Mike Hoerger, PhD MSCR MBA Profile picture
Sep 23, 2024 8 tweets 5 min read Read on X
PMC COVID-19 Forecasting Model, Sep 23, 2024
🧵 1/8

The U.S. continues to see an estimated 1.1 million daily COVID infections with 2.2% of the population actively infectious as we descend from the peak of a 9th Covid wave.

Transmission will remain very high the rest of 2024.Main PMC figure showing Covid transmission over time. It shows 9 waves. The current wave peaked in August, and we're still seeing >1 million infections/day in the U.S.
PMC COVID-19 Forecasting Model, Sep 23, 2024
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Looking at the year-over-year graph, note that we're in uncharted territory for this point in the fall. Expect a very high "lull" in early November before the winter surge sets in.

As we have noted previously, our current estimates are likely slight underestimates given elevated school-based transmission and the CDC data standardization process.

Kids: They are smaller, and make smaller "contributions" to wastewater. Basically, it takes more sick kids to produce the average amount of wastewater virus to equate to an average infection (mostly in adults). This issue evens out over time, but it means the model may underestimate during back-to-school periods.

CDC: They describe the details of their process for standardizing data over time. It's very strong, much better than what most localized wastewater orgs or WWS do. It's a bit Dunning-Kruger to question basic wastewater scientists in doing the most fundamental components of their jobs, and the data continue to correlate >.90 with other metrics like Biobot. In comparing with other data, I take their estimates as spot on, but could also see arguments that they may underestimate transmission by 0-5%. It's something we always keep an eye on. Trust, but verify.

Transmission is magnitudes higher than much of the public realizes, so we focus on the big-picture view rather than quibbling over such issues that tend to balance out over time.

I hear @jlerollblues is considering weighting a model based on estimates of the proportion of infections in children. That's actually tougher to estimate than it sounds at first glance. You should key an eye on his models too and the work he and others are doing with the WHN.Estimating a "lull" the 1st week of November, but at an alarming 850k daily infections in the U.S.
PMC COVID-19 Forecasting Model, Sep 23, 2024
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Zooming in from the big picture, here's the past year of the pandemic.

🔹1.1 million daily infections
🔹Bimodal peak (Aug 10 & 24) of 1.3 million daily infections
🔹50-60% of transmission happens on the back end of waves

Continue to educate family, friends, and co-workers. Look at how the wave descends much more gradually than is arose. Many infections to come, and to try to prevent! Also, most people are not monitoring wastewater. They keep track of the cumulative "anecdata" of people they know sick or diagnosed with Covid recently. In their mind, the peak will feel like late October, when the cumulative count has really built up. You may find people more open to listening during the next month.Annual graph. Shows transmission much higher than a year ago at 1.1 million daily infections today, but nowhere near the 1.9 million daily infections of last winter's peak.   The wave is descending slower than it rose, which is a reminder than much transmission happens on the back end of waves.
PMC COVID-19 Forecasting Model, Sep 23, 2024
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These statistics document the ongoing toll of the pandemic.

🔥Expect about 29 million infections in the U.S. over the next month if the model holds.

🔥In a classroom of 30-35 people, there's about a 50% chance at least one person is infectious if weak/no isolation policies.

🔥Transmission is higher than during 80% of the pandemic.Current Levels for Sep 23, 2024 % of the Population Infectious 2.2% (1 in 45) New Daily Infections 1,059,000  New Weekly Infections 7,413,000  Resulting Weekly Long COVID Cases 371,000 to 1,483,000  Monthly Forecast Average % of the Population Infectious 2.0% (1 in 49) Average New Daily Infections 969,467 New Infections During the Next Month 29,084,000 Resulting Monthly Long COVID Cases 1,454,000 to 5,817,000  Running Totals Infections Nationwide in 2024 214,525,000 Average Number of Infections Per Person All-Time, U.S. 3.42  How Does Risk Increase with More Social Contacts? Number of peopl...
PMC COVID-19 Forecasting Model, Sep 23, 2024
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Three states stand out.

Estimated percentage of populations actively infectious:

Oklahoma: 8.9%
Oregon: 5.3%
New Hampshire: 5.3%

Note, estimates get less precise when focusing on smaller geographic units, and sometimes high estimates are revised in hindsight.

Also, while these figures may seem high, keep in mind that as one focuses on narrower units, the peak is more targeted, so local peaks see higher percentages than state peaks, which are higher than regional peaks, which are higher than national peaks. Smaller units have more leptokurtic transmission.CDC heat map. Very high transmission across most of the U.S.
PMC COVID-19 Forecasting Model, Sep 23, 2024
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These are the present regional estimates in the U.S.

