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Mike Hoerger, PhD MSCR MBA Profile picture
@michael_hoerger
Nov 20 โ€ข 9 tweets โ€ข 4 min read Twitter logo Read on Twitter
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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

Mike Hoerger, PhD MSCR MBA Profile picture
Nov 13
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:
๐Ÿ”น 1.41% (1 in 71) are infectious
๐Ÿ”น >670,000 C0VID cases/day
๐Ÿ”น>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:
๐Ÿ”น 2.25% (1 in 44) likely to be infectious
๐Ÿ”น >1 million anticipated C0VID cases/day
๐Ÿ”น>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 ๐Ÿ˜ท๐Ÿ’‰

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
Read 8 tweets
Mike Hoerger, PhD MSCR MBA Profile picture
Oct 30
PMC C0VID-19 Tracker, Oct 30, 2023

We're at the onset of an 8th U.S. pandemic wave.

Today's Numbers:
๐Ÿ”น 1.27% (1 in 78) are infectious
๐Ÿ”น >600,000 C0VID cases/day
๐Ÿ”น>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:
๐Ÿ”น 1.76% (1 in 57) are infectious
๐Ÿ”น >800,000 C0VID cases/day
๐Ÿ”น>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. ๐Ÿ˜ท๐Ÿ’‰
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
Mike Hoerger, PhD MSCR MBA Profile picture
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
Mike Hoerger, PhD MSCR MBA Profile picture
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:
๐Ÿ”น 1.05% (1 in 95) are infectious
๐Ÿ”น >500,000 C0VID cases/day
๐Ÿ”น>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
Mike Hoerger, PhD MSCR MBA Profile picture
Oct 17
Did you know, you can still access recent national C0VID #wastewater data in the U.S.?

I'll walk you though it.

๐Ÿงต
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
Mike Hoerger, PhD MSCR MBA Profile picture
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

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