Mike Hoerger, PhD MSCR MBA Profile picture
Jan 9, 2024 10 tweets 7 min read Read on X
1/
PMC COVID-19 Forecast, Jan 8, 2024 (U.S.)

We're peaking at >2 million infections/day.
🔹1 in 23 people are actively infectious today
🔹1 in 3 people in the U.S. will be infected during the peak two months
🔹2nd biggest U.S. surge all-time

#MaskUp #VaxUpU.S. Winter 2023-24 COVID Surge - The Peak				 	Best Estimate		Range	 Rank among COVID waves	2nd		2nd	2nd Date of peak	Jan 5		Jan 3	Jan 10 Daily infections at peak	2.07 million/day		2.03 million/day	2.22 million/day Percentage of population infectious at peak	4.34% (1 in 23)		4.26% (1 in 23)	4.64% (1 in 22)  CURRENT ESTIMATES FOR January 8, 2024 Wastewater Levels (copies/mL) 1413 New Daily Cases 2,056,000 % of Population Infectious 4.3% (1 in 23 people) New Daily Long COVID Cases  103,000 to 411,000   4-WEEK FORECAST FOR February 5, 2024 Wastewater Levels (copies/mL) 1,096 (-22% lower) New ...
2/
Before diving into the #Covid forecast, know that YOU can make a difference!

We will soon apply for a large research grant to help people with #cancer across the U.S. reduce their risk of negative Covid outcomes.

Learn more:


#CovidCancer tulane.co1.qualtrics.com/jfe/form/SV_3C…
Announcement - 2024 Pandemic Research Grant Submission: Calling All Scientists, Clinicians, Patients, and Other Stakeholders!    We are preparing a grant application for a research project aimed at helping U.S. adults with cancer to avoid COVID infections. A letter of intent is due shortly, and the grant will get submitted in May. We are seeking a team of scientists, clinicians, patients, and other stakeholders passionate about COVID mitigation who may want to learn more about and potentially get involved with this project. Please help!  The project builds on our ongoing pilot projects fund...
3/
In the U.S. Covid #surge, it's not just the peak, it's the width of the mountain.

This is the 2nd highest peak all-time, but it's also brutally long. 1 in 3 people in the U.S. will get infected during the highest two months of transmission. 43% will get infected in the highest 3 months of transmission. Forecasted dates noted.

Those 142 million infections would conservatively translate into an eventual 7 million clinically significant #LongCovid cases.

Transmission will drop considerably from early February through late March. On February 13, 2.9% of the population will be actively infectious, falling to 2.1% by February 24, 1% by mid-March, and bottoming out around 0.7% in late March. These very long-range projections are more historical medians rather than precise forecasts.U.S. Winter 2023-24 COVID Surge - The Peak				 	Best Estimate		Range	 Rank among COVID waves	2nd		2nd	2nd Date of peak	Jan 5		Jan 3	Jan 10 Daily infections at peak	2.07 million/day		2.03 million/day	2.22 million/day Percentage of population infectious at peak	4.34% (1 in 23)		4.26% (1 in 23)	4.64% (1 in 22)  U.S. Winter 2023-24 COVID Surge - The Mountain			 Window	Approximate Dates	Total Infections	"% of Population Actively Infectious on End Date" Peak Month	Dec 31 to Jan 29	58 million (about 17% of the population)	3.6% (1 in 28 people) on Jan 29 Peak 2 Months	Dec 16 to Feb 13	107...
4/
Zooming out to the entire pandemic, you can witness the brutality of the current #Covid #surge.

2nd biggest peak all-time. It also makes the horrific 2023 late-summer wave look like nothing.

Transmission is worse in the U.S. today than during 96.5% of the days of the pandemic. We're already at 16 million Covid infections in 2024, which will conservatively ultimately result in 800 thousand #LongCovid cases.

All that remains to be settled is whether peak daily transmission will be closer to 2 million infections/day or 2.2 million per day.

