Mike Hoerger, PhD MSCR MBA Profile picture
Sep 9, 2023 4 tweets 3 min read Read on X
PMC C0VID-19 Tracker, Sep 6, 2023

U.S. #wastewater levels are higher than during 70% of the pandemic:
🔹1.95% (1 in 51) are infectious
🔹Nearly 1 million C0VID cases per day
🔹Causing >40,000 #LongCovid cases per day

Let's look at these wildly divergent forecasts for the next 4 weeks.

Real-time Model: If you assume Biobot is reporting accurate real-time wastewater data each week, follow the red line. This says we have peaked on our late summer wave. That would be great news in terms of less morbidity and mortality. The problem is that real-time reports have been prone to error lately, more often than not underestimating wastewater levels, and then corrected later.

Alt Model 1 (Turtle): The turtle model moves slow, like a turtle. It assumes the most recent week's data from Biobot are useless and ignores them. By ignoring the most recent data, it will be slow to detect a quick change in transmission, like a peak. It basically expects "more of the same" for a little longer. See green line.

Alt Model 2 (Cheetah): The cheetah model moves fast, like a cheetah. It assumes that if last week's Biobot wastewater data underreported levels by X% that this week's current real-time data are also underreporting by that same percent. Last week's real-time data were corrected upward by 15%, which makes a huge difference in forecasting whether we're leveling off or on a steep incline. The cheetah model has us getting up to 1.4 million cases/day, so this is a good model for a worst-case scenario. See yellow line.

Composite Model: This is the average of the three models. It's what we use in the red box for estimating cases 4 weeks from now. It's a good estimate if trying to cite a point estimate to coworkers (e.g., "The U.S. will see about 1 million new cases/day the next several weeks). However, from a forecasting perspective, it's less useful because the underlying models are so divergent. See black line.

Big-Picture Framing
The current state of the pandemic is extremely bad. Expect approximately 1 million new U.S. cases per day the next several weeks. Less if we're lucky, and more if we're not. As a psychologist, I would characterize denial about the current C0VID wave to peak in the next couple weeks. Most people believe "the pandemic is over" and we're "after C0VID." Expect further gaslighting for now.

#MaskUp #VaxUp #Ventilate #HEPA #CorsiRosenthalBox #remotework

1/
PMC 6-month view of wastewater levels, case estimates, and near-term forecast.   CURRENT ESTIMATES FOR September 6, 2023 Wastewater Levels (copies/mL) 641 New Daily Cases 933,000 % of Population Infectious 1.95% (1 in 51 people) New Daily Long C0VID Cases  47,000 to 187,000   4-WEEK FORECAST FOR October 4, 2023 Wastewater Levels (copies/mL) 716 (12% higher) New Daily Cases 1,042,000 % of Population Infectious 2.18% (1 in 46 people) New Daily Long C0VID Cases  52,000 to 208,000
Let's zoom out from the 6-month view to the full pandemic.

Given current levels and forecasts, we're in a wave of transmission similar to the winter of 2020-21 or Delta. 🔥🔥

178 million infections & >8 million #LongCovid cases in 2023 thus far.

2/ There is more COVID-19 transmission today        than during 70% of the pandemic.  CURRENT ESTIMATES FOR September 6, 2023 Wastewater Levels (copies/mL) 641 New Daily Cases 933,000 % of Population Infectious 1.95% (1 in 51 people) New Daily Long COVID Cases  47,000 to 187,000   WEEKLY ESTIMATES FOR September 6, 2023 New Weekly Cases 6,500,000 New Weekly Long COVID Cases  327,000 to 1,306,000   2023 CUMULATIVE ESTIMATES AS OF September 6, 2023 Total 2023 Cases To Date 178,600,000 Total 2023 Long COVID Cases To Date  8,930,000 to 35,720,000
With about 2% of the U.S. population actively infectious with C0VID, school and in-person work remain extremely risky.

