Mike Hoerger, PhD MSCR MBA Profile picture
Nov 13, 2023 8 tweets 5 min read Read on X
PMC C0VID-19 Tracker, Nov 13, 2023

We're entering the 8th pandemic wave, likely surging to >2% infectious (>1 million cases/day) in a month.

Today's numbers:
🔹 1.41% (1 in 71) are infectious
🔹 >670,000 C0VID cases/day
🔹>34,000 #LongCovid cases/day

1/
CURRENT ESTIMATES FOR  November 13, 2023  Wastewater Levels (copies/mL)  462  New Daily Cases  672,000  % of Population Infectious  1.41% (1 in 71 people)  New Daily Long COVID Cases   34,000 to 134,000    4-WEEK FORECAST FOR  December 11, 2023  Wastewater Levels (copies/mL)  739 (60% higher)  New Daily Cases  1,076,000  % of Population Infectious  2.25% (1 in 44 people)  New Daily Long COVID Cases   54,000 to 215,000
Note that the different forecasting models show high convergence.

December 11 by the Numbers:
🔹 2.25% (1 in 44) likely to be infectious
🔹 >1 million anticipated C0VID cases/day
🔹>50,000 resulting #LongCovid cases/day

2/ 4-WEEK FORECAST FOR  December 11, 2023  Wastewater Levels (copies/mL)  739 (60% higher)  New Daily Cases  1,076,000  % of Population Infectious  2.25% (1 in 44 people)  New Daily Long COVID Cases   54,000 to 215,000
Zooming out to the full #pandemic, there is no debate we're in an 8th U.S. C0VID wave, likely entering a "surge" in my view. That's not a word I take lightly.

There's more transmission than during 54% of pandemic days.
#MaskUp #VaxUp 😷💉

3/ There is more COVID-19 transmission today        than during 54.1% of the pandemic.  CURRENT ESTIMATES FOR November 13, 2023 Wastewater Levels (copies/mL) 462 New Daily Cases 672,000 % of Population Infectious 1.41% (1 in 71 people) New Daily Long COVID Cases 34,000 to 134,000  WEEKLY ESTIMATES FOR November 13, 2023 New Weekly Cases 4,700,000 New Weekly Long COVID Cases 235,000 to 941,000  2023 CUMULATIVE ESTIMATES AS OF November 13, 2023 Total 2023 Cases To Date 194,286,130 Total 2023 Long COVID Cases To Date 9,714,000 to 38,857,000
How Does the Oncoming 8th Wave Compare with Prior Waves?

I suspect we’re headed somewhere between the magnitude of Wave 2 (winter 20-21) & Wave 6 (last winter). If so, I would characterize us as heading into a surge. I do not use the word “surge” lightly.

More...
4/

In comparing waves, I see a qualitative distinction at about 1 million daily infections (wastewater levels of 750 copies/mL).

Waves 1, 2, 3, and 7 all hovered around that mark. I refer to these as waves, not surges.

Wave 4, 5, and 6 all had sustained time periods of weeks with over 1 million infections per day. The “area under the curve” is substantially higher, and I refer to these as “surges.”

If one ventures to use this distinction, will Wave 8 be a wave like Waves 1, 2, 3, and 7, or more of a surge with sustained daily infections of >1 million per day?

Remember, the model uses a combination of historical data plus what is happening during the preceding 4 weeks. This means we will know best when a couple weeks out. Beyond 4 weeks, the model is relying heavily on historical data, and the three prior winters (Waves 2, 4, and 6) are very different. Wave 4 is an outlier among the waves, obviously. Wave 2 was more typical of a non-winter wave. Wave 6 (surge) piggybacked on Wave 5 (surge) and may have been unique in that regard due to any fleeting population-level immunity. My model suggests we’re headed toward a surge slightly bigger than last year, and I could see that, because any fleeting immunity from Wave 7 is likely less than that derived from Wave 5, and people are not up-to-date on vaccinations. Other behavioral precautions are similar for this versus last winter: mostly non-existent. However, the model does not capture any of that. It’s predicting worse (more infections) than last year because it’s influenced by the BA.1 wave.

Acknowledging that, I suspect we will peak slightly lower than Wave 6, perhaps around the 1.5 million infections/day rate. Anything between Wave 2 and a 20% bigger version of Wave 6, I would consider a reasonable estimate at this point.
Full view of the pandemic waves with line drawn to compare "surges" with extended weeks of >1 million cases/day versus the other (also very terrible but not quite as terrible) waves.
Although only at the start of the 8th wave, transmission is already high on Nov 13.