You can read about the Turtle and Cheetah forecasting models in the online report. They basically adjust for the fact that Biobot has been retroactively correcting wastewater levels marginally upward. Perhaps locations with high transmission have more people out sick and report late.There is more COVID-19 transmission today        than during 96.5% of the pandemic.  CURRENT ESTIMATES FOR January 8, 2024 Wastewater Levels (copies/mL) 1413 New Daily Cases 2,056,000 % of Population Infectious 4.3% (1 in 23 people) New Daily Long COVID Cases 103,000 to 411,000  WEEKLY ESTIMATES FOR January 8, 2024 New Weekly Cases 14,400,000 New Weekly Long COVID Cases 720,000 to 2,878,000  2024 CUMULATIVE ESTIMATES AS OF January 8, 2024 Total 2024 Cases To Date 16,410,770 Total 2024 Long COVID Cases To Date 821,000 to 3,282,000
5/
U.S. Covid Risk Table for the week of Jan 8, 2024.

In a gathering of 15-20 people, it's a coin toss whether at least one person has infectious Covid.

Avoid large gatherings. #VaxUp #MaskUp. DIY fit test. Turn that thermostat from 'auto' to 'on,' or better yet, get outside or remote. Add supplemental air cleaning with HEPA and #DIYAirCleaners. Keep testing.How Does Risk Increase with More Social Contacts?	 Number of People  |  Chances Anyone is Infectious	 1	4.3% 2	8.4% 3	12.4% 4	16.1% 5	19.7% 6	23.2% 7	26.5% 8	29.7% 9	32.7% 10	35.6% 15	48.3% 20	58.5% 25	66.7% 30	73.3% 35	78.5% 40	82.8% 50	88.9% 75	96.3% 100	98.8% 150	99.9% 200	>99.9% 300	>99.9% 400	>99.9% 500	>99.9%
6/
Warning: U.S. schools likely have very high Covid transmission throughout January 2024.

The following table shows the risk that anyone would have COVID in classrooms, based on varying size, date, and region.

Left table: The left table shows the chances someone is infectious with Covid based on class size and date. Class size matters considerably. Date does not (for January), as we'll be riding out the peak of the surge, which is more like a month-long plateau. In a class of 8, there's about a 25-30% chance someone would have Covid at any given time in January, absent any precautions using screening, testing, isolation, or quarantine. In a college class of 50, it's more like an 85-90% chance.

Right table: We do not model separately by region. However, if you track Biobot, you'll note levels are higher in the Northeast and Midwest than in the South and West. If we assume the same ratio for Jan 8, this table shows you how the risk varies geographically. The true risk levels could be a bit higher in the South/West if they catch up. The geographic comparisons arguably are not particularly useful because the regional differences tend to be more about the number of specific counties in an extreme surge, while most counties in a region follow the national average. If good local data from Verily or elsewhere, consider that, but otherwise focus more on national numbers. Even using these estimates for the South/West, they are very bad. A class of 32 would have a >50% chance of COVID, absent any screening/testing/isolation/quarantine precautions.

Summary: Schools are often among the highest risk settings for COVID transmission because of the high density of people in classrooms, presenteeism, discontinuation of testing programs, lack of masking requirements, use of ill-fitting and low-quality masks, low vaccination rates, low air cleaning rates, and an emphasis on droplet dogma (handwashing, Lysol) for an airborne virus. As indicated in the letter linked in the next section, the solution is to re-implement comprehensive COVID mitigation, as the U.S. is in the 2nd-largest COVID surge of the pandemic.

Letter: Dr. Hoerger has prepared a letter for parents seeking to advocate for better COVID mitigation at schools. Parents can consider attaching the letter as an appendix to their own letter. Alternatively, they can replace Dr. Hoerger’s letter with their own and use the tables provided, or any graphics from this website. No permission is required to use any of the graphics or data.
pmc19.com/data/pmc_schoo…Estimated Chances Someone in a U.S. Classroom is Infectious by Week & by Region (pmc19.com model)  Estimates by Date, U.S. Average				 Class Size	Jan 1	Jan 8	Jan 15	Jan 22 8	29.1%	29.6%	28.4%	26.9% 16	49.7%	50.5%	48.7%	46.5% 24	64.3%	65.2%	63.3%	60.9% 32	74.7%	75.5%	73.7%	71.4% 40	82.0%	82.8%	81.2%	79.1% 50	88.3%	88.9%	87.6%	85.9% 75	96.0%	96.3%	95.6%	94.7% 100	98.6%	98.8%	98.5%	98.0% 200	99.9%	99.9%	99.9%	99.9% 300	99.9%	99.9%	99.9%	99.9% 500	99.9%	99.9%	99.9%	99.9%  Estimates by Region, Jan 8 Only		 Class Size	"Northeast & Midwest (Jan 8, Steady)"	"South & West  (Jan 8, Sti...
7/
International COVID Statistics

Independent estimates across 3 countries show that 4.2-5.0% of residents are actively infectious with Covid.

