Mike Hoerger, PhD MSCR MBA Profile picture
Oct 30, 2023 7 tweets 4 min read Read on X
PMC C0VID-19 Tracker, Oct 30, 2023

We're at the onset of an 8th U.S. pandemic wave.

Today's Numbers:
🔹 1.27% (1 in 78) are infectious
🔹 >600,000 C0VID cases/day
🔹>30,000 #LongCovid cases/day

We will pass the late-summer wave's peak in just over a month.

1/
CURRENT ESTIMATES FOR October 30, 2023 Wastewater Levels (copies/mL) 418 New Daily Cases 609,000 % of Population Infectious 1.27% (1 in 78 people) New Daily Long COVID Cases  30,000 to 122,000   4-WEEK FORECAST FOR November 27, 2023 Wastewater Levels (copies/mL) 579 (38% higher) New Daily Cases 842,000 % of Population Infectious 1.76% (1 in 57 people) New Daily Long COVID Cases  42,000 to 168,000
The different forecasting models reach a strikingly similar conclusion about where we'll be in a month: very bad.

November 27 by the Numbers:
🔹 1.76% (1 in 57) are infectious
🔹 >800,000 C0VID cases/day
🔹>40,000 #LongCovid cases/day

2/

Forecasting nuance:

Alt Model #1 (turtle) thinks the current real-time numbers are an underestimate, and it ignores the most recent week's data. Alt Model #2 (cheetah) accounts for recent errors in the real-time numbers; with low error, it maps on very closely to the real-time (red) line. The black line shows the composite used for reporting estimates. Note, everything converges in 4 weeks.
4-WEEK FORECAST FOR November 27, 2023 Wastewater Levels (copies/mL) 579 (38% higher) New Daily Cases 842,000 % of Population Infectious 1.76% (1 in 57 people) New Daily Long COVID Cases  42,000 to 168,000
Zooming out to the full pandemic, you can see that we are entering the 8th wave.

Today, there is more transmission than during 50.6% of pandemic days. It's a coin toss as to whether any particular day of the pandemic has had more or less transmission than today. 😷💉
3/ There is more COVID-19 transmission today        than during 50.6% of the pandemic.  CURRENT ESTIMATES FOR October 30, 2023 Wastewater Levels (copies/mL) 418 New Daily Cases 609,000 % of Population Infectious 1.27% (1 in 78 people) New Daily Long COVID Cases  30,000 to 122,000   WEEKLY ESTIMATES FOR October 30, 2023 New Weekly Cases 4,300,000 New Weekly Long COVID Cases  213,000 to 853,000   2023 CUMULATIVE ESTIMATES AS OF October 30, 2023 Total 2023 Cases To Date 185,317,950 Total 2023 Long COVID Cases To Date  9,266,000 to 37,064,000
Although we're about to exit the valley between the 7th & 8th waves, transmission is still very high. Large groups amplify transmission.

For example, in a group of 20-25, there's about a 25% chance someone would have infectious C19. In a large lecture hall, it's assumed.

4/ What’s the COVID Risk in an Office or in a Classroom?  Number of people  |  chances anyone is infectious  1	1.3% 2	2.5% 3	3.8% 4	5.0% 5	6.2% 6	7.4% 7	8.6% 8	9.8% 9	10.9% 10	12.0% 15	17.5% 20	22.6% 25	27.4% 30	31.9% 35	36.2% 40	40.1% 50	47.3% 75	61.8% 100	72.3% 150	85.4% 200	92.3% 300	97.9% 400	99.4% 500	99.8%
Here's the danger of a Thanksgiving gathering in the U.S. (Nov 23). Many people are finalizing holiday plans now.

In a large family gathering of 15-20 people, there's about a 25% chance someone would be infectious.

I am quite confident in these numbers.

5/ In the U.S., What’s the COVID Risk for Thanksgiving?  Number of people  |  Chances anyone is infectious  1	1.6% 2	3.3% 3	4.9% 4	6.4% 5	8.0% 6	9.5% 7	11.0% 8	12.4% 9	13.9% 10	15.3% 15	22.0% 20	28.2% 25	33.9% 30	39.2% 35	44.0% 40	48.5% 50	56.4% 75	71.2% 100	81.0% 150	91.7% 200	96.4% 300	99.3% 400	99.9% 500	>99.9%
Here's the possible danger of a Christmas gathering in the U.S. (Dec 25).

I am exceedingly cautious on posting long-range forecasts. They are speculative and do not account for the highly-valuable near-term fluctuations that can occur, particularly if there's an immune-evasive variant. Take these as my best point estimates nearly two months out, for illustrative purposes just so people get an idea of how bad things may be. Many people are booking trips now, so these rough estimates may be useful.

