Mike Hoerger, PhD MSCR MBA Profile picture
Oct 1 25 tweets 3 min read Read on X
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.
I remember when they took off their masks before children had vaccines because they said COVlD was mild in kids. They lied.
I remember when they said it was good for kids to get COVlD because it is mild in kids and would accelerate "herd immunity." They lied.
I remember when they said it was safe to send kids to school with cloth masks and low air quality. They lied.
I remember when it was "hot vax summer" (for adults), so they said it was extra safe for kids to return to schools. Then, there was the Delta wave. They lied.
I remember after the Delta wave, they said children had so much hybrid immunity, it was very super safe to return to schools. Then, there was the BA.1 Omicron wave. They lied.
I remember when I offered to donate countless air purifiers to local schools, but they said 1 ACH was sufficient. They lied, everyone got Omicron, and many got fired.
I remembered when they upgraded to 3 ACH and dropped masks. Everyone got COVlD. They lied.
I remember when they said kids had access to vaccines, had been through Delta, and had been through BA.1 Omicron and had super-duper hybrid immunity. They lied.
I remember when they said COVlD was seasonal but we kept having late summer waves when kids returned to school. COVlD is seasonal if kids don't count. They lied.
I remember when they said the pandemic was "over" because nobody seemed to be masking. More children got COVlD. They lied.
I remember when they used air quality as an offramp for masking. They lied.
I remember when they used the lack of masking as an apathy-based justification to throw away the air purifiers. They lied.
I remember when they said it was safe to send kids to school with no masks and low air quality. They lied.
I remember when they published tons of junk studies on nasal sprays to allow parents enough of a cover under defense mechanisms to put their children in risky spaces. They lied, and every single study is still junk.
I remember when they published that junk neti pot study where the main author still does not comprehend how bad the methodology is, and parents used it to justify putting kids in unsafe spaces. They lied.
I remember when they proclaimed "freedom" and "choice," and then required a prescription for vaccines, and demand plummeted so badly that pharmacies stopped carrying vaccines for Louisiana children. They lied.
I remember when they said infections are good, and it's better to get them at a younger age. They lied.
I remember when classmates, parents, and teachers picked on kids who were masking out of "health anxiety" (but it was really because they were vulnerable, had a vulnerable family member, or simply had health literacy). They lied.
I remember when parents were threatened by truancy officers for "neglecting" their children by keeping them home during COVlD waves. They lied.
I remember when families were torn apart, and unmasked judges with low health literacy placed children with the incautious parent. They lied.
I remember when they used apathy toward COVlD to reduce accommodations in schools. They lied.
I remember when they read the 2025 Lancet study on reinfections doubling the risk of #LongCOVID in kids. And rather than wonder what will happen by the 10th reinfection, they do nothing. They lie.
thelancet.com/journals/lanin…

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More from @michael_hoerger

Oct 3
BREAKING: 3 State Pharmacy Boards Still Block COVlD Boosters without a Prescription

ACIP voted against prescriptions for boosters & 47 states + DC follow that guidance.

Georgia, Missouri, & Louisiana require prescriptions.

Key points in my letter to the pharmacy boards. 🧵1/7 Map shows only Missouri, Louisiana, and Georgia are blocking residents from routing COVlD boosters unless they have a prescription.
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 Georgia:  State law does NOT require a prescription if it is a “vaccine that is included on the adult immunization schedule recommended by the Advisory Committee on Immunization Practices (ACIP)”1 ACIP voted against prescriptions, and 47 states have accepted that schedule.  The law does not mention a CDC Director sign-off, which may be delayed months. Act now to save lives.  1. https://law.justia.com/codes/georgia/title-43/chapter-34/article-2/section-43-34-26-1/
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.

🧵3/7 Louisiana:  State law does NOT require a prescription if the “vaccine is administered in conformance with the most current immunization administration protocol as set forth by the United States Centers for Disease Control and Prevention Advisory Committee on Immunization Practice.” 2 ACIP voted against prescriptions, and 47 states have accepted that protocol.  The law does not mention a CDC Director sign-off, which may be delayed months. Act now to save lives.  2. https://law.justia.com/codes/louisiana/revised-statutes/title-37/rs-37-1218-1/
Read 7 tweets
Sep 30
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....
Read 8 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

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