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Mike Hoerger, PhD MSCR MBA Profile picture
@michael_hoerger
Dec 4, 2023 • 7 tweets • 3 min read • Read on X
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PMC COVID-19 Tracker, Dec 4, 2023
The U.S. surge is worsening faster than anticipated.

Today:
🔹1.2 million daily infections
🔹1 in 38 infectious (2.6%)

In 4 weeks (New Year's Day):
🔹1.8 million daily infections
🔹1 in 26 infectious (3.9%)

1/
 CURRENT ESTIMATES FOR December 4, 2023 Wastewater Levels (copies/mL) 865 New Daily Cases 1,258,000 % of Population Infectious 2.63% (1 in 38 people) New Daily Long COVID Cases 63,000 to 252,000 4-WEEK FORECAST FOR January 1, 2024 Wastewater Levels (copies/mL) 1,284 (49% higher) New Daily Cases 1,869,000 % of Population Infectious 3.91% (1 in 26 people) New Daily Long COVID Cases 93,000 to 374,000
You'll note the diverging forecasts. Biobot #wastewater levels increased more than anticipated this week, and they updated last week's numbers upward too.

The cheetah forecast (yellow) assumes this week's levels will also get revised upward like last week's. The turtle model (green) ignores this week's data as an aberration. The real-time forecast (purple), which assumes all real-time estimates are accurate, is barely visible behind the red line. The red line is the composite average of all 3 forecasts.

You'll notice the blue line (wastewater levels) and red line (forecast) overlap marginally. Biobot reports levels for Nov 29, and we carry them forward in the forecasting model through Dec 4 (today). Transmission is accelerating so much, usually this 5 day lag isn't even visible graphically.

2/
 Zooming in on the forecast. See prior tweet for more detail.
This table shows how additional social contacts increase risk today (Dec 4).

🔥10 people (daycare, team meeting) = about a 1 in 4 chance someone has infectious COVID

🔥🔥30 people (large K-12 class) = over a 50% chance someone has infectious COVID

3/ Number of People | Chances Anyone is Infectious 1 2.6% 2 5.2% 3 7.7% 4 10.1% 5 12.5% 6 14.8% 7 17.0% 8 19.2% 9 21.3% 10 23.4% 15 33.0% 20 41.3% 25 48.7% 30 55.1% 35 60.7% 40 65.6% 50 73.6% 75 86.5% 100 93.1% 150 98.2% 200 99.5% 300 >99.9% 400 >99.9% 500 >99.9%
This table shows how socializing on Christmas will drive the worst of the winter surge. Estimates are revised upward today (Dec 4).

⭐️Large fam gathering (20 people) = over a 50% chance someone's infectious

⭐️⭐️Large restaurant/flight = near-certain someone's infectious

4/ Number of People | Chances Anyone is Infectious 1 3.5% 2 6.8% 3 10.1% 4 13.2% 5 16.2% 6 19.2% 7 22.0% 8 24.7% 9 27.3% 10 29.8% 15 41.2% 20 50.8% 25 58.8% 30 65.5% 35 71.1% 40 75.8% 50 83.0% 75 93.0% 100 97.1% 150 99.5% 200 99.9% 300 >99.9% 400 >99.9% 500 >99.9%
This table shows the risk of socializing on New Year's Day. Finger crossed, the surge should peak around then.

Not a great time to party. 🎉🎉

5/ Number of People | Chances Anyone is Infectious 1 3.9% 2 7.7% 3 11.3% 4 14.7% 5 18.1% 6 21.3% 7 24.4% 8 27.3% 9 30.2% 10 32.9% 15 45.0% 20 55.0% 25 63.1% 30 69.8% 35 75.2% 40 79.7% 50 86.4% 75 95.0% 100 98.1% 150 99.7% 200 >99.9% 300 >99.9% 400 >99.9% 500 >99.9%
Zooming out to the full pandemic shows the harm of the 8th U.S. Covid wave.

🔹More daily infections than 89% of the pandemic
🔹>25x more actual than reported cases
🔹>60,000 #LongCovid cases/day eventually resulting from these infections
🔹Winter peak like last year

6/ There is more COVID-19 transmission today than during 88.9% of the pandemic. CURRENT ESTIMATES FOR December 4, 2023 Wastewater Levels (copies/mL) 865 New Daily Cases 1,258,000 % of Population Infectious 2.63% (1 in 38 people) New Daily Long COVID Cases 63,000 to 252,000 WEEKLY ESTIMATES FOR December 4, 2023 New Weekly Cases 8,800,000 New Weekly Long COVID Cases 440,000 to 1,761,000 2023 CUMULATIVE ESTIMATES AS OF December 4, 2023 Total 2023 Cases To Date 214,388,450 Total 2023 Long COVID Cases To Date 10,719,000 to 42,878,000
Here's the full PMC Dashboard for Dec 4 to Jan 1.

