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Mike Hoerger, PhD MSCR MBA Profile picture
@michael_hoerger
Nov 23, 2025 • 10 tweets • 4 min read • Read on X
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PMC COVlD Update, Week of Nov 24, 2025 (U.S.)
🧵1/10

With CDC data operational again, the transmission map is back. The data are always a week old, so transmission is likely worse than depicted.

We estimate 1 in 116 people actively infectious and 422,000 new daily infections. Heat map: Indiana and Arkansas with "moderate" transmission. All others, "low" or "very low" (CDC categories).
PMC COVlD Update, Week of Nov 24, 2025 (U.S.)
🧵2/10

State level estimates are back. Note, the CDC changed their data processing approach in August, which tends to downplay transmission.

Does 1 in 45 in Indiana seem "moderate"?

Levels in MI may be mod/high (poor reporting). Alabama Very Low 1 in 153 (0.7%) Alaska Very Low 1 in 272 (0.4%) Arizona Low 1 in 63 (1.6%) Arkansas Moderate* 1 in 47 (2.1%) California Very Low 1 in 365 (0.3%) Colorado Very Low 1 in 137 (0.7%) Connecticut Low 1 in 103 (1.0%) Delaware Very Low 1 in 262 (0.4%) District of Columbia Very Low 1 in 418 (0.2%) Florida Very Low 1 in 408 (0.2%) Georgia Very Low 1 in 292 (0.3%) Guam Very Low 1 in 887 (0.1%) Hawaii Very Low 1 in 426 (0.2%) Idaho Very Low 1 in 116 (0.9%) Illinois Very Low 1 in 116 (0.9%) Indiana Moderate 1 in 45 (2.2%) Iowa Very Low 1 in 108 (0.9%) Kansas Very Low 1 in 109 (0.9%) Ke...
PMC COVlD Update, Week of Nov 24, 2025 (U.S.)
🧵3/10

State-level estimates (continued).

Current levels may be much higher than noted here. Note that CDC data are always at least a week old. The 2nd half of November is a time period historically of accelerating transmission. Missouri Very Low 1 in 202 (0.5%) Montana Very Low* 1 in 114 (0.9%) Nebraska Low 1 in 95 (1.1%) Nevada Very Low 1 in 228 (0.4%) New Hampshire Low 1 in 78 (1.3%) New Jersey Very Low 1 in 192 (0.5%) New Mexico Very Low 1 in 151 (0.7%) New York Very Low 1 in 212 (0.5%) North Carolina Very Low 1 in 212 (0.5%) North Dakota Very Low* 1 in 116 (0.9%) Ohio Very Low 1 in 109 (0.9%) Oklahoma Low* 1 in 70 (1.4%) Oregon Very Low 1 in 194 (0.5%) Pennsylvania Very Low 1 in 111 (0.9%) Rhode Island Very Low 1 in 167 (0.6%) South Carolina Very Low 1 in 112 (0.9%) South Dakota Very Low 1 in 127 (0.8%) Tennes...
PMC COVlD Update, Week of Nov 24, 2025 (U.S.)
🧵4/10

Transmission is estimated as low in the relative sense (1/3 of the recent wave peak) but high in the absolute sense (422,000 new daily).

On Dec 1 or 5, we should have more definitive info on the potential 12th wave. Graph of 11 waves
PMC COVlD Update, Week of Nov 24, 2025 (U.S.)
🧵5/10

New weekly infections are estimated to result in considerable morbidity and excess mortality. Proportion Actively Infectious 1 in 116 (0.9%) New Daily Infections 422,000 Infections the Past Week 2,650,000 Infections in 2025 224,000,000 Cumulative Infections per Person 4.86 Long COVID Long COVID Cases Resulting 21,000 to 84,000 from New Daily Infections Long COVID Cases Resulting 133,000 to 530,000 from New Weekly Infections Excess Deaths Excess Deaths Resulting 120 to 200 from New Daily Infections Excess Deaths Resulting ...
PMC COVlD Update, Week of Nov 24, 2025 (U.S.)
🧵6/10

If you joined 1,000 people for a funeral last week or plan to see family soon for Thanksgiving, remember exposure risk remains high in larger gatherings.

#MaskUp, test, clean the air, and get boosted ASAP. Number of People Chances Anyone is Infectious 1 0.9% 2 1.7% 3 2.6% 4 3.4% 5 4.2% 10 8.3% 15 12.2% 20 15.9% 25 19.5% 30 22.9% 50 35.2% 75 47.8% 100 58.0% 200 82.3% 300 92.6%
PMC COVlD Update, Week of Nov 24, 2025 (U.S.)
🧵7/10

We have revived the old dashboard pie chart, now in "barometer" form. #CovidIsNotOver. #DuringCOVID is today.

