Mike Hoerger, PhD MSCR MBA Profile picture
Dec 4, 2023 7 tweets 3 min read Read on X
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

Sep 16
PMC COVlD Report, Sep 15, 2025 (U.S.)
🧵1/7

COVlD-19 levels are "Very High" or "High" in the majority of states, per the CDC.

This includes 27 states & D.C.

🔥🔥Very High:
Alaska, Hawai'i, California, Nevada, Idaho, Utah, S. Dakota, Nebraska, Texas, Louisiana, Indiana, Kentucky, Tennessee, Florida, S. Carolina, N. Carolina, D.C., Maryland, and Connecticut.

🔥High:
Washington state, Oregon, Montana, probably N. Dakota (imputed), Arkansas, Alabama, Virginia, Delaware, Rhode Island, and Massachusetts.

PMC estimates 1 in 38 people (2.7%) are actively infectious. Wastewater-derived case estimates suggest 1.3 million new daily infections.Heat map using CDC levels. Key findings summarized in the post.
PMC COVlD Report, Sep 15, 2025 (U.S.)
🧵2/7

Transmission is peaking nationally, but regional variation is common. Know what's happening in your state, and get the word out.

Note that the levels CDC calls "low" are still quite alarming.State | CDC Level | PMC Estimate, % Actively Infectious Alabama	High	1 in 30 (3.4%) Alaska	Very High	1 in 22 (4.6%) Arizona	Moderate	1 in 40 (2.5%) Arkansas	High	1 in 28 (3.6%) California	Very High	1 in 21 (4.8%) Colorado	Moderate	1 in 50 (2.0%) Connecticut	Very High	1 in 19 (5.3%) Delaware	High	1 in 33 (3.0%) District of Columbia	Very High	1 in 17 (6.0%) Florida	Very High	1 in 24 (4.2%) Georgia	Moderate	1 in 46 (2.2%) Guam	Low	1 in 64 (1.6%) Hawaii	Very High	1 in 26 (3.8%) Idaho	Very High	1 in 14 (7.3%) Illinois	Moderate	1 in 44 (2.3%) Indiana	Very High	1 in 16 (6.1%) Iowa	Moderate	1 in 40...
PMC COVlD Report, Sep 15, 2025 (U.S.)
🧵3/7

Note that transmission is increasingly spreading from the South & West toward other areas. Know your state-level risk.

Transmission remains alarming even in areas CDC labels "Very Low" (e.g., Missouri, estimated 1 in 109). State | CDC Level | PMC Estimate, % Actively Infectious Missouri	Very Low	1 in 109 (0.9%) Montana	High	1 in 36 (2.8%) Nebraska	Very High	1 in 18 (5.5%) Nevada	Very High	1 in 17 (5.9%) New Hampshire	Low	1 in 64 (1.6%) New Jersey	Moderate	1 in 56 (1.8%) New Mexico	Very Low	1 in 106 (0.9%) New York	Low	1 in 73 (1.4%) North Carolina	Very High	1 in 17 (5.8%) North Dakota	High*	1 in 32 (3.2%) Ohio	Moderate	1 in 47 (2.1%) Oklahoma	Moderate*	1 in 44 (2.3%) Oregon	High	1 in 31 (3.2%) Pennsylvania	Moderate	1 in 44 (2.3%) Rhode Island	High	1 in 30 (3.3%) South Carolina	Very High	1 in 15 (6.6%) South D...
Read 7 tweets
Sep 13
California COVlD Surge Rages Higher

🔸CDC SARS-CoV-2 wastewater levels "Very High," and up from last week
🔸1 in 21 estimated actively infectious
🔸>250,000 estimated new daily infections statewide

Four figures...
1/4🧵 CDC: Very High: PMC Estimate: 1 in 21 actively infectious
CDC wastewater data in California show COVlD cases increasing from the already "Very High" levels last week.

