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
🧵2/8
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
🧵3/8
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
🧵4/8

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
🧵5/8

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
🧵6/8

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
🧵7/8

>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
🧵8/8

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

Nov 3
PMC COVlD Update, Nov 3, 2025 (U.S.)
1 of 9 🧵

The relative "lull" in SARS-CoV-2 transmission is unlikely to go much lower.

✨1 in 209 people are estimated actively infectious, likely the lowest levels of 2025 nationwide.

Get boosted. Stock up on masks, tests, & filters. Year-over-year graph
PMC COVlD Update, Nov 3, 2025 (U.S.)
2 of 9 🧵

No data presently suggest the rise of a winter wave any earlier than "usual."

If following historical trends, transmission will pick up Nov 15-29. Last year's rise was atypically late. Forecasted transmission
PMC COVlD Update, Nov 3, 2025 (U.S.)
3 of 9 🧵

Expect rising misinformation/disinformation as transmission heats up:
🔹Abuse of community notes, particularly surrounding wastewater methodology
🔹Paid bot army attacks, especially about boosters & masks
Read 9 tweets
Oct 28
PMC COVlD Update, Oct 27, 2025 (US)

Transmission typically accelerates in mid-November.

We are currently in a relative 'lull.' We estimate about a quarter-million new daily infections with 1 in 185 people actively infectious. Still bad, likely to get worse.

1/9 🧵 year over year graph
PMC COVlD Update, Oct 27, 2025 (US)

Our forecast through November 8 calls for flat transmission.

Nothing yet indicates the onset of a winter wave, but it would also be atypical for the lull to last much longer than another 2-3 weeks.

2/9 🧵 Graph of recent transmission and current forecast
PMC COVlD Update, Oct 27, 2025 (US)

We estimate 264,000 new daily infections during this 'lull' period.

Biobot data have returned. Our substitute data from WWS last week correlated r=.97 (near perfect) with that, but Biobot did retroactively increase recent estimates.

3/9 🧵 Graph of the 11 waves of the pandemic
Read 9 tweets
Oct 21
PMC COVlD Update, Oct 20, 2025 (U.S.)

SARS-CoV-2 transmission has fallen.
🔹1 in 191 (0.5%) actively infectious
🔹"Lull" levels at 20% of the summer peak
🔹255,000 new daily infections (still concerning)

Many will knock out higher-risk activities the next 2-4 weeks.
🧵1/11 Graph of the 11 waves, shows current lull.
PMC COVlD Update, Oct 20, 2025 (U.S.)

"Lull" transmission remains dangerous:
🔹1.8 million estimated new weekly infections
🔹>90,000 estimated new #LongCOVID conditions from this week's infections
🔹>500 excess deaths to result from this week's infections

🧵2/11 Infections						 Proportion Actively Infectious										1 in 191 (0.5%) New Daily Infections										 255,000  Infections the Past Week										 1,800,000  Infections in 2025										 191,000,000  Cumulative Infections per Person										 4.69  										 Long COVID										 Long COVID Cases Resulting								13,000 to 51,000		   from New Daily Infections										 Long COVID Cases Resulting								90,000 to 360,000		   from New Weekly Infections										 										 Excess Deaths										 Excess Deaths Resulting 									70 to 120	   from New Daily Infections										 Excess Deaths ...
PMC COVlD Update, Oct 20, 2025 (U.S.)

Exposure risk during "lull" transmission remains high when engaging in many social interactions.

Interacting with 25 people yields a 12% chance of exposure. 100 people? 41% chance of exposure, assuming no testing/isolation.

🧵3/11 Number of People		Chances Anyone is Infectious		 1				0.5% 2				1.0% 3				1.6% 4				2.1% 5				2.6% 10				5.1% 15				7.6% 20				10.0% 25				12.3% 30				14.5% 50				23.1% 75				32.5% 100				40.8% 200				64.9% 300				79.2%
Read 11 tweets
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

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