Mike Hoerger, PhD MSCR MBA Profile picture
Nov 20, 2023 โ€ข 9 tweets โ€ข 4 min read โ€ข Read on X
PMC COVID-19 Tracker, Nov 20, 2023

We're headed into a winter surge!

Today:
๐Ÿ”น762,000 daily cases
๐Ÿ”น1 in 63 infectious (1.6%)

In 4 weeks:
๐Ÿ”น1,265,000 daily cases
๐Ÿ”น1 in 38 infectious (2.7%)

1/
CURRENT ESTIMATES FOR  November 20, 2023  Wastewater Levels (copies/mL)  523  New Daily Cases  762,000  % of Population Infectious  1.59% (1 in 63 people)  New Daily Long COVID Cases   38,000 to 152,000     4-WEEK FORECAST FOR  December 18, 2023  Wastewater Levels (copies/mL)  869 (66% higher)  New Daily Cases  1,265,000  % of Population Infectious  2.65% (1 in 38 people)  New Daily Long COVID Cases   63,000 to 253,000
Zooming out to the full pandemic, we're clearly in the 8th U.S. COVID wave, which I would characterize as a #surge.
๐ŸŒŠ๐ŸŒŠ๐ŸŒŠ๐ŸŒŠ๐ŸŒŠ๐ŸŒŠ๐ŸŒŠ๐ŸŒŠ

There's already more virus circulating today than during 60% of the days of the pandemic.
2/ There is more COVID-19 transmission today        than during 60.7% of the pandemic.  CURRENT ESTIMATES FOR November 20, 2023 Wastewater Levels (copies/mL) 523 New Daily Cases 762,000 % of Population Infectious 1.59% (1 in 63 people) New Daily Long COVID Cases 38,000 to 152,000  WEEKLY ESTIMATES FOR November 20, 2023 New Weekly Cases 5,300,000 New Weekly Long COVID Cases 267,000 to 1,067,000  2023 CUMULATIVE ESTIMATES AS OF November 20, 2023 Total 2023 Cases To Date 199,496,320 Total 2023 Long COVID Cases To Date 9,975,000 to 39,899,000
BNO & popular news outlets focus on *reported* cases. Actual cases derived from the true levels of virus in wastewater indicate 25x more infections.

By undercounting, they are grossly underestimating the number of resulting #LongCOVID cases.


3/
WEEKLY ESTIMATES FOR November 20, 2023 New Weekly Cases 5,300,000 New Weekly Long COVID Cases 267,000 to 1,067,000
Contact reduction (spending time in-person with fewer people) is an extremely smart method of avoiding infection. You'll see this in the next two tables. One focuses on schools/meetings. The other is more generic. Let's see which one gets shared more.
4/
This table shows how the risk of interacting with someone with COVID increases as the size of a classroom or meeting increases, as of Nov 20.

With 10 people, there's a 15% chance someone has COVID. With 50 people, there's a 55% chance someone has COVID.

5/ 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	10.6% 8	12.1% 9	13.5% 10	14.8% 15	21.4% 20	27.5% 25	33.1% 30	38.3% 35	43.0% 40	47.4% 50	55.2% 75	70.0% 100	80.0% 150	91.0% 200	96.0% 300	99.2% 400	99.8% 500	>99.9%
This table has the same data but a more generic title. It should help people think about the typical number of people they interact with in a day.

In interacting with 10 people, there's a 15% chance someone has COVID. 50 people = 55% chance. Plane, restaurant, or theater with 100 people = 80% chance someone there has COVID.

Again, same table as Tweet #5, just framed with a different title.

6/
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	10.6% 8	12.1% 9	13.5% 10	14.8% 15	21.4% 20	27.5% 25	33.1% 30	38.3% 35	43.0% 40	47.4% 50	55.2% 75	70.0% 100	80.0% 150	91.0% 200	96.0% 300	99.2% 400	99.8% 500	>99.9%
Many families will gather for Thanksgiving in 3 days (Nov 23). Here's how COVID risk increases with the number of social interactions.

