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

Sep 13
California COVlD Surge Rages Higher

🔸CDC SARS-CoV-2 wastewater levels "Very High," and up from last week
🔸1 in 21 estimated actively infectious
🔸>250,000 estimated new daily infections statewide

Four figures...
1/4🧵 CDC: Very High: PMC Estimate: 1 in 21 actively infectious
CDC wastewater data in California show COVlD cases increasing from the already "Very High" levels last week.

2/4🧵 Line graph of the past 6 months showing the surge in wastewater viral levels
With an estimated 1 in 21 (or 4.8%) of California residents actively infectious of COVlD, risk increases dramatically in larger and more frequent social gatherings.

Interact with 25 people of average risk of being positive, and that's a >70% chance of exposure.
3/4🧵 How Does Risk Increase with More Social Contacts? Number of People | Chances Anyone is Infectious 1	4.8% 2	9.4% 3	13.7% 4	17.9% 5	21.8% 6	25.6% 7	29.1% 8	32.5% 9	35.8% 10	38.9% 15	52.2% 20	62.6% 25	70.8% 30	77.1% 35	82.1% 40	86.0% 50	91.5% 75	97.5% 100	99.3% 300	99.9%
Read 4 tweets
Sep 10
Let's say you're a dairy farmer. You have 100 cows. Each year, about 5 cows die, and another 5 cows are born. Then, along comes a virus. Let's call it "cowvid"...
1/
Let's say "cowvid" wipes out about half the cows over the course of a couple years. Now, you're down to 50 cows....
2/
The local mayor declares "cowvid" to be over. This surprises you as a farmer because 5 of your cows keep dying annually. 5 of 50 instead of 5 out of 100. Seems like more, but you're not a city slicker...
3/
Read 12 tweets
Sep 7
#DuringCOVID is today.

Image pack 1 of 9 🧵 Graph of the 11 waves of the pandemic in the U.S., tailored to a key message noted in the post.
1 million New Daily Infections.

Today!

Image pack 2 of 9 🧵 Graph of the 11 waves of the pandemic in the U.S., tailored to a key message noted in the post.
Where are the free vaccines, N95s, and tests?

Image pack 3 of 9 🧵 Graph of the 11 waves of the pandemic in the U.S., tailored to a key message noted in the post.
Read 9 tweets
Sep 3
PMC Dashboard Update (U.S.) 🧵1 of 8

The 11th wave is still rising.
🔥23 states/territories High/Very High
🔥Very High: Alabama, DC, Guam, Hawai'i, Louisiana, Nebraska, Nevada, South Carolina, Texas, Utah
🔥1 in 56 estimated actively infectious
🔥876,000 new daily infections CDC heat map, very high states noted in post. PMC estimate of 1 in 56 actively infectious nationwide
PMC Dashboard Update (U.S.) 🧵2 of 8

Note that the CDC has modified 📉 how transmission levels correspond to the categorical bins.

Take California. We estimate 1 in 30 actively infectious statewide. This would have previously been "Very High," now just "High."
#NewNormal CDC heatmap, with PMC estimate of 1 in 30
PMC Dashboard Update (U.S.) 🧵3 of 8

Here are the prevalence estimates for the first half of states/territories.

Notice how high the levels are in some of the "Moderate" states. State	CDC Level Alabama	Very High Alaska	High Arizona	High Arkansas	Moderate California	High Colorado	Moderate Connecticut	High Delaware	High District of Columbia	Very High Florida	High Georgia	Moderate Guam	Very High Hawaii	Very High Idaho	High Illinois	Very Low Indiana	Moderate* Iowa	Low Kansas	Low Kentucky	High Louisiana	Very High Maine	Low Maryland	Moderate Massachusetts	Moderate Michigan	Very Low Minnesota	Moderate Mississippi	High*
Read 9 tweets
Aug 21
During times like these when COVlD transmission heats up in the U.S., expect to see a lot more angry outbursts for three central reasons.

First, "displacement," or people trying to deny the reality of their anxiety by taking it out on other people....
Second, a lot of people can sustain a strong denial of reality about the ongoing pandemic during lulls. They suppress the existence of COVlD waves and excess deaths, disability, and retirements.

During waves, those defenses burst. Loss of control = anger...
Third, a lot of people (many reading this) understand COVlD correctly & experience righteous indignation during COVlD waves. We quite reasonably do not like all of the unjust and gratuitous suffering.

I find it helpful to channel that intensity into helping other people....
Read 6 tweets
Aug 19
I submitted my comment to endorse universal high-quality masks (respirators) in healthcare. Today is the final day.

Alt text continues in the following posts. RE: Z94.4, Selection, use, and care of respirators (New Edition)  Dear Colleagues,  As the director of a population science program at a major U.S. cancer center, I strongly endorse this draft proposal to increase the use of high-quality well-fitting masks (respirators) in medical settings. I will comment on the relevance of this proposal mainly for cancer care. In the U.S., cancer care is commonly more organized than other specialty care and, thus, often leads the way on policy initiatives, which then translate to other elements of care over time.  1. COVID-19 continues to cause excess dea...
They put forth projections, with the most granular detail for the U.S. and U.K., suggesting excess deaths will persist through at least 2033. Their projections do not show excess deaths stopping in 2033; that is simply the final year of their current analysis. Moreover, while they provide the most data for the U.S. and U.K., their analysis suggests a more general trend throughout the globe. The COVID-19-associated excess deaths are commonly identified as cardiovascular and cancer causes of death.   Swiss Re Institute. (2024). The future of excess mortality after COVID-19. https://www.swissr...
Alt text continued 2. The SARS-CoV-2 virus that causes COVID-19 continues to transmit at high rates worldwide. Overall, 28 nations continue to use wastewater surveillance to monitor SARS-CoV-2 levels. A directory is available at the dashboard that I oversee (pmc19.com/data). In the U.S., we are currently experiencing our 11th wave of transmission. Many nations are experiencing annual or twice annual waves of transmission.
Alt text continued 3. International consensus standards identify a broad range of patients at known high-risk of severe outcomes of COVID-19. The largest group at known high risk of severe outcomes is patients with cancer. Other diagnoses associated with above average risk include people undergoing transplants or receiving dialysis, and patients with any of these diagnoses: immunodeficiencies, renal disease, systemic-immune mediated or single-site immune-mediated inflammatory conditions, asplenia, anatomical barrier defects, pregnancy, and diabetes. These findings underscore the importance of standards in hea...
Read 7 tweets

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