Mike Hoerger, PhD MSCR MBA Profile picture
Sep 30 8 tweets 4 min read Read on X
PMC COVlD Update, Sep 29, 2025 (U.S.)

Summary: COVlD is everywhere.

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 🧵heat map based on CDC data, and PMC case estimates
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 🧵 Alabama	High	1 in 33 (3.0%) Alaska	Low	1 in 69 (1.5%) Arizona	Moderate*	1 in 42 (2.4%) Arkansas	High	1 in 38 (2.7%) California	High	1 in 36 (2.8%) Colorado	Low	1 in 69 (1.5%) Connecticut	Very High	1 in 18 (5.6%) Delaware	Very High	1 in 24 (4.1%) District of Columbia	Low	1 in 81 (1.2%) Florida	Low	1 in 62 (1.6%) Georgia	Low	1 in 101 (1.0%) Guam	Very Low	1 in 130 (0.8%) Hawaii	Moderate	1 in 53 (1.9%) Idaho	Low	1 in 62 (1.6%) Illinois	Moderate	1 in 60 (1.7%) Indiana	High	1 in 27 (3.8%) Iowa	Moderate	1 in 58 (1.7%) Kansas	Low	1 in 78 (1.3%) Kentucky	Moderate	1 in 39 (2.6%) Louisiana	High	1 in 3...
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 🧵 Missouri	Very Low	1 in 156 (0.6%) Montana	High	1 in 37 (2.7%) Nebraska	High	1 in 27 (3.8%) Nevada	Very High	1 in 15 (6.6%) New Hampshire	Moderate	1 in 59 (1.7%) New Jersey	Low	1 in 82 (1.2%) New Mexico	Low	1 in 102 (1.0%) New York	High	1 in 35 (2.8%) North Carolina	High	1 in 35 (2.9%) North Dakota	High*	1 in 34 (3.0%) Ohio	Moderate	1 in 58 (1.7%) Oklahoma	Low*	1 in 81 (1.2%) Oregon	High	1 in 32 (3.1%) Pennsylvania	Low	1 in 61 (1.6%) Rhode Island	High	1 in 33 (3.1%) South Carolina	Moderate	1 in 40 (2.5%) South Dakota	High	1 in 28 (3.5%) Tennessee	Low	1 in 75 (1.3%) Texas	Moderate	1 in 48 (2....
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.



4/8 🧵
PMC COVlD Update, Sep 29, 2025 (U.S.)

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 🧵 graph of 11 waves
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 🧵 Infections						Sep 29, 2025				pmc19.com/data Proportion Actively Infectious										1 in 66 (1.5%) New Daily Infections										 743,000  Infections the Past Week										 5,540,000  Infections in 2025										 185,000,000  Cumulative Infections per Person										 4.68  										 Long COVID										 Long COVID Cases Resulting								37,000 to 149,000		   from New Daily Infections										 Long COVID Cases Resulting								277,000 to 1,110,000		   from New Weekly Infections										 										 Excess Deaths										 Excess Deaths Resulting 									210 to 350	   from New Daily I...
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 🧵 year over year graph
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 🧵 Forecast of declining transmission the next several weeks

• • •

Missing some Tweet in this thread? You can try to force a refresh
 

Keep Current with Mike Hoerger, PhD MSCR MBA

Mike Hoerger, PhD MSCR MBA Profile picture

Stay in touch and get notified when new unrolls are available from this author!

Read all threads

This Thread may be Removed Anytime!

PDF

Twitter may remove this content at anytime! Save it as PDF for later use!

Try unrolling a thread yourself!

how to unroll video
  1. Follow @ThreadReaderApp to mention us!

  2. From a Twitter thread mention us with a keyword "unroll"
@threadreaderapp unroll

Practice here first or read more on our help page!

