Mike Hoerger, PhD MSCR MBA Profile picture
Oct 9, 2023 9 tweets 4 min read Read on X
Our new article is out documenting the burden of the #pandemic on food service workers.

What it boils down to is fighting an #AIRBORNE virus with droplet dogma.

I will walk you through some of the more shocking highlights.
1/
🧵 Background As an illustrative example of COVID-19 pandemic community-based participatory research (CBPR), we describe a community-academic partnership to prioritize future research most important to people experiencing high occupational exposure to COVID-19 – food service workers. Food service workers face key challenges surrounding (1) health and safety precautions, (2) stress and mental health, and (3) the long-term pandemic impact.  Method Using CBPR methodologies, academic scientists partnered with community stakeholders to develop the research aims, methods, and measures, and interpret...
During the BA.1 Omicron wave, for example, food service workers could often get free #HandSanitizer.

Yet, free high-quality masks (e.g., #N95) were hard to come by.

N95s prevent people from inhaling airborne virus into their lungs. Hand sanitizer does not.

2/ Survey Result, Statistic  Free hand sanitizer, well stocked 17 (73.9%) Encouraged to stay home when sick 16 (69.6%) Free soap, well stocked 15 (65.2%) Free gloves 13 (56.5%) HVAC (heating/air conditioning) system is well-maintained 10 (43.5%) Health insurance 9 (39.1%) Free cloth masks 9 (39.1%) Free surgical masks 9 (39.1%) Free COVID-19 testing 7 (30.4%) Paid sick leave 5 (21.7%) Free high-quality masks, e.g., N95, N99, N100, KN95, KF94 5 (21.7%) Dental insurance 4 (17.4%) Vision insurance 3 (13.0%) Mental health services/counseling 2 (8.7%) HEPA filters are provided in areas with many pe...
With a lack of #PublicHealth guidance, many in the food service industry have faced decision fatigue in handling C0VID-related issues.

Participants said co-workers struggle with what to do if sick (87%), when to return to work (83%), or whether to get a booster (61%).
3/ Estimate, whether any co-workers experience decision fatigue by area, No. (%)  What to do if possibly sick with COVID-19 20 (87.0%) What to do if a family member is diagnosed with COVID-19 19 (82.6%) How to interact with customers about showing proof of vaccination 19 (82.6%) When to return to work after COVID-19 19 (82.6%) What to do if a family member may have COVID-19 18 (78.3%) What to do if diagnosed with COVID-19 17 (73.9%) How to interact with customers who dislike vaccines 17 (73.9%) How to interact with customers who dislike masks 16 (69.6%) When a child should return to school aft...
Food service workers have expressed that C0VID has had a big impact on co-workers' #MentalHealth.

Anxiety, depression, and substance use lead the way. However, many respondents also noted a co-worker dealing with #bereavement, suicidal ideation, or violence (17-36%).
4/ Anxiety and worry 22 (95.7%) Depression and sadness 18 (78.3%) Substance use 16 (69.6%) Loneliness 11 (47.8%) Anger 11 (47.8%) Bereavement 6 (26.1%) Suicidal thoughts 4 (17.4%) Violence and abuse 4 (17.4%)
Shortly after the BA.1 Omicron surge, many in the food service industry were aware of a co-worker dealing with #LongCOVID.

"Fatigue" (often EXHAUSTION) led the way. Many knew a co-worker with prolonged loss of taste or smell, which are huge to that occupation.
5/ Awareness of someone personally in the food service industry dealing with a symptom or side effect > 3 months after getting COVID19 that the participant attributed to the virus (i.e., Long COVID symptoms)   Fatigue or overtired 15 (65.2%) Anxiety 13 (56.5%) Depression 12 (52.2%) Loss of taste 11 (47.8%) Difficulty sleeping 11 (47.8%) Headache 9 (39.1%) Attention difficulties 9 (39.1%) Loss of smell 7 (30.4%) Cough 7 (30.4%) Joint pain 6 (26.1%) Sick to one’s stomach 6 (26.1%) Pain 5 (21.7%) Difficulty breathing 5 (21.7%) Digestive problems 4 (17.4%) Weakened lung capacity 4 (17.4%) Weight l...
In the more recent days of the pandemic, food service workers emphasized that a key priority was reducing in-home spread of C0VID.

Experts you know from Twitter provided their guidance on reducing in-home spread. Here's a link to another resource.

6/ cleanaircrew.org/someone-in-my-…
COVID-19 Mitigation Professionals In-home mitigation Masks Wear N95 respirators (masks) or P100/N100 elastomerics if finances permit. Filtration Use HEPA filters or do-it-yourself (DIY) air cleaners called Corsi-Rosenthal boxes or SAFE air purifiers. Ventilation Open windows. Use fans to blow clean air in. Use fans to blow infected air out of isolation rooms. Isolation Create an isolation room at home. Family members testing negative stay outside as much as possible. The person who is ill should eat outside if possible. Testing and Treatment Testing Get PCR testing if possible. Use at-home ...
When explaining to other scientists that #CovidIsAirborne, I have found it helpful to quote Jha.