In a family gathering of 5, there's an 8% chance someone has COVID. A big gathering of 10 = 16% chance. Two family dinners each with 10 people (approx 20 people total) = 29% chance someone has COVID. Packed restaurant of 100 = 82% chance someone has COVID. Flight of 200 = 97% chance someone has COVID.

7/
Number of People  |  Chances Anyone is Infectious	 1	1.7% 2	3.3% 3	4.9% 4	6.5% 5	8.1% 6	9.6% 7	11.1% 8	12.6% 9	14.1% 10	15.5% 15	22.3% 20	28.6% 25	34.4% 30	39.7% 35	44.5% 40	49.0% 50	56.9% 75	71.7% 100	81.5% 150	92.0% 200	96.6% 300	99.4% 400	99.9% 500	>99.9%
Many families will gather for Christmas and other celebrations next month. Here's how COVID risk increases with the number of social interactions.

In a family gathering of 5, there's an 15% chance someone has COVID. A big gathering of 10 = 27% chance. Two family dinners each with 10 people (approx 20 people total) = 47% chance someone has COVID. Packed restaurant of 100 = 96% chance someone has COVID. Flight of 200 = 99.8% chance someone has COVID.

These numbers are speculative at 1-month out. The model will refine estimates as we get closer and closer. Stay tuned.

8/
Number of People  |  Chances Anyone is Infectious	 1	3.1% 2	6.2% 3	9.1% 4	12.0% 5	14.7% 6	17.4% 7	20.0% 8	22.5% 9	24.9% 10	27.3% 15	38.0% 20	47.1% 25	54.9% 30	61.6% 35	67.2% 40	72.0% 50	79.7% 75	90.8% 100	95.9% 150	99.2% 200	99.8% 300	>99.9% 400	>99.9% 500	>99.9%
Here's the full PMC Dashboard for Nov 20.

You can read the full report here:

Thanks everybody for sharing across platforms and your feedback on things like axis labels, making the percentages meaningful, etc. Much appreciated. The "C" in PMC is for collaborative.

9/pmc19.com/data/

There is more COVID-19 transmission today	        than during 60.7% of the pandemic.	 	 CURRENT ESTIMATES FOR	 November 20, 2023	 Wastewater Levels (copies/mL)	 523	 New Daily Cases	 762,000	 % of Population Infectious	 1.59% (1 in 63 people)	 New Daily Long COVID Cases	 38,000 to 152,000	 	 WEEKLY ESTIMATES FOR	 November 20, 2023	 New Weekly Cases	 5,300,000	 New Weekly Long COVID Cases	 267,000 to 1,067,000	 	 2023 CUMULATIVE ESTIMATES AS OF	 November 20, 2023	 Total 2023 Cases To Date	 199,496,320	 Total 2023 Long COVID Cases To Date	 9,975,000 to 39,899,000	 	 4-WEEK FORECAST FOR	 Decem...

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More from @michael_hoerger

Jul 2
๐ŸŒWant to track COVID transmission accurately worldwide?

This PMC thread walks you through leading dashboards with information more up to date than WHO & EU directories.

๐Ÿงต 1/ World map, countries with high-quality up-to-date surveillance systems shown in blue.
The Pandemic Mitigation Collaborative (PMC) Dashboard provides weekly COVID updates for the U.S., using wastewater surveillance derived case estimation models and analytic forecasting.