There's more COVID out there than 37% of the days since the pandemic began. Current levels are higher than 43% of the past 100 days, 33% of the past 365 days, and 37% of all days since the pandemic onset.
PMC COVlD Update, Week of Nov 24, 2025 (U.S.)
🧵8/10

Recent transmission (red line) has percolated in a lull longer than usual. Those CDC data are >1 week old.

We may see a later wave onset than usual (like last year), or the most recent data may get corrected upward. Year over year graph
PMC COVlD Update, Week of Nov 24, 2025 (U.S.)
🧵9/10

A forecasting model allows one to formalize all of the variables one might use to predict future transmission. We expect to surpass 500,000 new daily infections around the end of the month.

We may not know that until 12/1 (bad news), 12/5 (likely), or 12/12 (late onset wave) because of the reporting lags.

Any day now, you will start to hear of people who do not track these data closely claiming that the winter will be "mild." That's a misunderstanding of reporting lags, historical transmission, and forecasting.

Use our state-level directory to keep tabs on what's happening closer to home. Even in the "very low" states, some places have high or very high transmission.Recent data and forecast
PMC COVlD Update, Week of Nov 24, 2025 (U.S.)
🧵10/10

Now's the time to restock on tests, masks, and air filters, and get boosted if one has delayed doing so.

Thanks for your help in getting the word out. 🙏

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More from @michael_hoerger

Mike Hoerger, PhD MSCR MBA Profile picture
Jan 25
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/ Heat map using CDC data. National PMC prevalence estimate noted; estimated incidence of 732,000 new daily infections.
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/ Column 1: Table of state-level prevalence estimates. Highest estimates noted in the thread text. Column 2: Proportion Actively Infectious 1 in 67 (1.5%) New Daily Infections 732,000 Infections the Past Week 5,220,000 Infections in 2026 24,000,000 Cumulative Infections per Person 5.04 Long COVID Long COVID Cases Resulting 37,000 to 146,000 from New Daily Infections Long COVID Cases Resulting 261,000 to 1,040,000 from New Weekly Infections Excess Deaths Ex...
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/ Fig 1: Graph of 12 waves Fig 2: "Barometer" showing above average transmission Fig 3: Year-over-year graph, which informs the analytic forecast Fig 4: Forecast described in post
Read 4 tweets
Mike Hoerger, PhD MSCR MBA Profile picture
Jan 17
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 Heat map from CDC data with PMC estimates. Description of "Very High" states in next post
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 Proportion Actively Infectious 1 in 52 (1.9%) New Daily Infections 941,000 Infections the Past Week 6,020,000 Infections in 2026 18,000,000 Cumulative Infections per Person 5.01 Long COVID Long COVID Cases Resulting 47,000 to 188,000 from New Daily Infections Long COVID Cases Resulting 301,000 to 1,200,000 from New Weekly Infections Excess Deaths Excess Deaths Resulting 270 to 450 from New Daily Infections Excess Deaths Resulting ...
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.

🧵3/5 1) Graph of 12 waves 2) Barometer showing above-average transmission 3) Year over year graph 4) Forecast for transmission to decline and then percolate at high levels
Read 5 tweets
Mike Hoerger, PhD MSCR MBA Profile picture
Jan 10
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 Heat map and PMC estimates, 1 in 55 infectious and 892,000 new daily infections for Jan 12. We expedited the report to release it two days early.
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 Alabama Moderate Alaska Very Low Arizona Very Low Arkansas High* California Very Low Colorado Low Connecticut Very High Delaware Moderate District of Columbia Very Low Florida Very Low Georgia Very Low Guam Very Low Hawaii Very Low Idaho Very Low Illinois Very High Indiana Very High Iowa High Kansas Very High Kentucky Moderate Louisiana Moderate Maine High Maryland High Massachusetts Very High Michigan Very High* Minnesota Moderate Mississippi Low* Missouri Very High* Montana High Nebraska High Nevada Very Low New Hampshire Moderate New Jersey Low New Mexico Moderate New York High* North Ca...
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 12 waves of COVlD Pandemic barometer: Higher than 88% of the past 100 days, 73% of the past year, 68% of the entire pandemic. Year over year graph Forecast of slowly declining transmission.
Read 4 tweets
Mike Hoerger, PhD MSCR MBA Profile picture
Jan 8
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.

Let me walk you through it...

