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 #VaxUp
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.
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.
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.
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.
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…
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.
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.
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/data
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.
1) PMC COVID Dashboard for the Week of Jan 27, 2025 (U.S.)
🔹1 in 108 actively infectious
🔹3.1 million weekly infections
🔹>150,000 weekly resulting Long Covid conditions
2) We predicted the wave peak would be 0.8 to 1.3 million across various forecasts. We presently have it at 0.9-1.0 million, though retroactive corrections can change that. The WHN also runs an excellent model, with a peak estimated at 1.3 million. whn.global/estimation-of-…
3) Approx 1 million daily infections is quite serious. This is a far cry from the various #nothingburger predictions, and the Monday morning quarterbacks who in hindsight minimize U.S. infections, Long Covid, & disability.
Perhaps they have social media revenue COIs. I don't.
If we are lucky, the 10th wave has peaked, likely in the 0.9-1.1 million daily infections range, barring significant retroactive corrections.
Over the next month, we should still see about 14 million infections, resulting in 700K to 2.8 million new conditions and enduring symptoms under the umbrella of #LongCOVID. This is simply your reminder than transmission remains high on the back on of a wave.
Regarding the peak, there were huge retroactive downward corrections, especially in Oregon. The CDC data originally showed one of the largest waves there all-time, and then corrected it to say a complete lull the whole time. Once the Biobot data get updated, we may see the peak date change by a week, or jump a bit higher than what you see in the main figure.
What you see in the far end of the forecast is unlikely to be a "high lull," but rather an average between a low lull versus a sustained post-peak haunch of lingering transmission. So, keep an eye on the data. If you're putting off a non-urgent medical appointment, we could get into relatively lower transmission in the next 4-8 weeks. What has me concerned is a sneak-peek of @jlerollblues's long-term forecast indicating a clear possibility of an earlier "mid-year" wave than usual, perhaps even in April. We're still getting pretty lucky on the viral evolution front, but the longer that persists, in absent of major policy change, the bigger the wave we could get. It's a very important time to stay tuned.
Caveats: No data from Biobot in weeks (20% model weight). The California wildfires and pending severe storms in the Deep South are wildcards for transmission. School-based transmission could pick up, but to get a higher peak, transmission would need to pick up much faster in the South and West than in the Midwest and North (unlikely).
In the report, I note that PMC will persist even if the CDC drops or scales back their surveillance program. Also, the most two recent "odd" waves have helped clarify how to handle historical data, and a minor update to the model should help with future atypical waves. If time permits, we will fine-tune those changes further, but there are always more battles on the Covid front than we're able to fight. We also provide a link and light commentary on our recent pre-print showing what our current case estimation model for estimating present/prior daily infections has performed well, and why a lot of other models (BNO, JP, CDC) are underestimates.
Info for new readers:
For those unfamiliar with the PMC model, find full weekly reports for the past 1.5 years at pmc19.com/data
The models combine data from IHME, Biobot, and CDC to use wastewater to estimate case levels (r = .93 to .96) and forecast levels the next month based on typical levels for that date and recent patterns of changes in transmission the past 4 weeks.
Our work has been cited in top scientific journals and media outlets, which are fully sourced in a detailed technical appendix at pmc19.com/data/PMC_COVID…
Examples include JAMA Onc, JAMA-NO, BMC Public Health, Time, People, TODAY, the Washington Post, the Institute for New Economic Thinking, Salon, Forbes, the New Republic, Fox, CBS, NBC, and CNN. See pgs 11-13 at the above link.
#MaskUp #VaxUp #CleanTheAir #RapidTest
2) Here is the issue of Oregon I noted, with the "disappearing surge" in the CDC data. By that, I don't mean a surge that declined quickly. I mean, the CDC saying there was a huge surge in OR and then saying it was a lull the whole time. Baffling.
3) It's an important time to reflect that we have never had a federal Covid response commensurate with the magnitude of this $14-billion problem in the U.S.
3/11/20-1/19/21 = 290K infections/day (91 million total)
10 waves and >1 billion estimated infections in 5 years.
We have never had a well-conceived multi-layered mitigation strategy, and the strategy we have had has often underachieved due to insufficient operational management.
