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

Sep 16
PMC COVlD Report, Sep 15, 2025 (U.S.)
🧵1/7

COVlD-19 levels are "Very High" or "High" in the majority of states, per the CDC.

This includes 27 states & D.C.

🔥🔥Very High:
Alaska, Hawai'i, California, Nevada, Idaho, Utah, S. Dakota, Nebraska, Texas, Louisiana, Indiana, Kentucky, Tennessee, Florida, S. Carolina, N. Carolina, D.C., Maryland, and Connecticut.

🔥High:
Washington state, Oregon, Montana, probably N. Dakota (imputed), Arkansas, Alabama, Virginia, Delaware, Rhode Island, and Massachusetts.

PMC estimates 1 in 38 people (2.7%) are actively infectious. Wastewater-derived case estimates suggest 1.3 million new daily infections.Heat map using CDC levels. Key findings summarized in the post.
PMC COVlD Report, Sep 15, 2025 (U.S.)
🧵2/7

Transmission is peaking nationally, but regional variation is common. Know what's happening in your state, and get the word out.

Note that the levels CDC calls "low" are still quite alarming.State | CDC Level | PMC Estimate, % Actively Infectious Alabama	High	1 in 30 (3.4%) Alaska	Very High	1 in 22 (4.6%) Arizona	Moderate	1 in 40 (2.5%) Arkansas	High	1 in 28 (3.6%) California	Very High	1 in 21 (4.8%) Colorado	Moderate	1 in 50 (2.0%) Connecticut	Very High	1 in 19 (5.3%) Delaware	High	1 in 33 (3.0%) District of Columbia	Very High	1 in 17 (6.0%) Florida	Very High	1 in 24 (4.2%) Georgia	Moderate	1 in 46 (2.2%) Guam	Low	1 in 64 (1.6%) Hawaii	Very High	1 in 26 (3.8%) Idaho	Very High	1 in 14 (7.3%) Illinois	Moderate	1 in 44 (2.3%) Indiana	Very High	1 in 16 (6.1%) Iowa	Moderate	1 in 40...
PMC COVlD Report, Sep 15, 2025 (U.S.)
🧵3/7

Note that transmission is increasingly spreading from the South & West toward other areas. Know your state-level risk.

Transmission remains alarming even in areas CDC labels "Very Low" (e.g., Missouri, estimated 1 in 109). State | CDC Level | PMC Estimate, % Actively Infectious Missouri	Very Low	1 in 109 (0.9%) Montana	High	1 in 36 (2.8%) Nebraska	Very High	1 in 18 (5.5%) Nevada	Very High	1 in 17 (5.9%) New Hampshire	Low	1 in 64 (1.6%) New Jersey	Moderate	1 in 56 (1.8%) New Mexico	Very Low	1 in 106 (0.9%) New York	Low	1 in 73 (1.4%) North Carolina	Very High	1 in 17 (5.8%) North Dakota	High*	1 in 32 (3.2%) Ohio	Moderate	1 in 47 (2.1%) Oklahoma	Moderate*	1 in 44 (2.3%) Oregon	High	1 in 31 (3.2%) Pennsylvania	Moderate	1 in 44 (2.3%) Rhode Island	High	1 in 30 (3.3%) South Carolina	Very High	1 in 15 (6.6%) South D...
Read 7 tweets
Sep 13
California COVlD Surge Rages Higher

🔸CDC SARS-CoV-2 wastewater levels "Very High," and up from last week
🔸1 in 21 estimated actively infectious
🔸>250,000 estimated new daily infections statewide

Four figures...
1/4🧵 CDC: Very High: PMC Estimate: 1 in 21 actively infectious
CDC wastewater data in California show COVlD cases increasing from the already "Very High" levels last week.

2/4🧵 Line graph of the past 6 months showing the surge in wastewater viral levels
With an estimated 1 in 21 (or 4.8%) of California residents actively infectious of COVlD, risk increases dramatically in larger and more frequent social gatherings.

