At peak surge, we will have 2 million U.S. #COVID infections/day.
Nearly 1 in 3 Americans will get infected during the peak 2 months of this winter surge. That’s 105 million infections & >5 million resulting #LongCOVID cases.
2/ Today on Christmas, 3.5% of the U.S. population (1 in 29) is actively infectious with #COVID & rising toward a Jan 10 peak.
COVID transmission is higher than during 94.7% of the pandemic. There's a 50% chance of a COVID exposure if interacting with 20 people today.
3/ We posted our first “Christmas Risk” table on October 30, and as you can see, it performed exceedingly well.
These tables should lend confidence in the PMC dashboard, and raise concern about public health leadership and the news media.
Being able to accurately predict within a few percentage points the probability of infectiousness in a room of 20 people, for example, 8 weeks out is very helpful for planning. Moreover, many would estimate *today* that the risk in a room of 20 people is <1 percentage point. We’re talking about potentially magnitudes of difference in risk estimation, and this was highly predictable long ago. It’s not something unanticipated due to a new oddly-behaving sub-variant (there will always be a new sub-variant this time of year when no mitigation) or high rates of air travel (also unsurprising). It was highly predictable, and public health officials should not be given an out. The media will try to frame this as an unanticipated surge, and it simply was not, according to those who know how to forecast.
The formal PMC forecast keeps to 4 weeks, but sometimes a more speculative long-term estimate can help with planning, especially surrounding booking travel plans. People might want to take a wait-and-see approach to booking, purchase travel insurance, or cancel entirely. We characterized the table with appropriate caution, and hopefully it was helpful.
Putting out these forecasts requires putting one’s professional reputation as a scientist on the line. It’s very easy for anonymous and fake-name accounts to make speculative forecasts. The information we provide tends to be highly conservative within a much broader set of analyses, sensitivity analyses, and scenarios considered. Know that we are very cautious about what information we share, post considerable detail on the underlying methodology and assumptions in the online report, and carefully describe how estimates may be more precise or more speculative at times. A published peer-reviewed article will ultimately account for the strengths and limitations in the accuracy of the model.
4/ Christmas infections will seed New Year’s Eve/Day infections, leading to a peak around the 10th.
Around New Year’s, interacting with 15-20 people means a 50% chance of a COVID exposure. In a restaurant or plane, the risk jumps to >98%.
5/ Zooming out to the full pandemic, we are in the 8th U.S. COVID wave & 2nd biggest all-time.
That assumes no major wastewater corrections.
We've surpassed the 1st wave, winter of 2020-21, Delta, & 2023 summer wave. Claims that “COVID is over” are harmful misinformation.
6/ Hospitals & clinicians should require universal masking. Public health officials should warn of the surge & recommend multi-layered mitigation.
Anything less is grounded in politics, short-term revenue, or defensiveness against COVID anxiety.
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
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
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.
The PMC website includes an international directory of websites with COVlD wastewater monitoring. It is more up to date than the directories of the EU and WHO.
Let's review what's happening in Europe...
1/
Data in #Austria show a rising COVlD wave. The x axis (bottom) has infrequent labels, but the data shown go through October 8th.
An estimated 1 in 81 people are actively infectious during the ongoing 11th wave.
The "shutdown" has created a blackout at the state level.
Transmission is half that of the peak one month ago, and we anticipate a relative national "lull" in early-to-mid November, albeit still at dangerous levels.
Our model uses a combination of CDC and Biobot data, so we are able to estimate national statistics despite the CDC data going offline. On the map, note that Puerto Rico continues to update; they use a CDC-style system but were dropped by the CDC long ago. For full methodology, review the technical appendix on the website.
PMC COVlD Update, Week of Oct 6, 2025 (U.S.)
🧵2/9
#DuringCOVID is today. We estimate >600,000 new daily infections. This is about half the peak on September 6.
Notice current levels are similar to the estimated peaks of the first 3 waves.
PMC COVlD Update, Week of Oct 6, 2025 (U.S.)
🧵3/9
Weekly estimates:
🔹4.5 million infections
🔹>200,000 resulting long-term health conditions
🔹>1,300 resulting excess deaths
Key points in my letter to the pharmacy boards. 🧵1/7
Georgia law indicates that the pharmacy board is to follow ACIP. They do not dictate further nuance. Georgia continues to require prescriptions, going against the spirit of the law, ACIP, and 47 other states.
🧵2/7
Louisiana law tells the pharmacy board to follow ACIP. ACIP says do not require a prescription, and 47 other states agree.
The Louisiana pharmacy board continues to require a prescription.
On the back end of this unprecedented 11th wave, "times they are a-changin." In particular, COVlD levels are shifting north and east.
Notice that few states are in the highest and lowest categories. Much of the south and west have considerable transmission post-peak. Many places in the north and east are seeing steady or increasing transmission after relatively lower levels.
Overall, levels are lower than the past few weeks, but transmission remains considerable. Those relying on anecdata (friends, coworkers, and family infected) may increasingly realize we are in a wave.
We estimate nearly 750,000 new daily infections nationwide, meaning approximately 1 in 66 people or 1.5% are actively infectious.
These estimates are derived by linking wastewater levels to IHME true case estimates using methodology commonly employed worldwide, detailed on the website, noted in a pre-print. Many publications in leading medical journals link wastewater data to key metrics that matter, noted in the online technical appendix.
In this week's report, we note adding North Dakota and Puerto Rico to the heat map in support of health equity. We have been imputing ND levels since the launch of PMC 3.0 using data from neighboring states. PR continues to report qualitative levels using the CDC format but is not longer included on the CDC website.
1/8 🧵
PMC COVlD Update, Sep 29, 2025 (U.S.)
State-level prevalence estimates, AL to MS. The levels use CDC labels, which tend to have an optimistic portrayal of risk. For example, CO is listed at "low" (by our estimate 1.5% infectious).
#MaskUp at 1.5% if having lapsed.
2/8 🧵
PMC COVlD Update, Sep 29, 2025 (U.S.)
State-level prevalence estimates, Missouri to Wyoming.
New York had *huge* retroactive upward corrections, and is now "High," as many residents hypothesized.
Note, Puerto Rico only provides CDC qualitative levels, so no data.