This places society at greater systemic risk from repeat-infection Long COVID. The approach is unreasonable to people with primary immunodeficiencies, cancer, organ transplants, kidney disease, type 1 and 2 diabetes, Long COVID, pregnancy, and many other conditions. Upwards of 2 million older adults in the U.S. are in early retirement, with the labor participation rate still well below pre-pandemic levels, and older adults almost wholly accounting for that presently. The children that were pretended to be magically shielded from Covid are not doing well on the cumulative infection front either.
I do not see that changing. I hope the many scientists and public health officials biting their tongues the past 4 years now feel liberated to speak up on Covid. Note that state and regional organizations and individuals were a big reason why transmission was better under control in year 1 of the pandemic.
Note that our statistics are estimated "true" cases based on the PMC model, not reported cases, which are vast undercounts (ascertainment bias). See the first Tweet for info on our model, including our website, which contains hundreds of pages of reports (pmc19.com/data), or read our recent pre-print showing the high accuracy of our case estimation model, to the extent that is ascertainable (researchsquare.com/article/rs-578…). To believe the true infection estimates are lower than these figures, one would have to suspend cognitive reasoning and merely assume transmission happens at vastly lower rates in the U.S. than those documented through the most-rigorous testing-based program in Europe.
📈1 in 49 people actively infectious
🔥Nearly 1 million daily infections
🎲About a 50-50 chance someone has COVID in a large class if typical risk and no testing/isolating
🏥300,000+ new Long Covid conditions per week
The infections are likely minor underestimates. AZ and OR did not report this week. They were surging, so the lack of data brings down the average. As well, the model gives 80% weight to CDC wastewater data and 20% weight to Biobot, but Biobot took the week off, so this is dependent on observed changes in the CDC data.
It would be wise to add multiple imputation into the model to account for all the non-random missingness during surges, but I won't likely get to that anytime soon.
The peak is looking more and more like 1.4 million daily infections, but I wouldn't be surprised if it's earlier than shown and more like 1.3 million, based on the pattern of retroactive data corrections last winter. If the real-time data really stink, it could come in closer to 1.0-1.1 million. To top 1.6 million, we would probably need some serious immune escape that at present I just don't see happening. However, in past winters, transmission was declining nationally in early/mid January, and back-to-school is a wild card.
Info for new readers:
For those unfamiliar with the PMC model, find full weekly reports for the past 1.5 years at pmc19.com/data
The models combine data from IHME, Biobot, and CDC to use wastewater to estimate case levels (r = .93 to .96) and forecast levels the next month based on typical levels for that date and recent patterns of changes in transmission the past 4 weeks. Our work has been cited in top scientific journals and media outlets, which are fully sourced in a detailed technical appendix at pmc19.com/data/PMC_COVID…
Examples include JAMA Onc, JAMA-NO, BMC Public Health, Time, People, TODAY, the Washington Post, the Institute for New Economic Thinking, Salon, Forbes, the New Republic, Fox, CBS, NBC, and CNN. See pgs 11-13 at the above link.
We will have a pre-print out in the next week or so documenting very compelling evidence for the validity of using wastewater to estimate case rates. Forecasting is challenging in the context of the current viral evolution, but the real-time estimates of cases are impressively accurate to the best we can evaluate it.
#MaskUp #VaxUp #CleanTheAir #RapidTest
2) PMC COVID-19 Dashboard, Jan 6, 2025 (U.S.)
We're in the 10th wave of the pandemic (1st graph), and transmission this year has picked up atypically late, while coming on strong (2nd graph).
3) PMC COVID-19 Dashboard, Jan 6, 2025 (U.S.)
Note that sputtering in the West's rise is likely an aberration, as surging OR and AZ did not provide data this week.
I recently learned of a new strategy to get more clean indoor air to people's homes. I don't believe I've heard anyone mention this on here, but please add if you have made inroads.
1/
Last August, I was surprised to learn that Entergy, our regional energy company, was giving away free HEPA filters to customers.
This was surprising to me. Why would an energy company do this?
2/
Apparently, most jurisdictions in the U.S. have regulations that require a portion of consumers' energy payments to go toward an energy efficiency fund.
These are often used for discounts on thermostats but occasionally for Energy Star appliances.
