Mike Hoerger, PhD MSCR MBA Profile picture
Aug 24, 2024 1 tweets 1 min read Read on X
As a psychologist, I recommend reflecting each day on something that made you proud, no matter how simple. Then, ground it in the context of the pandemic.

For example:
"Today, I did _________, during the 9th wave of a pandemic that's infecting >1mil Americans/day."

The raging pandemic makes everything harder, especially amid rampant denialism. Perhaps you kept your kids safe, cleaned the house, were patient with someone, or went out of your way to help someone.

Acknowledging the small accomplishments can help maintain a sense of drive, build character, and avoid falling into denialism.

I think many people were better at this habit during the 1st year of the pandemic, when society was more aware and supportive. It remains important for persisting.

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More from @michael_hoerger

Oct 11
PMC COVlD Wave Update (Europe)
11 October 2025 🧵

The PMC website includes an international directory of websites with COVlD wastewater monitoring. It is more up to date than the directories of the EU and WHO.

Let's review what's happening in Europe...

1/ world map, nations with surveillance shown in blue. URL says pmc19.com/global
Data in #Austria show a rising COVlD wave. The x axis (bottom) has infrequent labels, but the data shown go through October 8th.

Find more here:

2/ pmc19.com/austrialongitudinal graph
COVlD levels have been percolating in #Belgium, with "moderate" levels overall.

The transmission pattern is similar across regions. Plants at Namur-Brumagne and Oostende report "high" levels.



3/ pmc19.com/belgiumheat map and longitudinal graph
Read 20 tweets
Oct 5
PMC COVlD Update, Week of Oct 6, 2025 (U.S.)
🧵1/9

An estimated 1 in 81 people are actively infectious during the ongoing 11th wave.

The "shutdown" has created a blackout at the state level.

Transmission is half that of the peak one month ago, and we anticipate a relative national "lull" in early-to-mid November, albeit still at dangerous levels.

Our model uses a combination of CDC and Biobot data, so we are able to estimate national statistics despite the CDC data going offline. On the map, note that Puerto Rico continues to update; they use a CDC-style system but were dropped by the CDC long ago. For full methodology, review the technical appendix on the website.Heat map, grayed out. 1 in 81 estimated actively infectious, or 602,000 new daily infections, per wastewater-derived estimates.
PMC COVlD Update, Week of Oct 6, 2025 (U.S.)
🧵2/9

#DuringCOVID is today. We estimate >600,000 new daily infections. This is about half the peak on September 6.

Notice current levels are similar to the estimated peaks of the first 3 waves. 11 wave graph
PMC COVlD Update, Week of Oct 6, 2025 (U.S.)
🧵3/9

Weekly estimates:
🔹4.5 million infections
🔹>200,000 resulting long-term health conditions
🔹>1,300 resulting excess deaths Infections						Oct 6, 2025				pmc19.com/data Proportion Actively Infectious										1 in 81 (1.2%) New Daily Infections										 602,000  Infections the Past Week										 4,540,000  Infections in 2025										 189,000,000  Cumulative Infections per Person										 4.69  										 Long COVID										 Long COVID Cases Resulting								30,000 to 120,000		   from New Daily Infections										 Long COVID Cases Resulting								227,000 to 910,000		   from New Weekly Infections										 										 Excess Deaths										 Excess Deaths Resulting 									170 to 280	   from New Daily Infe...
Read 9 tweets
Oct 3
BREAKING: 3 State Pharmacy Boards Still Block COVlD Boosters without a Prescription

ACIP voted against prescriptions for boosters & 47 states + DC follow that guidance.

Georgia, Missouri, & Louisiana require prescriptions.

Key points in my letter to the pharmacy boards. 🧵1/7 Map shows only Missouri, Louisiana, and Georgia are blocking residents from routing COVlD boosters unless they have a prescription.
Georgia law indicates that the pharmacy board is to follow ACIP. They do not dictate further nuance. Georgia continues to require prescriptions, going against the spirit of the law, ACIP, and 47 other states.

🧵2/7 Georgia:  State law does NOT require a prescription if it is a “vaccine that is included on the adult immunization schedule recommended by the Advisory Committee on Immunization Practices (ACIP)”1 ACIP voted against prescriptions, and 47 states have accepted that schedule.  The law does not mention a CDC Director sign-off, which may be delayed months. Act now to save lives.  1. https://law.justia.com/codes/georgia/title-43/chapter-34/article-2/section-43-34-26-1/
Louisiana law tells the pharmacy board to follow ACIP. ACIP says do not require a prescription, and 47 other states agree.

The Louisiana pharmacy board continues to require a prescription.

🧵3/7 Louisiana:  State law does NOT require a prescription if the “vaccine is administered in conformance with the most current immunization administration protocol as set forth by the United States Centers for Disease Control and Prevention Advisory Committee on Immunization Practice.” 2 ACIP voted against prescriptions, and 47 states have accepted that protocol.  The law does not mention a CDC Director sign-off, which may be delayed months. Act now to save lives.  2. https://law.justia.com/codes/louisiana/revised-statutes/title-37/rs-37-1218-1/
Read 7 tweets
Oct 1
I remember when they said kids don't transmit COVlD much because they are short, small, and have tiny lungs. They lied.
I remember when they said COVlD doesn't transmit in schools. They lied.
I remember when they said COVlD is mild in kids without understanding post-acute sequelae. They lied.
Read 25 tweets
Sep 30
PMC COVlD Update, Sep 29, 2025 (U.S.)

