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In mid-January, an unassuming man in khakis and a button-down shirt walked to a wooden lectern at a school board meeting in Spartanburg County, South Carolina. Most chairs in the audience were empty. The man, Tim Smith, was the only person signed up to speak during public comments. He had five minutes.

“I trust that each one of you had a good Christmas and New Year’s,” he began. “Unfortunately, I can’t say the same thing.”

His wife is an assistant teacher at a public elementary school in the county, epicenter of the state’s historic measles outbreak, and shortly before winter break she’d received a notice that a child in her classroom had measles. Given his wife is fully vaccinated, he wasn’t worried.

Then, she began to get sick. And sicker. She got a measles test and, to their shock, it came back positive. She was apparently among the very rare breakthrough infections.

Frightened, they took her to the hospital that night. “My wife was throwing up,” Smith said at the meeting. “She had diarrhea. She couldn’t breathe. All for what? This is — it’s absolute insanity.”

Dr. Leigh Bragg, a pediatrician working a county away, wasn’t even aware that anyone in South Carolina had been hospitalized with measles-related illnesses until a short time later when she logged on to Facebook and saw someone relay the distraught husband’s comments.

Part of the reason Bragg didn’t know is that South Carolina doesn’t require hospitals to report admissions for measles, potentially obscuring the disease’s severity. In the absence of mandatory reporting rules, she and other doctors are often left to rely on rumors, their grapevines of colleagues, and the fragments of information the state public health agency is able to gather and willing to share.

With 973 reported cases, South Carolina’s measles outbreak has ballooned into the nation’s largest since the virus was declared eliminated in the U.S. 25 years ago. Yet, since state health officials first confirmed the outbreak on Oct. 2, the state’s hospitals have reported only 20 measles-related admissions, or about 2% of cases. Some infectious disease experts say that the true number is likely much higher.

Hospitalization rates can vary greatly by a measles outbreak’s location and who is getting infected. But the Centers for Disease Control and Prevention estimates about 20% of measles cases will result in admissions.

“A hospitalization rate at 2% is ludicrous,” said Dr. Paul Offit, director of the Vaccine Education Center and an infectious disease physician at Children’s Hospital of Philadelphia who served on the Centers for Disease Control and Prevention’s immunization advisory committee.

“It’s vast underreporting,” Offit said. “Measles makes you sick.”

Measles is among the most contagious of viruses. In 2026 so far, almost half of states have reported cases. Yet it’s left largely to each state to decide how much infectious disease reporting to require about it.

“We don’t think we are getting an accurate picture at all of how these illnesses are impacting our community,” Linda Bell, the South Carolina state epidemiologist, said at a briefing last month. “We’re just not getting a picture of that now with the small number of hospitalizations that are known to us.”

Bell said the state Department of Public Health is urging hospitals to report their measles-related admissions, and seven hospitals have done so. (There are at least a dozen acute care hospitals in the Upstate alone.) But the state cannot force them to do so. Bell also said that the agency, which sets infectious disease reporting requirements, hasn’t considered adding hospitalizations to the list because the primary purpose of public health surveillance is to understand disease transmission, frequency and distribution — not to track complications.

That leaves doctors like Bragg advising patients, including vaccine-resistant parents, without the benefit of confirmed, real-time data about how many South Carolinians have been hospitalized with measles. Severe complications include pneumonia, dehydration and a potentially life-threatening brain swelling called encephalitis.

“It’s a very big disservice to the public not reporting complications we are seeing in hospitals or even ERs,” Bragg said. “Measles isn’t just a cold.”

ProPublica contacted state health agencies across the South and found most do not require hospitals to report measles-related admissions. Alabama does. So does Virginia, although it doesn’t release that data to the public. Like South Carolina, North Carolina and Texas don’t require reporting of hospitalizations, but epidemiologists can identify them during case investigations.

During the Texas measles outbreak last year, 99 people were hospitalized out of 762 cases.