The West is coming down from a second peak this wave but still with approximately 2.8% of the region actively infectious.

The Northeast region saw atypically low transmission this wave, relative to other regions. That area may see a different pattern of transmission than the rest of the U.S. the next several months. For example, within the northeast region, the winter peak could be larger than other areas. However, expect to also see more localized units where instead of 2 big waves (late summer and winter), there is 1 big wave in late Nov / early December, or a bumpy wave in the months ahead, like the west just saw. Last winter, we often posted examples of the "weird" transmission patterns in some areas.

I'd keep a closer eye on local data if in the Northeast region.Regional graph of transmission from the CDC.  Table from PMC  Estimated Percentage Actively Infectious National	2.2% (1 in 45) Northeast	1.2% (1 in 85) Midwest	2.4% (1 in 42) South	2.2% (1 in 45) West	2.8% (1 in 36)
PMC COVID-19 Forecasting Model, Sep 23, 2024
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Come join our team! I am accepting applicants for the Health Psychology PhD program at Tulane! 🎉

I'd love to work with someone passionate about research, cancer, & Covid safety. Should have a psych/similar background. 😷🧠Tulane University - Health Psychology PhD  Seeking applicants to our PhD program who Understand and are cautious about COVID, Have a background in psychology or a closely-related undergraduate or Master’s degree program, Plan to pursue a research-intensive career spanning multiple scientific disciplines, and Have a desire to help people with serious health conditions like cancer. Learn more: HealthPsychPhD.com or mhoerger@tulane.edu  Small images of a Tulane logo, a cancer ribbon, and a VFlex N95 mask
PMC COVID-19 Forecasting Model, Sep 23, 2024
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Current state of the COVID-19 pandemic in the U.S.

🔹1.1 million daily COVID infections
🔹1 in 45 actively infectious
🔹High "lull" coming early November
🔹Winter surge to follow

Full dashboard: pmc19.com/dataDashboard has 6 sections, summarized in Tweets 1-6

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More from @michael_hoerger

Apr 7
1) PMC COVlD Dashboard, April 7, 2025 (U.S.)

🔹1 in 120 actively infectious
🔹1 in 3 chance of exposure in a room of 50
🔹2.8 million weekly infections
🔹>140,000 resulting LC cases from the week's infections
🔹>1,000 deaths resulting from the week's infections Current Levels for Apr 7, 2025	 % of the Population Infectious	 0.8% (1 in 120)	 New Daily Infections	 399000	 New Weekly Infections	 2793000	 Resulting Weekly Long COVID Cases	 140,000 to 559,000	 Resulting Weekly Excess Deaths	 1,000 to 1,700	 	 Monthly Forecast	 Average % of the Population Infectious	 1.0% (1 in 105)	 Average New Daily Infections	 455766.6667	 New Infections During the Next Month	 13673000	 Resulting Monthly Long COVID Cases	 684,000 to 2,735,000	 Resulting Monthly Excess Deaths	 4,900 to 8,100	 	 Running Totals	 Infections Nationwide in 2025	 55591000	 Average Number of...
2) Watch this video to understand how we use excess death data from one of the world's largest reinsurers to estimate how this week's infections will result in >1,000 deaths.
3) Transmission is steady or declining across much of the nation, but remains high in 11 states and DC, per the CDC.

Other sources, such as WastewaterSCAN, show a near doubling of transmission in the Northeast the past few weeks, so remain cautious.
Read 4 tweets
Mar 31
🧵1 of 5
PMC Dashboard, March 31, 2025 (U.S.)

🔹800-1,400 deaths expected to result from this week's infections (new stat, see video next Tweet)
🔹100,000+ Long Covid conditions to result from this week's infections
🔹1 in 142 actively infectious todayCurrent Levels for Mar 31, 2025	 % of the Population Infectious	 0.7% (1 in 142)	 New Daily Infections	 337000	 New Weekly Infections	 2359000	 Resulting Weekly Long COVID Cases	 118,000 to 472,000	 Resulting Weekly Excess Deaths	 800 to 1,400	 	 Monthly Forecast	 Average % of the Population Infectious	 0.8% (1 in 120)	 Average New Daily Infections	 397233.3333	 New Infections During the Next Month	 11917000	 Resulting Monthly Long COVID Cases	 596,000 to 2,383,000	 Resulting Monthly Excess Deaths	 4,300 to 7,100	 	 Running Totals	 Infections Nationwide in 2025	 52303000	 Average Number of ...
🧵2 of 5
PMC Dashboard, March 31, 2025 (U.S.)

