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
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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
🧵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
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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

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
Jan 17
Based on today's CDC & Biobot data, we estimate the following for the week of Jan 19:

🔸1 in 52 people in the U.S. actively infectious
🔸25% chance of exposure in a room of 15 ppl
🔸Nearly 1 million new daily infections
🔸5 cumulative infections per person all-time (avg)
🧵1/5 Heat map from CDC data with PMC estimates. Description of "Very High" states in next post
Transmission estimates have been marginally corrected upward.

11 states have Very High COVlD levels:

🔸PA: 1 in 25 estimated actively infectious
🔸MI: 1 in 23
🔸OH & KY: 1 in 22
🔸SD: 1 in 20
🔸NE & IA: 1 in 18
🔸IL & ME: 1 in 17
🔸IN: 1 in 16
🔸WV: 1 in 11
🧵2/5 Proportion Actively Infectious										1 in 52 (1.9%) New Daily Infections										 941,000  Infections the Past Week										 6,020,000  Infections in 2026										 18,000,000  Cumulative Infections per Person										 5.01  										 Long COVID										 Long COVID Cases Resulting								47,000 to 188,000		   from New Daily Infections										 Long COVID Cases Resulting								301,000 to 1,200,000		   from New Weekly Infections										 										 Excess Deaths										 Excess Deaths Resulting 									270 to 450	   from New Daily Infections										 Excess Deaths Resulting 				...
We're in the middle of a 12th COVlD wave.

The peak has likely passed, but with students headed back to school, transmission is expected to remain high for at least the next several weeks.

🧵3/5 1) Graph of 12 waves 2) Barometer showing above-average transmission 3) Year over year graph 4) Forecast for transmission to decline and then percolate at high levels
Read 5 tweets
Jan 10
The size of the winter COVlD wave has been revised upward as post-holiday data come in.

We estimated 1 in 55 people in the U.S. are actively infectious.

🔥WV: 1 in 14
🔥IN: 1 in 15
🔥MI & OH: 1 in 21
🔥MO: 1 in 22
🔥CT: 1 in 24
🔥KS: 1 in 25
🔥MA & IL: 1 in 27

Quick 🧵 1/4 Heat map and PMC estimates, 1 in 55 infectious and 892,000 new daily infections for Jan 12.  We expedited the report to release it two days early.
Nationally, we are seeing an estimated 892,000 new daily SARS-CoV-2 infections, meaning a 1 in 4 chance of exposure in a room of 15 people. Risk varies considerably by state.

We are approaching an average of 5 infections per person since pandemic onset.
🧵 2/4 Alabama	Moderate Alaska	Very Low Arizona	Very Low Arkansas	High* California	Very Low Colorado	Low Connecticut	Very High Delaware	Moderate District of Columbia	Very Low Florida	Very Low Georgia	Very Low Guam	Very Low Hawaii	Very Low Idaho	Very Low Illinois	Very High Indiana	Very High Iowa	High Kansas	Very High Kentucky	Moderate Louisiana	Moderate Maine	High Maryland	High Massachusetts	Very High Michigan	Very High* Minnesota	Moderate Mississippi	Low* Missouri	Very High* Montana	High Nebraska	High Nevada	Very Low New Hampshire	Moderate New Jersey	Low New Mexico	Moderate New York	High* North Ca...
We are in the 12th COVlD wave of the U.S.

Current transmission is higher than 68% of all days since the pandemic onset in 2020.
🧵 3/4 12 waves of COVlD  Pandemic barometer: Higher than 88% of the past 100 days, 73% of the past year, 68% of the entire pandemic.  Year over year graph  Forecast of slowly declining transmission.
Read 4 tweets
Jan 8
You might not have heard, but the northeastern U.S. is in a COVlD surge.

We use wastewater levels to derive estimates of the proportion of people actively infectious in each state (prevalence), e.g., 1 in 24 people in Connecticut.

Let me walk you through it...

🧵1/8 Colors show CDC levels PMC prevalence estimates noted: -Maine 1 in 38 actively infectious with COVlD -New Hampshire 1 in 35 (limited data) -Vermont 1 in 75 -New York 1 in 44 (limited data) -Pennsylvania 1 in 44 -Massachusetts 1 in 36 -Connecticut 1 in 24 -Rhode Island 1 in 41 -New Jersey 1 in 82
Notice that #Connecticut has excellent SARS-CoV-2 wastewater surveillance. It's "Very High" across much of the state, per CDC.

Based on wastewater levels, we estimate 1 in 24 residents are actively infectious w/COVlD. That's a 66% exposure risk in a room of 25 people.

🧵2/8 Colors show CDC levels PMC estimate of prevalence
The CDC reports "Very High" levels in #Massachusetts.

