Mike Hoerger, PhD MSCR MBA Profile picture
Nov 5, 2024 1 tweets 3 min read Read on X
PMC COVID-19 Forecasting Model, Nov 4, 2024

We're seeing an uptick in U.S. Covid transmission with 1 in 115 actively infectious.

The percentage of the population actively infectious has increased from 0.7% last week (based on updated data) to 0.9% this week.

The uptick is barring retroactive downward corrections.

We place the "lull point" as likely around Oct 20, but it could be +/- 2 weeks around that. Looking back at the late-summer wave, you'll see the date of the high point was quite arbitrary, and the same is true for the "lull."

There is presently considerable variation by region and even when examining the same region across different data sources. Some areas are still cooling off, while others are increasing markedly, as one would expect in the peri-lull area. There's also a lot of volatility across other data sources not included in our model (e.g., WastewaterSCAN up 43% nationally from Oct 18-25, but back down on the most recent data point on the 26th).

You'll note two updates in the current PMC forecasting model starting this week. These are described in detail in the technical appendix.

1) Biobot's sun rises again. 🌅 Our composite indicator of Covid transmission had been weighted 40% Biobot and 60% CDC. When Biobot abruptly stopped reporting for several weeks in a row during the summer wave, we were forced to downgrade them to 0% with no data coming in. After weeks of consistent reporting and a near-perfect correlation with recent CDC data (r=.95), we have re-included them in our current case-estimation model at 20% Biobot and 80% weight for CDC. Note, some of our pandemic "running total" estimates are marginally adjusted downward, as Biobot reported a slightly narrower (leptokurtic) late-summer wave. Having two high-quality data sources for estimating current transmission increases precision in real-time estimates and prepares for the eventuality that one source by experience a gap in reporting near the winter peak.

2) Best-Case and Worst-Case Scenarios. In figure 3 (upper right of dashboard), we have added 50% and 95% confidence bands. See the Technical Appendix for estimation details. Essentially, consider the 50% band (shaded area) the normal variation, and the boundaries of the 95% band (light dashed lines) the worst- and best-case scenarios, barring something nearly unforeseen (approximately 2.5% chance of a worse or better scenario). We encourage non-scientists to provide feedback on that figure, as it is challenging to present more detailed data in ways that are easily digestible. In Version 1 of the forecast (Aug 2023-Aug 2024), we reported several forecasting models and a compositive. It's unclear how helpful this was to readers, as we got surprisingly little feedback on it. With 15 months of forecasting, we now have the data to provide meaningful confidence bands. If helpful, we will keep it. If not, we will change the graphical depiction or replace them.

Info for new readers:

For those unfamiliar with the PMC model, find full weekly reports for the past 14+ months at pmc19.com/data

The models combine data from IHME, Biobot, and CDC to use wastewater to estimate case levels (r = .93 to .96) and forecast levels the next month based on typical (median) levels for that date and recent patterns of changes in transmission the past 4 weeks.

Our work has been cited in top scientific journals and media outlets, which are fully sourced in a detailed technical appendix at pmc19.com/data/PMC_COVID…

Examples include JAMA Onc, JAMA-NO, BMC Public Health, Time, People, TODAY, the Washington Post, the Institute for New Economic Thinking, Salon, Forbes, the New Republic, Fox, CBS, and NBC. See pgs 10-11 at the above link.Current Levels for Nov 4, 2024 % of the Population Infectious 0.9% (1 in 115) New Daily Infections 417,000  New Weekly Infections 2,919,000  Resulting Weekly Long COVID Cases 146,000 to 584,000  Monthly Forecast Average % of the Population Infectious 1.5% (1 in 65) Average New Daily Infections 735,033 New Infections During the Next Month 22,051,000 Resulting Monthly Long COVID Cases 1,103,000 to 4,410,000  Running Totals Infections Nationwide in 2024 227,349,000 Average Number of Infections Per Person All-Time, U.S. 3.46  How Does Risk Increase with More Social Contacts? Number of people | ...

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More from @michael_hoerger

Sep 10
Let's say you're a dairy farmer. You have 100 cows. Each year, about 5 cows die, and another 5 cows are born. Then, along comes a virus. Let's call it "cowvid"...
1/
Let's say "cowvid" wipes out about half the cows over the course of a couple years. Now, you're down to 50 cows....
2/
The local mayor declares "cowvid" to be over. This surprises you as a farmer because 5 of your cows keep dying annually. 5 of 50 instead of 5 out of 100. Seems like more, but you're not a city slicker...
3/
Read 12 tweets
Sep 7
#DuringCOVID is today.

Image pack 1 of 9 🧵 Graph of the 11 waves of the pandemic in the U.S., tailored to a key message noted in the post.
1 million New Daily Infections.

Today!

Image pack 2 of 9 🧵 Graph of the 11 waves of the pandemic in the U.S., tailored to a key message noted in the post.
Where are the free vaccines, N95s, and tests?