That’s a rate of about 13%. In South Carolina, the reported rate is 2%.

Real-time hospitalization data can show where to target resources and help hospitals prepare for an influx of patients. “As vaccine rates decrease, it could also really help us understand the changing epidemiology of measles in this current context,” said Gabriel Benavidez, an epidemiology professor at Baylor University in Texas.

When ProPublica asked hospitals across the Upstate, the northwest quadrant of South Carolina where the outbreak is concentrated, if they are reporting their measles-related admissions to the state and how many patients they had treated, few responded. Only Spartanburg Regional Healthcare System shared its total. (As of mid-February, the number was four.)

A spokesperson for Prisma Health, a Greenville-based nonprofit that owns eight acute-care hospitals in the Upstate, said its hospitals are “reporting everything we are supposed to report.” She wouldn’t say how many measles patients have been hospitalized at Prisma hospitals or how many the system has reported to the state.

Bragg, who is board certified in pediatrics and pediatric infectious disease, works in the region of South Carolina where the outbreak is concentrated. It’s a highly religious expanse with the state’s lowest student vaccination rates. She recently met with a parent questioning the recommended vaccines for a 1-year-old child, which includes a first dose of measles vaccine.

“We’re in the middle of a measles outbreak,” Bragg thought.

Then she began a 30-minute discussion of the vaccine’s extreme safety and 97% lifetime effectiveness when two doses are given. She explained that 95% of people in South Carolina who have gotten measles were unvaccinated. She rattled off historic risks of measles complications.

Yet Bragg couldn’t tell the parent just how severely ill their fellow South Carolinians were getting from the outbreak sickening people around them.

She had heard about pneumonia, ICU admissions — and even a case of encephalitis. But she hadn’t been able to confirm it, or find out if it was a child, much less how the patient fared. (Shortly after, Bell announced that the state health agency had learned of encephalitis cases in children, but she didn’t provide the numbers of patients or their outcomes.)

As president of the South Carolina chapter of the American Academy of Pediatrics, Dr. Martha Edwards is connected to physicians across the state. “All I’m hearing about are ‘complications of measles,’” which can mean a lot of different things, she said.

Communicating the risks of severe illness is all the more important because few of today’s parents have seen measles up close. Neither have most practicing doctors.

Early in his career, Dr. William Schaffner, a professor at Vanderbilt University who focuses on the prevention of infectious diseases, worked with the CDC to implement the measles vaccine. When he tells medical students today that in the 1960s, before the measles vaccine, 400 to 500 kids died of measles and its complications each year, “They’re stunned.”

“If the severity of the illness cannot be ascertained — if it can’t be determined — it can’t be appropriately communicated to the public,” Schaffner said. “And the public might get the false impression that measles is milder than it really is.”

At a briefing, Dr. Robin LaCroix, a Prisma pediatric infectious disease physician, said the organization’s physicians “have seen the whole gamut of acute and post-measles infections that have afflicted these children. They are sick.” Children have become listless and suffered blotchy rashes, coughing and coughing spasms, dehydration and secondary infections including pneumonias.

Measles infections are particularly dangerous for babies who cannot get vaccinated yet and young children who haven’t gotten the second dose. Infections during pregnancy also pose severe risks for mothers who are not vaccinated or immune, including miscarriage and a tenfold increase in death due to pneumonia. Mothers can pass on the virus to their babies, “which can be catastrophic,” said Dr. Kendreia Dickens-Carr, a Prisma OB-GYN.

More than 900 confirmed measles cases have been reported across the country already in 2026, compared with 2,281 in all of 2025. Most of this year’s cases are in South Carolina, but Florida has reported 63 cases and neighboring North Carolina 15, including one hospitalization.

“We really do need to think about the way in which we report these things, because viruses and bacteria don’t respect state lines,” said Dr. Annie Andrews, a pediatrician running as a Democrat for the U.S. Senate in South Carolina. “Public health professionals from one state to another should be comparing apples to apples and oranges to oranges.”

