Mike Hoerger, PhD MSCR MBA Profile picture
Dec 25, 2023 8 tweets 5 min read Read on X
1/
PMC COVID-19 Tracker, Dec 25, 2023 (U.S.)

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.U.S. Winter 2023-24 COVID Surge				 	Best Estimate		Range	 Rank among COVID waves	2nd		2nd	4th Date of peak	Jan 10		Jan 3	Jan 17 Daily infections at peak	2.0 million/day		1.7 million/day	2.1 million/day Percentage of population infectious at peak	4.1% (1 in 24)		3.7% (1 in 27)	4.4% (1 in 23)  CURRENT ESTIMATES FOR December 25, 2023 Wastewater Levels (copies/mL) 1137 New Daily Cases 1,655,000 % of Population Infectious 3.46% (1 in 29 people) New Daily Long COVID Cases  83,000 to 331,000  4-WEEK FORECAST FOR January 22, 2024 Wastewater Levels (copies/mL) 1,293 (14% higher) New Daily Cases 1,8...
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. There is more COVID-19 transmission today        than during 94.7% of the pandemic.  Number of People  |  Chances Anyone is Infectious	 1	3.5% 2	6.8% 3	10.0% 4	13.2% 5	16.2% 6	19.1% 7	21.9% 8	24.6% 9	27.2% 10	29.7% 15	41.1% 20	50.6% 25	58.6% 30	65.3% 35	70.9% 40	75.6% 50	82.8% 75	92.9% 100	97.1% 150	99.5% 200	99.9% 300	>99.9% 400	>99.9% 500	>99.9%
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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.Comparison of the "Christmas Risk" table posted on October 30th versus today. The 8-week predictions were highly accurate. In October, we predicted that interacting with 20 people on Christmas Day would lead to a 47% chance of exposure. Today, we estimate that same risk as 50.6%, a negligible difference and vastly at odds with public expectations concerning risk.
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%. Number of People  |  Chances Anyone is Infectious	 1	3.9% 2	7.6% 3	11.2% 4	14.6% 5	17.9% 6	21.1% 7	24.1% 8	27.1% 9	29.9% 10	32.6% 15	44.7% 20	54.6% 25	62.7% 30	69.4% 35	74.9% 40	79.4% 50	86.1% 75	94.8% 100	98.1% 150	99.7% 200	>99.9% 300	>99.9% 400	>99.9% 500	>99.9%
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. There is more COVID-19 transmission today        than during 94.7% of the pandemic.  CURRENT ESTIMATES FOR December 25, 2023 Wastewater Levels (copies/mL) 1137 New Daily Cases 1,655,000 % of Population Infectious 3.46% (1 in 29 people) New Daily Long COVID Cases 83,000 to 331,000  WEEKLY ESTIMATES FOR December 25, 2023 New Weekly Cases 11,600,000 New Weekly Long COVID Cases 579,000 to 2,317,000  2023 CUMULATIVE ESTIMATES AS OF December 25, 2023 Total 2023 Cases To Date 241,674,380 Total 2023 Long COVID Cases To Date 12,084,000 to 48,335,000
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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.
7/
Here's the full PMC Dashboard for Dec 25 to Jan 22.

You can read the full report here:

Thank you for your continued questions, suggestions, gratitude, infographics, videos, & sharing across other platforms. pmc19.com/data/
There is more COVID-19 transmission today	        than during 94.7% of the pandemic.	 	 CURRENT ESTIMATES FOR	 December 25, 2023	 Wastewater Levels (copies/mL)	 1137	 New Daily Cases	 1,655,000	 % of Population Infectious	 3.46% (1 in 29 people)	 New Daily Long COVID Cases	 83,000 to 331,000	 	 WEEKLY ESTIMATES FOR	 December 25, 2023	 New Weekly Cases	 11,600,000	 New Weekly Long COVID Cases	 579,000 to 2,317,000	 	 2023 CUMULATIVE ESTIMATES AS OF	 December 25, 2023	 Total 2023 Cases To Date	 241,674,380	 Total 2023 Long COVID Cases To Date	 12,084,000 to 48,335,000	 	 4-WEEK FORECAST FOR	 ...
8/
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More from @michael_hoerger

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
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
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
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
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
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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