2/4🧵 Line graph of the past 6 months showing the surge in wastewater viral levels
With an estimated 1 in 21 (or 4.8%) of California residents actively infectious of COVlD, risk increases dramatically in larger and more frequent social gatherings.

Interact with 25 people of average risk of being positive, and that's a >70% chance of exposure.
3/4🧵 How Does Risk Increase with More Social Contacts? Number of People | Chances Anyone is Infectious 1	4.8% 2	9.4% 3	13.7% 4	17.9% 5	21.8% 6	25.6% 7	29.1% 8	32.5% 9	35.8% 10	38.9% 15	52.2% 20	62.6% 25	70.8% 30	77.1% 35	82.1% 40	86.0% 50	91.5% 75	97.5% 100	99.3% 300	99.9%
Read 4 tweets
Sep 10
Let's say you're a dairy farmer. You have 100 cows. Each year, about 5 cows die, and another 5 cows are born. Then, along comes a virus. Let's call it "cowvid"...
1/
Let's say "cowvid" wipes out about half the cows over the course of a couple years. Now, you're down to 50 cows....
2/
The local mayor declares "cowvid" to be over. This surprises you as a farmer because 5 of your cows keep dying annually. 5 of 50 instead of 5 out of 100. Seems like more, but you're not a city slicker...
3/
Read 12 tweets
Sep 7
#DuringCOVID is today.

Image pack 1 of 9 🧵 Graph of the 11 waves of the pandemic in the U.S., tailored to a key message noted in the post.
1 million New Daily Infections.

Today!

Image pack 2 of 9 🧵 Graph of the 11 waves of the pandemic in the U.S., tailored to a key message noted in the post.
Where are the free vaccines, N95s, and tests?

Image pack 3 of 9 🧵 Graph of the 11 waves of the pandemic in the U.S., tailored to a key message noted in the post.
Read 9 tweets
Sep 3
PMC Dashboard Update (U.S.) 🧵1 of 8

The 11th wave is still rising.
🔥23 states/territories High/Very High
🔥Very High: Alabama, DC, Guam, Hawai'i, Louisiana, Nebraska, Nevada, South Carolina, Texas, Utah
🔥1 in 56 estimated actively infectious
🔥876,000 new daily infections CDC heat map, very high states noted in post. PMC estimate of 1 in 56 actively infectious nationwide
PMC Dashboard Update (U.S.) 🧵2 of 8

Note that the CDC has modified 📉 how transmission levels correspond to the categorical bins.

Take California. We estimate 1 in 30 actively infectious statewide. This would have previously been "Very High," now just "High."
#NewNormal CDC heatmap, with PMC estimate of 1 in 30
PMC Dashboard Update (U.S.) 🧵3 of 8

Here are the prevalence estimates for the first half of states/territories.

Notice how high the levels are in some of the "Moderate" states. State	CDC Level Alabama	Very High Alaska	High Arizona	High Arkansas	Moderate California	High Colorado	Moderate Connecticut	High Delaware	High District of Columbia	Very High Florida	High Georgia	Moderate Guam	Very High Hawaii	Very High Idaho	High Illinois	Very Low Indiana	Moderate* Iowa	Low Kansas	Low Kentucky	High Louisiana	Very High Maine	Low Maryland	Moderate Massachusetts	Moderate Michigan	Very Low Minnesota	Moderate Mississippi	High*
Read 9 tweets
Aug 21
During times like these when COVlD transmission heats up in the U.S., expect to see a lot more angry outbursts for three central reasons.

First, "displacement," or people trying to deny the reality of their anxiety by taking it out on other people....
Second, a lot of people can sustain a strong denial of reality about the ongoing pandemic during lulls. They suppress the existence of COVlD waves and excess deaths, disability, and retirements.

During waves, those defenses burst. Loss of control = anger...
Third, a lot of people (many reading this) understand COVlD correctly & experience righteous indignation during COVlD waves. We quite reasonably do not like all of the unjust and gratuitous suffering.

I find it helpful to channel that intensity into helping other people....
Read 6 tweets

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