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More from @michael_hoerger

Mike Hoerger, PhD MSCR MBA

Jan 20

1) PMC COVID-19 Forecast for Jan 20, 2025 (U.S.)

If we are lucky, the 10th wave has peaked, likely in the 0.9-1.1 million daily infections range, barring significant retroactive corrections.

Over the next month, we should still see about 14 million infections, resulting in 700K to 2.8 million new conditions and enduring symptoms under the umbrella of #LongCOVID. This is simply your reminder than transmission remains high on the back on of a wave.

Regarding the peak, there were huge retroactive downward corrections, especially in Oregon. The CDC data originally showed one of the largest waves there all-time, and then corrected it to say a complete lull the whole time. Once the Biobot data get updated, we may see the peak date change by a week, or jump a bit higher than what you see in the main figure.

What you see in the far end of the forecast is unlikely to be a "high lull," but rather an average between a low lull versus a sustained post-peak haunch of lingering transmission. So, keep an eye on the data. If you're putting off a non-urgent medical appointment, we could get into relatively lower transmission in the next 4-8 weeks. What has me concerned is a sneak-peek of @jlerollblues's long-term forecast indicating a clear possibility of an earlier "mid-year" wave than usual, perhaps even in April. We're still getting pretty lucky on the viral evolution front, but the longer that persists, in absent of major policy change, the bigger the wave we could get. It's a very important time to stay tuned.

Caveats: No data from Biobot in weeks (20% model weight). The California wildfires and pending severe storms in the Deep South are wildcards for transmission. School-based transmission could pick up, but to get a higher peak, transmission would need to pick up much faster in the South and West than in the Midwest and North (unlikely).

In the report, I note that PMC will persist even if the CDC drops or scales back their surveillance program. Also, the most two recent "odd" waves have helped clarify how to handle historical data, and a minor update to the model should help with future atypical waves. If time permits, we will fine-tune those changes further, but there are always more battles on the Covid front than we're able to fight. We also provide a link and light commentary on our recent pre-print showing what our current case estimation model for estimating present/prior daily infections has performed well, and why a lot of other models (BNO, JP, CDC) are underestimates.

Info for new readers:

For those unfamiliar with the PMC model, find full weekly reports for the past 1.5 years 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 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, NBC, and CNN. See pgs 11-13 at the above link.

#MaskUp #VaxUp #CleanTheAir #RapidTest

https://x.com/michael_hoerger/status/1879764437575635160

2) Here is the issue of Oregon I noted, with the "disappearing surge" in the CDC data. By that, I don't mean a surge that declined quickly. I mean, the CDC saying there was a huge surge in OR and then saying it was a lull the whole time. Baffling.

https://x.com/michael_hoerger/status/1879764437575635160

3) It's an important time to reflect that we have never had a federal Covid response commensurate with the magnitude of this $14-billion problem in the U.S.

3/11/20-1/19/21 = 290K infections/day (91 million total)

1/20/21-1/19/25 = 759K infections/day (1.1 billion total)

10 waves and >1 billion estimated infections in 5 years.

We have never had a well-conceived multi-layered mitigation strategy, and the strategy we have had has often underachieved due to insufficient operational management.

This places society at greater systemic risk from repeat-infection Long COVID. The approach is unreasonable to people with primary immunodeficiencies, cancer, organ transplants, kidney disease, type 1 and 2 diabetes, Long COVID, pregnancy, and many other conditions. Upwards of 2 million older adults in the U.S. are in early retirement, with the labor participation rate still well below pre-pandemic levels, and older adults almost wholly accounting for that presently. The children that were pretended to be magically shielded from Covid are not doing well on the cumulative infection front either.

I do not see that changing. I hope the many scientists and public health officials biting their tongues the past 4 years now feel liberated to speak up on Covid. Note that state and regional organizations and individuals were a big reason why transmission was better under control in year 1 of the pandemic.

Note that our statistics are estimated "true" cases based on the PMC model, not reported cases, which are vast undercounts (ascertainment bias). See the first Tweet for info on our model, including our website, which contains hundreds of pages of reports (pmc19.com/data), or read our recent pre-print showing the high accuracy of our case estimation model, to the extent that is ascertainable (researchsquare.com/article/rs-578…). To believe the true infection estimates are lower than these figures, one would have to suspend cognitive reasoning and merely assume transmission happens at vastly lower rates in the U.S. than those documented through the most-rigorous testing-based program in Europe.

