Should say "most confirmed" cases since the actual number of infections is completely unknown. But given the minimal testing in the US, and the failure of many state governments to suppress the transmission rate, it's hard to imagine another nation surpassing the number of US cases.
US testing started out slow but it's now up to 100,000 tests per day (and more than half a million total), which I think is the most of any country (though probably not per capita)
No, they're testing people who are a) having issues as likely infections or b) those who have been exposed.
The odds of any random person getting it are still low, especially if you're not in one of the epicenters. Testing random people would be wasting time, effort, and tests. All of which are limited.
I'm interested in the theory that a fair amount of untested people have or had it, and are mostly asymptomatic. Iceland did some work there: https://www.buzzfeed.com/albertonardelli/coronavirus-testing... (Not my favorite source, but plenty of direct quotes)
That's a safe assumption since ~80% are asymptomatic and therefore probably think they don't have it or it's just a cold, allergies, etc.
That's where the "stay home!" mantra kicks in. If you have it and stay home for two weeks, maybe you infect your family but none of you infect anyone else. Therefore, it burns out without anyone else to spread to. Not a perfect world but it's the one we ahve.
As far as I'm aware, no country is doing that yet except Singapore; but fifteen minutes ago they announced that they would be supporting serological studies to reconcile the models with the numbers. You could think of the numbers we're seeing as a diagonal 2D slice on a more complex manifold: we're either seeing spread like this because there is a large mass of asymptomatic carriers, or because there are unexpectedly-tenacious mechanisms for infection.
A serological study, which you would usually only conduct post-mortem (but in light of the conditions, we may have use for an interim study), would shed light on how many people had been infected without knowledge, and give us some estimates of how infectious asymptomatic carriers are.
Short of that, in countries where testing has been highly available and unconditional, you can begin to get a picture of that; it's not as good though, since people who go for testing are still self-selecting to some extent.
Source? I can't find any information that Singapore's testing is random.
Also, if it is I stand corrected on my original statement. However, Singapore is a pretty small, cohesive nation with a strong central government. They, along with a handful of other city-states, are uniquely positioned for this. The poster child for testing-based control, South Korea, is not testing randomly. So, how is this a dig on the US?
The South China Morning Post (Hong Kong's newspaper of record) reports that China excluded 43,000 confirmed-but-asymptomatic cases from its official statistics, and kept the true number classified:
Well, if your statement is correct, then this actually lowers their death rate, the CFR (Case Fatality Ratio).
They reported 81,285 cases. So, 81,285 + 43,000 = 124,285 cases.
And 3287 deaths. So, that’s a 2.64% death rate.
At these numbers, and with the virus now worldwide, I think China’s numbers are now irrelevant. It’s better to begin focusing our energies on mitigation and containment.
I doubt China could have kept a lid on things if the virus has been spreading uncontrollably. Further, the majority of
documented cases from the peak have recovered. Which means the associated undocumented cases from then also recovered.
So, while they might have had more total cases, we likely have far more active cases.
At a certain point it's not about hiding cases, it's about hiding thousands of deaths and overwhelmed hospitals, complete with temporary tent facilities we could see easily by satellite.
Edit: Feel free to downvote this, but please offer an explanation as to precisely how China could be hiding an outbreak of any significant scale.
By just marking them down as general pneumonia like Russia probably is doing? This shit is NOT killing people at near the rate everyone is constantly panicking about.
And if anyone was going to decide not to try to ventilate every single case, it would be China, who already released a report that in 81% of cases, they die anyway.
Healthcare facilities have the capacity to match the normal needs of a community/region. They don't tend to have a ton of capacity beyond that. This is the entire problem with coronavirus. It is new diseases that requires significant additional healthcare resources beyond what currently exists in any healthcare system.
It's not just China hiding deaths. There are many more deaths in the US than reported officially. Simply no testing before they die and of course none after, then they don't count it.
Should adjust for population, but then the US will actually come out remarkably good in terms of both confirmed cases and mortality rates and whatever political/social case to be made on this will be lost.
Isn't the population density there such that a lockdown might not have the same effect it did elsewhere?
Edit: 29th ranked, behind Hong Kong, South Korea, but ahead of most other newsworthy COVID hot spots. I suspect large Indian cities are well above 29th.
"It seems this virus propagates much better in cold weather."
This hasn't been confirmed, but I've seen quotes from various professionals saying it is at least likely, and the distribution of cases certainly makes it feel true.
It's nice to hope that, but the virus doesn't seem to be struggling to spread in warm places. Curves in southern California, Louisiana, Australia are all following the standard trajectory.
I am not an expert but i am really puzzled by how one may think any goverment could stop a virus from spreading. Do you really think China managed to block the virus inside its borders when it already made it to other continents? That is utterly ridiculous.
The true numbers won't be known until serological studies are conducted. It's possible to tell who has had the virus, even months after the fact, by testing for antibodies in serum.
However, given how differently the US and China have responded to the virus, it's hard to see how the US will not surpass China (if it hasn't already done so) in total number of cases.
Japan is an enigma and I have yet to see a satisfactory explanation of how they have kept transmission and fatalities so low despite minimal government efforts.
However being here in Japan it does look like people haven’t been taking this seriously at all, not learning what is happening in other countries and how quickly it can go from negligible to nightmarish. Therefore Japan is ripe for a second wave. And it’s probably already happening...
