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

Dec 15
PMC COVID Update, Dec 15, 2025 (U.S.)

In the latest CDC data, 15 states have moderate to very high transmission.
🔹1 in 63 estimated actively infectious nationally, rising fastest in the Midwest & Northeast
🔹Very High: Indiana
🔹High: Nebraska, Vermont, Connecticut

🧵1/9 Heat map from CDC data and PMC estimates of 1 in 63 actively infectious and >700,000 new daily infections, based on wastewater derived estimates using models noted in the Technical Appendix at the website listed in the image.
PMC estimates 1 in 26 people in Indiana are infectious and 1 in 39 in Connecticut.

MI, MS, and AR may have higher levels than shown due to poor reporting.

States AL to MS shown.

🧵2/9 Alabama	Moderate	1 in 41 (2.4%) Alaska	Very Low	1 in 220 (0.5%) Arizona	Very Low	1 in 118 (0.8%) Arkansas	Low*	1 in 68 (1.5%) California	Very Low	1 in 382 (0.3%) Colorado	Very Low*	1 in 230 (0.4%) Connecticut	High	1 in 39 (2.6%) Delaware	Very Low	1 in 222 (0.4%) District of Columbia	Very Low	1 in 131 (0.8%) Florida	Very Low	1 in 320 (0.3%) Georgia	Very Low	1 in 275 (0.4%) Guam	Very Low	1 in 426 (0.2%) Hawaii	Very Low	1 in 670 (0.1%) Idaho	Very Low	1 in 108 (0.9%) Illinois	Low	1 in 71 (1.4%) Indiana	Very High	1 in 26 (3.8%) Iowa	Low	1 in 76 (1.3%) Kansas	Moderate	1 in 62 (1.6%) Kentucky	Mode...
PMC estimates 1 in 39 are infectious in both Nebraska and Vermont (coincidence, not typo).

Very few NY sites are reporting to the CDC, so use the NYS website there instead.

States MO to WY shown.

🧵3/9 Missouri	Low	1 in 80 (1.2%) Montana	Very Low	1 in 135 (0.7%) Nebraska	High	1 in 39 (2.5%) Nevada	Very Low	1 in 225 (0.4%) New Hampshire	Moderate	1 in 47 (2.1%) New Jersey	Very Low	1 in 200 (0.5%) New Mexico	Low	1 in 75 (1.3%) New York	Moderate*	1 in 49 (2.1%) North Carolina	Very Low	1 in 226 (0.4%) North Dakota	Low*	1 in 85 (1.2%) Ohio	Moderate	1 in 62 (1.6%) Oklahoma	Moderate*	1 in 47 (2.1%) Oregon	Low	1 in 89 (1.1%) Pennsylvania	Moderate	1 in 55 (1.8%) Rhode Island	Low	1 in 70 (1.4%) South Carolina	Very Low	1 in 215 (0.5%) South Dakota	Low	1 in 86 (1.2%) Tennessee	Moderate	1 in 60 (1.7%) ...
Read 9 tweets
Dec 8
PMC COVlD Update, Dec 8, 2025 (U.S.)
1/9

🔥🔥🔥Very High: Arizona (Yuma)
🔥🔥High: Indiana and Vermont
🔥Moderate: Nebraska and Alabama

Data only go through late November, and levels often increase following Thanksgiving. Heat map and PMC estimates of transmission (1 in 102 actively infectious).
PMC COVlD Update, Dec 8, 2025 (U.S.)
2/9

State-by-state estimates (part 1). Arizona is Very High, but sites were only online in the Yuma area. Indiana remains high.

MI and MS have considerable uncertainty.

DC is exceptionally low. Alabama	Moderate	1 in 47 (2.1%) Alaska	Very Low	1 in 220 (0.5%) Arizona	Very High*	1 in 18 (5.7%) Arkansas	Very Low*	1 in 138 (0.7%) California	Very Low	1 in 574 (0.2%) Colorado	Low	1 in 76 (1.3%) Connecticut	Low	1 in 91 (1.1%) Delaware	Very Low	1 in 307 (0.3%) District of Columbia	Very Low	1 in 5,777 (0.0%) Florida	Very Low	1 in 494 (0.2%) Georgia	Very Low	1 in 180 (0.6%) Guam	Very Low	1 in 289 (0.3%) Hawaii	Very Low	1 in 704 (0.1%) Idaho	Very Low	1 in 121 (0.8%) Illinois	Very Low	1 in 112 (0.9%) Indiana	High	1 in 30 (3.3%) Iowa	Low	1 in 83 (1.2%) Kansas	Low	1 in 105 (1.0%) Kentucky	Very L...
PMC COVlD Update, Dec 8, 2025 (U.S.)
3/9

State-by-state estimates (part 1). Vermont remains High. Tennessee has fallen rapidly from a quick surge.

Data quality are low in NY. Missouri	Very Low	1 in 176 (0.6%) Montana	Very Low	1 in 136 (0.7%) Nebraska	Moderate	1 in 45 (2.2%) Nevada	Very Low	1 in 372 (0.3%) New Hampshire	Very Low	1 in 109 (0.9%) New Jersey	Very Low	1 in 217 (0.5%) New Mexico	Very Low	1 in 118 (0.8%) New York	Very Low*	1 in 260 (0.4%) North Carolina	Very Low	1 in 233 (0.4%) North Dakota	Low*	1 in 101 (1.0%) Ohio	Low	1 in 70 (1.4%) Oklahoma	Low*	1 in 68 (1.5%) Oregon	Very Low	1 in 150 (0.7%) Pennsylvania	Low	1 in 89 (1.1%) Rhode Island	Very Low	1 in 187 (0.5%) South Carolina	Very Low	1 in 144 (0.7%) South Dakota	Low	1 in 82 (1.2%) Tennessee	Very Low...
Read 9 tweets
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

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