3/
2) This is one of the better scenarios I noted, with national levels coming in at about 3.33. Unfortunately, the rise was a little lower than anticipated only because transmission slowed in the west. Not uniform, so lots of uncertainty.
3) Transmission remains much higher than people realize. Many will get caught off guard by a seemingly #SilentSurge. This is in part because the CDC spent the past month downplaying numbers in misleading graphs.
🔹1 in 64 (1.6%) actively infectious in the U.S.
🔹750,000 new daily infections and rising
🔹Highest % increase in transmission in nearly 3 years
🔹10th wave is the "silent surge," coming on late out of nowhere
The video will walk you through each of the graphs on the dashboard and covered in this thread.
Info for new readers:
For those unfamiliar with the PMC model, find full weekly reports for the past 14+ months at pmc19.com/data
The models combine data from IHME, Biobot, and CDC to use wastewater to estimate case levels (r = .93 to .96) and forecast levels the next month based on typical levels for that date and recent patterns of changes in transmission the past 4 weeks.
Our work has been cited in top scientific journals and media outlets, which are fully sourced in a detailed technical appendix at pmc19.com/data/PMC_COVID…
Examples include JAMA Onc, JAMA-NO, BMC Public Health, Time, People, TODAY, the Washington Post, the Institute for New Economic Thinking, Salon, Forbes, the New Republic, Fox, CBS, and NBC. See pgs 11-13 at the above link.
We will have a pre-print out in the next month documenting very compelling evidence for the validity of using wastewater to estimate case rates. Forecasting is challenging in the context of the current viral evolution, but the real-time estimates of cases are impressively accurate to the best we can evaluate it.
PMC COVID-19 Dashboard, Dec 16, 2024
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🔹10th wave taking off (U.S.)
🔹5 million infections expected this week
🔹>250,000 post-infection conditions (#LongCovid) expected to develop from this week's infections
🔹Higher transmission than 73% of the pandemic
Info for new readers (as noted in Tweet 1):
For those unfamiliar with the PMC model, find full weekly reports for the past 14+ months at pmc19.com/data
The models combine data from IHME, Biobot, and CDC to use wastewater to estimate case levels (r = .93 to .96) and forecast levels the next month based on typical levels for that date and recent patterns of changes in transmission the past 4 weeks.
Our work has been cited in top scientific journals and media outlets, which are fully sourced in a detailed technical appendix at pmc19.com/data/PMC_COVID…
Examples include JAMA Onc, JAMA-NO, BMC Public Health, Time, People, TODAY, the Washington Post, the Institute for New Economic Thinking, Salon, Forbes, the New Republic, Fox, CBS, and NBC. See pgs 11-13 at the above link.
We will have a pre-print out in the next month documenting very compelling evidence for the validity of using wastewater to estimate case rates. Forecasting is challenging in the context of the current viral evolution, but the real-time estimates of cases are impressively accurate to the best we can evaluate it.
PMC COVID-19 Dashboard, Dec 16, 2024
🧵3 of 8
Areas of the U.S. depicted in darker red have higher transmission, as of 9 days ago. The map uses CDC data and is simply the CDC "cool blue" map recolored in more traditional red, which is best practices.
The line graph shows transmission increasing by region.
For those unfamiliar with the PMC model, find full weekly reports for the past 14+ months at pmc19.com/data
The models combine data from IHME, Biobot, and CDC to use wastewater to estimate case levels (r = .93 to .96) and forecast levels the next month based on typical levels for that date and recent patterns of changes in transmission the past 4 weeks.
Our work has been cited in top scientific journals and media outlets, which are fully sourced in a detailed technical appendix at pmc19.com/data/PMC_COVID…
Examples include JAMA Onc, JAMA-NO, BMC Public Health, Time, People, TODAY, the Washington Post, the Institute for New Economic Thinking, Salon, Forbes, the New Republic, Fox, CBS, and NBC. See pgs 11-13 at the above link.
We will have a pre-print out in the next month documenting very compelling evidence for the validity of using wastewater to estimate case rates. Forecasting is challenging in the context of the current viral evolution, but the real-time estimates of cases are impressively accurate to the best we can evaluate it.