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Mike Hoerger, PhD MSCR MBA Profile picture
@michael_hoerger
Sep 25, 2022 • 9 tweets • 6 min read • Read on X
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Know someone having a baby soon? CONGRATULATIONS! 🍼🍼🍼

As hospitals drop universal COVID protections, these are my top 7 tips for protecting unmaskable un-vaxable newborns from #nosocomial (hospital-acquired) COVID.

What did I miss?

THREAD of Top 7 Tips 🧵
Tip #1 – Determine your #mask rules. Some parents require staff to #N95. Compliance would vary by region/hospital. Prep for what you’ll say if staff don’t comply.

With our newborn twins, we supplied medical staff w/free N95s & tests. Nobody wanted N95s; 1 took a #RAT. 🤣
Tip #2 – U.S. hospitals SHOULD have excellent ventilation (air cleaning) by reg. But HVAC repair doesn’t have a CPT code. Many of my best & worst air quality readings are from hospitals.

Consider buying a #CO2monitor, read on that hashtag, & follow @joeyfox85 for basic tips.
Tip #3 – Bring 1-2 large #HEPA filters. Your GOAL is to keep them plugged in. When someone says they must unplug them, have a plan!

When told to unplug our HEPAs, I demanded to speak to the building engineer (too busy to ever show up) & …
Tip 3 (cont) – talk to the 'patient advocate' BEFORE letting anyone unplug the #HEPA.

If anyone unplugged my HEPAs, I would have kicked them off the care team, trashed the hospital on social media, called the news and a lawyer, and started picketing outside.

Have a plan.
Tip #4 – W/all the unmasked ppl roaming medical facilities, build a #PAPRbuggy/#HEPAbuggy to keep babies safer when leaving & for their many well visits.

I began testing designs in March. Read my empirical report (under review, see link to pre-print).
Tip #5 – Protect yourself. Get the bivalent #booster. Discuss nuance w/OBGYN/PCP. Mask well. Set vax & mask rules for any fam visitors.

I wore N95s >99% of the time in the hospital & my partner did except for meals (after a HEPA cleaning delay). Mask while sleeping.
Tip #6 – Develop testing protocols for fam who may visit in or after the hospital stay. I’ve administered hundreds of tests (RATs, PCR, antibody), talk about boogers, swab tactics, etc.

No family sees my babies w/o getting tested. Determine what’s right for your fam context.
Tip #7 – Give yourself grace. Health systems have little understanding that #COVIDisAirborne. The WH, CDC, and much of America are living in #delusion-ville while a 9/11 of ppl die each week. Whatever happens, you did the best you could.

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More from @michael_hoerger

Mike Hoerger, PhD MSCR MBA Profile picture
Dec 15
PMC COVID Update, Dec 15, 2025 (U.S.)

In the latest CDC data, 15 states have moderate to very high transmission.
🔹1 in 63 estimated actively infectious nationally, rising fastest in the Midwest & Northeast
🔹Very High: Indiana
🔹High: Nebraska, Vermont, Connecticut

🧵1/9 Heat map from CDC data and PMC estimates of 1 in 63 actively infectious and >700,000 new daily infections, based on wastewater derived estimates using models noted in the Technical Appendix at the website listed in the image.
PMC estimates 1 in 26 people in Indiana are infectious and 1 in 39 in Connecticut.

MI, MS, and AR may have higher levels than shown due to poor reporting.

States AL to MS shown.

🧵2/9 Alabama Moderate 1 in 41 (2.4%) Alaska Very Low 1 in 220 (0.5%) Arizona Very Low 1 in 118 (0.8%) Arkansas Low* 1 in 68 (1.5%) California Very Low 1 in 382 (0.3%) Colorado Very Low* 1 in 230 (0.4%) Connecticut High 1 in 39 (2.6%) Delaware Very Low 1 in 222 (0.4%) District of Columbia Very Low 1 in 131 (0.8%) Florida Very Low 1 in 320 (0.3%) Georgia Very Low 1 in 275 (0.4%) Guam Very Low 1 in 426 (0.2%) Hawaii Very Low 1 in 670 (0.1%) Idaho Very Low 1 in 108 (0.9%) Illinois Low 1 in 71 (1.4%) Indiana Very High 1 in 26 (3.8%) Iowa Low 1 in 76 (1.3%) Kansas Moderate 1 in 62 (1.6%) Kentucky Mode...
PMC estimates 1 in 39 are infectious in both Nebraska and Vermont (coincidence, not typo).

Very few NY sites are reporting to the CDC, so use the NYS website there instead.

States MO to WY shown.