We have added a list of international dashboards:
๐Ÿงต 2/
pmc19.com/data/index.phpโ€ฆAustralia: NSW Health Australia Department of Health, Western Australia Austria: Federal Government of Austria City of Vienna - Regional Coron-A Consortium Austria Czech Republic: State Health Institute Czech Republic Belgium: Belgian Institute for Health Canada: Government of Canada Andrew Young's Canada Visualization C19 Resources Canada * World Health Network (WHN) Canada **
Denmark: Statens Serum Institut Denmark Europe (multi-national): EU Wastewater Observatory Finland: National Institute for Health and Welfare Finland WHN Finland ** France: French Republic Data Airborne Risk Reduction Association (ARRA) France Zan Armstrong's France Visualization COVID Weather App France (Android, IOS, or Web) Thomas Delattre's France Visualization Germany: Infection Radar Germany Bay-VOC Bavaria Region Berlin Waterworks WHN Germany **
Hong Kong: Centre for Health Protection, Hong Kong Hungary: National Center for Public Health and Pharmacy of Hungary India: Pune Knowledge Cluster of India Gujarat Biotechnology Research Centre of India Ireland: Health Protection Surveillance Centre Ireland Japan: Japan Institute for Health Security Latvia: Institute of Food Safety, Animal Health and Environment Latvia Lithuania: National Public Health Centre of Luthuania Luxembourg: Microbs Luxembourg Netherlands: National Institute for Public Health and the Environment Netherlands WHN Netherlands ** New Zealand: New Zealand Institute for...
Slovenia: National Institute of Public Health Slovenia Spain: Government of Catalonia - Regional South Africa: National Institute for Communicable Diseases of South Africa South Korea: Korea Disease Control and Prevention Agency Sweden: Pathogens Sweden Switzerland: Swiss Confederation Federal Office of Public Health ETH Zurich Switzerland WISE Dashboard U.K.: Public Health Scotland Buckinghamshire Disability Service (BuDS) U.K.  *See the numbers 1-21 along the lower left. Click on 3-6 for national and regional data. ** Click on the dropdown menu. May need to try a different web browser.
Our international directory includes official government dashboards & those developed by citizen scientists.

We exclude countries that have stopped reporting in the past 2-12 months even if on EU or WHO lists. We also exclude low-quality data from opt-in testing programs.
๐Ÿงต 3/
Read 43 tweets
Jun 24
PMC COVlD Dashboard, Jun 23, 2025 (U.S.)

๐Ÿ”ฅBiggest uptick since Jan
๐Ÿ”ฅ1 in 167 actively infectious
๐Ÿ”ฅ>2 million weekly infections
๐Ÿ”ฅ700-1,200 resulting excess deaths from weekly infections

Track transmission closer to home w/our new state & international resources ๐Ÿ‘‡

๐Ÿงต1/6
PMC COVlD Dashboard, Jun 23, 2025 (U.S.)

๐Ÿ”นWith >90% probability, we have entered the 11th COVlD wave.
๐Ÿ”นIn a room of 50 people, there is already a 1 in 4 chance of an exposure.
๐Ÿ”นWe expect nearly 15 million infections in the next month, and rising.

๐Ÿงต2/6Current Levels for Jun 23, 2025	 % of the Population Infectious	 0.6% (1 in 167)	 New Daily Infections	 287000	 New Weekly Infections	 2009000	 Resulting Weekly Long COVID Cases	 100,000 to 402,000	 Resulting Weekly Excess Deaths	 700 to 1,200	 	 Monthly Forecast	 Average % of the Population Infectious	 1.0% (1 in 97)	 Average New Daily Infections	 493300	 New Infections During the Next Month	 14799000	 Resulting Monthly Long COVID Cases	 740,000 to 2,960,000	 Resulting Monthly Excess Deaths	 5,300 to 8,800	 	 Running Totals	 Infections Nationwide in 2025	 74869000	 Average Number of Infect...
PMC COVlD Dashboard, Jun 23, 2025 (U.S.)

We continue to expect transmission to break 500,000 daily infections in the U.S. around July 9th.

This is the same prediction as last week, as the forecast was dead on. Yet, there is considerably uncertainty around this timing.

๐Ÿงต3/6Longitudinal transmission, past 12 months and 1-month forecast
Read 6 tweets
Jun 17
1) PMC COVlD Dashboard, June 16, 2025 (U.S.)

Current transmission (red line) closely tracks that of summer 2023 (yellow line).

