Mike Hoerger, PhD MSCR MBA Profile picture
Jul 14, 2022 10 tweets 10 min read Read on X
Kids <2 yrs old can’t mask.
Kids <6 months can’t vax.

Many parents are using strollers w/rain covers to try to get some protection during essential activities.

Does adding a #PAPR or #HEPA device help?

I tried 6 models: engrxiv.org/preprint/view/…

#PAPRbuggy #HEPAbuggy
1/10 Image
First off, thanks @RealSexyCyborg for the original design. Thanks to @ccwake1, @gjmf, @drgregkelly for ideas too. Happy to acknowledge!

My goal was to test 6 models & help relate them to non-engineers.

2/10

The PAPR & HEPA buggies I tested had an estimated 57-951 air changes per hour (ACH) in these TINY spaces. The worst design had about 3x the air cleaning of an OR.

You can make a #PAPRbuggy that’s super discrete for about $110 more than an existing stroller & rain cover.

3/10 Image
With even a cheapo ($55) HEPA, you can make a relatively discrete #HEPAbuggy w/good air cleaning (see Figure A1.5 in preprint).

BUT, I also tested some power models. This one runs at an estimated 900+ ACH, or about 60x the minimum rate of an OR. 😎 Vroom vroom.

4/10
Want to learn more about a #PAPRbuggy or #HEPAbuggy?

See the preprint:
🔸 Figure A1: Design ideas
🔸 Tables 1 & A4: Estimated specs
🔸 Table A3: Parts & supplies w/links
🔸 Tables A1-A2: Help w/any calculations

engrxiv.org/preprint/view/…

5/10 Image
If you are a COVID-cautious parent, be forearmed that trolls will troll.

Sticks & stones. I knight you a #PublicHealth ambassador. Stand tall. Your work is needed.

Check out Table A5 for what to expect (final page).
engrxiv.org/preprint/view/…

6/10
If you’re a #COVID-cautious #parent, I also hope you’ll read the 1st paragraph of this paper (pg. 3).

✅ You’re doing the right thing
✅ You’re smart
✅ Feel validated
✅ Reference #7 is absolutely damning
✅ Kids deserve a better world

engrxiv.org/preprint/view/…

7/10
H/t 🎩to @sri_srikrishna for the #CorsiRosenthalBox article that inspired my write up.
sciencedirect.com/science/articl…

Thanks also to @JimRosenthal4, @CorsIAQ, @joeyfox85, and others for teaching about air cleaning

8/10
I posted Naomi’s original design, but also check out Greg’s "Pram-PAPR." He’s got a different air filter & older child.

Mine are baby twins, so I’ve got some different models in the paper & will test out more double strollers down the line too.

9/10
Thank you for your advocacy - @MamaWeasleyy, @PTF_org, @Annalisa840917, @mir_ocall, @maskupmama, #ImmunizeUnder5s #covidkids

Please share the #PAPRbuggy & #HEPAbuggy with families of young children!

If I have to 🔒 my account, send the link:
engrxiv.org/preprint/view/…

10/10

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More from @michael_hoerger

Apr 22
🧵1 of 8 | PMC Dashboard, April 21, 2025 (U.S.)

🌤️Only 1 in 5 days of the pandemic have seen transmission as low as today
🌤️1 in 196 actively infectious
⚡️BUT still 1.7 million weekly infections, resulting in >85,000 LC cases and up to 1,000 deaths

I'll walk you through it... Current Levels for Apr 21, 2025	 % of the Population Infectious	 0.5% (1 in 196)	 New Daily Infections	 244000	 New Weekly Infections	 1708000	 Resulting Weekly Long COVID Cases	 85,000 to 342,000	 Resulting Weekly Excess Deaths	 600 to 1,000	 	 Monthly Forecast	 Average % of the Population Infectious	 0.7% (1 in 147)	 Average New Daily Infections	 324800	 New Infections During the Next Month	 9744000	 Resulting Monthly Long COVID Cases	 487,000 to 1,949,000	 Resulting Monthly Excess Deaths	 3,500 to 5,800	 	 Running Totals	 Infections Nationwide in 2025	 62331000	 Average Number of Infecti...
🧵2 of 8 | PMC Dashboard, April 21, 2025 (U.S.)

We're in the 6th year. See the small red line, bottom left. Notice how closely it tracks the median (gray), year 4 (yellow), & year 5 (orange).

Acknowledging caveats, those are plausible gist-level scenarios for months ahead. year over year graph, summarized in post
🧵3 of 8 | PMC Dashboard, April 21, 2025 (U.S.)

Expect steady transmission bouncing up and down around the current national lull-level estimate the next several weeks. 200-350k daily infections nationally.

This is about as low as lulls bottom out anymore. Past 12 months and forecast, summarized in post
Read 8 tweets
Apr 14
🧵1/5 | PMC Dashboard, Apr1il 14, 2025 (U.S.)