This video explains U.S. COVID excess death statistics, which we have incorporated into the dashboard.

🧵3 of 5
PMC Dashboard, March 31, 2025 (U.S.)

The transmission forecast suggests 300-500k daily infections the next month. If the data get retroactively corrected downward, we could dip to 200k.

Check local dashboards, and time events accordingly.Forecast graph, described in post
Read 5 tweets
Mar 31
PMC Update on #ExcessDeaths

🔥109,000-175,000 people in the U.S. are expected to die as a result of COVID in 2025, based on estimates derived from Swiss Re
🔥COVID deaths expected to be on par with lung cancer in the U.S. in 2025
🔥Death data added to the dashboard
2) Full video links to learn more about COVID #ExcessDeaths in the U.S.

Dashboard page (presently featured): pmc19.com/data
Downloadable file: pmc19.com/data/deaths033…
Veed platform: veed.io/view/558039f4-…
3) The new #ExcessDeath statistics build on what we described in the 5-year pandemic anniversary video.

Watch from 12:14-20:00 to see how simplistic models underestimate COVID deaths. The Swiss Re model solves that problem. PMC extends that work.
Read 6 tweets
Mar 24
PMC Dashboard, Mar 24, 2025 (U.S.)
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🔹3 million new weekly infections in a persistent "lull" of substantial transmission
🔹1 in 107 (0.9%) of the population actively infectious
🔹1 in 3 regions in high/very high transmission (16 states and DC)Heat map of transmission, described in Tweet
PMC Dashboard, Mar 24, 2025 (U.S.)
🧵2/5

We have had a steady state of about a half million infections the past several weeks. That's over 50 million estimated infections so far in 2025.

In a room of 40-50 people, there's a 1-in-3 chance of exposure if no testing/isolation.Current Levels for Mar 24, 2025	 % of the Population Infectious	 0.9% (1 in 107)	 New Daily Infections	 446000	 New Weekly Infections	 3122000	 Resulting Weekly Long COVID Cases	 156,000 to 624,000	 	 Monthly Forecast	 Average % of the Population Infectious	 1.0% (1 in 96)	 Average New Daily Infections	 496566.6667	 New Infections During the Next Month	 14897000	 Resulting Monthly Long COVID Cases	 745,000 to 2,979,000	 	 Running Totals	 Infections Nationwide in 2025	 50757000	 Average Number of Infections	 Per Person All-Time, U.S.	 3.708526284	 	 How Does Risk Increase with More Social Co...
PMC Dashboard, Mar 24, 2025 (U.S.)
🧵3/5

There's a good chance of steady transmission the next month. Often, we'd head into a low lull about now. BUT there are no universal precautions, immunity is waning from the fall & winter 2023-24, & viral evolution looks less 'lucky.'Middle forecast shows 400-600k daily infections.
Read 5 tweets
Mar 11
1) 5-yr Anniversary of the WHO Pandemic Declaration

🔥10 waves
🔥Covid mortality rivals lung cancer
🔥8 infections/person by 2030
🔥Long Covid as catastrophic
🔥Death trajectories becoming complex
🔥"During Covid" as anti-science rhetoric
🔥Serious ppl take Covid seriously
🧵
2) Wastewater-derived estimates of case rates show international consensus 20-26% of populations got Covid during the peak 2 months of the 2023-24 winter wave in the U.S., Canada, and the U.K.
3) The ratio of reported cases versus true cases has remained consistent, demonstrating the validity of wastewater-derived estimates. True cases are 15-30x reported cases, a consistent ratio. There are no examples demonstrating low case rates.
Read 25 tweets
Feb 26
1) Mardi Gras 2020 was 5 years ago today. ⚜️

It was before the pandemic declaration, before the federal government recommended masking.

COVlD spread quickly through New Orleans, leading to one of the highest mortality rates per capita in the U.S.... Timeline showing Mardi Gras 2020 just 4 days before the first known reported death of C19 in the U.S.  Note. "Peak" diagnoses refers to the peak of the 1st wave.
2) New Orleans service workers were disproportionately hit by the early pandemic. Many died. Many developed #LongCOVID at the time or have now through repeat infections. Many have switched to other sectors....

3) The sad fact is that many service workers are continuing to get #LongCOVID through repeat infections today because the pandemic is ongoing and many restaurants have high occupant density and horrendous air quality....

Read 4 tweets

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