Carrie E

PharmD. PNW. Dog is my Copilot. Born at 338ppm. she/her/hers

[Carrie E @carriepharmd]

@michael_hoerger You’re the only reason I still have this dead 🐦 account. Thank you, as always. If you ever migrate to Substack, will follow.

[Mike Hoerger, PhD MSCR MBA @michael_hoerger]

PMC Forecasting Dashboard - Week of Jan 13, 2025

Based on the CDC's most recent update on Monday (with data from Jan 4), we estimate 1 in 56 people were actively infectious on Jan 4. That's about 860,000 daily infections.

Carrying forward with the forecast, this would amount to 1 in 45 actively infectious on Jan 13. That's about 1.06 million daily infections.

I do not see evidence yet that we have peaked by Jan 4, but the data are significantly lagged, more than usual, and may get retroactively corrected higher earlier, which was the case last year. I would consider that a 1-in-3 scenario. Hopefully we level off soon.

We recently posted a pre-print comparing our case estimation model to that of models in Canada and the UK as the UKHSA ran a very rigorous testing-based surveillance study last winter. You can read it online:
https://t.co/3tKeZ9idh3

The gist is that our case estimation model performed far better than I would have imagined. The estimated peaks for the U.S. and U.K were near identical, and the broader estimates of transmission for the peak 2 months of the wave were quite similar across the three nations. It's possible our case estimation model overestimates or underestimates true daily cases, but overall the performance was quite strong.

I would be concerned about models suggesting much lower case rates (BNO reported cases, CDC estimated cases), as they really don't have evidence for that and should start using a reasonable multiplier. It would require assuming that case rates are vastly lower here than in other nations. There is no evidence for that.

Case estimation is different from forecasting, so those who do not like forecasts and prefer to stick to the outdated CDC data should feel more confident in the present-day and historical case estimates we present.

No web update this week due to the extended reporting lags from CDC (3 days) and Biobot (still waiting) as well as yesterday's grant deadline. I'll have a video available perhaps tomorrow or Friday with some broader pandemic updates.

Info for new readers:

For those unfamiliar with the PMC model, find full weekly reports for the past 1.5 years at https://t.co/xmDnq5NN8N

The models combine data from IHME, Biobot, and CDC to use wastewater to estimate case levels (r = .93 to .96) and forecast levels the next month based on typical levels for that date and recent patterns of changes in transmission the past 4 weeks.

Our work has been cited in top scientific journals and media outlets, which are fully sourced in a detailed technical appendix at https://t.co/ddcyi164IX

Examples include JAMA Onc, JAMA-NO, BMC Public Health, Time, People, TODAY, the Washington Post, the Institute for New Economic Thinking, Salon, Forbes, the New Republic, Fox, CBS, NBC, and CNN. See pgs 11-13 at the above link.

#MaskUp #VaxUp #CleanTheAir #RapidTest

[usaama @yoUsaama]

30K UP! 😭🍉

we're sending 500 kids in Gaza shopping for winter clothes ❤️‍🩹🫶🏼

CAN YOU HELP ME FINISH THIS? 🥹

https://t.co/fEXJBMaw7U

[Mike Hoerger, PhD MSCR MBA @michael_hoerger]

PMC COVID-19 Forecasting Model, Dec 2, 2024

In a best-case scenario, we could see 700,000 daily infections/day near the peak. Worst-case, probably 1.4 million. These are all very bad levels of transmission, but nowhere near last winter, where we peaked near 2 million daily infections.

There's a reasonable chance the winter peak will be smaller than the summer wave. That's good news in terms of lower anticipated transmission, but bad news in that our lulls are bad and peaks are still terrible.

If the forecast holds, this will further challenge received public health wisdom that winter is necessarily "respiratory virus season," and suggest a need for closer monitoring of transmission and mitigation year round. We need to expand wastewater and testing-based surveillance programs, generate better consensus methodologic standards, and better link transmission levels to actionable public health guidance.

It remains to be seen how much this winter is an aberration. It could be a consequence of public health guidance switching to a 1-day isolation period that helped create such a large summer wave. Subvariant evolution has also been "lucky" the past several months.

In terms of the raw numbers, transmission was up marginally for the week ending on Nov 23, leading into busy holiday travel and gatherings. The regional patterns are not clear, given variation across data sets.

There is no formal report on the website this week.

Info for new readers:

For those unfamiliar with the PMC model, find full weekly reports for the past 14+ months at https://t.co/xmDnq5NN8N

The models combine data from IHME, Biobot, and CDC to use wastewater to estimate case levels (r = .93 to .96) and forecast levels the next month based on typical levels for that date and recent patterns of changes in transmission the past 4 weeks.

Our work has been cited in top scientific journals and media outlets, which are fully sourced in a detailed technical appendix at https://t.co/xruNpyn4ef

Examples include JAMA Onc, JAMA-NO, BMC Public Health, Time, People, TODAY, the Washington Post, the Institute for New Economic Thinking, Salon, Forbes, the New Republic, Fox, CBS, and NBC. See pgs 11-13 at the above link.

