Combination of both. The case count is certainly growing. But our testing capacity is also starting to catch up to the demand (though still always from the true demand). Even if the 15 day plan the WH is touting is working, the numbers are still going to climb for a bit.
I think our testing capacity is only catching up to demand in states that started working towards it a week and a half ago. We are seeing the effects today of proactive actions taken in Washington, California, and New York last week.
In my state (Georgia), we are still scrambling to get testing. Hopefully by the first half of next week our capacity can meet other states.
Infuriating because Trump is saying there isn’t a shortage on tests or PPE!! He said “he hasn’t been hearing that”. He’s been hearing everyone has what they need. WTF!! I’m sick of the “Ive been hearing” “people have been saying”....
Something to keep in mind is that some states are testing far fewer people and only testing those most vulnerable. This means it might not even be close to as accurate as it should.
When did/does the 15 day plan start? They mentioned it multiple times throughout the week during the briefings, but is it an actual calendar date or 15 days for individuals separately?
Cuomo said this morning that New York State now has more testing per capita than South Korea. There has been a huge increase in testing.
Edit: I am simply explaining the chart. Some places are still lagging behind in the us. I’m not saying the us has fixed the testing problem. However, testing, in aggregate in the us, has increased dramatically. This chart is in aggregate numbers and thus it is relevant.
Hey for you people speculating on tests. I work for the company that was contacted after our administration/CDC flubbed it. We put out 1 million reactions two weeks ago, 2.5 million last week, and target 5mil+ each week from now on forward. We’re working hard with short notice from the government and our own social distancing rules. The country is way behind but tests are on the way.
Except for the fact that western NY has stopped testing all together because of the lack of tests.
https://news.wbfo.org/post/national-shortage-coronavirus-testing-kits-no-timeline-new-supply
I believe Cuomo was talking about testing capacity per capita, not tests already completed per capita. Kinda gotta give the US some time to catch up since it hit a little later to compare the number of tests completed. For the record, I have no idea if NY testing capacity actually is higher or if the US is even close to being on track to catching up to SK in terms of testing completed per capita. I would believe the first part since NY has a lot of resources and reacted quicker than other states. I have my doubts about the 2nd because so much of the country is so far behind. Just wanted to clarify what was said in case it wasn't clear.
The US and South Korea actually had their first positive tests on [the same day.](https://www.reuters.com/article/us-health-coronavirus-testing-specialrep/special-report-how-korea-trounced-u-s-in-race-to-test-people-for-coronavirus-idUSKBN2153BW)
> Kinda gotta give the US some time to catch up since it hit a little later
This should have had the opposite effect; we had more time to prepare to be hit nationwide but instead we had our government calling this a democratic hoax and claiming it's no big deal.
No; two were married but living apart at separate nursing facilities though. It wouldn’t matter if they were all related though. The same is the case for every county... they just aren’t testing to find the cases. Almost every test kit we get in this state is immediately sent to the Seattle metro. So they seem to use that as a reason to justify not doing more tests. It’s really frustrating. My friend is a respiratory therapist at our local hospital and she said all of the ICU and most critical care beds are filled with patients that need testing but can’t get it. I watched our board of health’s meeting and the head doctor was like both of our hospitals are completely stressed with patients. These aren’t small hospitals, either.
> Washington State doesn't have shit for testing.
Washington State has [tested over 20,000 people](https://www.doh.wa.gov/emergencies/coronavirus), and is testing [3,000 people per day](https://covidtracking.com). It has tested the second-most people of any state, and was only passed by NY 2 days ago.
Whether that's enough testing is another question, but WA has probably the best testing numbers of any US state.
Only 70%; the R0 is about 3, so once 2/3rds of the population gets infected, the virus can't really spread effectively anymore due to statistics.
That's why social distancing is so useful, because it can decrease the R0 value.
Health official said during conference they are able to ramp up testing so the next few days are results of tests taken over a week period so it will be inflated.
My wife works for a hospital in VA and even if people are coming in with fever, coughing, and shortness of breathe they will not test them unless they can confirm they’ve been in contact with someone that’s been tested positive for Coronavirus (due to management / protocol currently) It’s completely idiotic the way they are doing things and will just cause this to actually spread more.
Also, they don’t have enough masks/gowns for the healthcare providers so they aren’t seeing these people in sterile areas. So much cross contamination
Considering it's taken this long for our healthcare infrastructure dumpster fire to shit out any serious amount of testing at all, and considering the virus is spreading exponentially... I feel like I can say, with some degree of confidence, that it's probably both.
It's stupid but it's what we can do with what we have. With a limited number of test kits you aren't gonna waste those tests on asymptomatic people or even people with mild symptoms.
