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Mike Hoerger, PhD MSCR MBA Profile picture
@michael_hoerger
Sep 3, 2025 • 9 tweets • 4 min read • Read on X
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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*
PMC Dashboard Update (U.S.) 🧵4 of 8

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

What's striking here is that you see some of the "Very Low" states like NY and NM are at nearly 1% actively infectious. Missouri High* Montana Low Nebraska Very High Nevada Very High New Hampshire Low New Jersey Low New Mexico Very Low New York Very Low North Carolina Moderate North Dakota Moderate* Ohio Very Low* Oklahoma Very Low* Oregon Moderate Pennsylvania Low Rhode Island Very Low South Carolina Very High South Dakota High Tennessee Moderate Texas Very High Utah Very High Vermont Moderate Virginia High Washington High West Virginia Low Wisconsin Very Low Wyoming Moderate
PMC Dashboard Update (U.S.) 🧵5 of 8

We're in an 11th COVlD wave.

Many are getting infected while waiting on delayed vaccine approvals. Millions more are being denied vaccine access entirely.

Few public health groups mention the importance of N95 masks and air purifiers. Longitudinal graph of the 11 waves of COVlD in the U.S.
PMC Dashboard Update (U.S.) 🧵6 of 8

Based on Swiss Re actuarial data, we partition excess deaths according to wastewater levels & estimate up to 2,900 Americans will die from this week's infections.

They will be cardiovascular, cancer, & misc deaths. Rarely counted as C19. Infections pmc19.com/data Proportion Actively Infectious 1 in 56 (1.8%) New Daily Infections 876,000 Infections the Past Week 6,040,000 Infections in 2025 153,000,000 Cumulative Infections per Person 4.57 Long COVID Long COVID Cases Resulting 44,000 to 175,000 from New Daily Infections Long COVID Cases Resulting 302,000 to 1,210,000 from New Weekly Infections Excess Deaths Excess Deaths Resulting 250 to 420 from New Daily Infections ...
PMC Dashboard Update (U.S.) 🧵7 of 8

We just had the largest relative increase in summer transmission in 4 years.

But transmission has leveled off (red line). This is atypical based on the most similar prior waves (blue, yellow).

We may so a retroactive correction upward. year over year graph of transmission
PMC Dashboard Update (U.S.) 🧵8 of 8

We have improved the forecasting model, especially for summer waves, but have increased the expected level of error in real-time reporting (CDC corrections, Biobot lags), which yields broader confidence intervals.

If the CDC retroactively corrects the most recent real-time data upward, which is plausible, we could head toward 1.2-1.5 million new daily infections. If the numbers hold, the peak will be closer to 0.9 to 1.0 million new daily infections and occur around Sept 6. Significant transmission occurs on the back end of waves. Most people won't even realize we're in a wave until mid to late September.

I don't envision a more optimistic scenario but hope for it.Graph of the forecasting model. Shows hovering around 900k daily NDIs for the central prediction, peak around Sept 6
Find the full report at

I'll post plenty of explainer posts over the next 2 weeks. Please also use, improve, and share widely. I'm mostly here and on IG these days.pmc19.com/data

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More from @michael_hoerger

Mike Hoerger, PhD MSCR MBA Profile picture
Jan 25
During this 12th COVlD wave, the CDC reports 1-in-3 states have "High" or "Very High" levels.

PMC estimates the proportion of residents actively infectious (prevalence):
◾️USA: 1 in 67
◾️IA: 1 in 27
◾️MI: 1 in 25
◾️IN & CT: 1 in 23
◾️ME: 1 in 21
◾️OK & SD: 1 in 17

🧵1/ Heat map using CDC data. National PMC prevalence estimate noted; estimated incidence of 732,000 new daily infections.
On average, Americans have have 5.0 cumulative SARS-CoV-2 infections.

This week's infections are expected to result in 1/4 to 1 million new #LongCOVID conditions and ≈2,000 excess deaths.
🧵2/ Column 1: Table of state-level prevalence estimates. Highest estimates noted in the thread text. Column 2: Proportion Actively Infectious 1 in 67 (1.5%) New Daily Infections 732,000 Infections the Past Week 5,220,000 Infections in 2026 24,000,000 Cumulative Infections per Person 5.04 Long COVID Long COVID Cases Resulting 37,000 to 146,000 from New Daily Infections Long COVID Cases Resulting 261,000 to 1,040,000 from New Weekly Infections Excess Deaths Ex...
The wave peak is now estimated >10% higher than last week at 1.2 million new daily infections, nearly double the Delta wave.

