Mike Hoerger, PhD MSCR MBA Profile picture
Sep 10, 2024 7 tweets 4 min read Read on X
PMC COVID-19 Forecasting Model, Sept 9, 2024
🧵1/7

Nationally, we appear to have passed the peak of our late-summer wave, and it's not pretty.

At peak:
🔹>1.3 million daily infections
🔹2.8% (1 in 36) actively infectious
🔹Transmission higher than 90.5% of the pandemic

We are showing a peak around Aug 10, but as you look closely at the graph and in later Tweets, you'll see it was bimodal, with near-identical transmission on Aug 10 and Aug 24.

The CDC consistently corrects historical data, so in hindsight, we might expect the official peak date to flip to the 24th, or for the stats on the 10th to jump higher.

We had expected that Friday's data release might show this was the largest summer peak all-time (by the slimmest of margins), but the prior week's data were retroactively corrected downward by about 5%.

This is a common occurrence, which is why it's important to focus on the big-picture forecast (very bad transmission the remainder of 2024) as opposed to minute details.

Let's walk through the details in this Thread....Figure shows the 9 waves of the U.S. COVID-19 pandemic. We are in the 5th-largest wave, and the 2nd largest summer wave. The statistics in the Tweet summarize the peak of the current wave.
PMC COVID-19 Forecasting Model, Sept 9, 2024
🧵2/7

The current year-over-year graph on Covid transmission is troubling. We just had the worst August of Covid transmission in the U.S.

We are likely to have our worst September, worst October, and potentially worst November of transmission.

We expect to bottom out around 850,000 daily infections in early November, before the winter surge picks up.

These new monthly records for Covid transmission are the consequence of #LaissezFairePublicHealth, especially the 1-day isolation policy, but more generally that public health officials are not describing transmission frankly and the need for multi-layered mitigation.Graph of year-over-year transmission. The current surge appears to have peaked, just under the daily peak of the 2022 summer wave, and is setting the stage for four months of monthly records in transmission, based on year-over-year monthly comparisons.
PMC COVID-19 Forecasting Model, Sept 9, 2024
🧵3/7

Zooming in, see the forest for the trees: About 74 days in a row with 1 million daily infections.

The peak date is somewhat arbitrary, and either Aug 10 or 24 may be estimated the peak in hindsight.Graph shows the prior year of transmission and 1-month forecast. Daily infections will remain >1 million for nearly another month, and are projected to reach 74 days in total.   Once below 1 million, only expect daily infections to get down to about 850,000/day in early November, then get much worse.
PMC COVID-19 Forecasting Model, Sept 9, 2024
🧵4/7

Statistics to reinforce the significance of the ongoing pandemic:
🔹1.1 million daily infections on average the next month
🔹2.2% (1 in 45) actively infectious any given day of the next month
🔹High-risk in classroom-sized settings
🔹>1.5 million resulting Long COVID cases from infections derived during the next monthCurrent Levels for Sep 9, 2024 % of the Population Infectious 2.4% (1 in 41) New Daily Infections 1,157,000  New Weekly Infections 8,099,000  Resulting Weekly Long COVID Cases 405,000 to 1,620,000  Monthly Forecast Average % of the Population Infectious 2.2% (1 in 45) Average New Daily Infections 1,061,933 New Infections During the Next Month 31,858,000 Resulting Monthly Long COVID Cases 1,593,000 to 6,372,000  Running Totals Infections Nationwide in 2024 199,788,000 Average Number of Infections Per Person All-Time, U.S. 3.38  How Does Risk Increase with More Social Contacts? Number of peop...
PMC COVID-19 Forecasting Model, Sept 9, 2024
🧵5/7

This is the current heat map for Covid transmission. We released this Friday, given the ongoing debate about the CDC coloring their map in cool blue using the same data.

PMC COVID-19 Forecasting Model, Sept 9, 2024
🧵6/7

Here are regional estimates of transmission. Note that you can estimate the percent of your state actively infectious by looking up the CDC Level on their website and multiplying it by 0.330.

These are approximate estimates and higher quality in states with more and longer-standing wastewater sites.

Go here, select a state from the drop-down:


For example, in Louisiana the most recently-reported CDC Level is 8.31.

8.31 * 0.330 = 2.74, signifying that 2.74% of the state is estimated to be actively infectious with Covid.

Take 100 divided by that number to get the "1 in ____" statistic. For example, 100/2.74 = 36.45, signifying that 1 in 36 people in Louisiana are estimated to be actively infectious.

Watch your decimals, and remember these formulas can't just be thrown at any random wastewater tracker.cdc.gov/nwss/rv/COVID1…Estimated Percentage Actively Infectious  PMC Model (carries forward to Sept 9) | Raw CDC Data (uses most recent data from the CDC website on Aug 31)  National	2.4% (1 in 41)		2.6% (1 in 39) Northeast	1.7% (1 in 57)		1.8% (1 in 54) Midwest	2.7% (1 in 38)		2.8% (1 in 35) South	2.6% (1 in 38)		2.8% (1 in 36) West	2.9% (1 in 35)		3.0% (1 in 33)
PMC COVID-19 Forecasting Model, Sept 9, 2024
🧵7/7

Here's the complete dashboard. Use, crop, improve, and share as desired across other platforms and the web. Tag me if helpful.

Read the full report and technical appendix online:
pmc19.com/dataDashboard had six areas, summarized in each of the preceding Tweets

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More from @michael_hoerger

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
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

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