We expect to break 500k daily infections between July 9 and the end of July. Our current forecast...Year over year graph of tranmission
2) PMC COVlD Dashboard, June 16, 2025 (U.S.)

Our current forecast is a bit more aggressive, predicting breaking 500k daily infections by July 9. The 2023 trend suggests end of July.

The 95% confidence interval shows large variation. Note that...Past 12 months of transmission (U.S.) and forecast
3) PMC COVlD Dashboard, June 16, 2025 (U.S.)

Note that CDC and Biobot both had retroactive corrections to last week's data, meaning the relative "lull" will last a little longer than the uncorrected data suggested. No big news on NB.1.8.1.

All good news, but...10 pandemic waves. Soon 11
Read 7 tweets
Jun 16
1) Here's a quick example of how the federal government is censoring the best scientific research. It's not just cuts to ongoing research.

It's new grant submissions too... "No forbidden words found"
2) In January, I re-submitted a promising Covid/cancer grant to a non-federal funder. Hundreds of pages. Hundreds of hours of work. The best proposal I've submitted as a scientist.

Out of curiosity, I used Sean Mullen's Scan Assist tool to see how many banned words it had...
3) The proposal had 1,750 banned words. No big deal -- they're non-federal.

BUT I had planned to submit a smaller version to NIH this month as a "back up." Impossible!

It's not a matter of using a thesaurus or the find/replace command. The grant is on *Covid*... 1,750 banned words found
Read 13 tweets
Jun 9
1) PMC COVlD Dashboard, June 9, 2025

CDC wastewater surveillance data show transmission rising. This is our forecast if transmission growth follows typical patterns.

The high & low estimates could be thought of as optimistic & pessimistic scenarios for NB.1.8.1.Forecast graph: Rising transmission the next month
2) PMC COVlD Dashboard, June 9, 2025

Notice that current transmission (red line, lower left) tracks closely with two years ago (yellow), slightly below the median (gray), and not far below last year (orange).

Consider each of these trajectories realistic scenarios.Image
3) PMC COVlD Dashboard, June 9, 2025

All indications are that we are headed into the start of an 11th national wave in the U.S.

We could percolate near the lull point another couple weeks (fingers crossed), but that scenario is becoming less likely.Graph of 10 C19 waves
Read 7 tweets
Jun 3
1/ PMC COVlD Dashboard, June 2, 2025 (U.S.)

National COVlD transmission recently fell to its lowest levels since the pre-Delta era.

It's go-time for many who have delayed medical appointments. The situation will likely get much worse in Jul/Aug.
2/ PMC COVlD Dashboard, June 2, 2025 (U.S.)

An estimated 1 in 211 are actively infectious. Most states are "low" or "very low" per CDC.

The situation remains serious even in a relative "lull." >1.5 million weekly estimated infections to result in 600-900 excess deaths.C19 heat map
year over year graph, tracking closely with the median and past 2 years
Current Levels for Jun 2, 2025	 % of the Population Infectious	 0.5% (1 in 211)	 New Daily Infections	 227000	 New Weekly Infections	 1589000	 Resulting Weekly Long COVID Cases	 79,000 to 318,000	 Resulting Weekly Excess Deaths	 600 to 900	 	 Monthly Forecast	 Average % of the Population Infectious	 0.7% (1 in 139)	 Average New Daily Infections	 344566.6667	 New Infections During the Next Month	 10337000	 Resulting Monthly Long COVID Cases	 517,000 to 2,067,000	 Resulting Monthly Excess Deaths	 3,700 to 6,200	 	 Running Totals	 Infections Nationwide in 2025	 70132000	 Average Number of Infe...
Graph of the whole pandemic, 11th wave forthcoming
3/ PMC COVlD Dashboard, June 2, 2025 (U.S.)

By the end of the month, we forecast an increase to 450k daily infections. If NB.1.8.1 takes off, closer to 600k. If overhyped, percolating only slightly higher.Past 12 months and forecast
Read 5 tweets

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