You can read the full report here:

Thank you for your continued questions, suggestions, gratitude, and sharing across other platforms. Please offer any success stories to encourage others.

7/ pmc19.com/data/
There is more COVID-19 transmission today than during 88.9% of the pandemic. CURRENT ESTIMATES FOR December 4, 2023 Wastewater Levels (copies/mL) 865 New Daily Cases 1,258,000 % of Population Infectious 2.63% (1 in 38 people) New Daily Long COVID Cases 63,000 to 252,000 WEEKLY ESTIMATES FOR December 4, 2023 New Weekly Cases 8,800,000 New Weekly Long COVID Cases 440,000 to 1,761,000 2023 CUMULATIVE ESTIMATES AS OF December 4, 2023 Total 2023 Cases To Date 214,388,450 Total 2023 Long COVID Cases To Date 10,719,000 to 42,878,000 4-WEEK FORECAST FOR Janua...

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More from @michael_hoerger

Mike Hoerger, PhD MSCR MBA Profile picture
Apr 14
PMC COVlD Update, Apr 13, 2026

Levels are flat during a relative "lull" in transmission.
▪️1 in 187 estimated actively infectious
▪️260,000 estimated new daily infections
▪️High: OK, MS, WV
▪️Moderate: VT
▪️All other states low/very low in relative transmission

🧵THREAD 1/6 Heat map from CDC data and PMC prevalence estimates harmonizing CDC and Biobot wastewater data with IHME true case estimates to derive ongoing transmission projections
COVID-19 persists in 2026.

We are in a relative "lull" following a 12th wave, but at a baseline of 200-300K estimated new daily infections.

Transmission was lower in the era many refer to as #DuringCOVID, when multi-layered mitigation was used instead of denial.

🧵THREAD 2/6 Annotated graph of the 12 waves (U.S.)
Transmission during a "lull" is high in an absolute sense. Many people are getting infected.

Simultaneously, its low in a relative sense, or compared to so-called "typical" transmission. In most places, it's a safer time for medical/dental care.

🧵THREAD 3/6 Barometer showing lower relative transmission than usual
Read 6 tweets
Mike Hoerger, PhD MSCR MBA Profile picture
Apr 6
PMC COVlD Update, April 6, 2026

Transmission is stable in a relative "lull" nationally between waves.

We estimate that approximately 313,000 people are still getting infected per day, with outbreaks radiating from TN and MS.

🧵1 of 10 (don't miss #10)! Heat map with PMC estimates
With limited data reported, Mississippi has an estimated 1 in 27 residents actively infectious.

In a room of 25 people, that's a 61% chance of exposure, if no testing/isolation protocols.

🧵2 of 10 Alabama Low Alaska Very Low Arizona Very Low* Arkansas Low California Very Low Colorado Very Low Connecticut Low Delaware Low District of Columbia Very Low Florida Very Low Georgia Low Guam Low Hawaii Very Low Idaho Very Low Illinois Very Low Indiana Very Low Iowa Very Low Kansas Low Kentucky Moderate Louisiana Moderate Maine Very Low Maryland Low Massachusetts Very Low Michigan Low Minnesota Very Low Mississippi Very High*
1 in 24 people in Tennessee are estimated to be actively infectious with SARS-CoV-2. That's a 65% chance of exposure in a room of 25 people where nobody is testing/isolating.

🧵3 of 10 Missouri Moderate* Montana Very Low Nebraska Very Low Nevada Very Low New Hampshire Very Low New Jersey Low New Mexico Very Low New York Very Low North Carolina Low North Dakota Very Low* Ohio Very Low Oklahoma Low* Oregon Very Low Pennsylvania Low Rhode Island Very Low South Carolina Very Low South Dakota Low Tennessee Very High Texas Low Utah Very Low Vermont Moderate Virginia Moderate Washington Very Low West Virginia Low Wisconsin Very Low Wyoming Very Low
Read 10 tweets
Mike Hoerger, PhD MSCR MBA Profile picture
Apr 3
This is an unethically misleading study with findings easily explained by residual confounding. Some health systems and patients have thorough record keeping. Others don't. All sorts of variables will correlate (infections, cancers, anything else tracked in medical records).
This is a really obvious issue for an international epi study. It should not have been published.
The above study is using the same processes the anti-vaxxers use -- junk epi that does not account for confounding -- to support whatever pre-conceived notions the authors have, with absurdly large effects.