Read 5 tweets

Mike Hoerger, PhD MSCR MBA

@michael_hoerger

Jan 6

1) PMC COVID-19 Dashboard, Jan 6, 2025 (U.S.)

📈1 in 49 people actively infectious
🔥Nearly 1 million daily infections
🎲About a 50-50 chance someone has COVID in a large class if typical risk and no testing/isolating
🏥300,000+ new Long Covid conditions per week

The infections are likely minor underestimates. AZ and OR did not report this week. They were surging, so the lack of data brings down the average. As well, the model gives 80% weight to CDC wastewater data and 20% weight to Biobot, but Biobot took the week off, so this is dependent on observed changes in the CDC data.

It would be wise to add multiple imputation into the model to account for all the non-random missingness during surges, but I won't likely get to that anytime soon.

The peak is looking more and more like 1.4 million daily infections, but I wouldn't be surprised if it's earlier than shown and more like 1.3 million, based on the pattern of retroactive data corrections last winter. If the real-time data really stink, it could come in closer to 1.0-1.1 million. To top 1.6 million, we would probably need some serious immune escape that at present I just don't see happening. However, in past winters, transmission was declining nationally in early/mid January, and back-to-school is a wild card.

Info for new readers:

For those unfamiliar with the PMC model, find full weekly reports for the past 1.5 years 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 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, NBC, and CNN. See pgs 11-13 at the above link.

We will have a pre-print out in the next week or so documenting very compelling evidence for the validity of using wastewater to estimate case rates. Forecasting is challenging in the context of the current viral evolution, but the real-time estimates of cases are impressively accurate to the best we can evaluate it.

#MaskUp #VaxUp #CleanTheAir #RapidTest

2) PMC COVID-19 Dashboard, Jan 6, 2025 (U.S.)

We're in the 10th wave of the pandemic (1st graph), and transmission this year has picked up atypically late, while coming on strong (2nd graph).

https://x.com/michael_hoerger/status/1875423655326363669

3) PMC COVID-19 Dashboard, Jan 6, 2025 (U.S.)

Note that sputtering in the West's rise is likely an aberration, as surging OR and AZ did not provide data this week.

https://x.com/michael_hoerger/status/1875423655326363669

Read 5 tweets

Mike Hoerger, PhD MSCR MBA

@michael_hoerger

Jan 3

📢Clean Air Advocates📢

I recently learned of a new strategy to get more clean indoor air to people's homes. I don't believe I've heard anyone mention this on here, but please add if you have made inroads.
1/

Last August, I was surprised to learn that Entergy, our regional energy company, was giving away free HEPA filters to customers.

This was surprising to me. Why would an energy company do this?
2/

Apparently, most jurisdictions in the U.S. have regulations that require a portion of consumers' energy payments to go toward an energy efficiency fund.

These are often used for discounts on thermostats but occasionally for Energy Star appliances.
3/

Read 4 tweets

Mike Hoerger, PhD MSCR MBA

@michael_hoerger

Dec 20, 2024

x.com/i/article/1870…

https://x.com/michael_hoerger/status/1869463565394219071

2) This is one of the better scenarios I noted, with national levels coming in at about 3.33. Unfortunately, the rise was a little lower than anticipated only because transmission slowed in the west. Not uniform, so lots of uncertainty.

https://x.com/michael_hoerger/status/1869463565394219071

https://x.com/michael_hoerger/status/1870110154295067084

3) Transmission remains much higher than people realize. Many will get caught off guard by a seemingly #SilentSurge. This is in part because the CDC spent the past month downplaying numbers in misleading graphs.

https://x.com/michael_hoerger/status/1870110154295067084

Read 8 tweets

Mike Hoerger, PhD MSCR MBA

@michael_hoerger

Dec 16, 2024

PMC COVID-19 Dashboard, Dec 16, 2024
🧵1 of 8

🔹1 in 64 (1.6%) actively infectious in the U.S.
🔹750,000 new daily infections and rising
🔹Highest % increase in transmission in nearly 3 years
🔹10th wave is the "silent surge," coming on late out of nowhere

The video will walk you through each of the graphs on the dashboard and covered in this thread.

