Mike Hoerger, PhD MSCR MBA Profile picture
Aug 2, 2024 2 tweets 3 min read Read on X
PMC COVID-19 Forecast, Aug 2, 2024 (U.S.)

Expect 2 more weeks of very high and stable transmission before the summer wave accelerates.

Currently at an estimated 850,000 daily infections, 1 in 56 Americans contagious, 43,000 resulting Long COVID cases/day.

Deep Dive:
Over the next two weeks, we should see very high and stable transmission, before transmission increases rapidly. Note that transmission estimates are down marginally – of no practical impact – relative to last week. One might be tempted to consider that the summer wave is subsiding. That might be a 5-10% probability.

This is where the model gets interesting. The forecasts are derived from a combination of recent patterns in transmission (levels, change, rate of change, rate of rate of change) as well as historical medians for that date. If only using the recent patterns, a decline in the wave would be reasonable.

However, the historic data capture all of that useful information on variation in human behavior (back to school, end of summer vacations, flights, Labor Day) that focusing only on recent patterns would miss. Because behavioral patterns also fuel viral evolution, these historical data also get, to some extent, at the idea of viral evolution of new variants, which we do not track directly in the model.

When considering the forecast, view it two ways. One, based on current trends and historic data, this is what we would expect. Two, if human behavior defied historic trends, we could see something much different, such as a wave subsiding if everyone were more cautious than average this year, or unfortunately something slightly worse than predicted due to the decline in public health guidance on mitigation.

According to the composite forecasting model, that means hovering between 700,000 to 1,050,000 infections/day over the next month. Transmission is very high, and we may reach a later-summer peak of 1.1-1.3 daily infections around September 11.

Although the forecast is for steady transmission over the next two weeks, the forecast is volatile due to quality issues with incoming data.

Schools, medical facilities, and businesses should now escalate precautions and prepare for the disruption of a high percentage of the population getting sick through the remainder of 2024.CURRENT ESTIMATES FOR August 2, 2024 Wastewater Levels (copies/mL) 586 New Daily Cases 852,000 % of Population Infectious 1.78% (1 in 56 people) New Daily Long COVID Cases 43,000 to 170,000  4-WEEK FORECAST FOR August 30, 2024 Wastewater Levels (copies/mL) 712 (22% higher) New Daily Cases 983,000 % of Population Infectious 2.06% (1 in 49 people) New Daily Long COVID Cases 49,000 to 197,000
You can find the full PMC COVID-19 dashboard and weekly report for Aug 2, 2024 online.

In the report, I have included a link to the PPT slides from yesterday's Space on the new JAMA-NO #KeepMasksInHealthcare article.

Report: pmc19.com/dataThere is more COVID-19 transmission today	        than during 64.2% of the pandemic.	 	 CURRENT ESTIMATES FOR	 August 2, 2024	 Wastewater Levels (copies/mL)	 586	 New Daily Cases	 852,000	 % of Population Infectious	 1.78% (1 in 56 people)	 New Daily Long COVID Cases	 43,000 to 170,000	 	 WEEKLY ESTIMATES FOR	 August 2, 2024	 New Weekly Cases	 6,000,000	 New Weekly Long COVID Cases	 298,000 to 1,193,000	 	 2024 CUMULATIVE ESTIMATES AS OF	 August 2, 2024	 Total 2024 Cases To Date	 155,573,470	 Total 2024 Long COVID Cases To Date	 7,779,000 to 31,115,000	 	 4-WEEK FORECAST FOR	 August 30, 202...

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More from @michael_hoerger

Apr 14
PMC COVlD Update, Apr 13, 2026

Levels are flat during a relative "lull" in transmission.
▪️1 in 187 estimated actively infectious
▪️260,000 estimated new daily infections
▪️High: OK, MS, WV
▪️Moderate: VT
▪️All other states low/very low in relative transmission

🧵THREAD 1/6 Heat map from CDC data and PMC prevalence estimates harmonizing CDC and Biobot wastewater data with IHME true case estimates to derive ongoing transmission projections
COVID-19 persists in 2026.

We are in a relative "lull" following a 12th wave, but at a baseline of 200-300K estimated new daily infections.

Transmission was lower in the era many refer to as #DuringCOVID, when multi-layered mitigation was used instead of denial.

🧵THREAD 2/6 Annotated graph of the 12 waves (U.S.)
Transmission during a "lull" is high in an absolute sense. Many people are getting infected.

Simultaneously, its low in a relative sense, or compared to so-called "typical" transmission. In most places, it's a safer time for medical/dental care.

🧵THREAD 3/6 Barometer showing lower relative transmission than usual
Read 6 tweets
Apr 6
PMC COVlD Update, April 6, 2026

Transmission is stable in a relative "lull" nationally between waves.

We estimate that approximately 313,000 people are still getting infected per day, with outbreaks radiating from TN and MS.

🧵1 of 10 (don't miss #10)! Heat map with PMC estimates
With limited data reported, Mississippi has an estimated 1 in 27 residents actively infectious.

In a room of 25 people, that's a 61% chance of exposure, if no testing/isolation protocols.

🧵2 of 10 Alabama	Low Alaska	Very Low Arizona	Very Low* Arkansas	Low California	Very Low Colorado	Very Low Connecticut	Low Delaware	Low District of Columbia	Very Low Florida	Very Low Georgia	Low Guam	Low Hawaii	Very Low Idaho	Very Low Illinois	Very Low Indiana	Very Low Iowa	Very Low Kansas	Low Kentucky	Moderate Louisiana	Moderate Maine	Very Low Maryland	Low Massachusetts	Very Low Michigan	Low Minnesota	Very Low Mississippi	Very High*
1 in 24 people in Tennessee are estimated to be actively infectious with SARS-CoV-2. That's a 65% chance of exposure in a room of 25 people where nobody is testing/isolating.

🧵3 of 10 Missouri	Moderate* Montana	Very Low Nebraska	Very Low Nevada	Very Low New Hampshire	Very Low New Jersey	Low New Mexico	Very Low New York	Very Low North Carolina	Low North Dakota	Very Low* Ohio	Very Low Oklahoma	Low* Oregon	Very Low Pennsylvania	Low Rhode Island	Very Low South Carolina	Very Low South Dakota	Low Tennessee	Very High Texas	Low Utah	Very Low Vermont	Moderate Virginia	Moderate Washington	Very Low West Virginia	Low Wisconsin	Very Low Wyoming	Very Low
Read 10 tweets
Apr 3
This is an unethically misleading study with findings easily explained by residual confounding. Some health systems and patients have thorough record keeping. Others don't. All sorts of variables will correlate (infections, cancers, anything else tracked in medical records).
This is a really obvious issue for an international epi study. It should not have been published.
The above study is using the same processes the anti-vaxxers use -- junk epi that does not account for confounding -- to support whatever pre-conceived notions the authors have, with absurdly large effects.

Read 4 tweets
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

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