Mike Hoerger, PhD MSCR MBA Profile picture
Dec 11, 2023 8 tweets 5 min read Read on X
PMC COVID-19 Tracker, Dec 11, 2023
The surge continues.

Today:
🔹1.2 million daily infections
🔹1 in 41 infectious (2.5%)

In 4 weeks (Jan 8):
🔹1.6 million daily infections
🔹1 in 30 infectious (3.3%)

1/

A few key methodologic updates.
1) Biobot correct levels downward for the past two weeks, so you might notice that this week's estimates seem similar to last week's or marginally lower.

2) Our forecasting model uses a combination of historic data (situation past several years) and current data (past 4 weeks). In the historic model, we switched from using mean-type data to median-type data. This avoids overestimating levels based on the BA.1 surge and allows us to predict accurately a little faster, rather than predicting high and waiting for the current 4-week's data to correct it.

3) The forecasts depend a lot on the most recent week's data. To the extent Biobot is accurate or inaccurate in real-time, this leads to divergent forecasts.CURRENT ESTIMATES FOR December 11, 2023 Wastewater Levels (copies/mL) 807 New Daily Cases 1,174,000 % of Population Infectious 2.46% (1 in 41 people) New Daily Long COVID Cases  59,000 to 235,000   4-WEEK FORECAST FOR January 8, 2024 Wastewater Levels (copies/mL) 1,083 (34% higher) New Daily Cases 1,576,000 % of Population Infectious 3.3% (1 in 30 people) New Daily Long COVID Cases  79,000 to 315,000
You'll see the forecasts differ considerably (1.3 to 1.9 million daily infections) in 4 weeks.

2/

However, they mostly agree on the peak. It could be as early as Jan 1 or as late as Jan 15. It's a moot point. Transmission will be similar across that timespan and the weekly reports lack the precision to say whether it will peak on the 4th or 9th, for example. Early Jan will remain bad.

Details:

The real-time model (purple) anticipates the highest surge levels. This assumes that Biobot real-time reports are accurate, but they were substantially corrected for the past two weeks, and there were some issues with real-time accuracy during the summer wave. The turtle model (green) discount’s the most recent week’s data as an aberration, assumes transmission should be corrected upward a little, and predicts a steady rise with peak around January 1. The cheetah model (yellow) says that because last week’s data were corrected downward, this week’s estimate should be too, so it’s much more conservative on the next several weeks. The average of all models (red) guides forecasted numbers for the next four weeks. A month from now, we will see about 1.6 million new U.S. cases per day (range of 1.3 to 1.9 million across forecasting models), with 3.3% of the U.S. population or 1 in 30 people actively infectious.Zoomed in version of prior tweet
Zooming out, you'll see that we're in a very bad place historically. With the divergent forecasts, it's merely a matter of whether this is the 2nd biggest U.S. COVID surge or 4th biggest.

The #LongCOVID cases resulting from these infections may top 400,000/week.

3/ There is more COVID-19 transmission today        than during 87.2% of the pandemic.  CURRENT ESTIMATES FOR December 11, 2023 Wastewater Levels (copies/mL) 807 New Daily Cases 1,174,000 % of Population Infectious 2.46% (1 in 41 people) New Daily Long COVID Cases 59,000 to 235,000  WEEKLY ESTIMATES FOR December 11, 2023 New Weekly Cases 8,200,000 New Weekly Long COVID Cases 411,000 to 1,644,000  2023 CUMULATIVE ESTIMATES AS OF December 11, 2023 Total 2023 Cases To Date 221,642,490 Total 2023 Long COVID Cases To Date 11,082,000 to 44,328,000
These are the chances of interacting with someone infectious on Dec 11, based on the total number of social contacts.

Interact with 10 people = 22% chance someone is infectious.

This helps explain why so many kids are getting sick at school lately.