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

5/ What’s the COVID Risk in an Office or in a Classroom?	 Number of People  |  Chances Anyone is Infectious	 1	1.4% 2	2.8% 3	4.2% 4	5.5% 5	6.8% 6	8.1% 7	9.4% 8	10.7% 9	12.0% 10	13.2% 15	19.1% 20	24.7% 25	29.8% 30	34.6% 35	39.1% 40	43.2% 50	50.7% 75	65.4% 100	75.7% 150	88.0% 200	94.1% 300	98.6% 400	99.7% 500	>99.9%
Here's an update on the danger of a #Thanksgiving gathering in the U.S. (Nov 23).

In a large gathering of 15-20 people, there's about a 25% chance someone would be infectious. I remain quite confident in these numbers, virtually identical to last week's forecast.

6/ In the U.S., What’s the COVID Risk for Thanksgiving?	 Number of People  |  Chances Anyone is Infectious	 1	1.6% 2	3.2% 3	4.7% 4	6.2% 5	7.7% 6	9.2% 7	10.7% 8	12.1% 9	13.5% 10	14.9% 15	21.5% 20	27.6% 25	33.2% 30	38.3% 35	43.1% 40	47.5% 50	55.3% 75	70.1% 100	80.0% 150	91.1% 200	96.0% 300	99.2% 400	99.8% 500	>99.9%
Here's an updated estimate on the possible danger of a #Christmas gathering in the U.S. (Dec 25).

I am exceedingly cautious on posting long-range forecasts.

7/

More...

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. These estimates are virtually identical to those in the forecast from last week.

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.
In the U.S., What’s the COVID Risk for Christmas Day?	 Number of People  |  Chances Anyone is Infectious	 1	3.1% 2	6.1% 3	9.1% 4	11.9% 5	14.7% 6	17.3% 7	19.9% 8	22.4% 9	24.8% 10	27.2% 15	37.9% 20	47.0% 25	54.8% 30	61.4% 35	67.1% 40	71.9% 50	79.5% 75	90.7% 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 Nov 13.

You can read the full report at

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

8/ pmc19.com/data
There is more COVID-19 transmission today	        than during 54.1% of the pandemic.	 	 CURRENT ESTIMATES FOR	 November 13, 2023	 Wastewater Levels (copies/mL)	 462	 New Daily Cases	 672,000	 % of Population Infectious	 1.41% (1 in 71 people)	 New Daily Long COVID Cases	 34,000 to 134,000	 	 WEEKLY ESTIMATES FOR	 November 13, 2023	 New Weekly Cases	 4,700,000	 New Weekly Long COVID Cases	 235,000 to 941,000	 	 2023 CUMULATIVE ESTIMATES AS OF	 November 13, 2023	 Total 2023 Cases To Date	 194,286,130	 Total 2023 Long COVID Cases To Date	 9,714,000 to 38,857,000	 	 4-WEEK FORECAST FOR	 Decembe...

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More from @michael_hoerger

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
Jan 17
Based on today's CDC & Biobot data, we estimate the following for the week of Jan 19:

🔸1 in 52 people in the U.S. actively infectious
🔸25% chance of exposure in a room of 15 ppl
🔸Nearly 1 million new daily infections
🔸5 cumulative infections per person all-time (avg)
🧵1/5 Heat map from CDC data with PMC estimates. Description of "Very High" states in next post
Transmission estimates have been marginally corrected upward.

11 states have Very High COVlD levels:

🔸PA: 1 in 25 estimated actively infectious
🔸MI: 1 in 23
🔸OH & KY: 1 in 22
🔸SD: 1 in 20
🔸NE & IA: 1 in 18
🔸IL & ME: 1 in 17
🔸IN: 1 in 16
🔸WV: 1 in 11
🧵2/5 Proportion Actively Infectious										1 in 52 (1.9%) New Daily Infections										 941,000  Infections the Past Week										 6,020,000  Infections in 2026										 18,000,000  Cumulative Infections per Person										 5.01  										 Long COVID										 Long COVID Cases Resulting								47,000 to 188,000		   from New Daily Infections										 Long COVID Cases Resulting								301,000 to 1,200,000		   from New Weekly Infections										 										 Excess Deaths										 Excess Deaths Resulting 									270 to 450	   from New Daily Infections										 Excess Deaths Resulting 				...
We're in the middle of a 12th COVlD wave.

The peak has likely passed, but with students headed back to school, transmission is expected to remain high for at least the next several weeks.

🧵3/5 1) Graph of 12 waves 2) Barometer showing above-average transmission 3) Year over year graph 4) Forecast for transmission to decline and then percolate at high levels
Read 5 tweets

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