The U.S. numbers are now up to date, while the estimates in Canada and the U.K. are delayed by the holidays.International COVID Statistics from High-Quality Data Sources			 Compiled by the Pandemic Mitigation Collaborative (PMC19.com), January 8, 2024			 	U.S.A.	Canada	U.K. % of Population Actively Infectious	4.3% (1 in 23)	5.0% (1 in 20)	4.2% (1 in 24) Chances Someone is Infectious…			      In a Group of 10	35.6%	40.1%	34.9%      In a Group of 30	73.3%	78.5%	72.4%      In a Group of 50	88.9%	92.3%	88.3% Primary Data Source	Wastewater	Wastewater	Surveillance Testing Reference	"Michael Hoerger, PhD, MSCR, MBA @michael_hoerger pmc19.com/data"	"Tara Moriarty, PhD @MoriartyLab covid19r...
8/
Toll of the COVID-19 pandemic in the U.S. in 2023

There were an estimated >250 million infections in the U.S. in 2023.

If assuming within-year reinfections were 0-30% of total reinfections, an estimated 53-76% of the U.S. population was infected at least once in 2023.

With a conservative estimate that 5% of infections will result in clinically significant Long Covid, that’s >12 million new #LongCovid cases.

These outcomes are the product of a highly-risky laissez-faire public health response to widespread viral transmission that contradicts the precautionary principle.CUMULATIVE TOTAL ESTIMATE OF 2023 U.S. SARS-CoV-2 Infections  Total infections = 254,670,431 (53-76% of population infected at least once, depending on the percentage of infections that were reinfections)  Total resulting long covid cases = 12-50 million
9/
Full PMC COVID-19 Forecasting Dashboard for the Week of Jan 8, 2024

Here's the entire dashboard. You can read the full report, which includes supplemental tables and analysis online:
pmc19.com/dataThere is more COVID-19 transmission today	        than during 96.5% of the pandemic.	 	 CURRENT ESTIMATES FOR	 January 8, 2024	 Wastewater Levels (copies/mL)	 1413	 New Daily Cases	 2,056,000	 % of Population Infectious	 4.3% (1 in 23 people)	 New Daily Long COVID Cases	 103,000 to 411,000	 	 WEEKLY ESTIMATES FOR	 January 8, 2024	 New Weekly Cases	 14,400,000	 New Weekly Long COVID Cases	 720,000 to 2,878,000	 	 2024 CUMULATIVE ESTIMATES AS OF	 January 8, 2024	 Total 2024 Cases To Date	 16,410,770	 Total 2024 Long COVID Cases To Date	 821,000 to 3,282,000	 	 4-WEEK FORECAST FOR	 February 5,...
10/end
Thank you to everyone engaged in pandemic advocacy.

The current surge demonstrates that public policy underlies human behavior that will continue to guide high transmission, viral evolution, and continued waves.

It's up to us to change that trajectory. 🙏

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More from @michael_hoerger

Jul 29
PMC COVID Dashboard, July 28, 2025 (U.S.)
🧵1/12

PMC estimates 400,000 new daily infections. 1 in 118 people actively infectious.

Weekly stats:
🔹2.8 million infections (>40x reported cases)
🔹>140,000 resulting #LongCOVID cases
🔹>1,000 resulting excess deaths Heat map Very High: Louisiana, Guam High: Hawai'i, Florida
PMC COVID Dashboard, July 28, 2025 (U.S.)
🧵2/12

Please excuse any typos and delays. Any time Mimal's boot turns deep red, we're doing local outreach in addition to dashboard work, etc.

If you don't know Mimal yet, you won't be able to unsee them.
es.wikipedia.org/wiki/MIMALDeep red boot = Louisiana
Minnesota (M), Iowa (I), Missouri (M), Arkansas (A), Louisiana (L) = Mimal  Louisiana is the boot.   Sometimes depicted with Kentucky fried chicken on a Tennessee pan.
PMC COVID Dashboard, July 28, 2025 (U.S.)
🧵3/12

It's HOT COVID SUMMER in the Deep South. No geographic/political prejudices, see next.

