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Mike Hoerger, PhD MSCR MBA Profile picture
@michael_hoerger
Dec 15, 2022 • 5 tweets • 4 min read • Read on X
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Our #pandemic global strategy:
"If I paint a rosy picture, will you promise not to cry?"


1/5 ascopubs.org/doi/full/10.12…
Image
Written a decade ago, the article was about how clinicians too often falsely reassured patients w/terminal #cancer that treatment was working just fine.

There are many parallels b/w cancer cancer, the pandemic, & climate change.

Mortality salience elicits #denial.
2/5 ImageImage
Don't believe me?

Look back at the 1960s. Only 12% of patients were even told they had #cancer.

Society will tolerate BS for a long time to avoid immediate discomfort. So too w/the pandemic. Hardly a mask in sight & reinfections mount.

jamanetwork.com/journals/jama/…
3/5 Image
In the U.S., the "rosy picture" differs by political ideology.

Today in the NEJM: The conservative rosy picture is that COVID is like a cold or the flu. The liberal rosy picture is that leaders are doing just fine by pushing vax-and-relax.

nejm.org/doi/full/10.10…
4/5 Image
The "rosy picture" strategy almost always fails, and if we settle for rosy on COVID, we're going to need a lot more roses.

5/5 Image

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More from @michael_hoerger

Mike Hoerger, PhD MSCR MBA Profile picture
May 15
1) Good luck getting any new federal research to support #LongCOVID until "covid" is dropped from the dirty words that get grant applications triaged to the trash bin.

You know which senator to call.

I just did, and got a staffer instead of voicemail.Lengthy list of words that get federal grants triaged to the trash bin, unfunded after favorable review, or defunded if already in progress. Includes "Covid-19," and no, it's not a matter of simply restating as "SARS2" or "The Rona." It might make it one step further in the review process, but this gets checked closed, and it will get canned. Hundreds of hours of work, flushed down the toilet. And that's the point.
2) I told the staffer that #LongCOVID is affecting millions and that no research will be funded to address this while "covid" remains on the banned word list.

I asked if they wanted to hear more. He did...

Here's the word list, btw
pen.org/banned-words-l…
3) I told them about my family member who was a strong Special Forces veteran, got covid once, & according to their neurologist, it triggered #LongCOVID in the form of Dementia w/Lewy Bodies.

DLB is one of the worst conditions imaginable. After a 2yr battle, they died in 2024.
Read 5 tweets
Mike Hoerger, PhD MSCR MBA Profile picture
May 3
30 million excess deaths attributable to COVID is a tremendous underestimate because most analyses insufficiently account for mortality displacement.

In the U.S., it's about 50% worse than people realize.
Mortality displacement or "harvesting" is the idea that so many people died of COVID in the early pandemic that we should actually expect to see *fewer* deaths today if COVID were "over."
In fact, we see similar or slightly higher mortality relative to pre-pandemic levels. Despite the millions of people that have died, the mortality faucet keeps running strong. It should have slowed.
Read 9 tweets
Mike Hoerger, PhD MSCR MBA Profile picture
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
Mike Hoerger, PhD MSCR MBA Profile picture
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
Mike Hoerger, PhD MSCR MBA Profile picture
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
Mike Hoerger, PhD MSCR MBA Profile picture
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

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