Image pack 3 of 9 🧵 Graph of the 11 waves of the pandemic in the U.S., tailored to a key message noted in the post.
Read 9 tweets
Sep 3
PMC Dashboard Update (U.S.) 🧵1 of 8

The 11th wave is still rising.
🔥23 states/territories High/Very High
🔥Very High: Alabama, DC, Guam, Hawai'i, Louisiana, Nebraska, Nevada, South Carolina, Texas, Utah
🔥1 in 56 estimated actively infectious
🔥876,000 new daily infections CDC heat map, very high states noted in post. PMC estimate of 1 in 56 actively infectious nationwide
PMC Dashboard Update (U.S.) 🧵2 of 8

Note that the CDC has modified 📉 how transmission levels correspond to the categorical bins.

Take California. We estimate 1 in 30 actively infectious statewide. This would have previously been "Very High," now just "High."
#NewNormal CDC heatmap, with PMC estimate of 1 in 30
PMC Dashboard Update (U.S.) 🧵3 of 8

Here are the prevalence estimates for the first half of states/territories.

Notice how high the levels are in some of the "Moderate" states. State	CDC Level Alabama	Very High Alaska	High Arizona	High Arkansas	Moderate California	High Colorado	Moderate Connecticut	High Delaware	High District of Columbia	Very High Florida	High Georgia	Moderate Guam	Very High Hawaii	Very High Idaho	High Illinois	Very Low Indiana	Moderate* Iowa	Low Kansas	Low Kentucky	High Louisiana	Very High Maine	Low Maryland	Moderate Massachusetts	Moderate Michigan	Very Low Minnesota	Moderate Mississippi	High*
Read 9 tweets
Aug 21
During times like these when COVlD transmission heats up in the U.S., expect to see a lot more angry outbursts for three central reasons.

First, "displacement," or people trying to deny the reality of their anxiety by taking it out on other people....
Second, a lot of people can sustain a strong denial of reality about the ongoing pandemic during lulls. They suppress the existence of COVlD waves and excess deaths, disability, and retirements.

During waves, those defenses burst. Loss of control = anger...
Third, a lot of people (many reading this) understand COVlD correctly & experience righteous indignation during COVlD waves. We quite reasonably do not like all of the unjust and gratuitous suffering.

I find it helpful to channel that intensity into helping other people....
Read 6 tweets
Aug 19
I submitted my comment to endorse universal high-quality masks (respirators) in healthcare. Today is the final day.

Alt text continues in the following posts. RE: Z94.4, Selection, use, and care of respirators (New Edition)  Dear Colleagues,  As the director of a population science program at a major U.S. cancer center, I strongly endorse this draft proposal to increase the use of high-quality well-fitting masks (respirators) in medical settings. I will comment on the relevance of this proposal mainly for cancer care. In the U.S., cancer care is commonly more organized than other specialty care and, thus, often leads the way on policy initiatives, which then translate to other elements of care over time.  1. COVID-19 continues to cause excess dea...
They put forth projections, with the most granular detail for the U.S. and U.K., suggesting excess deaths will persist through at least 2033. Their projections do not show excess deaths stopping in 2033; that is simply the final year of their current analysis. Moreover, while they provide the most data for the U.S. and U.K., their analysis suggests a more general trend throughout the globe. The COVID-19-associated excess deaths are commonly identified as cardiovascular and cancer causes of death.   Swiss Re Institute. (2024). The future of excess mortality after COVID-19. https://www.swissr...
Alt text continued 2. The SARS-CoV-2 virus that causes COVID-19 continues to transmit at high rates worldwide. Overall, 28 nations continue to use wastewater surveillance to monitor SARS-CoV-2 levels. A directory is available at the dashboard that I oversee (pmc19.com/data). In the U.S., we are currently experiencing our 11th wave of transmission. Many nations are experiencing annual or twice annual waves of transmission.
Alt text continued 3. International consensus standards identify a broad range of patients at known high-risk of severe outcomes of COVID-19. The largest group at known high risk of severe outcomes is patients with cancer. Other diagnoses associated with above average risk include people undergoing transplants or receiving dialysis, and patients with any of these diagnoses: immunodeficiencies, renal disease, systemic-immune mediated or single-site immune-mediated inflammatory conditions, asplenia, anatomical barrier defects, pregnancy, and diabetes. These findings underscore the importance of standards in hea...
Read 7 tweets
Aug 16
🚩🚩🚩
As a vigorous defender of #CDC data, their switch from using normalized to non-normalized COVlD wastewater surveillance data today harms data quality.

"Normalizing" means accounting for basic confounders like rain levels. It is a choice to use worse data.
1/5🧵 Image
Historically, the CDC data have correlated near-perfectly with similar metrics, such as Biobot's wastewater estimates (still active) or the IHME true case estimates (through mid-2023).

The changes reduce those correlations. It's like going from an A+ to a B.

2/5🧵
You can readily see the loss of data quality in the PMC "whole pandemic" graph (preview shown, subject to change) with choppier waves, caused by the CDC adding extra noise to the data and applying retroactively from BA.1 Omicron to present.

3/5🧵 Longitudinal graph of the pandemic waves. Notice how they start becoming choppier in 2022, as a result of today's changes at the CDC
Read 5 tweets

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