Covid is burning through Guam, Louisiana, Florida, and Texas (underestimate due to sites down). Louisiana: 1 in 32, Very High (CDC)
Texas: 1 in 98, Moderate (underestimate, CDC)
Guam: 1 in 25, Very High (CDC)
Florida: 1 in 59, High (CDC)
Read 12 tweets
Jul 25
U.S. CDC numbers just released. Good news (for those not in Louisiana). "Only" a 5% national increase.

2025 has closely tracked with summer 2023 transmission. A 12-13% increase would have been expected based on those numbers. That said... Up: Midwest, Northeast Down: West, South
real-time data have been prone to retroactive corrections. This is frustrating, of course, because it leaves people making decisions based on data that are only of good quality when 2 weeks old.

If we saw a 12% increase this week, I'd say look at 2023 for a glimpse...
at the future. Instead, I would consider these plausible scenarios:
🔹Wave still similar to 2023
🔹Later wave with schools more implicated
🔹Something temporarily much better

Of course, temporarily better often means...
Read 6 tweets
Jul 21
1. PMC COVlD Dashboard, July 21, 2025 (U.S.)

COVlD is surging in 7 states, according to the CDC.
🔹Hawai'i (Very High)
🔹California (High)
🔹Nevada (High)
🔹Texas (High)
🔹Louisiana (High)
🔹Florida (High)
🔹South Carolina (High) Heat map, summarized in post
2. PMC COVlD Dashboard, July 21, 2025 (U.S.)

Western surge:
🔹California: 1 in 63 actively infectious, much higher in LA & Bay areas
🔹Hawai'i: 1 in 35 actively infectious
🔹Nevada: 1 in 63 actively infectious

These are wastewater derived estimates, not from individual tests CA map with stat summarized in post
NV  map with stat summarized in post
HI  map with stat summarized in post
3. PMC COVlD Dashboard, July 21, 2025 (U.S.)

Southern surge:

🔹Texas: 1 in 56
🔹Louisiana (New Orleans): 1 in 65
🔹Florida: 1 in 66
🔹South Carolina: 1 in 71

Again, wastewater estimates (wise indicator), not individual testing (low-quality data). SC map and stat noted in post
LA map and stat noted in post
FL map and stat noted in post
TX map and stat noted in post
Read 12 tweets
Jul 15
1) PMC COVlD Dashboard, July 14, 2025 (U.S.) 🧵

We estimate 1 in 148 Americans are actively infectious. This equates to 2.3 million infections/week, expected to result in >100,000 new #LongCOVID conditions & >800 deaths.

A room of 100 people is a coin toss of an exposure. Figure shows each wave of the pandemic.   Tables: Current Levels for Jul 14, 2025	 % of the Population Infectious	 0.7% (1 in 148)	 New Daily Infections	 324000	 New Weekly Infections	 2268000	 Resulting Weekly Long COVID Cases	 113,000 to 454,000	 Resulting Weekly Excess Deaths	 800 to 1,300	 	 Monthly Forecast	 Average % of the Population Infectious	 1.3% (1 in 80)	 Average New Daily Infections	 598766.6667	 New Infections During the Next Month	 17963000	 Resulting Monthly Long COVID Cases	 898,000 to 3,593,000	 Resulting Monthly Excess Deaths	 6,400 to 10,700	 	 Running Totals	 Infection...
2) PMC COVlD Dashboard, July 14, 2025 (U.S.) 🧵

Transmission (red) is closely tracking the path of 2 years ago (yellow). However, the incoming data are spotty. >20% of CDC states have limited/no data, & Biobot hasn't reported in weeks.

Could be MUCH worse or slightly better. Graph of year over year transmission. The current year (red) is tracking the path of two years ago (yellow) extremely closely. Two years ago, the peak was around September 1, at about 1 million daily estimated infections, and significantly higher than the Delta wave (blue).
3) PMC COVlD Dashboard, July 14, 2025 (U.S.) 🧵

Our model formalizes the mathematical assumptions in those predictions. If transmission follows what we know in terms of how waves grow or slow generally and historical patterns, this is what we'd expect.

The spottiness of the current real-time data reduce precision substantially. Retroactive corrections can make the forecast jump around from better to worse from one week to the next. Expect the worst. Hope for the best.Graph shows national transmission expected to increase the next several weeks.
Read 11 tweets
Jul 2
🌍Want to track COVID transmission accurately worldwide?