4/ 1	2.5% 2	4.9% 3	7.2% 4	9.5% 5	11.7% 6	13.9% 7	16.0% 8	18.0% 9	20.1% 10	22.0% 15	31.1% 20	39.2% 25	46.3% 30	52.6% 35	58.1% 40	63.0% 50	71.2% 75	84.5% 100	91.7% 150	97.6% 200	99.3% 300	>99.9% 400	>99.9% 500	>99.9%
As of Dec 11, these are the updated chances of interacting with someone infectious on Christmas Day, based on the size of gathering(s).

At 6 people, the chances of interacting with someone infectious are the same as rolling a "1" on a die. At 20-25 people, it's a coin toss.
5/ 1	2.8% 2	5.6% 3	8.3% 4	10.9% 5	13.5% 6	15.9% 7	18.3% 8	20.6% 9	22.9% 10	25.1% 15	35.2% 20	43.9% 25	51.5% 30	58.0% 35	63.6% 40	68.5% 50	76.4% 75	88.6% 100	94.4% 150	98.7% 200	99.7% 300	>99.9% 400	>99.9% 500	>99.9%
In the U.S., the current surge will peak sometime between Jan 1 and Jan 15. These are the chances of interacting with someone infectious around New Year's Day, near the peak.

6/ 1	3.1% 2	6.2% 3	9.1% 4	11.9% 5	14.7% 6	17.4% 7	20.0% 8	22.5% 9	24.9% 10	27.2% 15	37.9% 20	47.1% 25	54.8% 30	61.5% 35	67.1% 40	72.0% 50	79.6% 75	90.8% 100	95.8% 150	99.2% 200	99.8% 300	>99.9% 400	>99.9% 500	>99.9%
Here's the full PMC Dashboard for Dec 11 to Jan 8.

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/
       than during 87.2% of the pandemic.	 	 CURRENT ESTIMATES FOR	 December 11, 2023	 Wastewater Levels (copies/mL)	 807	 New Daily Cases	 1,174,000	 % of Population Infectious	 2.46% (1 in 41 people)	 New Daily Long COVID Cases	 59,000 to 235,000	 	 WEEKLY ESTIMATES FOR	 December 11, 2023	 New Weekly Cases	 8,200,000	 New Weekly Long COVID Cases	 411,000 to 1,644,000	 	 2023 CUMULATIVE ESTIMATES AS OF	 December 11, 2023	 Total 2023 Cases To Date	 221,642,490	 Total 2023 Long COVID Cases To Date	 11,082,000 to 44,328,000	 	 4-WEEK FORECAST FOR	 January 8, 2024	 Wastewater Levels (copies/mL...
As a reminder, we have a contest to see who can use these data to help others. Please post success stories on the Tweet below.

8/

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More from @michael_hoerger

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
Jan 17
Based on today's CDC & Biobot data, we estimate the following for the week of Jan 19:

🔸1 in 52 people in the U.S. actively infectious
🔸25% chance of exposure in a room of 15 ppl
🔸Nearly 1 million new daily infections
🔸5 cumulative infections per person all-time (avg)
🧵1/5 Heat map from CDC data with PMC estimates. Description of "Very High" states in next post
Transmission estimates have been marginally corrected upward.

11 states have Very High COVlD levels:

🔸PA: 1 in 25 estimated actively infectious
🔸MI: 1 in 23
🔸OH & KY: 1 in 22
🔸SD: 1 in 20
🔸NE & IA: 1 in 18
🔸IL & ME: 1 in 17
🔸IN: 1 in 16
🔸WV: 1 in 11
🧵2/5 Proportion Actively Infectious										1 in 52 (1.9%) New Daily Infections										 941,000  Infections the Past Week										 6,020,000  Infections in 2026										 18,000,000  Cumulative Infections per Person										 5.01  										 Long COVID										 Long COVID Cases Resulting								47,000 to 188,000		   from New Daily Infections										 Long COVID Cases Resulting								301,000 to 1,200,000		   from New Weekly Infections										 										 Excess Deaths										 Excess Deaths Resulting 									270 to 450	   from New Daily Infections										 Excess Deaths Resulting 				...
We're in the middle of a 12th COVlD wave.

The peak has likely passed, but with students headed back to school, transmission is expected to remain high for at least the next several weeks.