We expect sustained high transmission (≈600,000 to 750,000 new daily infections) the next few weeks as COVlD circulates through schools/families.
🧵3/ Fig 1: Graph of 12 waves Fig 2: "Barometer" showing above average transmission Fig 3: Year-over-year graph, which informs the analytic forecast Fig 4: Forecast described in post
Read 4 tweets
Mike Hoerger, PhD MSCR MBA Profile picture
Jan 17
Based on today's CDC & Biobot data, we estimate the following for the week of Jan 19:

🔸1 in 52 people in the U.S. actively infectious
🔸25% chance of exposure in a room of 15 ppl
🔸Nearly 1 million new daily infections
🔸5 cumulative infections per person all-time (avg)
🧵1/5 Heat map from CDC data with PMC estimates. Description of "Very High" states in next post
Transmission estimates have been marginally corrected upward.

11 states have Very High COVlD levels:

🔸PA: 1 in 25 estimated actively infectious
🔸MI: 1 in 23
🔸OH & KY: 1 in 22
🔸SD: 1 in 20
🔸NE & IA: 1 in 18
🔸IL & ME: 1 in 17
🔸IN: 1 in 16
🔸WV: 1 in 11
🧵2/5 Proportion Actively Infectious 1 in 52 (1.9%) New Daily Infections 941,000 Infections the Past Week 6,020,000 Infections in 2026 18,000,000 Cumulative Infections per Person 5.01 Long COVID Long COVID Cases Resulting 47,000 to 188,000 from New Daily Infections Long COVID Cases Resulting 301,000 to 1,200,000 from New Weekly Infections Excess Deaths Excess Deaths Resulting 270 to 450 from New Daily Infections Excess Deaths Resulting ...
We're in the middle of a 12th COVlD wave.

The peak has likely passed, but with students headed back to school, transmission is expected to remain high for at least the next several weeks.

🧵3/5 1) Graph of 12 waves 2) Barometer showing above-average transmission 3) Year over year graph 4) Forecast for transmission to decline and then percolate at high levels
Read 5 tweets
Mike Hoerger, PhD MSCR MBA Profile picture
Jan 10
The size of the winter COVlD wave has been revised upward as post-holiday data come in.

We estimated 1 in 55 people in the U.S. are actively infectious.

🔥WV: 1 in 14
🔥IN: 1 in 15
🔥MI & OH: 1 in 21
🔥MO: 1 in 22
🔥CT: 1 in 24
🔥KS: 1 in 25
🔥MA & IL: 1 in 27

Quick 🧵 1/4 Heat map and PMC estimates, 1 in 55 infectious and 892,000 new daily infections for Jan 12. We expedited the report to release it two days early.
Nationally, we are seeing an estimated 892,000 new daily SARS-CoV-2 infections, meaning a 1 in 4 chance of exposure in a room of 15 people. Risk varies considerably by state.

We are approaching an average of 5 infections per person since pandemic onset.
🧵 2/4 Alabama Moderate Alaska Very Low Arizona Very Low Arkansas High* California Very Low Colorado Low Connecticut Very High Delaware Moderate District of Columbia Very Low Florida Very Low Georgia Very Low Guam Very Low Hawaii Very Low Idaho Very Low Illinois Very High Indiana Very High Iowa High Kansas Very High Kentucky Moderate Louisiana Moderate Maine High Maryland High Massachusetts Very High Michigan Very High* Minnesota Moderate Mississippi Low* Missouri Very High* Montana High Nebraska High Nevada Very Low New Hampshire Moderate New Jersey Low New Mexico Moderate New York High* North Ca...
We are in the 12th COVlD wave of the U.S.

Current transmission is higher than 68% of all days since the pandemic onset in 2020.
🧵 3/4 12 waves of COVlD Pandemic barometer: Higher than 88% of the past 100 days, 73% of the past year, 68% of the entire pandemic. Year over year graph Forecast of slowly declining transmission.
Read 4 tweets
Mike Hoerger, PhD MSCR MBA Profile picture
Jan 8
You might not have heard, but the northeastern U.S. is in a COVlD surge.

We use wastewater levels to derive estimates of the proportion of people actively infectious in each state (prevalence), e.g., 1 in 24 people in Connecticut.

Let me walk you through it...

🧵1/8 Colors show CDC levels PMC prevalence estimates noted: -Maine 1 in 38 actively infectious with COVlD -New Hampshire 1 in 35 (limited data) -Vermont 1 in 75 -New York 1 in 44 (limited data) -Pennsylvania 1 in 44 -Massachusetts 1 in 36 -Connecticut 1 in 24 -Rhode Island 1 in 41 -New Jersey 1 in 82
Notice that #Connecticut has excellent SARS-CoV-2 wastewater surveillance. It's "Very High" across much of the state, per CDC.

Based on wastewater levels, we estimate 1 in 24 residents are actively infectious w/COVlD. That's a 66% exposure risk in a room of 25 people.

🧵2/8 Colors show CDC levels PMC estimate of prevalence
The CDC reports "Very High" levels in #Massachusetts.

