urged people to stay home and on Monday authorized law enforcement officers statewide to break up gatherings of more than three people that pose a risk. But, while he's ordered schools closed and restaurants to stop dine-in service, he has stopped short of officially ordering people statewide to stay home.
Morris said his forecast of 40,000 cases in South Carolina by mid-April is based on the assumption that the state's medical infrastructure can test that many people.
"Testing capacity is being ramped up dramatically," Toomey said, as there will soon be about 30 labs approved to process tests.
Trying to identify everyone is no longer the goal.
As the state shifts from containing the disease to lessening the severity, "testing strategies transition from attempting to test all possible cases in a community to testing a reasonable sample of those who are ill," focusing on those at higher risk of exposure or of getting seriously ill, Bell said.
"Our goal is to monitor disease spread in a community and not identify every case," she said.
That means we don't have accurate numbers of who does and who doesn't have the disease, Morris said.