COVlD-19 levels are "Very High" or "High" in the majority of states, per the CDC.
This includes 27 states & D.C.
🔥🔥Very High:
Alaska, Hawai'i, California, Nevada, Idaho, Utah, S. Dakota, Nebraska, Texas, Louisiana, Indiana, Kentucky, Tennessee, Florida, S. Carolina, N. Carolina, D.C., Maryland, and Connecticut.
🔥High:
Washington state, Oregon, Montana, probably N. Dakota (imputed), Arkansas, Alabama, Virginia, Delaware, Rhode Island, and Massachusetts.
PMC estimates 1 in 38 people (2.7%) are actively infectious. Wastewater-derived case estimates suggest 1.3 million new daily infections.
PMC COVlD Report, Sep 15, 2025 (U.S.)
🧵2/7
Transmission is peaking nationally, but regional variation is common. Know what's happening in your state, and get the word out.
Note that the levels CDC calls "low" are still quite alarming.
PMC COVlD Report, Sep 15, 2025 (U.S.)
🧵3/7
Note that transmission is increasingly spreading from the South & West toward other areas. Know your state-level risk.
Transmission remains alarming even in areas CDC labels "Very Low" (e.g., Missouri, estimated 1 in 109).
PMC COVlD Report, Sep 15, 2025 (U.S.)
🧵4/7
"During COVlD" is today.
The U.S. experiences semi-annual waves. Wastewater-derived case estimates suggest the surge is peaking near 1.3 million new daily infections.
Note. CDC and Biobot made significant upward corrections to their levels reported last week, 5% and 31%, which pushes the estimated wave peak much higher.
PMC COVlD Report, Sep 15, 2025 (U.S.)
🧵5/7
Wastewater-derived case estimates suggest the U.S. is seeing approximately 9.0 million infections per week.
The past week's infections will result in up to 4,200 excess deaths.
Vaccination choice and access are being limited.
PMC COVlD Report, Sep 15, 2025 (U.S.)
🧵6/7
Current transmission (red) has closely tracked that of year 4 (yellow). Data through Sep 6 are shown.
If transmission drops sharply, like in year 4, Sep 6 would be the peak. Otherwise, we would have the latest U.S. summer peak so far.
PMC COVlD Report, Sep 15, 2025 (U.S.)
🧵7/7
Last week we noted the following as a plausible scenario. “A very large retroactive correction could shoot the peak substantially higher.” In fact, transmission was retroactively corrected upward, and that creates more uncertainty about the timing of the peak between the 6th and 13th.
The central projection for the current forecast appears to show a plateau heading into a gradual decline in transmission. However, it is best to consider this as an average scenario that must account for both a sudden drop as well as the possibility of continued increases.
Scenario #1: Peak on September 6 (approximately 40% chance). This would be similar to year 4 (see year-over-year graph), with a sharp, pointed peak. The peak would be estimated at approximately 1.25 million new daily infections.
Scenario #2: Peak on September 13 or late (approximately 60% chance). This would more resemble years 3 and 5, where transmission came down more gradually. The peak would be estimated at approximately 1.30 million new daily infections.
The truth may be somewhere in between, but the data only update weekly, so that level of precision is rarely possible. More importantly, transmission varies considerably regionally, so track local data closely.
Finally, note that significant transmission occurs post-peak, so ongoing multi-layered mitigation remains key. We advocate for national policy to increase vaccine eligibility and access across the nation, not merely in select states. I have volunteered to speak at ACIP, and if selected through the lottery system, will focus comments on ongoing and long-term excess mortality.
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An estimated 1 in 81 people are actively infectious during the ongoing 11th wave.
The "shutdown" has created a blackout at the state level.
Transmission is half that of the peak one month ago, and we anticipate a relative national "lull" in early-to-mid November, albeit still at dangerous levels.
Our model uses a combination of CDC and Biobot data, so we are able to estimate national statistics despite the CDC data going offline. On the map, note that Puerto Rico continues to update; they use a CDC-style system but were dropped by the CDC long ago. For full methodology, review the technical appendix on the website.
PMC COVlD Update, Week of Oct 6, 2025 (U.S.)
🧵2/9
#DuringCOVID is today. We estimate >600,000 new daily infections. This is about half the peak on September 6.
Notice current levels are similar to the estimated peaks of the first 3 waves.
PMC COVlD Update, Week of Oct 6, 2025 (U.S.)
🧵3/9
Weekly estimates:
🔹4.5 million infections
🔹>200,000 resulting long-term health conditions
🔹>1,300 resulting excess deaths
Key points in my letter to the pharmacy boards. 🧵1/7
Georgia law indicates that the pharmacy board is to follow ACIP. They do not dictate further nuance. Georgia continues to require prescriptions, going against the spirit of the law, ACIP, and 47 other states.
🧵2/7
Louisiana law tells the pharmacy board to follow ACIP. ACIP says do not require a prescription, and 47 other states agree.
The Louisiana pharmacy board continues to require a prescription.
On the back end of this unprecedented 11th wave, "times they are a-changin." In particular, COVlD levels are shifting north and east.
Notice that few states are in the highest and lowest categories. Much of the south and west have considerable transmission post-peak. Many places in the north and east are seeing steady or increasing transmission after relatively lower levels.
Overall, levels are lower than the past few weeks, but transmission remains considerable. Those relying on anecdata (friends, coworkers, and family infected) may increasingly realize we are in a wave.
We estimate nearly 750,000 new daily infections nationwide, meaning approximately 1 in 66 people or 1.5% are actively infectious.
These estimates are derived by linking wastewater levels to IHME true case estimates using methodology commonly employed worldwide, detailed on the website, noted in a pre-print. Many publications in leading medical journals link wastewater data to key metrics that matter, noted in the online technical appendix.
In this week's report, we note adding North Dakota and Puerto Rico to the heat map in support of health equity. We have been imputing ND levels since the launch of PMC 3.0 using data from neighboring states. PR continues to report qualitative levels using the CDC format but is not longer included on the CDC website.
1/8 🧵
PMC COVlD Update, Sep 29, 2025 (U.S.)
State-level prevalence estimates, AL to MS. The levels use CDC labels, which tend to have an optimistic portrayal of risk. For example, CO is listed at "low" (by our estimate 1.5% infectious).
#MaskUp at 1.5% if having lapsed.
2/8 🧵
PMC COVlD Update, Sep 29, 2025 (U.S.)
State-level prevalence estimates, Missouri to Wyoming.
New York had *huge* retroactive upward corrections, and is now "High," as many residents hypothesized.
Note, Puerto Rico only provides CDC qualitative levels, so no data.
The CDC reports 29 states & DC are experiencing High or Very High transmission.
The heat map is a patchwork quilt with COVlD levels varying considerably state by state.
Transmission is shifting north + east.
🧵1/8
PMC COVlD Dashboard, Sep 22, 2025 (U.S.)
COVlD levels by state, AL to MS.
Note that even levels the CDC calls "Low" like Guam at 1.5% actively infectious are at the threshold where I would tell people who have lapsed that it's time to #MaskUp.
🧵2/8
PMC COVlD Dashboard, Sep 22, 2025 (U.S.)
COVlD levels by state, Missouri to Wyoming.
New York is a good example of where the CDC label of "Moderate" simply does not cut it. 1 in 49 is very high, and the data quality statewide has been poor.