The surveillance is less robust, but we estimate 1 in 26 residents are actively infectious, similar to our estimate in CT where coverage is better.

In a room of 25 people, that's a 62% chance of an exposure.

🧵3/8 Colors show CDC levels PMC prevalence estimates provided
Read 8 tweets
Mike Hoerger, PhD MSCR MBA Profile picture
Jan 8
We're in the middle of a 12th COVlD wave in the U.S., with transmission particularly high in the Midwest and Northeast.

The CDC announced this week that COVlD continues to kill more Americans than breast and prostate cancer combined.

Get boosted & #MaskUp 💉💪😷
1/4🧵 Heat map of CDC data with PMC prevalence estimate
Levels are "Moderate" to "Very High" in 26 states.

However, data reporting is slow, and about 1/3 of states have low-quality data this week due to the holidays and illness.

2/4🧵 National estimates: Number of People Chances Anyone is Infectious 1 1.5% 2 3.0% 3 4.5% 4 6.0% 5 7.4% 10 14.3% 15 20.7% 20 26.5% 25 32.0% 30 37.0% 50 53.8% 75 68.6% 100 78.6% 200 95.4% 300 99.0%
Barometer: Higher transmission than 90 of the past 100 days (perhaps higher still, due to low data reporting quality)
State CDC Level Actively Infectious Alabama Moderate 1 in 48 (2.1%) Alaska Very Low 1 in 152 (0.7%) Arizona Very Low 1 in 201 (0.5%) Arkansas High* 1 in 36 (2.8%) California Very Low 1 in 484 (0.2%) Colorado Moderate 1 in 49 (2.0%) Connecticut Very High 1 in 24 (4.2%) Delaware Low* 1 in 70 (1.4%) District of Columbia Very Low 1 in 5,835 (0.0%) Florida Very Low 1 in 284 (0.4%) Georgia Low 1 in 90 (1.1%) Guam Very Low 1 in 687 (0.1%) Hawaii Very Low 1 in 874 (0.1%) Idaho Very Low 1 in 169 (0.6%) Illinois Moderate* 1 in 56 (1.8%) Indiana High* 1 in 34 (2.9%) Iowa Moderate 1 in 41 (2.4%) Kansas...
State CDC Level Actively Infectious Missouri Moderate* 1 in 42 (2.4%) Montana High 1 in 34 (2.9%) Nebraska Very High 1 in 26 (3.9%) Nevada Very Low 1 in 138 (0.7%) New Hampshire High* 1 in 35 (2.9%) New Jersey Low 1 in 82 (1.2%) New Mexico Low 1 in 87 (1.2%) New York Moderate* 1 in 44 (2.3%) North Carolina Low 1 in 82 (1.2%) North Dakota High* 1 in 34 (3.0%) Ohio Very High 1 in 27 (3.7%) Oklahoma Moderate* 1 in 62 (1.6%) Oregon Very Low 1 in 170 (0.6%) Pennsylvania Moderate 1 in 44 (2.3%) Rhode Island Moderate 1 in 41 (2.4%) South Carolina Moderate 1 in 54 (1.9%) South Dakota Very High 1 in...
If like years 1-4 of the pandemic, the winter wave has peaked. If like last year, we could hover near peak levels for a month.

Forecasting quality is low with 1/3 of states having data issues. Hopefully, we'll know a lot more in a few days.

3/4🧵 12 waves
Proportion Actively Infectious 1 in 65 (1.5%) New Daily Infections 749,000 Infections the Past Week 5,390,000 Infections in 2026 3,000,000 Cumulative Infections per Person 4.88 Long COVID Long COVID Cases Resulting 37,000 to 150,000 from New Daily Infections Long COVID Cases Resulting 270,000 to 1,080,000 from New Weekly Infections Excess Deaths Excess Deaths Resulting 220 to 370 from New Daily Infections Excess Deaths Resulting ...
year over year graph
forecast
Read 4 tweets
Mike Hoerger, PhD MSCR MBA Profile picture
Jan 5
We told you that 109,000-175,000 Americans would died of COVID (excess deaths) in 2025.

Today, the CDC estimates 101,000 deaths/year (flat from Oct 2022 to Sep 2024), and likely higher when considering more nebulous non-acute excess deaths (heart attack 6 months later).
1/5
The CDC estimates are actually higher than I would have guessed, given their methodology, which models estimates based on easily countable factors in healthcare and expert input on multiplier values. It lends credence to the PMC upper bound of excess deaths of 175,000/yr.
2/5
What's troubling is the CDC has annual mortality flat. My expectation based on mortality displacement and Swiss Re data is that it should be declining. If is stays flat, we're running on something like breast+prostate cancer or lung cancer deaths per year in perpetuity.
3/5
Read 6 tweets

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