Yes, this is what I hear from people on the ground in Japan. But, if this is the case, where are the overwhelmed hospitals? Where's the surge of respiratory-related deaths. This coronavirus has been in Japan much longer than most places, and the government efforts to suppress it have been minimal. So where is the impact we expect to see from this virus, like we have seen in Italy and Iran? It doesn't add up.
Hence why I’m not delving into theories about olympics and suppression. Simply observing the facts that confirmed cases are rising again and more rapidly, people appear too relaxed, and we’re very much at risk of a second wave and a bad one.
Hoping the medical system can cope. Hoping it won’t be a bad second wave.
The US has been doing a lot of testing for literally just a few days. Spain has over twice the testing rate (per capita) as the US, and Italy several times more than that.
I try to avoid politics here. But our current state around testing, consistent policy, communication, coordinated efforts around supply shortages, etc. I'm embarrassed to be a US citizen right now.
We could be so much better at this with really very little effort. Lots of capable people just needing direction. I wish the president would appoint a credible corona-czar and give up the microphone.
One should of course normalize by population. The USA has a population of 327 million. Eight nations in Western Europe (France, Italy, Spain, Switzerland, Austria, Netherlands, Belgium, and Germany) which are the core of the EU, have a population of 303 million. The US has 82,612 cases today according to worldometers.info. Those eight nations in Western Europe have a total of 289,767 cases today, which is about 3.78 times the US rate on a per capita basis.
At the same time, New York, with a population of 19.5M, has nearly half as many cases as Italy, which has a population of 60.5M.
But then we can drill further and compare Lombardy, which has a similar population to NYC's. They have 35k and 22k cases, respectively.
I think the only thing we learned here is that snap-judgement narratives are fairly useless here. Just look at the raw data if you want to have an opinion, it's quite accessible.
You can easily do that yourself! I recommend https://covid19info.live/ for playing around with the data in most cases. For regional data though, I'd probably check the Wikipedia articles on the respective countries.
Each figure tells you something new. No datapoint "trumps" another by being more interesting. These two numbers do add useful context though, so thanks for that.
Interesting may not be the right word. Though CFRs that are an order of magnitude apart suggests the discrepancy between actual and confirmed cases in many regions of the world is much greater than that in the US.
We know deaths lag behind infections by a week or two. [1] and we know the US was a couple of weeks behind Italy and Spain in their infections blowing up.
So we'll have to wait until a couple of weeks after peak infections before we can see the true mortality rate in any given region/country.
The testing rate to date in Spain is about 2x that of the US per capita. In Italy it is closer to 4x. That, plus the complete failure of the US to suppress transmission rates throughout huge parts of the population, must be taken in to account.
Are you using the latest numbers? More tests are being done every day now in the US than had been done total about a week ago, and we're up to 520,000 tests.
These curves are all lagging by weeks, and are influenced heavily by test rates and transmission rates. Our tests rates are low (until about 3 days ago) and our transmission rates are high (because many populous states have issues no shelter-at-home directives). You don't have to wait long to see more clearly, just about a week.
To clarify, I'm talking about the death curves--these seem to be the most credible statistics. Looking at those, most of the curves do not look significantly different. The exceptions are (perhaps) China, South Korea, and Japan.
China's credibility on mass death statistics is a bit shaky, and Japan has had a serious moral hazard given their 2020 Olympic hosting (and there has been a sudden blip in Tokyo in the last day or two).
Looking at the curves, though, it's hard to avoid the conclusion that that of the USA, however bad, is not obviously different than those of most countries currently undergoing the epidemic.
Perhaps some think the US should be significantly better than most countries. I'm not really a believer in exceptionalism myself.
Just extrapolation of the trend from plot my friend has prepared: https://covid.matemaciek.com/ - I won't be surprised if the number of confirmed cases in the USA reaches 300k in a week and overtakes cumulative number in mentioned group of core European countries in two weeks.
> Especially for mortality rates where the US is currently doing better than most large developed countries
That's to be expected, because deaths lag behind infections by a week or two. [1] and we know the US was a couple of weeks behind Italy and Spain in their infections blowing up.
We'll have to wait until a couple of weeks after peak infections before we can see the true mortality rate in any given region/country.
Well, this is only the beginning, it is gonna get really bad and quick. USA will have the highest number of infections normalized by the population and most likely the highest dead rate also. The reason is USA only started testing and only 21 states told people to stay home as of today.
Do you also take testing per capita into account? The US seems to be far behind on that. Or the US has found a super effective approach that no other nation has found to this kind of test/positives ratio. Also these countries don't seem to be at the same point in time as the US, we know the US is a week or two behind some of them. Comparing them like is not really fair.
Exactly, people can argue endlessly about who has the most cases and what it means, but at the end of the day it’s the deaths per capita that matters. And the US is very low in that regard.
Cases are only skyrocketing inline with testing. You can see how incompetent most nations have been [1]. The handful of countries that have exceeded US testing figures all have some of the lowest CFRs:
More aggressive testing explicitly lowers CFR, as the harder cases that will eventually die are confirmed under both strict and aggressive testing policies but the light cases are only confirmed by more expansive testing.
The death rate is worrying for the US right now because it's currently accelerating, not decelerating like many other countries that are in full lockdown. I guess we'll have to give it a few more days to validate, but they could actually cross the line into deaths doubling every 3 days.
Since a lot of the world's population is in places where testing is very limited or nonexistent, this distinction might not mean very much.
Probably more useful is to watch the death count. Even there, though, many will not necessarily be correctly attributed to the virus, given that hotspots can be overwhelmed and politics in general.