🧵3/9 Missouri Low 1 in 80 (1.2%) Montana Very Low 1 in 135 (0.7%) Nebraska High 1 in 39 (2.5%) Nevada Very Low 1 in 225 (0.4%) New Hampshire Moderate 1 in 47 (2.1%) New Jersey Very Low 1 in 200 (0.5%) New Mexico Low 1 in 75 (1.3%) New York Moderate* 1 in 49 (2.1%) North Carolina Very Low 1 in 226 (0.4%) North Dakota Low* 1 in 85 (1.2%) Ohio Moderate 1 in 62 (1.6%) Oklahoma Moderate* 1 in 47 (2.1%) Oregon Low 1 in 89 (1.1%) Pennsylvania Moderate 1 in 55 (1.8%) Rhode Island Low 1 in 70 (1.4%) South Carolina Very Low 1 in 215 (0.5%) South Dakota Low 1 in 86 (1.2%) Tennessee Moderate 1 in 60 (1.7%) ...
Read 9 tweets
Mike Hoerger, PhD MSCR MBA Profile picture
Dec 8
PMC COVlD Update, Dec 8, 2025 (U.S.)
1/9
🔥🔥🔥Very High: Arizona (Yuma)
🔥🔥High: Indiana and Vermont
🔥Moderate: Nebraska and Alabama

Data only go through late November, and levels often increase following Thanksgiving. Heat map and PMC estimates of transmission (1 in 102 actively infectious).
PMC COVlD Update, Dec 8, 2025 (U.S.)
2/9
State-by-state estimates (part 1). Arizona is Very High, but sites were only online in the Yuma area. Indiana remains high.

MI and MS have considerable uncertainty.

DC is exceptionally low. Alabama Moderate 1 in 47 (2.1%) Alaska Very Low 1 in 220 (0.5%) Arizona Very High* 1 in 18 (5.7%) Arkansas Very Low* 1 in 138 (0.7%) California Very Low 1 in 574 (0.2%) Colorado Low 1 in 76 (1.3%) Connecticut Low 1 in 91 (1.1%) Delaware Very Low 1 in 307 (0.3%) District of Columbia Very Low 1 in 5,777 (0.0%) Florida Very Low 1 in 494 (0.2%) Georgia Very Low 1 in 180 (0.6%) Guam Very Low 1 in 289 (0.3%) Hawaii Very Low 1 in 704 (0.1%) Idaho Very Low 1 in 121 (0.8%) Illinois Very Low 1 in 112 (0.9%) Indiana High 1 in 30 (3.3%) Iowa Low 1 in 83 (1.2%) Kansas Low 1 in 105 (1.0%) Kentucky Very L...
PMC COVlD Update, Dec 8, 2025 (U.S.)
3/9
State-by-state estimates (part 1). Vermont remains High. Tennessee has fallen rapidly from a quick surge.

Data quality are low in NY. Missouri Very Low 1 in 176 (0.6%) Montana Very Low 1 in 136 (0.7%) Nebraska Moderate 1 in 45 (2.2%) Nevada Very Low 1 in 372 (0.3%) New Hampshire Very Low 1 in 109 (0.9%) New Jersey Very Low 1 in 217 (0.5%) New Mexico Very Low 1 in 118 (0.8%) New York Very Low* 1 in 260 (0.4%) North Carolina Very Low 1 in 233 (0.4%) North Dakota Low* 1 in 101 (1.0%) Ohio Low 1 in 70 (1.4%) Oklahoma Low* 1 in 68 (1.5%) Oregon Very Low 1 in 150 (0.7%) Pennsylvania Low 1 in 89 (1.1%) Rhode Island Very Low 1 in 187 (0.5%) South Carolina Very Low 1 in 144 (0.7%) South Dakota Low 1 in 82 (1.2%) Tennessee Very Low...
Read 9 tweets
Mike Hoerger, PhD MSCR MBA Profile picture
Nov 23
PMC COVlD Update, Week of Nov 24, 2025 (U.S.)
🧵1/10

With CDC data operational again, the transmission map is back. The data are always a week old, so transmission is likely worse than depicted.

We estimate 1 in 116 people actively infectious and 422,000 new daily infections. Heat map: Indiana and Arkansas with "moderate" transmission. All others, "low" or "very low" (CDC categories).
PMC COVlD Update, Week of Nov 24, 2025 (U.S.)
🧵2/10

State level estimates are back. Note, the CDC changed their data processing approach in August, which tends to downplay transmission.

Does 1 in 45 in Indiana seem "moderate"?

