Mike Hoerger, PhD MSCR MBA Profile picture
Aug 27, 2024 8 tweets 5 min read Read on X
PMC COVID-19 Forecasting Model, August 26, 2024
🧵1/8

We're in uncharted territory during the back-to-school period.

1.2 million people in the U.S. are getting infected per day.

1 in 41 people (2.5%) are actively infectious.Figure shows the 9 waves of the pandemic and the figures cited in-Tweet.
PMC COVID-19 Forecasting Model, August 26, 2024
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The year-over-year graphs shows that we are experiencing much high transmission than during previous back-to-school periods.

This is a much higher and wider wave than Y1, Y2, and Y4 of the pandemic. Year 3's summer wave was very bad, but much earlier.

The 1-day isolation period, decline in most other mitigation, and a culture of denialism ("post pandemic," "Covid is over,") will fuel many infections among young people, teachers, school staff, and parents.

Expect absences at schools. Expect substantial workforce problems related to sick parents.Graph shows year-over-year transmission, emphasizes the current wave is much higher and wider than in prior Augusts.
PMC COVID-19 Forecasting Model, August 26, 2024
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Here's a zoomed in version of current transmission and the forecast.

Notice that transmission will likely remain >1 million infections per day for the next month and counting.

Note that the national peak appears just behind us. The CDC graphs may suggest that we're currently peaking, but note their data are >1 week old. The forecast provides an updated best estimate for today. The peak and shape of the observed wave could change as CDC and Biobot retroactively correct numbers (perhaps a bigger, earlier spike). Alternatively, Biobot has been slow to update their data, and their data were suggesting a later peak. However, I suspect the current picture won't change terrible much in hindsight.

We're seeking a less spiky, more plateau-like peak because there is substantial regional variation. The West and South regions have extremely high transmission and have likely peaked. The Midwest and Northeast are lower but rising.

Keep an eye on regional or local data, and overall remember that local peaks could occur weeks before or after the national peak. Also, 50-60% of transmission commonly occurs on the back end of waves.Graphs shows the most recent year of transmission and 1-month forecast. Daily infections surpassed 1 million around July 1 and are expected to continue beyond the next month.
PMC COVID-19 Forecasting Model, August 26, 2024
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These statistics document the public health burden of the ongoing pandemic. Examples:

🔹Higher transmission than 86% of the pandemic
🔹34 million infections the next month
🔹>50% chance of a Covid exposure in a class of 30Current Levels for Aug 26, 2024 % of the Population Infectious 2.5% (1 in 41) New Daily Infections 1,173,000  New Weekly Infections 8,211,000  Resulting Weekly Long COVID Cases 411,000 to 1,642,000  Monthly Forecast Average % of the Population Infectious 2.4% (1 in 42) Average New Daily Infections 1,148,067 New Infections During the Next Month 34,442,000 Resulting Monthly Long COVID Cases 1,722,000 to 6,888,000  Running Totals Infections Nationwide in 2024 180,090,000 Average Number of Infections Per Person All-Time, U.S. 3.32  How does risk increase with more social contacts? Number of peo...
PMC COVID-19 Forecasting Model, August 26, 2024
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This is the current heat map for the U.S. The data are from the most recent CDC update.

ALT text includes estimates of the percentage actively infectious in each of the deep red states.Color-coded U.S. map of current Covid transmission. Here are the estimates of the percentage infectious in the "worst" states.  State	Percent Infectious Oregon	7.8% (1 in 13) Minnesota	5.2% (1 in 19) Washington, D.C.	5.2% (1 in 19) Arkansas	5.2% (1 in 19) Idaho	4.9% (1 in 21) New Hampshire	4.8% (1 in 21) North Carolina	4.5% (1 in 22) Washington (state)	4.4% (1 in 23) Alabama	4.2% (1 in 24) Colorado	4.1% (1 in 24) California	4.1% (1 in 24) Maryland	4.0% (1 in 25) Wyoming	4.0% (1 in 25) Louisiana	4.0% (1 in 25) Utah	3.9% (1 in 26) Kansas	3.6% (1 in 27)
PMC COVID-19 Forecasting Model, August 26, 2024
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These are estimates of the percentage of each region of the U.S. that is actively infectious with Covid.

For example, while about 2.5% of the U.S. is actively infectious, the figures are higher in the South and West regions, and lower in the Midwest and Northeast (though catching up).

The estimates on the left re-weight the CDC data by combining Biobot and CDC data and carry forward to the current date using modeling, even though the public data always have a reporting lag.

The values on the right are purely derived from the most recent data reported on the CDC website (>1 week old). Anyone can compute these. Find the current CDC level, and multiply it by the PMC Multiplier. Example in next Tweet.

In either case, you'll note the estimates are similar. Feel free to report either or a range.Figure and table showing regional variation in transmission. PMC estimates:  National	2.5% (1 in 41) Northeast	2.0% (1 in 51) Midwest	1.9% (1 in 52) South	2.9% (1 in 35) West	3.5% (1 in 29)
PMC COVID-19 Forecasting Model, August 26, 2024
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>5% of people in Oregon, DC, Minnesota, and Arkansas are estimated to have infectious Covid. 12 other states are close behind.