The most advanced pediatric care in the state is provided at the Medical University of South Carolina’s campus in Charleston, several hours away from the Upstate on the coast. So far, its children’s hospital hasn’t admitted any measles patients, doctors said.

Dr. Danielle Scheurer, the chief quality officer at MUSC, celebrated the state’s low hospitalization rate and said she doubted hospitals would object to required reporting of measles-related admissions if the state health agency were to change its rules.

“Transparency here is going to help other states,” Scheurer said. “The more transparent we are about all of our statistics, the better off any other state is going to be in preparing.”

Across South Carolina, large health care systems have bought up local hospitals and doctors’ practices. With that control, they can exert influence over what those doctors and hospital employees say publicly, especially when it comes to potentially controversial topics like vaccines. At the same time, they face pressure from Republican lawmakers and a growing segment of vaccine-wary patients.

The result is often highly controlled information sharing, or a lack thereof.

“There’s this level of caution that wasn’t there before,” Edwards said. She understands that hospitals don’t want to offend patients who are dubious of vaccines. Bragg agreed but said given that 93% of the state’s students are vaccinated, she worries the hospitals are “pandering to a small group.”

A pending bill, sponsored by several of Spartanburg County’s state representatives, seeks to prevent hospitals and doctors from questioning or interfering “in any manner” with a patient’s right to refuse treatments or vaccines. During COVID-19, the bill contends, federal agencies collaborated with medical organizations and others “to orchestrate a coordinated and coercive propaganda campaign” to shame people who declined COVID-19 vaccines. Doctors and hospitals argue they must balance public health risks with individuals who decline to take vaccines.

The state’s Republican governor, Henry McMaster, and major GOP candidates to replace him have largely framed their responses to the measles outbreak around the concept of medical freedom, particularly when discussing vaccine mandates.

Andrews, the pediatrician running for the U.S. Senate, said she’s experienced the “chilling effect” the GOP’s “anti-science movements” have had on health care systems and individual physicians. “If you speak up, you are at risk of being censored,” Andrews said. “If you speak up, you are at risk of losing your job. So everyone is just trying to keep their head down and do what’s best for their patients.”

Bragg is among the declining ranks of doctors who run their own independent practices. She has the freedom to post what she wants to on social media and to wear pro-vaccine T-shirts that say things like, “Got polio? Me neither because I got the vaccine.”

But one recent day, her 10-year-old son asked why she insisted on wearing the T-shirts. “Even a 10-year-old can tell you how polarizing vaccines have become,” Bragg said. Despite that, she has continued to wear them.

by TOM DAVIS

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This week, I filed a joint resolution in the South Carolina Senate – S. 936 – that may prove to be among the most consequential actions the General Assembly takes this session. The resolution directs a unified state response to the U.S. Department of Energy (DOE)’s January 28th Request for Information seeking state partners to host Nuclear Lifecycle Innovation Campuses, integrated environments spanning the full civilian nuclear value chain, from fuel production and reactor construction to advanced manufacturing and workforce development.

This is not a routine federal solicitation. It is one of the most significant economic and national security initiatives the federal government has launched in a generation, and South Carolina cannot afford to treat it as anything less.

Think of a Nuclear Lifecycle Innovation Campus as a nuclear industrial city — a large, self-contained complex where every step of the nuclear energy process happens under one roof, in one place, on one expanse of land: raw material processing, fuel fabrication, reactor operation, energy generation, waste management, and the research and manufacturing infrastructure that ties it all together. The Savannah River Site, with its nearly 310 square miles of federal land in Aiken and Barnwell counties, is purpose-built for exactly this kind of mission. It already houses world-class nuclear facilities, a national laboratory, and decades of operational infrastructure. There is no site in America more ready.

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The case for South Carolina is not aspirational. It is grounded in facts no other state can match. South Carolina ranks first in the nation in nuclear employment concentration. We produce approximately fifty percent of the nation’s nuclear fuel. Nuclear energy generates roughly half of our electricity, one of the highest shares in the country.

