Mike Hoerger, PhD MSCR MBA Profile picture
Feb 29, 2024 5 tweets 4 min read Read on X
PMC COVID-19 Forecast, Week of Feb 26, 2024
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Forecast for the next month
Over the next month, we should see transmission fall from 790,000 infections/day toward more like a range of 200,000-450,000 infections per day, depending on better or worse scenarios.

That's "good" news in the relative sense for those putting off medical appointments the past 6 months, though still extremely high transmission in any objective sense.

See the online report for details on the models.

Surge in Context
At this point in the surge, it is clear that the peak transmission day was around December 27 (1.92 million/day), and the midpoint of “surging” infections (>1 million/day) was around January 9.

We are estimated to have had 85 total days with >1 million infections per day (November 28 through February 20) during the surge, though these numbers may still fluctuate with corrections the next few weeks.

The low-point leading into the surge was October 18 at 547,000 infections/day. Infections have been at “wave” levels (>500,000 infections/day or higher) since the onset of the late summer wave surpassed that milestone on July 27. We are estimated to dip below 500,000 infections/day around March 6.

This is very unfortunate timing because the medical facilities that enacted universal masking may end policies on March 1. Many were hoping for a period of lower transmission before such policies ended. As of today, the estimated low point for transmission is March 27 (348,000 infections/day), but the level and date are subject to much uncertainty.CURRENT ESTIMATES FOR February 26, 2024 Wastewater Levels (copies/mL) 546 New Daily Cases 794,000 % of Population Infectious 1.66% (1 in 60 people) New Daily Long COVID Cases  40,000 to 159,000   4-WEEK FORECAST FOR March 25, 2024 Wastewater Levels (copies/mL) 242 (-56% lower) New Daily Cases 353,000 % of Population Infectious 0.74% (1 in 135 people) New Daily Long COVID Cases  18,000 to 71,000
PMC COVID-19 Forecast, Week of Feb 26, 2024
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Current State of the Pandemic
🔹73 million infections in the U.S. in 2024 (so far)
🔹790,000 daily infections
🔹1.66% (1 in 60) actively infectious
🔹40,000+ resulting #LongCOVID cases/day

Deeper Dive
Transmission is finally starting to decline again, and expect major declines the next four week.

U.S. wastewater levels indicate that COVID transmission is higher than during 58.4% of the days of the pandemic (down from 85.9% a week ago). Transmission is lower than 41.6% of the pandemic.

As we noted the past two weeks, we believed the post-peak hill was itself peaking on around February 7th and that last week’s slightly higher values might get retroactively corrected downward. That was, in fact, the case (the peak was the 7th), and transmission has fallen further since.

We are still at very high “wave” levels, but no longer “surging” at over a million infections/day. The big picture remains very bad, but this is good news for people putting off medical appointments for months.There is more COVID-19 transmission today        than during 58.4% of the pandemic.  CURRENT ESTIMATES FOR February 26, 2024 Wastewater Levels (copies/mL) 546 New Daily Cases 794,000 % of Population Infectious 1.66% (1 in 60 people) New Daily Long COVID Cases 40,000 to 159,000  WEEKLY ESTIMATES FOR February 26, 2024 New Weekly Cases 5,600,000 New Weekly Long COVID Cases 278,000 to 1,112,000  2024 CUMULATIVE ESTIMATES AS OF February 26, 2024 Total 2024 Cases To Date 73,585,610 Total 2024 Long COVID Cases To Date 3,679,000 to 14,717,000
PMC COVID-19 Forecast, Week of Feb 26, 2024
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Risks in Group Settings
Although transmission is falling, it's easy to get distracted by the relative changes and ignore that the absolute risk remains high, especially in large groups with limited or no mitigation.

In a group of 10, there's a 15% at least one person is actively infectious. In a group of 30, it's a 40% chance, and so forth. Almost nobody would take those chances of a serious illness if informed and capable of grappling with the seriousness of that risk without becoming defensive. Unfortunately, a lot of institutions are pushing minimizer narratives if not directly forcing students and workers into more dangerous settings.How Does Risk Increase with More Social Contacts?	 Number of People  |  Chances Anyone is Infectious	 1	1.7% 2	3.3% 3	4.9% 4	6.5% 5	8.0% 6	9.6% 7	11.1% 8	12.5% 9	14.0% 10	15.4% 15	22.2% 20	28.5% 25	34.2% 30	39.5% 35	44.4% 40	48.8% 50	56.7% 75	71.5% 100	81.3% 150	91.9% 200	96.5% 300	99.3% 400	99.9% 500	>99.9%
PMC COVID-19 Forecast, Week of Feb 26, 2024
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International Comparisons
The percentage of the U.S. actively infectious (1.7%) is very much in line with recent high-quality estimates for Canada (2.1%) and the U.K. (1.5%).