🧵3/5 1) Graph of 12 waves 2) Barometer showing above-average transmission 3) Year over year graph 4) Forecast for transmission to decline and then percolate at high levels
Read 5 tweets
Jan 10
The size of the winter COVlD wave has been revised upward as post-holiday data come in.

We estimated 1 in 55 people in the U.S. are actively infectious.

🔥WV: 1 in 14
🔥IN: 1 in 15
🔥MI & OH: 1 in 21
🔥MO: 1 in 22
🔥CT: 1 in 24
🔥KS: 1 in 25
🔥MA & IL: 1 in 27

Quick 🧵 1/4 Heat map and PMC estimates, 1 in 55 infectious and 892,000 new daily infections for Jan 12.  We expedited the report to release it two days early.
Nationally, we are seeing an estimated 892,000 new daily SARS-CoV-2 infections, meaning a 1 in 4 chance of exposure in a room of 15 people. Risk varies considerably by state.

We are approaching an average of 5 infections per person since pandemic onset.
🧵 2/4 Alabama	Moderate Alaska	Very Low Arizona	Very Low Arkansas	High* California	Very Low Colorado	Low Connecticut	Very High Delaware	Moderate District of Columbia	Very Low Florida	Very Low Georgia	Very Low Guam	Very Low Hawaii	Very Low Idaho	Very Low Illinois	Very High Indiana	Very High Iowa	High Kansas	Very High Kentucky	Moderate Louisiana	Moderate Maine	High Maryland	High Massachusetts	Very High Michigan	Very High* Minnesota	Moderate Mississippi	Low* Missouri	Very High* Montana	High Nebraska	High Nevada	Very Low New Hampshire	Moderate New Jersey	Low New Mexico	Moderate New York	High* North Ca...
We are in the 12th COVlD wave of the U.S.

Current transmission is higher than 68% of all days since the pandemic onset in 2020.
🧵 3/4 12 waves of COVlD  Pandemic barometer: Higher than 88% of the past 100 days, 73% of the past year, 68% of the entire pandemic.  Year over year graph  Forecast of slowly declining transmission.
Read 4 tweets
Jan 8
You might not have heard, but the northeastern U.S. is in a COVlD surge.

We use wastewater levels to derive estimates of the proportion of people actively infectious in each state (prevalence), e.g., 1 in 24 people in Connecticut.

Let me walk you through it...

🧵1/8 Colors show CDC levels PMC prevalence estimates noted: -Maine 1 in 38 actively infectious with COVlD -New Hampshire 1 in 35 (limited data) -Vermont 1 in 75 -New York 1 in 44 (limited data) -Pennsylvania 1 in 44 -Massachusetts 1 in 36 -Connecticut 1 in 24 -Rhode Island 1 in 41 -New Jersey 1 in 82
Notice that #Connecticut has excellent SARS-CoV-2 wastewater surveillance. It's "Very High" across much of the state, per CDC.

Based on wastewater levels, we estimate 1 in 24 residents are actively infectious w/COVlD. That's a 66% exposure risk in a room of 25 people.

🧵2/8 Colors show CDC levels PMC estimate of prevalence
The CDC reports "Very High" levels in #Massachusetts.

The surveillance is less robust, but we estimate 1 in 26 residents are actively infectious, similar to our estimate in CT where coverage is better.

In a room of 25 people, that's a 62% chance of an exposure.

🧵3/8 Colors show CDC levels PMC prevalence estimates provided
Read 8 tweets
Jan 8
We're in the middle of a 12th COVlD wave in the U.S., with transmission particularly high in the Midwest and Northeast.

The CDC announced this week that COVlD continues to kill more Americans than breast and prostate cancer combined.

Get boosted & #MaskUp 💉💪😷
1/4🧵 Heat map of CDC data with PMC prevalence estimate
Levels are "Moderate" to "Very High" in 26 states.

However, data reporting is slow, and about 1/3 of states have low-quality data this week due to the holidays and illness.