The surveillance is less robust, but we estimate 1 in 26 residents are actively infectious, similar to our estimate in CT where coverage is better.

In a room of 25 people, that's a 62% chance of an exposure.

🧵3/8 Colors show CDC levels PMC prevalence estimates provided
Read 8 tweets
Jan 8
We're in the middle of a 12th COVlD wave in the U.S., with transmission particularly high in the Midwest and Northeast.

The CDC announced this week that COVlD continues to kill more Americans than breast and prostate cancer combined.

Get boosted & #MaskUp 💉💪😷
1/4🧵 Heat map of CDC data with PMC prevalence estimate
Levels are "Moderate" to "Very High" in 26 states.

However, data reporting is slow, and about 1/3 of states have low-quality data this week due to the holidays and illness.

2/4🧵 National estimates: Number of People		Chances Anyone is Infectious			 1				1.5%	 2				3.0%	 3				4.5%	 4				6.0%	 5				7.4%	 10				14.3%	 15				20.7%	 20				26.5%	 25				32.0%	 30				37.0%	 50				53.8%	 75				68.6%	 100				78.6%	 200				95.4%	 300				99.0%
Barometer: Higher transmission than 90 of the past 100 days (perhaps higher still, due to low data reporting quality)
State	CDC Level	Actively Infectious Alabama	Moderate	1 in 48 (2.1%) Alaska	Very Low	1 in 152 (0.7%) Arizona	Very Low	1 in 201 (0.5%) Arkansas	High*	1 in 36 (2.8%) California	Very Low	1 in 484 (0.2%) Colorado	Moderate	1 in 49 (2.0%) Connecticut	Very High	1 in 24 (4.2%) Delaware	Low*	1 in 70 (1.4%) District of Columbia	Very Low	1 in 5,835 (0.0%) Florida	Very Low	1 in 284 (0.4%) Georgia	Low	1 in 90 (1.1%) Guam	Very Low	1 in 687 (0.1%) Hawaii	Very Low	1 in 874 (0.1%) Idaho	Very Low	1 in 169 (0.6%) Illinois	Moderate*	1 in 56 (1.8%) Indiana	High*	1 in 34 (2.9%) Iowa	Moderate	1 in 41 (2.4%) Kansas...
State	CDC Level	Actively Infectious Missouri	Moderate*	1 in 42 (2.4%) Montana	High	1 in 34 (2.9%) Nebraska	Very High	1 in 26 (3.9%) Nevada	Very Low	1 in 138 (0.7%) New Hampshire	High*	1 in 35 (2.9%) New Jersey	Low	1 in 82 (1.2%) New Mexico	Low	1 in 87 (1.2%) New York	Moderate*	1 in 44 (2.3%) North Carolina	Low	1 in 82 (1.2%) North Dakota	High*	1 in 34 (3.0%) Ohio	Very High	1 in 27 (3.7%) Oklahoma	Moderate*	1 in 62 (1.6%) Oregon	Very Low	1 in 170 (0.6%) Pennsylvania	Moderate	1 in 44 (2.3%) Rhode Island	Moderate	1 in 41 (2.4%) South Carolina	Moderate	1 in 54 (1.9%) South Dakota	Very High	1 in...
If like years 1-4 of the pandemic, the winter wave has peaked. If like last year, we could hover near peak levels for a month.

Forecasting quality is low with 1/3 of states having data issues. Hopefully, we'll know a lot more in a few days.

3/4🧵 12 waves
Proportion Actively Infectious										1 in 65 (1.5%) New Daily Infections										 749,000  Infections the Past Week										 5,390,000  Infections in 2026										 3,000,000  Cumulative Infections per Person										 4.88  										 Long COVID										 Long COVID Cases Resulting								37,000 to 150,000		   from New Daily Infections										 Long COVID Cases Resulting								270,000 to 1,080,000		   from New Weekly Infections										 										 Excess Deaths										 Excess Deaths Resulting 									220 to 370	   from New Daily Infections										 Excess Deaths Resulting 					...
year over year graph
forecast
Read 4 tweets
Jan 5
We told you that 109,000-175,000 Americans would died of COVID (excess deaths) in 2025.

Today, the CDC estimates 101,000 deaths/year (flat from Oct 2022 to Sep 2024), and likely higher when considering more nebulous non-acute excess deaths (heart attack 6 months later).
1/5
The CDC estimates are actually higher than I would have guessed, given their methodology, which models estimates based on easily countable factors in healthcare and expert input on multiplier values. It lends credence to the PMC upper bound of excess deaths of 175,000/yr.
2/5
What's troubling is the CDC has annual mortality flat. My expectation based on mortality displacement and Swiss Re data is that it should be declining. If is stays flat, we're running on something like breast+prostate cancer or lung cancer deaths per year in perpetuity.
3/5
Read 6 tweets

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