7/
Jha - C19 is "purely airborne"
Too often, restaurants continue to be superspreaders of C0VID and other airborne illnesses.

#ASHRAE indicates that they should be cleaning the air 28-40 times per hour. Instead, many are doing more like 0.8
8/ The new standards indicate that restaurants and similar establishments should clean the air approximately 28–40 times per hour, depending on occupancy level (more precisely, 40 cubic feet per minute per person [cfm/person] or 20 L per second per person [l/s/person]) to reduce airborne illness transmission, approximately double the historic standard of 15 air changes per hour in U.S. operating rooms. To put in context, many restaurants, bars, and similar establishments clean the air 0.8 times per hour [43], 35–50 times lower than the current ASHRAE air cleaning standards.
In fact, we clean fish tanks better than we clean the air in many dangerous settings like restaurants.
@sri_srikrishna
9/ As the engineer Devabhaktuni Srikrishna frequently notes, even fish get 4–6 full water exchanges per hour in properly running fish tanks [44]. Essentially, food service venues are among the highest-risk settings and have the lowest mitigation. The ASHRAE standards are a firm indication of the occupational hazards of food service work.

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More from @michael_hoerger

Jul 2
🌍Want to track COVID transmission accurately worldwide?

This PMC thread walks you through leading dashboards with information more up to date than WHO & EU directories.

🧵 1/ World map, countries with high-quality up-to-date surveillance systems shown in blue.
The Pandemic Mitigation Collaborative (PMC) Dashboard provides weekly COVID updates for the U.S., using wastewater surveillance derived case estimation models and analytic forecasting.

We have added a list of international dashboards:
🧵 2/
pmc19.com/data/index.php…Australia: NSW Health Australia Department of Health, Western Australia Austria: Federal Government of Austria City of Vienna - Regional Coron-A Consortium Austria Czech Republic: State Health Institute Czech Republic Belgium: Belgian Institute for Health Canada: Government of Canada Andrew Young's Canada Visualization C19 Resources Canada * World Health Network (WHN) Canada **
Denmark: Statens Serum Institut Denmark Europe (multi-national): EU Wastewater Observatory Finland: National Institute for Health and Welfare Finland WHN Finland ** France: French Republic Data Airborne Risk Reduction Association (ARRA) France Zan Armstrong's France Visualization COVID Weather App France (Android, IOS, or Web) Thomas Delattre's France Visualization Germany: Infection Radar Germany Bay-VOC Bavaria Region Berlin Waterworks WHN Germany **
Hong Kong: Centre for Health Protection, Hong Kong Hungary: National Center for Public Health and Pharmacy of Hungary India: Pune Knowledge Cluster of India Gujarat Biotechnology Research Centre of India Ireland: Health Protection Surveillance Centre Ireland Japan: Japan Institute for Health Security Latvia: Institute of Food Safety, Animal Health and Environment Latvia Lithuania: National Public Health Centre of Luthuania Luxembourg: Microbs Luxembourg Netherlands: National Institute for Public Health and the Environment Netherlands WHN Netherlands ** New Zealand: New Zealand Institute for...
Slovenia: National Institute of Public Health Slovenia Spain: Government of Catalonia - Regional South Africa: National Institute for Communicable Diseases of South Africa South Korea: Korea Disease Control and Prevention Agency Sweden: Pathogens Sweden Switzerland: Swiss Confederation Federal Office of Public Health ETH Zurich Switzerland WISE Dashboard U.K.: Public Health Scotland Buckinghamshire Disability Service (BuDS) U.K.  *See the numbers 1-21 along the lower left. Click on 3-6 for national and regional data. ** Click on the dropdown menu. May need to try a different web browser.
Our international directory includes official government dashboards & those developed by citizen scientists.

We exclude countries that have stopped reporting in the past 2-12 months even if on EU or WHO lists. We also exclude low-quality data from opt-in testing programs.
🧵 3/
Read 43 tweets
Jun 24
PMC COVlD Dashboard, Jun 23, 2025 (U.S.)

🔥Biggest uptick since Jan
🔥1 in 167 actively infectious
🔥>2 million weekly infections
🔥700-1,200 resulting excess deaths from weekly infections

Track transmission closer to home w/our new state & international resources 👇

🧵1/6
PMC COVlD Dashboard, Jun 23, 2025 (U.S.)

🔹With >90% probability, we have entered the 11th COVlD wave.
🔹In a room of 50 people, there is already a 1 in 4 chance of an exposure.
🔹We expect nearly 15 million infections in the next month, and rising.

