We've headed from a false summit toward a larger peak in back-to-school transmission. Next week we'll know whether this is the largest or 2nd largest summer wave all-time. Expect 1.4-1.5 million daily infections at the peak.
This secondary peak is larger than anticipated previously, even when accounting for patterns of back-to-school transmission in prior years.
One, the West and South were peaking earlier, and the Northeast and Midwest have transmission picking up much faster than its falling off elsewhere. These are atypical regional differences.
Two, the 1-day isolation policy and general decline in school-based mitigation have unleashed transmission at higher levels than would be anticipated in prior years, even when accounting for the already-high levels of transmission as children went back to school.
Three, our model uses a combination of CDC and Biobot (former CDC contractor) data, using a 60% versus 40% mix for current case estimation. Biobot has not updated their data the prior two weeks without explanation. They were running much cooler than the CDC data, whether reflective of reality, or merely reporting delays. We have downgraded them to 20% in the model, and they will be downgraded further to 0% if they do not update their data this week.
You can take points 1 and 2 to account for the secondary and higher peak (shape of transmission), when models accounting for prior years would have suggested transmission slowing already, and point 3 accounting for a shift toward a slightly higher overall estimate of transmission.
PMC COVID-19 Forecasting Model, Sept 2, 2024
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This graph shows year-over-year transmission. It clarifies the unusual shape of the transmission distribution. A "peak" or false summit, followed by a very slight decline in transmission (negligible), then a 2nd (true) peak.
PMC COVID-19 Forecasting Model, Sept 2, 2024
🧵3/8
Presently, we estimate a peak at 1.4 million daily infections. Next week, we will have a much better sense. It could be in the 1.3-1.5 million range. There's about a 50% chance it will be the largest summer wave.
PMC COVID-19 Forecasting Model, Sept 2, 2024
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Happy Labor Day!
We're seeing higher transmission than during 91.6% of the pandemic, so COVID is very much not "over." In a gathering of 10 people of average risk, there would be a 1 in 4 chance someone has COVID if no special rules (testing, isolating, etc.).
Some schools still have not started yet and will begin tomorrow. Classrooms should presume someone has COVID. Mask, test, isolate until repeatedly negative.
PMC COVID-19 Forecasting Model, Sept 2, 2024
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Here's the heat map of transmission. You'll see a lack of a clear pattern because the South/West are slowing and the Midwest/Northeast are picking up.
Nationally, we see 1 in 35 people are actively infectious. The South is the highest with about 1 in 30 actively infectious.
PMC COVID-19 Forecasting Model, Sept 2, 2024
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Michigan (yellow line) has atypically low transmission. Happy to hear theories on this.
They have typically had unusual patterns of transmission. Perhaps the extended precautions during the 1st two years of the pandemic play some ongoing role.
About 0.9% are actively infectious in MI, about 1/3 the national average.
PMC COVID-19 Forecasting Model, Sept 2, 2024
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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/
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/
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/
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
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
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.
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
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
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
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.
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