We will have a pre-print out in the next month or two documenting very compelling evidence for the validity of using wastewater to estimate case rates.

[Carrie E @carriepharmd]

@michael_hoerger Increased risk for clots w/C19, and platelets hold 5HT. When clots break apart & release extra serotonin, anxiety can spike. Giving an SSRI to an undiagnosed cardiac patient for “GAD” is just 🤦🏼‍♀️

[حسام شبات @HossamShabat]

Israeli occupation forces just targeted me and my colleagues while en route to cover a nearby bombing. We were in our car, which clearly reads "press” , they are preparing for something big in the north , if we don’t make it please keep taking about Gaza .

[Omar Sakr @omarsakrpoet]

The Lancet article estimating the death toll stood *conservatively* at 186,000 was based on a timeline going to June 2024. It would now stand at 335,500 according to Prof Devi Sridhar, chair of global public health at Edinburgh University https://t.co/hMQMxZvCpm

[Dr Mohammed Al Najjar 🇵🇸🇵🇸 @M7madNajar]

This is the last photo from ICU in Al-Aqsa Martyrs Hospital. We have been forced to evacuate hospital, there will be no doctor or nurse, and patients will be left to inevitably.
Please any one can see this post do any thing to stop this genocide
I will not leave the hospital

[AYMAN @AymanMSNBC]

"I've seen combat in war zones...this is nothing like this...I've done more amputations & seen more traumatic amputations of children than I've seen during my entire career in the last 2 weeks." Dr. Adam Hamawy, fmr trauma surgeon who served in Iraq, on the conditions in Gaza

[Carrie E @carriepharmd]

@Kahlissee @SenJeffMerkley while food rots waiting at Rafah crossing, here’s the other crossing. And the West Bank burns with settler violence. All funded by our tax dollars and we can’t get healthcare, paid sick leave, student loan forgiveness, school lunches for kids.

[Carrie E @carriepharmd]

@Amani39185109 @Julius_S_Malema @SenJeffMerkley You were supposed to do something about this. Instead you voted to send more of our tax dollars in military aid to fund g*cide and ecocide while people starve and die for lack of food & healthcare.

[Physicians for Human Rights Israel (PHRI) @PHRIsrael]

470 physicians, nurses, paramedics, medical students, pharmacists, psychologists, physical therapists, lab technicians, and researchers have been killed since the start of Israel's military assault on #Gaza.

[Carrie E @carriepharmd]

458 HCWs were dead before this. 6 days into the 5th seige on AlShifa, Congress passes funding for more #warcrimes like this.🩸on their hands. May the victims’ screams haunt & torment our officials.

[Carrie E @carriepharmd]

@MiddleEastEye Ore delegation voted to fund this and defund UNWRA. Blood on your hands @RonWyden @SenJeffMerkley @repblumenauer you approved #warcrimes including more m*rdered HCWs in violation of international law. SHAME.

[Carrie E @carriepharmd]

@azaizamotaz9 @SenJeffMerkley @RonWyden this is what you send out tax $ for instead of keeping UNWRA open with a fraction of the funds. blood on your hands for 458 dead HCWs, and countless #warcrimes

[Carrie E @carriepharmd]

@SenJeffMerkley You just voted to defund UNWRA and send more $ for war crimes. Shame.

[Carrie E @carriepharmd]

While Israel doesn’t have the “right” to self defense under international law as the occupying force, it does have the responsibility to ensure clean water, food, shelter, and medical aid for civilians in the territory it occupies. Please do more to #StopIsraelicrimes

[Senator Jeff Merkley @SenJeffMerkley]

Joint statement with @ChrisVanHollen pressing for action following our visit to the Rafah Crossing, Egypt, and Jordan ⬇️ 
https://t.co/H7IqvJmkeg

[Al Jazeera English @AJEnglish]

For feminists, silence on Gaza is no longer an option — #AJOpinion by @maryam_dh.

🔗: https://t.co/mI43oQvt2W

[MoTaz @motazazaiza9]

أهل غزة كثير عظيمين
وصلت لطريق كنت فيه كثير متعب،محطم ومهزوم نفسياً وجسدياً من الفقد والتعب والخوف
اهلي وناسي اهل غزة رغم ما اصابنا جميعا من نكسة
الا انهم كانوا بس يشوفوني بمكان يطبطبوا علية ويحكولي ولا يهمك واحنا معك وبظهرك
بكافة شرائحهم واختلافاتهم
بستمد قوتي منهم وعهد على نفسي ان اكون لغزة مخلص وان اضع كل ما اتاني الله من قوة في سبيل اعادة احياء غزة.
لن التفت للمنظرين الذين لا يهمهم دمائنا المستباحة
اللهم اني قدمت كل ما املك من قوة في سبيل الوطن وفضح الإحتلال ونصرة لاهلي وشعبي
والحمد لله على كل حال.
معتز عزايزة