For decades, the Savannah River Site and Savannah River National Laboratory have served as trusted stewards of the nation’s most sensitive nuclear assets, building an operational record that speaks for itself. Our research universities, technical colleges, registered apprenticeship programs, and veteran workforce have produced the deep bench of nuclear engineers, fuel cycle specialists, and precision manufacturers that a program of this scale demands.

Other states can point to nuclear history. South Carolina can point to nuclear infrastructure, and to something no other prospective host state can offer: we are actively engaging in a process to complete the construction of two nuclear reactors right now.

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When the General Assembly passed Act 73 of 2025, directing Santee Cooper to solicit competitive bids for the restart and completion of VC Summer Units 2 and 3, skeptics questioned whether the state was serious. Santee Cooper’s subsequent acceptance of Brookfield Renewable Partners’ bid answered that question decisively.

Those reactors would add 2,200 megawatts of carbon-free baseload generating capacity to our grid. More importantly for purposes of this federal competition, they demonstrate South Carolina’s unique capacity to support the full nuclear lifecycle — not in theory, but in practice, in real time.

The Department of Energy is looking for state partners ready to lead. South Carolina is not standing at the starting line waiting for the gun. We are already running.

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NEW LIVE SHOW WEDNESDAYS @ 7:00 P.M.

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The benefits of designation would be profound and lasting. High-wage employment opportunities would flow not only to our urban centers but to rural communities near our existing federal and industrial assets. Billions in private capital investment would follow, accelerating growth in advanced manufacturing across the state. Our research universities would gain federal partnerships and resources that attract talent for generations. The economic ripple effects would extend into communities that have long needed exactly this kind of sustained, high-quality investment.

The South Carolina Department of Commerce has already convened a Steering Committee drawing on state agencies, research universities, Savannah River National Laboratory, private industry, utilities, and workforce institutions. South Carolina is organized, aligned, and moving. What the state response needs now is the General Assembly’s formal expression of support, a clear signal to Washington that our commitment is institutional, not merely administrative.

That is what today’s resolution provides. I urge my colleagues to pass it without delay. This opportunity will not wait, and neither should we.

ABOUT THE AUTHOR…

Tom Davis represents Beaufort and Jasper counties in the South Carolina Senate.

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A former South Carolina Gamecock is on the move in the professional coaching world.

According to a report from CBS Sports’ Matt Zenitz, the Arizona Cardinals are hiring Rod Wilson to be the team’s new inside linebackers coach. The Cardinals’ current linebackers coach, Cristian Garcia, will move to safeties. The move is expected to be the final major move for new head coach Mike LaFleur in Arizona.

Wilson had spent the last four years and seven of the last nine in various roles with the Kansas City Chiefs. He won three Super Bowl rings with Kansas City, one as a special teams assistant and two more as a defensive assistant. Most recently, he was the team’s outside linebackers coach.

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Wilson was a former starter for the South Carolina defense and also spent some time coaching with his alma mater.

To start his playing career under head coach Lou Holtz, Wilson was on the offensive side of the ball. A high school quarterback, he transitioned to the wide receiver position before moving to defense. Splitting time between the safety, linebacker, and hybrid “spur” positions, Wilson became a team captain. During his final season in garnet and black, he earned some All-SEC recognition and led the team in total tackles.

Following graduation, he enjoyed a six-year career in the NFL with the Chicago Bears, Tampa Bay Buccaneers, and Jacksonville Jaguars. He got into coaching shortly thereafter, getting his first collegiate coaching opportunity at Charleston Southern.

Following three years at CSU and his first stint with the Chiefs, Wilson spent the 2020 season coaching linebackers at South Carolina under head coach Will Muschamp and defensive coordinator Travaris Robinson. He helped guide Ernest Jones to an All-SEC campaign that season, ahead of third-round NFL Draft selection.