Interact with 25 people of average risk of being positive, and that's a >70% chance of exposure.
3/4🧵 How Does Risk Increase with More Social Contacts? Number of People | Chances Anyone is Infectious 1	4.8% 2	9.4% 3	13.7% 4	17.9% 5	21.8% 6	25.6% 7	29.1% 8	32.5% 9	35.8% 10	38.9% 15	52.2% 20	62.6% 25	70.8% 30	77.1% 35	82.1% 40	86.0% 50	91.5% 75	97.5% 100	99.3% 300	99.9%
Read 4 tweets
Sep 10
Let's say you're a dairy farmer. You have 100 cows. Each year, about 5 cows die, and another 5 cows are born. Then, along comes a virus. Let's call it "cowvid"...
1/
Let's say "cowvid" wipes out about half the cows over the course of a couple years. Now, you're down to 50 cows....
2/
The local mayor declares "cowvid" to be over. This surprises you as a farmer because 5 of your cows keep dying annually. 5 of 50 instead of 5 out of 100. Seems like more, but you're not a city slicker...
3/
Read 12 tweets
Sep 7
#DuringCOVID is today.

Image pack 1 of 9 🧵 Graph of the 11 waves of the pandemic in the U.S., tailored to a key message noted in the post.
1 million New Daily Infections.

Today!

Image pack 2 of 9 🧵 Graph of the 11 waves of the pandemic in the U.S., tailored to a key message noted in the post.
Where are the free vaccines, N95s, and tests?

Image pack 3 of 9 🧵 Graph of the 11 waves of the pandemic in the U.S., tailored to a key message noted in the post.
Read 9 tweets
Sep 3
PMC Dashboard Update (U.S.) 🧵1 of 8

The 11th wave is still rising.
🔥23 states/territories High/Very High
🔥Very High: Alabama, DC, Guam, Hawai'i, Louisiana, Nebraska, Nevada, South Carolina, Texas, Utah
🔥1 in 56 estimated actively infectious
🔥876,000 new daily infections CDC heat map, very high states noted in post. PMC estimate of 1 in 56 actively infectious nationwide
PMC Dashboard Update (U.S.) 🧵2 of 8

Note that the CDC has modified 📉 how transmission levels correspond to the categorical bins.

Take California. We estimate 1 in 30 actively infectious statewide. This would have previously been "Very High," now just "High."
#NewNormal CDC heatmap, with PMC estimate of 1 in 30
PMC Dashboard Update (U.S.) 🧵3 of 8

Here are the prevalence estimates for the first half of states/territories.

Notice how high the levels are in some of the "Moderate" states. State	CDC Level Alabama	Very High Alaska	High Arizona	High Arkansas	Moderate California	High Colorado	Moderate Connecticut	High Delaware	High District of Columbia	Very High Florida	High Georgia	Moderate Guam	Very High Hawaii	Very High Idaho	High Illinois	Very Low Indiana	Moderate* Iowa	Low Kansas	Low Kentucky	High Louisiana	Very High Maine	Low Maryland	Moderate Massachusetts	Moderate Michigan	Very Low Minnesota	Moderate Mississippi	High*
Read 9 tweets
Aug 21
During times like these when COVlD transmission heats up in the U.S., expect to see a lot more angry outbursts for three central reasons.

First, "displacement," or people trying to deny the reality of their anxiety by taking it out on other people....
Second, a lot of people can sustain a strong denial of reality about the ongoing pandemic during lulls. They suppress the existence of COVlD waves and excess deaths, disability, and retirements.

During waves, those defenses burst. Loss of control = anger...
Third, a lot of people (many reading this) understand COVlD correctly & experience righteous indignation during COVlD waves. We quite reasonably do not like all of the unjust and gratuitous suffering.

I find it helpful to channel that intensity into helping other people....
Read 6 tweets

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