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.
3/8 🧵
PMC COVlD Update, Sep 29, 2025 (U.S.)
We made this infographic to show that COVlD levels are considerable across key Northeastern states.
The huge retroactive upward correction to NYS was so alarming, we released it prior to our full report.
We are in a serious 11th COVlD wave. Share this figure with others.
We peaked nationally around Sep 6 at 1.24 million estimated new daily infections. The forecast was spot on, with close estimates of timing & level amid noisy data. 5/8 🧵
PMC COVlD Update, Sep 29, 2025 (U.S.)
Our model estimates 5.5 million new weekly infections, expected to result in >200,000 individuals with long-term health sequelae and 1,600-2,600 excess deaths.
Check your blood pressure. Avoid a silent post-infection heart attack. 6/8 🧵
PMC COVlD Update, Sep 29, 2025 (U.S.)
Notice that current transmission (red) is so closely tracking 2 years ago, it's challenging to see the yellow line.
Look ahead for a simple "forecast." Simple is good. Share with others who do not track COVlD data. 7/8 🧵
PMC COVlD Update, Sep 29, 2025 (U.S.)
Our forecast has us dipping a bit lower than the relative "lull" 2 years ago, but these are noisy data.
Also, real and perceived barriers to boosters create uncertainty. #MaskUp, get boosted, and check your BP while there. ❤️🩹😷💉 8/8 🧵
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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/
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/
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/
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
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
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.
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
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
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
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.
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