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

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 24
PMC Dashboard, Mar 24, 2025 (U.S.)
🧵1/5

🔹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
Feb 17
1) PMC COVlD Dashboard, Feb 17, 2025 (U.S.)

🔥1 in 72 actively infectious
🔥Sustained high transmission
🔥30 states in high/very high transmission (CDC)
🔥3x the transmission of Feb 2021
🔥668,000 daily infections
🔥Only 1 in 28 cases reportedGraph shows 10 waves of the pandemic.  Tables summarized partially in post. Additionally, transmission is higher than during 59% of the pandemic.  How Does Risk Increase with More Social Contacts? Number of People | Chances anyone is infectious 1	1.4% 2	2.8% 3	4.1% 4	5.5% 5	6.8% 6	8.1% 7	9.4% 8	10.6% 9	11.9% 10	13.1% 15	19.0% 20	24.5% 25	29.7% 30	34.4% 35	38.9% 40	43.0% 50	50.5% 75	65.2% 100	75.5% 300	98.5%
2) PMC COVlD Dashboard, Feb 17, 2025 (U.S.)

This is a mid-sized wave, meaning substantial transmission. Notice that transmission remains steady at high rates.

Expect steady or slightly declining transmission, unless the real-time data are retroactively corrected.Two graphs, showing year-over-year transmission and the forecast, summarized in the post.
3) PMC COVlD Dashboard, Feb 17, 2025 (U.S.)

Notice that 30 states remain in high/very high transmission, per CDC categories.

This is the same as last week. Transmission is 3x higher than in Feb 2021, when people were taking more precautions around masking and testing.Transmission heat map and CDC line graph of regional variation in transmission.
Read 5 tweets
Feb 11
1) A lot of high-risk/aware patients I talk to -- mostly getting cancer treatment -- tend to protect themselves from infection by staying home more.

In the work we do, we help patients to understand that a well-fitting high-quality mask can allow them to attend events safely.
2) These are some tips for finding a well-fitting mask among common options in the U.S. and Canada.

3) Here's a more comprehensive diagram of masks that fit most. Aside from #5, these are widely available.

*#5 (Aegle) was the first N95 widely available during the ongoing pandemic for <$1. Hard to find these days, but I gave some to students.
Read 7 tweets

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