More from @michael_hoerger

Oct 1
I remember when they said kids don't transmit COVlD much because they are short, small, and have tiny lungs. They lied.
I remember when they said COVlD doesn't transmit in schools. They lied.
I remember when they said COVlD is mild in kids without understanding post-acute sequelae. They lied.
Read 25 tweets
Sep 27
BREAKING: COVlD transmission surges across the Northeast amid 11th wave.

CDC levels & PMC prevalence estimates:
🔹CT: Very High (1 in 18 people actively infectious)
🔹RI: High (1 in 33)
🔹NY: High (1 in 35)
🔹MA: High (1 in 37)

Quick thread 🧵 1/7 Heat map from CDC data with PMC prevalence estimates noted in post
#NewYork has "High" transmission statewide & many counties are seeing "Very High" transmission, per CDC.

PMC estimates 1 in 35 people are actively infectious statewide.

A lot of sites are offline, but notice the overall coverage remains strong. Bad picture statewide.
🧵 2/7 Heat map with prevalence estimate, noted in post
In #Connecticut, we estimate 1 in 18 people are actively infectious. The CDC indicates "Very High" levels.

Statewide coverage is good. Assume it's very high risk everywhere.
🧵 3/7 Heat map and pmc estimate
Read 7 tweets
Sep 23
PMC COVlD Dashboard, Sep 22, 2025 (U.S.)

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 Heat map: 29 states and DC in high/very high transmission PMC: Estimates 850,000 new daily infections or 1 in 57 people actively infectious
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  State	CDC Level	Actively Infectious Alabama	Very High	1 in 24 (4.2%) Alaska	High	1 in 38 (2.6%) Arizona	Low	1 in 101 (1.0%) Arkansas	Very High	1 in 25 (4.0%) California	Very High	1 in 25 (4.0%) Colorado	Moderate	1 in 56 (1.8%) Connecticut	Very High	1 in 20 (4.9%) Delaware	High	1 in 33 (3.1%) District of Columbia	High	1 in 28 (3.6%) Florida	Very High	1 in 25 (3.9%) Georgia	Moderate	1 in 53 (1.9%) Guam	Low	1 in 68 (1.5%) Hawaii	Very High	1 in 25 (4.1%) Idaho	Very High	1 in 22 (4.6%) Illinois	Moderate	1 in 53 (1.9%) Indiana	Very High	1 in 18 (5.7%) Iowa	Moderate	1 in 56 (1.8%) Kansas	High	1 i...
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.

🧵3/8 State	CDC Level	Actively Infectious Missouri	Very Low	1 in 129 (0.8%) Montana	Moderate	1 in 45 (2.2%) Nebraska	Very High	1 in 23 (4.3%) Nevada	Very High	1 in 12 (8.5%) New Hampshire	Low*	1 in 78 (1.3%) New Jersey	Low	1 in 96 (1.0%) New Mexico	Low	1 in 99 (1.0%) New York	Moderate	1 in 49 (2.1%) North Carolina	Very High	1 in 26 (3.9%) North Dakota	High*	1 in 34 (3.0%) Ohio	Moderate	1 in 52 (1.9%) Oklahoma	Moderate*	1 in 42 (2.4%) Oregon	High	1 in 35 (2.9%) Pennsylvania	Moderate	1 in 51 (1.9%) Rhode Island	High	1 in 34 (2.9%) South Carolina	Very High	1 in 18 (5.7%) South Dakota	Very High	1 in ...
Read 8 tweets
Sep 20
Three years ago, the American public was told in passing that the "pandemic is over."

PMC estimates that since that day, U.S. residents have experienced nearly 1 billion SARS-CoV-2 infections. Specifically, 974,190,702 infections, based on wastewater-derived estimates.

1/5
Far from harmless, recent high-quality data (e.g., PCORnet) suggest each infection leads about 30% of people to experience long-term health sequelae.

Per infection.

Some of these changes will be temporary, and others permanent.

2/5

COVlD is still killing people. It's now less acute. Deaths weeks, months, or years after infection.

Heart attacks. Strokes. Organ failure. A cancer prognosis that suddenly turns from favorable to fatal.

