COLUMBIA, S.C. (AP) — After finally knocking down a two-month summer spike in COVID-19 cases, officials in South Carolina are worried things will get worse again if people don't continue to wear masks and stay socially distant throughout the holidays.

The new hot spot in the state is around Greenville, where 1,600 COVID-19 cases have been diagnosed in the past two weeks — or nearly 10% of all cases since the pandemic began in mid-March.

Greenville Mayor Knox White told the residents in his mostly conservative, business-oriented city that failing to take precautions and allowing the virus to continue to spread rapidly is a danger to their health, but to their pocketbooks too because even if businesses aren't shut down, people may be too scared to go out and spend money.

“We determine where the COVID goes. We determine where the economy goes," White said at a Friday news conference.

There are concerning trends on the health side too. Both major hospital systems in Greenville have seen their number of COVID-19 patients hospitalized nearly double since the beginning of September.

“The number of non-COVID patients has gone up as well. And they are a lot sicker,” said Dr. Marcus Blackstone, the chief clinical officer for Bon Secours St Francis Hospital in Greenville.

Blackstone thinks that is because some people delayed trips to the doctor or hospital at the beginning of the pandemic because they worried about getting COVID-19, and now they have no choice but to seek treatment.

Across South Carolina, nearly 85% of the state's more than 10,000 hospital beds are occupied. About one in 10 had COVID-19, but those virus patients were filling a quarter of the ICU beds, according to data from the South Carolina Department of Health and Environmental Control.

The number of hospital patients has seen a steady rise across the state in the past month, and health experts said a rise in deaths is following. South Carolina is averaging 20 COVID-19 deaths a day, a level not seen for a month, according to health data.

More than 3,640 people have died from COVID-19 in South Carolina and about 165,000 people have been infected with the virus, according to the state health department.

Officials are starting to shift their COVID-19 safety messages from back to school and back to work to the holidays.

They recommend no large gatherings for Halloween, Thanksgiving or Christmas and holding smaller gatherings outside if possible. If they are inside, people need to wear masks at all times unless they are eating and stay 6 feet (2 meters) apart, interim state Public Health Director Dr. Brannon Traxler said.

Traxler said she understands people are getting tired of the inconvenience of the new recommendations.

“We recognize these are the same things we have been urging time and time again for months now and people are tired of hearing of COVID-19," Traxler said. "But think of the first responders."

And think of elderly relatives, who continue to be most at risk of dying if they get the virus, said Dr. Wendell James, a senior vice president with Prisma Health in Greenville.

James said he typically has up to 35 people in his home for Thanksgiving, a gathering dear to his family and his parents, who are in their 80's.

“I can’t do that this year. Not the way we have historically done. We have to be responsible for one another and our loved ones," James said.

With the spike in hospitalizations, people need to be careful depending too much on new COVID-19 treatments instead of on inexpensive masks, hand sanitizer and soap.

“The more people we get sick, regardless of the level of therapy and treatment they get, the more people are going to die," James said. “That is what we do not want to see. We want to keep people from getting sick to start with.”


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