All three countries are following a similar pattern, though Canada and the U.K. appear to have peaked earlier, and are likely seeing earlier declines in transmission. Note that their numbers are marginally more delayed.International COVID Statistics from High-Quality Data Sources Compiled by the Pandemic Mitigation Collaborative (PMC19.com), February 26, 2024  % of Population Actively Infectious Chances Someone is Infectious…      In a Group of 10      In a Group of 30      In a Group of 50  U.S.A. 1.7% (1 in 60) 15.4% 39.5% 56.7%  Canada 2.1% (1 in 47) 19.3% 47.5% 65.9%  U.K. 1.5% (1 in 67) 14.0% 36.5% 53.0%
PMC COVID-19 Forecast, Week of Feb 26, 2024
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Here is the full PMC Dashboard. You can also read the report online at

Please share anything you like across platforms. Never a need to ask permission. 🙏pmc19.com/dataThere is more COVID-19 transmission today	        than during 58.4% of the pandemic.	 	 CURRENT ESTIMATES FOR	 February 26, 2024	 Wastewater Levels (copies/mL)	 546	 New Daily Cases	 794,000	 % of Population Infectious	 1.66% (1 in 60 people)	 New Daily Long COVID Cases	 40,000 to 159,000	 	 WEEKLY ESTIMATES FOR	 February 26, 2024	 New Weekly Cases	 5,600,000	 New Weekly Long COVID Cases	 278,000 to 1,112,000	 	 2024 CUMULATIVE ESTIMATES AS OF	 February 26, 2024	 Total 2024 Cases To Date	 73,585,610	 Total 2024 Long COVID Cases To Date	 3,679,000 to 14,717,000	 	 4-WEEK FORECAST FOR	 March ...

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More from @michael_hoerger

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
Jan 8
We're in the middle of a 12th COVlD wave in the U.S., with transmission particularly high in the Midwest and Northeast.

The CDC announced this week that COVlD continues to kill more Americans than breast and prostate cancer combined.

Get boosted & #MaskUp 💉💪😷
1/4🧵 Heat map of CDC data with PMC prevalence estimate
Levels are "Moderate" to "Very High" in 26 states.

However, data reporting is slow, and about 1/3 of states have low-quality data this week due to the holidays and illness.

2/4🧵 National estimates: Number of People		Chances Anyone is Infectious			 1				1.5%	 2				3.0%	 3				4.5%	 4				6.0%	 5				7.4%	 10				14.3%	 15				20.7%	 20				26.5%	 25				32.0%	 30				37.0%	 50				53.8%	 75				68.6%	 100				78.6%	 200				95.4%	 300				99.0%
Barometer: Higher transmission than 90 of the past 100 days (perhaps higher still, due to low data reporting quality)
State	CDC Level	Actively Infectious Alabama	Moderate	1 in 48 (2.1%) Alaska	Very Low	1 in 152 (0.7%) Arizona	Very Low	1 in 201 (0.5%) Arkansas	High*	1 in 36 (2.8%) California	Very Low	1 in 484 (0.2%) Colorado	Moderate	1 in 49 (2.0%) Connecticut	Very High	1 in 24 (4.2%) Delaware	Low*	1 in 70 (1.4%) District of Columbia	Very Low	1 in 5,835 (0.0%) Florida	Very Low	1 in 284 (0.4%) Georgia	Low	1 in 90 (1.1%) Guam	Very Low	1 in 687 (0.1%) Hawaii	Very Low	1 in 874 (0.1%) Idaho	Very Low	1 in 169 (0.6%) Illinois	Moderate*	1 in 56 (1.8%) Indiana	High*	1 in 34 (2.9%) Iowa	Moderate	1 in 41 (2.4%) Kansas...
State	CDC Level	Actively Infectious Missouri	Moderate*	1 in 42 (2.4%) Montana	High	1 in 34 (2.9%) Nebraska	Very High	1 in 26 (3.9%) Nevada	Very Low	1 in 138 (0.7%) New Hampshire	High*	1 in 35 (2.9%) New Jersey	Low	1 in 82 (1.2%) New Mexico	Low	1 in 87 (1.2%) New York	Moderate*	1 in 44 (2.3%) North Carolina	Low	1 in 82 (1.2%) North Dakota	High*	1 in 34 (3.0%) Ohio	Very High	1 in 27 (3.7%) Oklahoma	Moderate*	1 in 62 (1.6%) Oregon	Very Low	1 in 170 (0.6%) Pennsylvania	Moderate	1 in 44 (2.3%) Rhode Island	Moderate	1 in 41 (2.4%) South Carolina	Moderate	1 in 54 (1.9%) South Dakota	Very High	1 in...
If like years 1-4 of the pandemic, the winter wave has peaked. If like last year, we could hover near peak levels for a month.

Forecasting quality is low with 1/3 of states having data issues. Hopefully, we'll know a lot more in a few days.

3/4🧵 12 waves
Proportion Actively Infectious										1 in 65 (1.5%) New Daily Infections										 749,000  Infections the Past Week										 5,390,000  Infections in 2026										 3,000,000  Cumulative Infections per Person										 4.88  										 Long COVID										 Long COVID Cases Resulting								37,000 to 150,000		   from New Daily Infections										 Long COVID Cases Resulting								270,000 to 1,080,000		   from New Weekly Infections										 										 Excess Deaths										 Excess Deaths Resulting 									220 to 370	   from New Daily Infections										 Excess Deaths Resulting 					...
year over year graph
forecast
Read 4 tweets
Jan 5
We told you that 109,000-175,000 Americans would died of COVID (excess deaths) in 2025.

Today, the CDC estimates 101,000 deaths/year (flat from Oct 2022 to Sep 2024), and likely higher when considering more nebulous non-acute excess deaths (heart attack 6 months later).
1/5
The CDC estimates are actually higher than I would have guessed, given their methodology, which models estimates based on easily countable factors in healthcare and expert input on multiplier values. It lends credence to the PMC upper bound of excess deaths of 175,000/yr.
2/5
What's troubling is the CDC has annual mortality flat. My expectation based on mortality displacement and Swiss Re data is that it should be declining. If is stays flat, we're running on something like breast+prostate cancer or lung cancer deaths per year in perpetuity.
3/5
Read 6 tweets

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