🧵2/6Current Levels for Jun 23, 2025	 % of the Population Infectious	 0.6% (1 in 167)	 New Daily Infections	 287000	 New Weekly Infections	 2009000	 Resulting Weekly Long COVID Cases	 100,000 to 402,000	 Resulting Weekly Excess Deaths	 700 to 1,200	 	 Monthly Forecast	 Average % of the Population Infectious	 1.0% (1 in 97)	 Average New Daily Infections	 493300	 New Infections During the Next Month	 14799000	 Resulting Monthly Long COVID Cases	 740,000 to 2,960,000	 Resulting Monthly Excess Deaths	 5,300 to 8,800	 	 Running Totals	 Infections Nationwide in 2025	 74869000	 Average Number of Infect...
PMC COVlD Dashboard, Jun 23, 2025 (U.S.)

We continue to expect transmission to break 500,000 daily infections in the U.S. around July 9th.

This is the same prediction as last week, as the forecast was dead on. Yet, there is considerably uncertainty around this timing.

🧵3/6Longitudinal transmission, past 12 months and 1-month forecast
Read 6 tweets
Jun 17
1) PMC COVlD Dashboard, June 16, 2025 (U.S.)

Current transmission (red line) closely tracks that of summer 2023 (yellow line).

We expect to break 500k daily infections between July 9 and the end of July. Our current forecast...Year over year graph of tranmission
2) PMC COVlD Dashboard, June 16, 2025 (U.S.)

Our current forecast is a bit more aggressive, predicting breaking 500k daily infections by July 9. The 2023 trend suggests end of July.

The 95% confidence interval shows large variation. Note that...Past 12 months of transmission (U.S.) and forecast
3) PMC COVlD Dashboard, June 16, 2025 (U.S.)

Note that CDC and Biobot both had retroactive corrections to last week's data, meaning the relative "lull" will last a little longer than the uncorrected data suggested. No big news on NB.1.8.1.

All good news, but...10 pandemic waves. Soon 11
Read 7 tweets
Jun 16
1) Here's a quick example of how the federal government is censoring the best scientific research. It's not just cuts to ongoing research.

It's new grant submissions too... "No forbidden words found"
2) In January, I re-submitted a promising Covid/cancer grant to a non-federal funder. Hundreds of pages. Hundreds of hours of work. The best proposal I've submitted as a scientist.

Out of curiosity, I used Sean Mullen's Scan Assist tool to see how many banned words it had...
3) The proposal had 1,750 banned words. No big deal -- they're non-federal.

BUT I had planned to submit a smaller version to NIH this month as a "back up." Impossible!

It's not a matter of using a thesaurus or the find/replace command. The grant is on *Covid*... 1,750 banned words found
Read 13 tweets
Jun 9
1) PMC COVlD Dashboard, June 9, 2025

CDC wastewater surveillance data show transmission rising. This is our forecast if transmission growth follows typical patterns.

The high & low estimates could be thought of as optimistic & pessimistic scenarios for NB.1.8.1.Forecast graph: Rising transmission the next month
2) PMC COVlD Dashboard, June 9, 2025

Notice that current transmission (red line, lower left) tracks closely with two years ago (yellow), slightly below the median (gray), and not far below last year (orange).

Consider each of these trajectories realistic scenarios.Image
3) PMC COVlD Dashboard, June 9, 2025

All indications are that we are headed into the start of an 11th national wave in the U.S.

We could percolate near the lull point another couple weeks (fingers crossed), but that scenario is becoming less likely.Graph of 10 C19 waves
Read 7 tweets
Jun 3
1/ PMC COVlD Dashboard, June 2, 2025 (U.S.)

National COVlD transmission recently fell to its lowest levels since the pre-Delta era.

It's go-time for many who have delayed medical appointments. The situation will likely get much worse in Jul/Aug.
2/ PMC COVlD Dashboard, June 2, 2025 (U.S.)

An estimated 1 in 211 are actively infectious. Most states are "low" or "very low" per CDC.

The situation remains serious even in a relative "lull." >1.5 million weekly estimated infections to result in 600-900 excess deaths.C19 heat map
year over year graph, tracking closely with the median and past 2 years
Current Levels for Jun 2, 2025	 % of the Population Infectious	 0.5% (1 in 211)	 New Daily Infections	 227000	 New Weekly Infections	 1589000	 Resulting Weekly Long COVID Cases	 79,000 to 318,000	 Resulting Weekly Excess Deaths	 600 to 900	 	 Monthly Forecast	 Average % of the Population Infectious	 0.7% (1 in 139)	 Average New Daily Infections	 344566.6667	 New Infections During the Next Month	 10337000	 Resulting Monthly Long COVID Cases	 517,000 to 2,067,000	 Resulting Monthly Excess Deaths	 3,700 to 6,200	 	 Running Totals	 Infections Nationwide in 2025	 70132000	 Average Number of Infe...
Graph of the whole pandemic, 11th wave forthcoming
3/ PMC COVlD Dashboard, June 2, 2025 (U.S.)

By the end of the month, we forecast an increase to 450k daily infections. If NB.1.8.1 takes off, closer to 600k. If overhyped, percolating only slightly higher.Past 12 months and forecast
Read 5 tweets

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