This PMC thread walks you through leading dashboards with information more up to date than WHO & EU directories.

🧵 1/ World map, countries with high-quality up-to-date surveillance systems shown in blue.
The Pandemic Mitigation Collaborative (PMC) Dashboard provides weekly COVID updates for the U.S., using wastewater surveillance derived case estimation models and analytic forecasting.

We have added a list of international dashboards:
🧵 2/
pmc19.com/data/index.php…Australia: NSW Health Australia Department of Health, Western Australia Austria: Federal Government of Austria City of Vienna - Regional Coron-A Consortium Austria Czech Republic: State Health Institute Czech Republic Belgium: Belgian Institute for Health Canada: Government of Canada Andrew Young's Canada Visualization C19 Resources Canada * World Health Network (WHN) Canada **
Denmark: Statens Serum Institut Denmark Europe (multi-national): EU Wastewater Observatory Finland: National Institute for Health and Welfare Finland WHN Finland ** France: French Republic Data Airborne Risk Reduction Association (ARRA) France Zan Armstrong's France Visualization COVID Weather App France (Android, IOS, or Web) Thomas Delattre's France Visualization Germany: Infection Radar Germany Bay-VOC Bavaria Region Berlin Waterworks WHN Germany **
Hong Kong: Centre for Health Protection, Hong Kong Hungary: National Center for Public Health and Pharmacy of Hungary India: Pune Knowledge Cluster of India Gujarat Biotechnology Research Centre of India Ireland: Health Protection Surveillance Centre Ireland Japan: Japan Institute for Health Security Latvia: Institute of Food Safety, Animal Health and Environment Latvia Lithuania: National Public Health Centre of Luthuania Luxembourg: Microbs Luxembourg Netherlands: National Institute for Public Health and the Environment Netherlands WHN Netherlands ** New Zealand: New Zealand Institute for...
Slovenia: National Institute of Public Health Slovenia Spain: Government of Catalonia - Regional South Africa: National Institute for Communicable Diseases of South Africa South Korea: Korea Disease Control and Prevention Agency Sweden: Pathogens Sweden Switzerland: Swiss Confederation Federal Office of Public Health ETH Zurich Switzerland WISE Dashboard U.K.: Public Health Scotland Buckinghamshire Disability Service (BuDS) U.K.  *See the numbers 1-21 along the lower left. Click on 3-6 for national and regional data. ** Click on the dropdown menu. May need to try a different web browser.
Our international directory includes official government dashboards & those developed by citizen scientists.

We exclude countries that have stopped reporting in the past 2-12 months even if on EU or WHO lists. We also exclude low-quality data from opt-in testing programs.
🧵 3/
Read 43 tweets
Jun 24
PMC COVlD Dashboard, Jun 23, 2025 (U.S.)

🔥Biggest uptick since Jan
🔥1 in 167 actively infectious
🔥>2 million weekly infections
🔥700-1,200 resulting excess deaths from weekly infections

Track transmission closer to home w/our new state & international resources 👇

🧵1/6
PMC COVlD Dashboard, Jun 23, 2025 (U.S.)

🔹With >90% probability, we have entered the 11th COVlD wave.
🔹In a room of 50 people, there is already a 1 in 4 chance of an exposure.
🔹We expect nearly 15 million infections in the next month, and rising.

🧵2/6Current Levels for Jun 23, 2025	 % of the Population Infectious	 0.6% (1 in 167)	 New Daily Infections	 287000	 New Weekly Infections	 2009000	 Resulting Weekly Long COVID Cases	 100,000 to 402,000	 Resulting Weekly Excess Deaths	 700 to 1,200	 	 Monthly Forecast	 Average % of the Population Infectious	 1.0% (1 in 97)	 Average New Daily Infections	 493300	 New Infections During the Next Month	 14799000	 Resulting Monthly Long COVID Cases	 740,000 to 2,960,000	 Resulting Monthly Excess Deaths	 5,300 to 8,800	 	 Running Totals	 Infections Nationwide in 2025	 74869000	 Average Number of Infect...
PMC COVlD Dashboard, Jun 23, 2025 (U.S.)

We continue to expect transmission to break 500,000 daily infections in the U.S. around July 9th.

This is the same prediction as last week, as the forecast was dead on. Yet, there is considerably uncertainty around this timing.

🧵3/6Longitudinal transmission, past 12 months and 1-month forecast
Read 6 tweets

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