Offer remote activities. #MaskUp. #VaxUp again when allowed. Read up on and improve indoor air quality. Avoid indoor dining. #RapidTest frequently.

3/ Number of People,	Chances Anyone is Infectious 1	2.0% 2	3.9% 3	5.7% 4	7.6% 5	9.4% 6	11.2% 7	12.9% 8	14.6% 9	16.3% 10	17.9% 15	25.6% 20	32.6% 25	38.9% 30	44.6% 35	49.8% 40	54.5% 50	62.7% 75	77.2% 100	86.1% 150	94.8% 200	98.1% 300	99.7% 400	>99.9% 500	>99.9% 25	38.9% 30	44.6% 35	49.8% 40	54.5% 50	62.7% 75	77.2% 100	86.1% 150	94.8% 200	98.1% 300	99.7% 400	>99.9% 500	>99.9%
Here's the full PMC C0VID-19 Dashboard for Sep 6, 2023.

Please share here and across other platforms if you found any of the above Tweets helpful. I'd love to hear how you're using the data and if it's helped you with any "wins" on #pandemic safety.

Thank you 🙏

4/
Overall PMC C0VID Dashboard. A series of tables and figures summarized in each of the preceding Tweets (text and alt text).

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More from @michael_hoerger

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
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
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
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
Oct 21
PMC COVlD Update, Oct 20, 2025 (U.S.)

SARS-CoV-2 transmission has fallen.
🔹1 in 191 (0.5%) actively infectious
🔹"Lull" levels at 20% of the summer peak
🔹255,000 new daily infections (still concerning)

Many will knock out higher-risk activities the next 2-4 weeks.
🧵1/11 Graph of the 11 waves, shows current lull.
PMC COVlD Update, Oct 20, 2025 (U.S.)

"Lull" transmission remains dangerous:
🔹1.8 million estimated new weekly infections
🔹>90,000 estimated new #LongCOVID conditions from this week's infections
🔹>500 excess deaths to result from this week's infections

🧵2/11 Infections						 Proportion Actively Infectious										1 in 191 (0.5%) New Daily Infections										 255,000  Infections the Past Week										 1,800,000  Infections in 2025										 191,000,000  Cumulative Infections per Person										 4.69  										 Long COVID										 Long COVID Cases Resulting								13,000 to 51,000		   from New Daily Infections										 Long COVID Cases Resulting								90,000 to 360,000		   from New Weekly Infections										 										 Excess Deaths										 Excess Deaths Resulting 									70 to 120	   from New Daily Infections										 Excess Deaths ...
PMC COVlD Update, Oct 20, 2025 (U.S.)

Exposure risk during "lull" transmission remains high when engaging in many social interactions.

Interacting with 25 people yields a 12% chance of exposure. 100 people? 41% chance of exposure, assuming no testing/isolation.

🧵3/11 Number of People		Chances Anyone is Infectious		 1				0.5% 2				1.0% 3				1.6% 4				2.1% 5				2.6% 10				5.1% 15				7.6% 20				10.0% 25				12.3% 30				14.5% 50				23.1% 75				32.5% 100				40.8% 200				64.9% 300				79.2%
Read 11 tweets
Oct 11
PMC COVlD Wave Update (Europe)
11 October 2025 🧵

The PMC website includes an international directory of websites with COVlD wastewater monitoring. It is more up to date than the directories of the EU and WHO.

Let's review what's happening in Europe...

1/ world map, nations with surveillance shown in blue. URL says pmc19.com/global
Data in #Austria show a rising COVlD wave. The x axis (bottom) has infrequent labels, but the data shown go through October 8th.

Find more here:

2/ pmc19.com/austrialongitudinal graph
COVlD levels have been percolating in #Belgium, with "moderate" levels overall.

The transmission pattern is similar across regions. Plants at Namur-Brumagne and Oostende report "high" levels.



3/ pmc19.com/belgiumheat map and longitudinal graph
Read 20 tweets

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