In a small gathering of 9-10 people, there's about a 25% chance someone is infectious. Once you start looking at large family or multi-family gatherings that span 20-25 people, you basically begin to assume someone has infectious C19.

6/
In the U.S., What’s the COVID Risk for Christmas Day?  Number of People  |  Chances anyone is infectious 1	3.1% 2	6.2% 3	9.1% 4	11.9% 5	14.7% 6	17.4% 7	19.9% 8	22.5% 9	24.9% 10	27.2% 15	37.9% 20	47.0% 25	54.8% 30	61.5% 35	67.1% 40	72.0% 50	79.6% 75	90.8% 100	95.8% 150	99.1% 200	99.8% 300	>99.9% 400	>99.9% 500	>99.9%
Here's the full PMC Dashboard for Oct 30.

You can read the full report at

Please share across other social media platforms. Much appreciated. 🙏

7/pmc19.com/data

There is more COVID-19 transmission today        than during 50.6% of the pandemic.  CURRENT ESTIMATES FOR October 30, 2023 Wastewater Levels (copies/mL) 418 New Daily Cases 609,000 % of Population Infectious 1.27% (1 in 78 people) New Daily Long COVID Cases  30,000 to 122,000   WEEKLY ESTIMATES FOR October 30, 2023 New Weekly Cases 4,300,000 New Weekly Long COVID Cases  213,000 to 853,000   2023 CUMULATIVE ESTIMATES AS OF October 30, 2023 Total 2023 Cases To Date 185,317,950 Total 2023 Long COVID Cases To Date  9,266,000 to 37,064,000   4-WEEK FORECAST FOR November 27, 2023 Wastewater Leve...

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More from @michael_hoerger

Apr 14
PMC COVlD Update, Apr 13, 2026

Levels are flat during a relative "lull" in transmission.
▪️1 in 187 estimated actively infectious
▪️260,000 estimated new daily infections
▪️High: OK, MS, WV
▪️Moderate: VT
▪️All other states low/very low in relative transmission

🧵THREAD 1/6 Heat map from CDC data and PMC prevalence estimates harmonizing CDC and Biobot wastewater data with IHME true case estimates to derive ongoing transmission projections
COVID-19 persists in 2026.

We are in a relative "lull" following a 12th wave, but at a baseline of 200-300K estimated new daily infections.

Transmission was lower in the era many refer to as #DuringCOVID, when multi-layered mitigation was used instead of denial.

🧵THREAD 2/6 Annotated graph of the 12 waves (U.S.)
Transmission during a "lull" is high in an absolute sense. Many people are getting infected.

Simultaneously, its low in a relative sense, or compared to so-called "typical" transmission. In most places, it's a safer time for medical/dental care.

🧵THREAD 3/6 Barometer showing lower relative transmission than usual
Read 6 tweets
Apr 6
PMC COVlD Update, April 6, 2026

Transmission is stable in a relative "lull" nationally between waves.

We estimate that approximately 313,000 people are still getting infected per day, with outbreaks radiating from TN and MS.

🧵1 of 10 (don't miss #10)! Heat map with PMC estimates
With limited data reported, Mississippi has an estimated 1 in 27 residents actively infectious.

In a room of 25 people, that's a 61% chance of exposure, if no testing/isolation protocols.

🧵2 of 10 Alabama	Low Alaska	Very Low Arizona	Very Low* Arkansas	Low California	Very Low Colorado	Very Low Connecticut	Low Delaware	Low District of Columbia	Very Low Florida	Very Low Georgia	Low Guam	Low Hawaii	Very Low Idaho	Very Low Illinois	Very Low Indiana	Very Low Iowa	Very Low Kansas	Low Kentucky	Moderate Louisiana	Moderate Maine	Very Low Maryland	Low Massachusetts	Very Low Michigan	Low Minnesota	Very Low Mississippi	Very High*
1 in 24 people in Tennessee are estimated to be actively infectious with SARS-CoV-2. That's a 65% chance of exposure in a room of 25 people where nobody is testing/isolating.