2/4🧵 National estimates: Number of People		Chances Anyone is Infectious			 1				1.5%	 2				3.0%	 3				4.5%	 4				6.0%	 5				7.4%	 10				14.3%	 15				20.7%	 20				26.5%	 25				32.0%	 30				37.0%	 50				53.8%	 75				68.6%	 100				78.6%	 200				95.4%	 300				99.0%
Barometer: Higher transmission than 90 of the past 100 days (perhaps higher still, due to low data reporting quality)
State	CDC Level	Actively Infectious Alabama	Moderate	1 in 48 (2.1%) Alaska	Very Low	1 in 152 (0.7%) Arizona	Very Low	1 in 201 (0.5%) Arkansas	High*	1 in 36 (2.8%) California	Very Low	1 in 484 (0.2%) Colorado	Moderate	1 in 49 (2.0%) Connecticut	Very High	1 in 24 (4.2%) Delaware	Low*	1 in 70 (1.4%) District of Columbia	Very Low	1 in 5,835 (0.0%) Florida	Very Low	1 in 284 (0.4%) Georgia	Low	1 in 90 (1.1%) Guam	Very Low	1 in 687 (0.1%) Hawaii	Very Low	1 in 874 (0.1%) Idaho	Very Low	1 in 169 (0.6%) Illinois	Moderate*	1 in 56 (1.8%) Indiana	High*	1 in 34 (2.9%) Iowa	Moderate	1 in 41 (2.4%) Kansas...
State	CDC Level	Actively Infectious Missouri	Moderate*	1 in 42 (2.4%) Montana	High	1 in 34 (2.9%) Nebraska	Very High	1 in 26 (3.9%) Nevada	Very Low	1 in 138 (0.7%) New Hampshire	High*	1 in 35 (2.9%) New Jersey	Low	1 in 82 (1.2%) New Mexico	Low	1 in 87 (1.2%) New York	Moderate*	1 in 44 (2.3%) North Carolina	Low	1 in 82 (1.2%) North Dakota	High*	1 in 34 (3.0%) Ohio	Very High	1 in 27 (3.7%) Oklahoma	Moderate*	1 in 62 (1.6%) Oregon	Very Low	1 in 170 (0.6%) Pennsylvania	Moderate	1 in 44 (2.3%) Rhode Island	Moderate	1 in 41 (2.4%) South Carolina	Moderate	1 in 54 (1.9%) South Dakota	Very High	1 in...
If like years 1-4 of the pandemic, the winter wave has peaked. If like last year, we could hover near peak levels for a month.

Forecasting quality is low with 1/3 of states having data issues. Hopefully, we'll know a lot more in a few days.

3/4🧵 12 waves
Proportion Actively Infectious										1 in 65 (1.5%) New Daily Infections										 749,000  Infections the Past Week										 5,390,000  Infections in 2026										 3,000,000  Cumulative Infections per Person										 4.88  										 Long COVID										 Long COVID Cases Resulting								37,000 to 150,000		   from New Daily Infections										 Long COVID Cases Resulting								270,000 to 1,080,000		   from New Weekly Infections										 										 Excess Deaths										 Excess Deaths Resulting 									220 to 370	   from New Daily Infections										 Excess Deaths Resulting 					...
year over year graph
forecast
Read 4 tweets
Jan 5
We told you that 109,000-175,000 Americans would died of COVID (excess deaths) in 2025.

Today, the CDC estimates 101,000 deaths/year (flat from Oct 2022 to Sep 2024), and likely higher when considering more nebulous non-acute excess deaths (heart attack 6 months later).
1/5
The CDC estimates are actually higher than I would have guessed, given their methodology, which models estimates based on easily countable factors in healthcare and expert input on multiplier values. It lends credence to the PMC upper bound of excess deaths of 175,000/yr.
2/5
What's troubling is the CDC has annual mortality flat. My expectation based on mortality displacement and Swiss Re data is that it should be declining. If is stays flat, we're running on something like breast+prostate cancer or lung cancer deaths per year in perpetuity.
3/5
Read 6 tweets

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