You probably saw this week's NEJM article on #LongCOVID. We did a special section on it in this week's PMC COVID-19 Forecasting Report (pgs 6-8).
THREAD of tables. 🧵🔢
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Details:
Our model continues to provide estimates of Long COVID cases that will ultimately result from each day’s infections.
We provide a credible interval that 5-20% of infections will result in Long COVID.
This week, Al-Aly and colleagues reported in the New England Journal that in the more recent era of the pandemic, vaccinated individuals have a 3.5% chance of developing Long COVID from a particular infection.
They focused on medically documented new serious health conditions. We continue to view 5% as a useful lower bound for two reasons.
Long COVID chances were higher in unvaccinated individuals in their study, and there were no analyses based on time since last vaccination.
With many Americans still unvaccinated and many not vaccinated in the past year, the true estimate for a 2024 infection could well surpass 5% for a medically documented new serious health condition.
Moreover, Long COVID is a heterogeneous condition, and many cases are likely not medically documented, especially at the less debilitating end of the spectrum.
The following tables show the risk of ever developing Long COVID from an infection assuming 3.5%, 5.0%, and 20.0% rates.
These statistics document the seriousness of Long COVID with Americans getting infected nearly once a year (average of 12.5 months by our estimates).
However, it is also important to know that some effects are enduring, and others more likely to improve, so many with Long COVID will improve.
Many will also have repeated bouts of Long COVID, likely with different phenotypes.pmc19.com/data/
If you assume 3.5% of people get Long COVID per infection, the risk grows sizably with reinfections, which are happening nearly once per year. Avg of 9 infections/American the next decade.
In the previous Tweet, we note how 3.5% is an obvious underestimate.
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Based on that 3.5% estimate, a more realistic low-ball estimate of serious long COVID is 5-7%, given that not all serious new health conditions are documented in medical records & rates are higher among those unvaxxed or not recently vaxxed.
Bad decade (9 inf's) ahead.
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If LC translates into 3.5% more new serious health conditions documented in medical records, a reasonable estimate would be that 20% or more develop any #LongCOVID per infection.
Many do not go to a PCP for loss of smell or taste, fatigue, or "brain fog."
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However, even if assuming 3.5%. Let's consider a family of 4, where Covid burns through everyone each infection. In such cases, these are the number of "burn through" (unmitigated) household infections before someone gets #LongCOVID.
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Americans are getting Covid nearly once a year on average (every 12.5 months). The 4-10 year scenarios, even w/low-ball estimates are terrible, especially when considering family impacts. More of us will get #LongCOVID, know others with LC, & know struggling families.
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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
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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.
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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/
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
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
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.
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
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
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
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.
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.
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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.
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