🧵3 of 10 Missouri	Moderate* Montana	Very Low Nebraska	Very Low Nevada	Very Low New Hampshire	Very Low New Jersey	Low New Mexico	Very Low New York	Very Low North Carolina	Low North Dakota	Very Low* Ohio	Very Low Oklahoma	Low* Oregon	Very Low Pennsylvania	Low Rhode Island	Very Low South Carolina	Very Low South Dakota	Low Tennessee	Very High Texas	Low Utah	Very Low Vermont	Moderate Virginia	Moderate Washington	Very Low West Virginia	Low Wisconsin	Very Low Wyoming	Very Low
Read 10 tweets
Apr 3
This is an unethically misleading study with findings easily explained by residual confounding. Some health systems and patients have thorough record keeping. Others don't. All sorts of variables will correlate (infections, cancers, anything else tracked in medical records).
This is a really obvious issue for an international epi study. It should not have been published.
The above study is using the same processes the anti-vaxxers use -- junk epi that does not account for confounding -- to support whatever pre-conceived notions the authors have, with absurdly large effects.

Read 4 tweets
Mar 23
PMC #COVID Update, March 23, 2026 (U.S.)

Transmission levels have plummeted nationally as we shift from the 12th wave toward a relative "lull."

Over half the states have "Very Low" relative transmission, per the CDC.

🧵THREAD 1 of 8 Heat map using CDC levels and PMC estimate of prevalence (1 in 147 actively infectious nationwide).
Transmission varies considerably by state.

Highest
🔥Mississippi: 1 in 31 estimated actively infectious
🔥Michigan: 1 in 41
*Both states w/limited data though

Rates are quite low in relative terms in California, AZ, FL, HI, ID, MA, NV, NY, OR, RI, UT, WI

🧵THREAD 2 of 8 Alabama	Very Low Alaska	Very Low Arizona	Very Low Arkansas	Low* California	Very Low Colorado	Very Low Connecticut	Low Delaware	Moderate District of Columbia	Low Florida	Very Low Georgia	Very Low Guam	Very Low Hawaii	Very Low Idaho	Very Low Illinois	Very Low Indiana	Low Iowa	Moderate Kansas	Low Kentucky	Moderate Louisiana	Low Maine	Very Low Maryland	Moderate Massachusetts	Very Low Michigan	High* Minnesota	Moderate Mississippi	High* Missouri	Low Montana	Very Low Nebraska	Low Nevada	Very Low New Hampshire	Low* New Jersey	Low New Mexico	Very Low New York	Very Low North Carolina	Low North Dakota...
The 6th anniversary of the WHO's pandemic declaration was March 11.

Bots, minimizers, & individuals' psychological defense mechanisms will downplay that.

Yet, the U.S. just had a 12th wave. We estimate >5 cumulative infections/person & ongoing health harms.

🧵THREAD 3 of 8 Graph of the 12 waves of the pandemic (U.S.)
Read 8 tweets
Mar 14
As of today, the COVID-19 pandemic is now longer than WWII.
If you have been living in denial the past 6 years, know that the U.S. is winding down from a 12th wave of infections presently.
Denial is but one of several obvious defense mechanisms people use to try to block their awareness of the ongoing toll of COVID-19. There are many others.

Short-term capital also plays a role, but even that requires a large dose of defense mechanisms.

Read 7 tweets
Jan 25
During this 12th COVlD wave, the CDC reports 1-in-3 states have "High" or "Very High" levels.

PMC estimates the proportion of residents actively infectious (prevalence):
◾️USA: 1 in 67
◾️IA: 1 in 27
◾️MI: 1 in 25
◾️IN & CT: 1 in 23
◾️ME: 1 in 21
◾️OK & SD: 1 in 17

🧵1/ Heat map using CDC data. National PMC prevalence estimate noted; estimated incidence of 732,000 new daily infections.
On average, Americans have have 5.0 cumulative SARS-CoV-2 infections.

This week's infections are expected to result in 1/4 to 1 million new #LongCOVID conditions and ≈2,000 excess deaths.
🧵2/ Column 1: Table of state-level prevalence estimates. Highest estimates noted in the thread text.  Column 2:  Proportion Actively Infectious										1 in 67 (1.5%) New Daily Infections										 732,000  Infections the Past Week										 5,220,000  Infections in 2026										 24,000,000  Cumulative Infections per Person										 5.04  										 Long COVID										 Long COVID Cases Resulting								37,000 to 146,000		   from New Daily Infections										 Long COVID Cases Resulting								261,000 to 1,040,000		   from New Weekly Infections										 										 Excess Deaths										 Ex...
The wave peak is now estimated >10% higher than last week at 1.2 million new daily infections, nearly double the Delta wave.

We expect sustained high transmission (≈600,000 to 750,000 new daily infections) the next few weeks as COVlD circulates through schools/families.
🧵3/ Fig 1: Graph of 12 waves  Fig 2: "Barometer" showing above average transmission  Fig 3: Year-over-year graph, which informs the analytic forecast  Fig 4: Forecast described in post
Read 4 tweets

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