🧵1/8 Colors show CDC levels PMC prevalence estimates noted: -Maine 1 in 38 actively infectious with COVlD -New Hampshire 1 in 35 (limited data) -Vermont 1 in 75 -New York 1 in 44 (limited data) -Pennsylvania 1 in 44 -Massachusetts 1 in 36 -Connecticut 1 in 24 -Rhode Island 1 in 41 -New Jersey 1 in 82
Notice that #Connecticut has excellent SARS-CoV-2 wastewater surveillance. It's "Very High" across much of the state, per CDC.

Based on wastewater levels, we estimate 1 in 24 residents are actively infectious w/COVlD. That's a 66% exposure risk in a room of 25 people.

🧵2/8 Colors show CDC levels PMC estimate of prevalence
The CDC reports "Very High" levels in #Massachusetts.

The surveillance is less robust, but we estimate 1 in 26 residents are actively infectious, similar to our estimate in CT where coverage is better.

In a room of 25 people, that's a 62% chance of an exposure.

🧵3/8 Colors show CDC levels PMC prevalence estimates provided
Read 8 tweets
Mike Hoerger, PhD MSCR MBA Profile picture
Jan 8
We're in the middle of a 12th COVlD wave in the U.S., with transmission particularly high in the Midwest and Northeast.

The CDC announced this week that COVlD continues to kill more Americans than breast and prostate cancer combined.

Get boosted & #MaskUp 💉💪😷
1/4🧵 Heat map of CDC data with PMC prevalence estimate
Levels are "Moderate" to "Very High" in 26 states.

However, data reporting is slow, and about 1/3 of states have low-quality data this week due to the holidays and illness.

2/4🧵 National estimates: Number of People Chances Anyone is Infectious 1 1.5% 2 3.0% 3 4.5% 4 6.0% 5 7.4% 10 14.3% 15 20.7% 20 26.5% 25 32.0% 30 37.0% 50 53.8% 75 68.6% 100 78.6% 200 95.4% 300 99.0%
Barometer: Higher transmission than 90 of the past 100 days (perhaps higher still, due to low data reporting quality)
State CDC Level Actively Infectious Alabama Moderate 1 in 48 (2.1%) Alaska Very Low 1 in 152 (0.7%) Arizona Very Low 1 in 201 (0.5%) Arkansas High* 1 in 36 (2.8%) California Very Low 1 in 484 (0.2%) Colorado Moderate 1 in 49 (2.0%) Connecticut Very High 1 in 24 (4.2%) Delaware Low* 1 in 70 (1.4%) District of Columbia Very Low 1 in 5,835 (0.0%) Florida Very Low 1 in 284 (0.4%) Georgia Low 1 in 90 (1.1%) Guam Very Low 1 in 687 (0.1%) Hawaii Very Low 1 in 874 (0.1%) Idaho Very Low 1 in 169 (0.6%) Illinois Moderate* 1 in 56 (1.8%) Indiana High* 1 in 34 (2.9%) Iowa Moderate 1 in 41 (2.4%) Kansas...
State CDC Level Actively Infectious Missouri Moderate* 1 in 42 (2.4%) Montana High 1 in 34 (2.9%) Nebraska Very High 1 in 26 (3.9%) Nevada Very Low 1 in 138 (0.7%) New Hampshire High* 1 in 35 (2.9%) New Jersey Low 1 in 82 (1.2%) New Mexico Low 1 in 87 (1.2%) New York Moderate* 1 in 44 (2.3%) North Carolina Low 1 in 82 (1.2%) North Dakota High* 1 in 34 (3.0%) Ohio Very High 1 in 27 (3.7%) Oklahoma Moderate* 1 in 62 (1.6%) Oregon Very Low 1 in 170 (0.6%) Pennsylvania Moderate 1 in 44 (2.3%) Rhode Island Moderate 1 in 41 (2.4%) South Carolina Moderate 1 in 54 (1.9%) South Dakota Very High 1 in...
If like years 1-4 of the pandemic, the winter wave has peaked. If like last year, we could hover near peak levels for a month.

Forecasting quality is low with 1/3 of states having data issues. Hopefully, we'll know a lot more in a few days.

3/4🧵 12 waves
Proportion Actively Infectious 1 in 65 (1.5%) New Daily Infections 749,000 Infections the Past Week 5,390,000 Infections in 2026 3,000,000 Cumulative Infections per Person 4.88 Long COVID Long COVID Cases Resulting 37,000 to 150,000 from New Daily Infections Long COVID Cases Resulting 270,000 to 1,080,000 from New Weekly Infections Excess Deaths Excess Deaths Resulting 220 to 370 from New Daily Infections Excess Deaths Resulting ...
year over year graph
forecast
Read 4 tweets
Mike Hoerger, PhD MSCR MBA Profile picture
Jan 5
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
Read 6 tweets

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