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 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 11-13 at the above link.

We will have a pre-print out in the next month documenting very compelling evidence for the validity of using wastewater to estimate case rates. Forecasting is challenging in the context of the current viral evolution, but the real-time estimates of cases are impressively accurate to the best we can evaluate it.

PMC COVID-19 Dashboard, Dec 16, 2024
🧵2 of 8

🔹10th wave taking off (U.S.)
🔹5 million infections expected this week
🔹>250,000 post-infection conditions (#LongCovid) expected to develop from this week's infections
🔹Higher transmission than 73% of the pandemic

Info for new readers (as noted in Tweet 1):

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 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 11-13 at the above link.

We will have a pre-print out in the next month documenting very compelling evidence for the validity of using wastewater to estimate case rates. Forecasting is challenging in the context of the current viral evolution, but the real-time estimates of cases are impressively accurate to the best we can evaluate it.

PMC COVID-19 Dashboard, Dec 16, 2024
🧵3 of 8

Areas of the U.S. depicted in darker red have higher transmission, as of 9 days ago. The map uses CDC data and is simply the CDC "cool blue" map recolored in more traditional red, which is best practices.

The line graph shows transmission increasing by region.

CDC map:
cdc.gov/nwss/rv/COVID1…

CDC regional graph:
cdc.gov/nwss/rv/COVID1…

Info for new readers (as noted in Tweet 1):

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 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 11-13 at the above link.

We will have a pre-print out in the next month documenting very compelling evidence for the validity of using wastewater to estimate case rates. Forecasting is challenging in the context of the current viral evolution, but the real-time estimates of cases are impressively accurate to the best we can evaluate it.

Read 8 tweets

Mike Hoerger, PhD MSCR MBA

@michael_hoerger

Oct 22, 2024

PMC COVID-19 Forecasting Model, Oct 21, 2024
🧵1 of 4

Every indication is that the 10th U.S. Covid wave is on the way. Within 2 weeks, expect transmission to be meaningfully higher.

Current estimates from PMC:
🔹1 in 115 actively infectious
🔹Higher transmission than during 43% of the pandemic
🔹Nearly 3 million weekly infections

These estimates are high in the absolute sense, but low relative to the recent summer wave and likely winter surge.

The CDC data show transmission increasing in the Northeast, and a slowing of the decline in transmission elsewhere. Biobot data also show flattening transmission. The raw CDC and Biobot wastewater data are delayed >1 week. Walgreens shows positive cases, testing, and positivity ratios flattening and is delayed only 1 day.

For those unfamiliar with the 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.

PMC COVID-19 Forecasting Model, Oct 21, 2024
🧵2 of 4

These graphs show the forecast for changes in transmission over the next month.

The first graph shows year-over-year transmission. The 2nd focuses on the most recent year. Within a month, expect to see 0.7 to 1.0 million daily infections, if the assumptions of the model hold.

If lucky, we could get a slightly longer "lull" than what the model shows. The model likely underestimates the true value for the recent summer peak because many children were infected while going back to school, in fact, the highest peak at that time period all-time. Wastewater underestimates child infections ("contributions" correlate highly with body weight, so it takes four ill 50 lb kids to show up as one ill 200 lb adult). In underestimating the peak, transmission also fell more rapidly than anticipated post-peak. To the extent we underestimated the magnitude of the peak, there may be fewer than anticipated infections the next two weeks and a longer lull.

If you look at the first graph, however, you will see a clear patterns of escalating transmission in November, so it's more a matter of how quickly the situation will worsen than whether it will worsen.

During this relative "lull," it's an excellent time to stock up on high-quality masks, get vaccinated, upgrade the quality and quantity of air cleaners, re-stock on rapid tests, and encourage others to do the same.

PMC COVID-19 Forecasting Model, Oct 21, 2024
🧵3 of 4

Regional differences suggest that the NE may already be rebounding in transmission. Transmission declines are slowing elsewhere.

We compare the PMC map in standard red against the CDC map using the same data in cool blue.

Read 4 tweets

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