3/5

Read 5 tweets
Sep 16
PMC COVlD Report, Sep 15, 2025 (U.S.)
🧵1/7

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.Heat map using CDC levels. Key findings summarized in the post.
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.State | CDC Level | PMC Estimate, % Actively Infectious Alabama	High	1 in 30 (3.4%) Alaska	Very High	1 in 22 (4.6%) Arizona	Moderate	1 in 40 (2.5%) Arkansas	High	1 in 28 (3.6%) California	Very High	1 in 21 (4.8%) Colorado	Moderate	1 in 50 (2.0%) Connecticut	Very High	1 in 19 (5.3%) Delaware	High	1 in 33 (3.0%) District of Columbia	Very High	1 in 17 (6.0%) Florida	Very High	1 in 24 (4.2%) Georgia	Moderate	1 in 46 (2.2%) Guam	Low	1 in 64 (1.6%) Hawaii	Very High	1 in 26 (3.8%) Idaho	Very High	1 in 14 (7.3%) Illinois	Moderate	1 in 44 (2.3%) Indiana	Very High	1 in 16 (6.1%) Iowa	Moderate	1 in 40...
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). State | CDC Level | PMC Estimate, % Actively Infectious Missouri	Very Low	1 in 109 (0.9%) Montana	High	1 in 36 (2.8%) Nebraska	Very High	1 in 18 (5.5%) Nevada	Very High	1 in 17 (5.9%) New Hampshire	Low	1 in 64 (1.6%) New Jersey	Moderate	1 in 56 (1.8%) New Mexico	Very Low	1 in 106 (0.9%) New York	Low	1 in 73 (1.4%) North Carolina	Very High	1 in 17 (5.8%) North Dakota	High*	1 in 32 (3.2%) Ohio	Moderate	1 in 47 (2.1%) Oklahoma	Moderate*	1 in 44 (2.3%) Oregon	High	1 in 31 (3.2%) Pennsylvania	Moderate	1 in 44 (2.3%) Rhode Island	High	1 in 30 (3.3%) South Carolina	Very High	1 in 15 (6.6%) South D...
Read 7 tweets
Sep 13
California COVlD Surge Rages Higher

🔸CDC SARS-CoV-2 wastewater levels "Very High," and up from last week
🔸1 in 21 estimated actively infectious
🔸>250,000 estimated new daily infections statewide

Four figures...
1/4🧵 CDC: Very High: PMC Estimate: 1 in 21 actively infectious
CDC wastewater data in California show COVlD cases increasing from the already "Very High" levels last week.

2/4🧵 Line graph of the past 6 months showing the surge in wastewater viral levels
With an estimated 1 in 21 (or 4.8%) of California residents actively infectious of COVlD, risk increases dramatically in larger and more frequent social gatherings.

Interact with 25 people of average risk of being positive, and that's a >70% chance of exposure.
3/4🧵 How Does Risk Increase with More Social Contacts? Number of People | Chances Anyone is Infectious 1	4.8% 2	9.4% 3	13.7% 4	17.9% 5	21.8% 6	25.6% 7	29.1% 8	32.5% 9	35.8% 10	38.9% 15	52.2% 20	62.6% 25	70.8% 30	77.1% 35	82.1% 40	86.0% 50	91.5% 75	97.5% 100	99.3% 300	99.9%
Read 4 tweets

Did Thread Reader help you today?

Support us! We are indie developers!


This site is made by just two indie developers on a laptop doing marketing, support and development! Read more about the story.

Become a Premium Member ($3/month or $30/year) and get exclusive features!

Become Premium

Don't want to be a Premium member but still want to support us?

Make a small donation by buying us coffee ($5) or help with server cost ($10)

Donate via Paypal

Or Donate anonymously using crypto!

Ethereum

0xfe58350B80634f60Fa6Dc149a72b4DFbc17D341E copy

Bitcoin

3ATGMxNzCUFzxpMCHL5sWSt4DVtS8UqXpi copy

Thank you for your support!

Follow Us!

:(