Levels in MI may be mod/high (poor reporting). Alabama Very Low 1 in 153 (0.7%) Alaska Very Low 1 in 272 (0.4%) Arizona Low 1 in 63 (1.6%) Arkansas Moderate* 1 in 47 (2.1%) California Very Low 1 in 365 (0.3%) Colorado Very Low 1 in 137 (0.7%) Connecticut Low 1 in 103 (1.0%) Delaware Very Low 1 in 262 (0.4%) District of Columbia Very Low 1 in 418 (0.2%) Florida Very Low 1 in 408 (0.2%) Georgia Very Low 1 in 292 (0.3%) Guam Very Low 1 in 887 (0.1%) Hawaii Very Low 1 in 426 (0.2%) Idaho Very Low 1 in 116 (0.9%) Illinois Very Low 1 in 116 (0.9%) Indiana Moderate 1 in 45 (2.2%) Iowa Very Low 1 in 108 (0.9%) Kansas Very Low 1 in 109 (0.9%) Ke...
PMC COVlD Update, Week of Nov 24, 2025 (U.S.)
🧵3/10

State-level estimates (continued).

Current levels may be much higher than noted here. Note that CDC data are always at least a week old. The 2nd half of November is a time period historically of accelerating transmission. Missouri Very Low 1 in 202 (0.5%) Montana Very Low* 1 in 114 (0.9%) Nebraska Low 1 in 95 (1.1%) Nevada Very Low 1 in 228 (0.4%) New Hampshire Low 1 in 78 (1.3%) New Jersey Very Low 1 in 192 (0.5%) New Mexico Very Low 1 in 151 (0.7%) New York Very Low 1 in 212 (0.5%) North Carolina Very Low 1 in 212 (0.5%) North Dakota Very Low* 1 in 116 (0.9%) Ohio Very Low 1 in 109 (0.9%) Oklahoma Low* 1 in 70 (1.4%) Oregon Very Low 1 in 194 (0.5%) Pennsylvania Very Low 1 in 111 (0.9%) Rhode Island Very Low 1 in 167 (0.6%) South Carolina Very Low 1 in 112 (0.9%) South Dakota Very Low 1 in 127 (0.8%) Tennes...
Read 10 tweets
Mike Hoerger, PhD MSCR MBA Profile picture
Nov 8
PMC COVID Update, Week of Nov 10, 2025 (U.S.)
1/6🧵

🔹301,000 new daily infections based on wastewater-derived models
🔹1 in 162 people (0.6%) actively infectious
🔹Levels the past 2 months corrected upward by Biobot
🔹"Lull point" estimated between Nov 5-21. Rising soon. Year over year graph, emphasizing that levels commonly rise in mid November
PMC COVID Update, Week of Nov 10, 2025 (U.S.)
2/6🧵

The central estimate of the forecast suggests we will surpass 500,000 new daily infections on Nov 22.

There's a 25% chance of a prolonged lull like last year. More likely, we are in wave territory by the end of the month. Close up of the most recent 3 months of data, including the forecast.
PMC COVID Update, Week of Nov 10, 2025 (U.S.)
3/6🧵

We are presently in a lull between the 11th and 12th wave. Now is the time to get boosted and stock up on N95 masks, tests, and air purifier filters.

Do a DIY fit test if you've been putting it off. Graph of the 11 waves
Read 6 tweets
Mike Hoerger, PhD MSCR MBA Profile picture
Nov 3
PMC COVlD Update, Nov 3, 2025 (U.S.)
1 of 9 🧵

The relative "lull" in SARS-CoV-2 transmission is unlikely to go much lower.

✨1 in 209 people are estimated actively infectious, likely the lowest levels of 2025 nationwide.

Get boosted. Stock up on masks, tests, & filters. Year-over-year graph
PMC COVlD Update, Nov 3, 2025 (U.S.)
2 of 9 🧵

No data presently suggest the rise of a winter wave any earlier than "usual."

If following historical trends, transmission will pick up Nov 15-29. Last year's rise was atypically late. Forecasted transmission
PMC COVlD Update, Nov 3, 2025 (U.S.)
3 of 9 🧵

Expect rising misinformation/disinformation as transmission heats up:
🔹Abuse of community notes, particularly surrounding wastewater methodology
🔹Paid bot army attacks, especially about boosters & masks
Read 9 tweets
Mike Hoerger, PhD MSCR MBA Profile picture
Oct 28
PMC COVlD Update, Oct 27, 2025 (US)

Transmission typically accelerates in mid-November.

We are currently in a relative 'lull.' We estimate about a quarter-million new daily infections with 1 in 185 people actively infectious. Still bad, likely to get worse.

1/9 🧵 year over year graph
PMC COVlD Update, Oct 27, 2025 (US)

Our forecast through November 8 calls for flat transmission.

Nothing yet indicates the onset of a winter wave, but it would also be atypical for the lull to last much longer than another 2-3 weeks.

2/9 🧵 Graph of recent transmission and current forecast
PMC COVlD Update, Oct 27, 2025 (US)

We estimate 264,000 new daily infections during this 'lull' period.

Biobot data have returned. Our substitute data from WWS last week correlated r=.97 (near perfect) with that, but Biobot did retroactively increase recent estimates.

3/9 🧵 Graph of the 11 waves of the pandemic
Read 9 tweets

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