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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Levels are flat during a relative "lull" in transmission.
▪️1 in 187 estimated actively infectious
▪️260,000 estimated new daily infections
▪️High: OK, MS, WV
▪️Moderate: VT
▪️All other states low/very low in relative transmission
🧵THREAD 1/6
COVID-19 persists in 2026.
We are in a relative "lull" following a 12th wave, but at a baseline of 200-300K estimated new daily infections.
Transmission was lower in the era many refer to as #DuringCOVID, when multi-layered mitigation was used instead of denial.
🧵THREAD 2/6
Transmission during a "lull" is high in an absolute sense. Many people are getting infected.
Simultaneously, its low in a relative sense, or compared to so-called "typical" transmission. In most places, it's a safer time for medical/dental care.
Transmission is stable in a relative "lull" nationally between waves.
We estimate that approximately 313,000 people are still getting infected per day, with outbreaks radiating from TN and MS.
🧵1 of 10 (don't miss #10)!
With limited data reported, Mississippi has an estimated 1 in 27 residents actively infectious.
In a room of 25 people, that's a 61% chance of exposure, if no testing/isolation protocols.
🧵2 of 10
1 in 24 people in Tennessee are estimated to be actively infectious with SARS-CoV-2. That's a 65% chance of exposure in a room of 25 people where nobody is testing/isolating.
This is an unethically misleading study with findings easily explained by residual confounding. Some health systems and patients have thorough record keeping. Others don't. All sorts of variables will correlate (infections, cancers, anything else tracked in medical records).
This is a really obvious issue for an international epi study. It should not have been published.
The above study is using the same processes the anti-vaxxers use -- junk epi that does not account for confounding -- to support whatever pre-conceived notions the authors have, with absurdly large effects.
Denial is but one of several obvious defense mechanisms people use to try to block their awareness of the ongoing toll of COVID-19. There are many others.
Short-term capital also plays a role, but even that requires a large dose of defense mechanisms.
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/