Summary: COVlD is everywhere.

On the back end of this unprecedented 11th wave, "times they are a-changin." In particular, COVlD levels are shifting north and east.

Notice that few states are in the highest and lowest categories. Much of the south and west have considerable transmission post-peak. Many places in the north and east are seeing steady or increasing transmission after relatively lower levels.

Overall, levels are lower than the past few weeks, but transmission remains considerable. Those relying on anecdata (friends, coworkers, and family infected) may increasingly realize we are in a wave.

We estimate nearly 750,000 new daily infections nationwide, meaning approximately 1 in 66 people or 1.5% are actively infectious.

These estimates are derived by linking wastewater levels to IHME true case estimates using methodology commonly employed worldwide, detailed on the website, noted in a pre-print. Many publications in leading medical journals link wastewater data to key metrics that matter, noted in the online technical appendix.

In this week's report, we note adding North Dakota and Puerto Rico to the heat map in support of health equity. We have been imputing ND levels since the launch of PMC 3.0 using data from neighboring states. PR continues to report qualitative levels using the CDC format but is not longer included on the CDC website.

1/8 🧵heat map based on CDC data, and PMC case estimates
PMC COVlD Update, Sep 29, 2025 (U.S.)

State-level prevalence estimates, AL to MS. The levels use CDC labels, which tend to have an optimistic portrayal of risk. For example, CO is listed at "low" (by our estimate 1.5% infectious).

#MaskUp at 1.5% if having lapsed.

2/8 🧵 Alabama	High	1 in 33 (3.0%) Alaska	Low	1 in 69 (1.5%) Arizona	Moderate*	1 in 42 (2.4%) Arkansas	High	1 in 38 (2.7%) California	High	1 in 36 (2.8%) Colorado	Low	1 in 69 (1.5%) Connecticut	Very High	1 in 18 (5.6%) Delaware	Very High	1 in 24 (4.1%) District of Columbia	Low	1 in 81 (1.2%) Florida	Low	1 in 62 (1.6%) Georgia	Low	1 in 101 (1.0%) Guam	Very Low	1 in 130 (0.8%) Hawaii	Moderate	1 in 53 (1.9%) Idaho	Low	1 in 62 (1.6%) Illinois	Moderate	1 in 60 (1.7%) Indiana	High	1 in 27 (3.8%) Iowa	Moderate	1 in 58 (1.7%) Kansas	Low	1 in 78 (1.3%) Kentucky	Moderate	1 in 39 (2.6%) Louisiana	High	1 in 3...
PMC COVlD Update, Sep 29, 2025 (U.S.)

State-level prevalence estimates, Missouri to Wyoming.

New York had *huge* retroactive upward corrections, and is now "High," as many residents hypothesized.

Note, Puerto Rico only provides CDC qualitative levels, so no data.

3/8 🧵 Missouri	Very Low	1 in 156 (0.6%) Montana	High	1 in 37 (2.7%) Nebraska	High	1 in 27 (3.8%) Nevada	Very High	1 in 15 (6.6%) New Hampshire	Moderate	1 in 59 (1.7%) New Jersey	Low	1 in 82 (1.2%) New Mexico	Low	1 in 102 (1.0%) New York	High	1 in 35 (2.8%) North Carolina	High	1 in 35 (2.9%) North Dakota	High*	1 in 34 (3.0%) Ohio	Moderate	1 in 58 (1.7%) Oklahoma	Low*	1 in 81 (1.2%) Oregon	High	1 in 32 (3.1%) Pennsylvania	Low	1 in 61 (1.6%) Rhode Island	High	1 in 33 (3.1%) South Carolina	Moderate	1 in 40 (2.5%) South Dakota	High	1 in 28 (3.5%) Tennessee	Low	1 in 75 (1.3%) Texas	Moderate	1 in 48 (2....
Read 8 tweets
Sep 27
BREAKING: COVlD transmission surges across the Northeast amid 11th wave.

CDC levels & PMC prevalence estimates:
🔹CT: Very High (1 in 18 people actively infectious)
🔹RI: High (1 in 33)
🔹NY: High (1 in 35)
🔹MA: High (1 in 37)

Quick thread 🧵 1/7 Heat map from CDC data with PMC prevalence estimates noted in post
#NewYork has "High" transmission statewide & many counties are seeing "Very High" transmission, per CDC.

PMC estimates 1 in 35 people are actively infectious statewide.

A lot of sites are offline, but notice the overall coverage remains strong. Bad picture statewide.
🧵 2/7 Heat map with prevalence estimate, noted in post
In #Connecticut, we estimate 1 in 18 people are actively infectious. The CDC indicates "Very High" levels.

Statewide coverage is good. Assume it's very high risk everywhere.
🧵 3/7 Heat map and pmc estimate
Read 7 tweets

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