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
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.
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/
If you're using the PMC dashboard to help others, please post your success stories, infographics, photos, videos, and more in the following Tweet.

We will make awards at the end of the year. The examples are inspirational.

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More from @michael_hoerger

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
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

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