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

We're headed into a winter surge!

Today:
🔹762,000 daily cases
🔹1 in 63 infectious (1.6%)

In 4 weeks:
🔹1,265,000 daily cases
🔹1 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.
🌊🌊🌊🌊🌊🌊🌊🌊

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

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
Oct 21
PMC COVlD Update, Oct 20, 2025 (U.S.)

SARS-CoV-2 transmission has fallen.
🔹1 in 191 (0.5%) actively infectious
🔹"Lull" levels at 20% of the summer peak
🔹255,000 new daily infections (still concerning)

Many will knock out higher-risk activities the next 2-4 weeks.
🧵1/11 Graph of the 11 waves, shows current lull.
PMC COVlD Update, Oct 20, 2025 (U.S.)

"Lull" transmission remains dangerous:
🔹1.8 million estimated new weekly infections
🔹>90,000 estimated new #LongCOVID conditions from this week's infections
🔹>500 excess deaths to result from this week's infections

🧵2/11 Infections						 Proportion Actively Infectious										1 in 191 (0.5%) New Daily Infections										 255,000  Infections the Past Week										 1,800,000  Infections in 2025										 191,000,000  Cumulative Infections per Person										 4.69  										 Long COVID										 Long COVID Cases Resulting								13,000 to 51,000		   from New Daily Infections										 Long COVID Cases Resulting								90,000 to 360,000		   from New Weekly Infections										 										 Excess Deaths										 Excess Deaths Resulting 									70 to 120	   from New Daily Infections										 Excess Deaths ...
PMC COVlD Update, Oct 20, 2025 (U.S.)

Exposure risk during "lull" transmission remains high when engaging in many social interactions.

Interacting with 25 people yields a 12% chance of exposure. 100 people? 41% chance of exposure, assuming no testing/isolation.

🧵3/11 Number of People		Chances Anyone is Infectious		 1				0.5% 2				1.0% 3				1.6% 4				2.1% 5				2.6% 10				5.1% 15				7.6% 20				10.0% 25				12.3% 30				14.5% 50				23.1% 75				32.5% 100				40.8% 200				64.9% 300				79.2%
Read 11 tweets

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