Read 4 tweets
Mike Hoerger, PhD MSCR MBA Profile picture
Mar 23
PMC #COVID Update, March 23, 2026 (U.S.)

Transmission levels have plummeted nationally as we shift from the 12th wave toward a relative "lull."

Over half the states have "Very Low" relative transmission, per the CDC.

🧵THREAD 1 of 8 Heat map using CDC levels and PMC estimate of prevalence (1 in 147 actively infectious nationwide).
Transmission varies considerably by state.

Highest
🔥Mississippi: 1 in 31 estimated actively infectious
🔥Michigan: 1 in 41
*Both states w/limited data though

Rates are quite low in relative terms in California, AZ, FL, HI, ID, MA, NV, NY, OR, RI, UT, WI

🧵THREAD 2 of 8 Alabama Very Low Alaska Very Low Arizona Very Low Arkansas Low* California Very Low Colorado Very Low Connecticut Low Delaware Moderate District of Columbia Low Florida Very Low Georgia Very Low Guam Very Low Hawaii Very Low Idaho Very Low Illinois Very Low Indiana Low Iowa Moderate Kansas Low Kentucky Moderate Louisiana Low Maine Very Low Maryland Moderate Massachusetts Very Low Michigan High* Minnesota Moderate Mississippi High* Missouri Low Montana Very Low Nebraska Low Nevada Very Low New Hampshire Low* New Jersey Low New Mexico Very Low New York Very Low North Carolina Low North Dakota...
The 6th anniversary of the WHO's pandemic declaration was March 11.

Bots, minimizers, & individuals' psychological defense mechanisms will downplay that.

Yet, the U.S. just had a 12th wave. We estimate >5 cumulative infections/person & ongoing health harms.

🧵THREAD 3 of 8 Graph of the 12 waves of the pandemic (U.S.)
Read 8 tweets
Mike Hoerger, PhD MSCR MBA Profile picture
Mar 14
As of today, the COVID-19 pandemic is now longer than WWII.
If you have been living in denial the past 6 years, know that the U.S. is winding down from a 12th wave of infections presently.
Denial is but one of several obvious defense mechanisms people use to try to block their awareness of the ongoing toll of COVID-19. There are many others.

Short-term capital also plays a role, but even that requires a large dose of defense mechanisms.

Read 7 tweets
Mike Hoerger, PhD MSCR MBA Profile picture
Jan 25
During this 12th COVlD wave, the CDC reports 1-in-3 states have "High" or "Very High" levels.

PMC estimates the proportion of residents actively infectious (prevalence):
◾️USA: 1 in 67
◾️IA: 1 in 27
◾️MI: 1 in 25
◾️IN & CT: 1 in 23
◾️ME: 1 in 21
◾️OK & SD: 1 in 17

🧵1/ Heat map using CDC data. National PMC prevalence estimate noted; estimated incidence of 732,000 new daily infections.
On average, Americans have have 5.0 cumulative SARS-CoV-2 infections.

This week's infections are expected to result in 1/4 to 1 million new #LongCOVID conditions and ≈2,000 excess deaths.
🧵2/ Column 1: Table of state-level prevalence estimates. Highest estimates noted in the thread text. Column 2: Proportion Actively Infectious 1 in 67 (1.5%) New Daily Infections 732,000 Infections the Past Week 5,220,000 Infections in 2026 24,000,000 Cumulative Infections per Person 5.04 Long COVID Long COVID Cases Resulting 37,000 to 146,000 from New Daily Infections Long COVID Cases Resulting 261,000 to 1,040,000 from New Weekly Infections Excess Deaths Ex...
The wave peak is now estimated >10% higher than last week at 1.2 million new daily infections, nearly double the Delta wave.

We expect sustained high transmission (≈600,000 to 750,000 new daily infections) the next few weeks as COVlD circulates through schools/families.
🧵3/ Fig 1: Graph of 12 waves Fig 2: "Barometer" showing above average transmission Fig 3: Year-over-year graph, which informs the analytic forecast Fig 4: Forecast described in post
Read 4 tweets

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