You can take the CDC levels for a geographic entity and multiple it by the PMC Multiplier to get an estimate of the percentage of the population infectious in that region.

Here are the states with the highest transmission, acknowledging the most recent CDC data are >1 week old.

Just take the CDC level and multiply by 0.329, e.g., 23.82 x 0.329 = 7.8, meaning 7.8% are infectious. Take 100/7.8 to get the 1 in ____ infectious number.

Note, these are point estimates. Assume broader confidence intervals when focusing on smaller geographic units, especially if they have fewer sites reporting. These should serve heuristic value in local conversations, particularly in states that are experiencing very high transmission.PMC Multiplier 0.329  State	CDC Level	Percent Infectious	Sites Reporting Oregon	23.82	7.8% (1 in 13)	28 Minnesota	15.95	5.2% (1 in 19)	33 Washington, D.C.	15.68	5.2% (1 in 19)	1 Arkansas	15.66	5.2% (1 in 19)	8 Idaho	14.76	4.9% (1 in 21)	3 New Hampshire	14.63	4.8% (1 in 21)	11 North Carolina	13.64	4.5% (1 in 22)	33 Washington (state)	13.23	4.4% (1 in 23)	29 Alabama	12.86	4.2% (1 in 24)	7 Colorado	12.52	4.1% (1 in 24)	23 California	12.43	4.1% (1 in 24)	42 Maryland	12.19	4.0% (1 in 25)	10 Wyoming	12.16	4.0% (1 in 25)	2 Louisiana	12.02	4.0% (1 in 25)	50 Utah	11.78	3.9% (1 in 26)	33 Kansas	11.08...
PMC COVID-19 Forecasting Model, August 26, 2024
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The full PMC Dashboard documents the ongoing toll of the COVID-19 pandemic. Please screenshot, improve, and share any of this work across platforms. #MaskUp

Reports/Methods: pmc19.com/data/Full PMC dashboard, six sections, summarized in tweets 1-6 and alt text.

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More from @michael_hoerger

Sep 16
PMC COVlD Report, Sep 15, 2025 (U.S.)
🧵1/7

COVlD-19 levels are "Very High" or "High" in the majority of states, per the CDC.

This includes 27 states & D.C.

🔥🔥Very High:
Alaska, Hawai'i, California, Nevada, Idaho, Utah, S. Dakota, Nebraska, Texas, Louisiana, Indiana, Kentucky, Tennessee, Florida, S. Carolina, N. Carolina, D.C., Maryland, and Connecticut.

🔥High:
Washington state, Oregon, Montana, probably N. Dakota (imputed), Arkansas, Alabama, Virginia, Delaware, Rhode Island, and Massachusetts.

PMC estimates 1 in 38 people (2.7%) are actively infectious. Wastewater-derived case estimates suggest 1.3 million new daily infections.Heat map using CDC levels. Key findings summarized in the post.
PMC COVlD Report, Sep 15, 2025 (U.S.)
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Transmission is peaking nationally, but regional variation is common. Know what's happening in your state, and get the word out.

Note that the levels CDC calls "low" are still quite alarming.State | CDC Level | PMC Estimate, % Actively Infectious Alabama	High	1 in 30 (3.4%) Alaska	Very High	1 in 22 (4.6%) Arizona	Moderate	1 in 40 (2.5%) Arkansas	High	1 in 28 (3.6%) California	Very High	1 in 21 (4.8%) Colorado	Moderate	1 in 50 (2.0%) Connecticut	Very High	1 in 19 (5.3%) Delaware	High	1 in 33 (3.0%) District of Columbia	Very High	1 in 17 (6.0%) Florida	Very High	1 in 24 (4.2%) Georgia	Moderate	1 in 46 (2.2%) Guam	Low	1 in 64 (1.6%) Hawaii	Very High	1 in 26 (3.8%) Idaho	Very High	1 in 14 (7.3%) Illinois	Moderate	1 in 44 (2.3%) Indiana	Very High	1 in 16 (6.1%) Iowa	Moderate	1 in 40...
PMC COVlD Report, Sep 15, 2025 (U.S.)
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Note that transmission is increasingly spreading from the South & West toward other areas. Know your state-level risk.

Transmission remains alarming even in areas CDC labels "Very Low" (e.g., Missouri, estimated 1 in 109). State | CDC Level | PMC Estimate, % Actively Infectious Missouri	Very Low	1 in 109 (0.9%) Montana	High	1 in 36 (2.8%) Nebraska	Very High	1 in 18 (5.5%) Nevada	Very High	1 in 17 (5.9%) New Hampshire	Low	1 in 64 (1.6%) New Jersey	Moderate	1 in 56 (1.8%) New Mexico	Very Low	1 in 106 (0.9%) New York	Low	1 in 73 (1.4%) North Carolina	Very High	1 in 17 (5.8%) North Dakota	High*	1 in 32 (3.2%) Ohio	Moderate	1 in 47 (2.1%) Oklahoma	Moderate*	1 in 44 (2.3%) Oregon	High	1 in 31 (3.2%) Pennsylvania	Moderate	1 in 44 (2.3%) Rhode Island	High	1 in 30 (3.3%) South Carolina	Very High	1 in 15 (6.6%) South D...
Read 7 tweets
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

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