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

Oct 30
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
Read 7 tweets
Oct 25
New #LongCOVID article out today in one of the top science journals, @Nature.

The most striking finding to me was that more frequent vaccination reduced the risk of yearlong LC from the 4.3-5.2% range (in their sample, which is low) to just 0.38%. That's a >10x reduction.

1/ Trimmed version of Table 1
Their sample is at the low end of #LongCOVID estimates overall, so for a fairer comparison, I could imagine 20% of the under-vaccinated group with LC & about 2% in the more frequently vaxxed group.

We could quibble on the base rates, but the risk reduction is the key stat.

2/
I always advocate for multilayered mitigation because a 0.4-2% chance of a new severe disability is considerable for individuals and populations. Effects are cumulative. Also, vaccines wane, and evading variants emerge unpredictably. Forward transmission is common. Etc.

3/
Read 8 tweets
Oct 23
PMC C0VID-19 Tracker, Oct 23, 2023
"As Good As It Gets"

U.S. #wastewater levels are higher than during 44% of the pandemic:
🔹 1.05% (1 in 95) are infectious
🔹 >500,000 C0VID cases/day
🔹>25,000 #LongCovid cases/day

Fall cases bottom out in 2 days or so.
1/
PMC19 Cases and Forecast, 6 month view. We've passed the late-summer wave, are projected to bottom out for the fall on October 25 (or perhaps a little later). Then, every day remaining in 2023 will see worse transmission.
Zooming out from the 6-month view to the full pandemic, note that fall transmission is bottoming out at a high rate.

The U.S. 8th wave this winter will start to pick up soon, at a fast clip, and transmission will accelerate in December.

2/ Graph of C19 wastewater data from Biobot, with case estimates and forecast, full pandemic to date.  There is more COVID-19 transmission today        than during 43.8% of the pandemic.  CURRENT ESTIMATES FOR October 23, 2023 Wastewater Levels (copies/mL) 345 New Daily Cases 502,000 % of Population Infectious 1.05% (1 in 95 people) New Daily Long COVID Cases  25,000 to 100,000   WEEKLY ESTIMATES FOR October 23, 2023 New Weekly Cases 3,500,000 New Weekly Long COVID Cases  176,000 to 703,000   2023 CUMULATIVE ESTIMATES AS OF October 23, 2023 Total 2023 Cases To Date 181,044,020 Total 2023 Long ...
With 1.05% of the U.S. population actively infectious (Oct 23), larger group activities continue to be increasingly risky.

Expect similar numbers the next two weeks. Then, activities will get much more dangerous.

#MaskUp #FitTest #VaxUp (if allowed/available)
3/ Number of People | Chances Anyone is Infectious 1	1.1% 2	2.1% 3	3.1% 4	4.1% 5	5.1% 6	6.1% 7	7.1% 8	8.1% 9	9.1% 10	10.0% 15	14.6% 20	19.0% 25	23.2% 30	27.1% 35	30.9% 40	34.4% 50	41.0% 75	54.7% 100	65.2% 150	79.5% 200	87.9% 300	95.8% 400	98.5% 500	99.5%
Read 9 tweets
Oct 17
Did you know, you can still access recent national C0VID #wastewater data in the U.S.?

I'll walk you though it.

🧵
1/ Verily national wastewater graph
First, go to Verily's #wastewater website.


Click on the little Line Graph icon on the left side.

2/ data.wastewaterscan.org
Click the line graph icon
When you click on the Line Graph icon, it makes an annoying pop-up.

In the 1st menu, choose SARS-CoV-2.

In the 2nd menu, click *ANY* location. We want national, but they don't include it there. So pick anywhere, and we'll fix it later.

3/ Useless pop-up window
Read 11 tweets
Oct 11
Biobot (blue) versus Verily (black) #wastewater data.

You'll see Verily data suggest the most recent wave (#7) has had considerably more transmission than Delta (#3). And that last winter (#6) was similar (or worse!) than the prior winter's BA.1 surge (#4).

Who wins?

1/ Graph of biobot and verily wastewater data. Both show similarly timed waves but vary in magnitude.
Here are the correlations among Biobot levels, Verily levels, & IHME true cases for the 1st of each month from Jan '21 to Apr '23.

Biobot correlates r=.94 (freakish) with IHME. Verily only correlates r=.67.

Either Biobot is much better, or Verily knows something we don't.
2/ Correlation table for biobot, verily, and ihme data
The CDC awarded Biobot's contract to Verily.

Once Verily brings on Biobot's former CDC-contracted wastewater sites, that should help. Case estimation will be easier if they fold in the historic data to more accurately represent the nation.

Forecasting is easy regardless.
3/
Read 5 tweets
Oct 9
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...
Read 9 tweets

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