🔹2.2 million weekly infections
🔹1 in 149 actively infectious
🔹>100,000 LC cases resulting from the week's infections
🔹>800 deaths resulting from the week's infections
🔹"Lull" transmission steady/slightly decliningCurrent Levels for Apr 14, 2025	 % of the Population Infectious	 0.7% (1 in 149)	 New Daily Infections	 320000	 New Weekly Infections	 2240000	 Resulting Weekly Long COVID Cases	 112,000 to 448,000	 Resulting Weekly Excess Deaths	 800 to 1,300	 	 Monthly Forecast	 Average % of the Population Infectious	 0.7% (1 in 138)	 Average New Daily Infections	 345366.6667	 New Infections During the Next Month	 10361000	 Resulting Monthly Long COVID Cases	 518,000 to 2,072,000	 Resulting Monthly Excess Deaths	 3,700 to 6,200	 	 Running Totals	 Infections Nationwide in 2025	 60891000	 Average Number of ...
🧵2/5 | PMC Dashboard, Apr1il 14, 2025 (U.S.)

Year-over-year transmission (red line, lower left) is tracking the median (grey), year 4 (yellow), and year 5 (orange) closely.

If that trend continues, expect steady yet bumpy transmission the next couple months, until June/July.line graphs, described in tweet
🧵3/5 | PMC Dashboard, Apr1il 14, 2025 (U.S.)

The heat map shows only 4 states in the CDC 'high' level and none in the 'very' high level.

Check local data. Those timing activities to lulls may see a clear opportunity.heat map, described in tweet
Read 6 tweets
Apr 9
The NIH Clinical Center drops universal masking after 5 months of protecting patients, family, & staff.

Wastewater-derived estimates indicate 2.79 million Americans are getting Covid per week AND top actuaries suggest an American dies of Covid every 3 minutes.

🧵1/5 Masks are optional beginning April 11. Staff will mask on request.
These are the current wastewater-derived estimates of transmission.

2.79 million Covid infections/week in the U.S. in the current high "lull."
🧵2/5
This thread with video explains in exquisite detail how every 3 minutes in 2025 an American dies of Covid.

🧵3/5
Read 5 tweets
Apr 7
1) PMC COVlD Dashboard, April 7, 2025 (U.S.)

🔹1 in 120 actively infectious
🔹1 in 3 chance of exposure in a room of 50
🔹2.8 million weekly infections
🔹>140,000 resulting LC cases from the week's infections
🔹>1,000 deaths resulting from the week's infections Current Levels for Apr 7, 2025	 % of the Population Infectious	 0.8% (1 in 120)	 New Daily Infections	 399000	 New Weekly Infections	 2793000	 Resulting Weekly Long COVID Cases	 140,000 to 559,000	 Resulting Weekly Excess Deaths	 1,000 to 1,700	 	 Monthly Forecast	 Average % of the Population Infectious	 1.0% (1 in 105)	 Average New Daily Infections	 455766.6667	 New Infections During the Next Month	 13673000	 Resulting Monthly Long COVID Cases	 684,000 to 2,735,000	 Resulting Monthly Excess Deaths	 4,900 to 8,100	 	 Running Totals	 Infections Nationwide in 2025	 55591000	 Average Number of...
2) Watch this video to understand how we use excess death data from one of the world's largest reinsurers to estimate how this week's infections will result in >1,000 deaths.
3) Transmission is steady or declining across much of the nation, but remains high in 11 states and DC, per the CDC.

Other sources, such as WastewaterSCAN, show a near doubling of transmission in the Northeast the past few weeks, so remain cautious.
Read 4 tweets
Mar 31
🧵1 of 5
PMC Dashboard, March 31, 2025 (U.S.)

🔹800-1,400 deaths expected to result from this week's infections (new stat, see video next Tweet)
🔹100,000+ Long Covid conditions to result from this week's infections
🔹1 in 142 actively infectious todayCurrent Levels for Mar 31, 2025	 % of the Population Infectious	 0.7% (1 in 142)	 New Daily Infections	 337000	 New Weekly Infections	 2359000	 Resulting Weekly Long COVID Cases	 118,000 to 472,000	 Resulting Weekly Excess Deaths	 800 to 1,400	 	 Monthly Forecast	 Average % of the Population Infectious	 0.8% (1 in 120)	 Average New Daily Infections	 397233.3333	 New Infections During the Next Month	 11917000	 Resulting Monthly Long COVID Cases	 596,000 to 2,383,000	 Resulting Monthly Excess Deaths	 4,300 to 7,100	 	 Running Totals	 Infections Nationwide in 2025	 52303000	 Average Number of ...
🧵2 of 5
PMC Dashboard, March 31, 2025 (U.S.)

This video explains U.S. COVID excess death statistics, which we have incorporated into the dashboard.

🧵3 of 5
PMC Dashboard, March 31, 2025 (U.S.)

The transmission forecast suggests 300-500k daily infections the next month. If the data get retroactively corrected downward, we could dip to 200k.

Check local dashboards, and time events accordingly.Forecast graph, described in post
Read 5 tweets
Mar 31
PMC Update on #ExcessDeaths

🔥109,000-175,000 people in the U.S. are expected to die as a result of COVID in 2025, based on estimates derived from Swiss Re
🔥COVID deaths expected to be on par with lung cancer in the U.S. in 2025
🔥Death data added to the dashboard
2) Full video links to learn more about COVID #ExcessDeaths in the U.S.

Dashboard page (presently featured): pmc19.com/data
Downloadable file: pmc19.com/data/deaths033…
Veed platform: veed.io/view/558039f4-…
3) The new #ExcessDeath statistics build on what we described in the 5-year pandemic anniversary video.

Watch from 12:14-20:00 to see how simplistic models underestimate COVID deaths. The Swiss Re model solves that problem. PMC extends that work.
Read 6 tweets

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