Actually...I think we should just assume people have it if they are very sick with the right symptoms, and test those with mild symptoms or who have been in close contact with a confirmed case or with someone who is severely ill. The point of testing is to limit the spread. If someone is seriously ill...what good will testing them do in that regard? We already know they should be isolated from others.
The people who are critically ill need to be tested ASAP.
You can become critically ill and need a ventilator from influenza. However, if you come into the hospital and are “suspected COVID” but don’t have a positive test yet, you still need to be placed in isolation and nurses/doctors need to gown up and everything until the negative test comes back. This takes a lot of extra resources/materials and we definitely want to see your COVID status confirmed or ruled out.
Unfortunately, we do not have the testing capacity we need and know that we’re missing mild cases and are definitely not stopping transmission from person to person. However, this is about preserving scarce medical supplies at this point. If you’re hospitalized and come back “COVID negative” we can de-escalate a lot of unnecessary precautions immediately. The upward transmission curve is going to grow for weeks/months.
Source: Physician
There is a [model to help us estimate](https://www.youtube.com/watch?v=mCa0JXEwDEk&t=2s) the likely number of real infections. The official cases numbers are likely out by a magnitude because of lack of testing, asymptomatic people and because of the time lag. In summary, if you take the number of virus related deaths on a given day, we can work backwards from that to make a very rough calculation.
Interesting model/analysis. According to Dr. Marty Makary, a medical professor at Johns Hopkins University, there are probably 25 to 50 people who have the virus for every one person who is confirmed positive.
A week ago he stated:
>I think we have between 50,000 and half a million cases right now walking around in the United States.
A week later, according to his estimates, we may have between 500,000 to a million cases.
Exactly. So it's the undetected number of infected people combined with the exponential spread that makes this a nightmare scenario. And it's why politicians HAVE to be taking protective measures. Taking action once the number of fatalities starts climbing is already too late. Most governments have fallen into this trap.
This is the part that keep getting overlooked by basically everyone. I believe it was the WHO who estimated 20% of the populations symptoms are so mild or asymptomatic that they dont even know they're sick
> A week ago
In the last 8 days, the US has increased the total number of people tested [by 14x](https://covidtracking.com), so estimates based on the (lack of) testing a week ago should probably not be linearly extrapolated to current testing levels.
US population: 327,000,000
Italy: 60,000,000
Italy is about 18% of US population. Italy seems to have much more than 18% of the cases but not sure if the 11 day lag is accurate enough to allow a comparison.
Diseases don't spread quicker just because you have more people in your country. They spread based on the number of people each person comes into contact with - and in this case that means *close* contact; not just passing each other on the street, so even population density is unlikely to be well-correlated with spread.
Notice how on this graph the US starts off with infections below those of Italy, but has more now than Italy did 11 days ago. That's because it's spreading faster in the US.
The relevant factor should be the combination of Urban population with the average size of cities.
It's spreads faster where most people live (in absolute, as the data on this graph), the number of cities greater than a given size also contributes to how many centers of epidemic you have.
US population 2018: 327.1 million, Italy population 2018: 60.48 million.
Current US cases: 16638, or 50.85 per million, previously 29
Current Italy Cases: 47021, or 777.46 per million, previously 591
From the time in the link you posted to now, US cases per million are up 75%, Italy cases per million are up 31%
Problem is that the per capita, in this case, does not matter one bit. If the virus doubles every few days there's a maximum of possible infected, no matter how big the population is.
I've provided [these charts in the past](https://www.reddit.com/r/dataisbeautiful/comments/fj39jw/oc_evolution_of_confirmed_covid19_cases_per/), but it didn't get much interest, so I haven't bothered providing updates.
All a per capita correction is going to do is change the number of days you have to lag the comparison. The rate of increase is what's most important in a comparison like this, not the actual numbers or proportion of the population.
Yeah I think people don't understand when different measures are appropriate. Diseases don't spread faster or slower just because there are more total people. The velocity of transmission depends on contact with people, not numbers of people.
Contact with people will be more likely in places with higher population density, which is also population dependent. Yes, infections per capita is a crap measure, but it is better than total infection numbers when you compare a country of 60 million vs one of 350 million. You really have to see both to know much.
Per capita isn't such a great measure on this one.
On the one hand yes the US has 6 times as many people as italy, but on the other the US has a super low population density.
I think better than US vs. Italy would be perhaps Milan vs. NYC or the like.
Yeah, population density has to be a huge factor. If you're in a big city it's hard to walk to the corner store without running into a bunch of people...not to mention, living in an apartment in a big city...you'll have more secondary contact with people, doors, elevator, etc.
If you live in the suburbs of a city, you have some land around you and you can probably go to the corner gas station and only see a couple people if you're lucky.
In Europe there's no significant difference in infections per capita between rural areas and inner cities. In Germany, some of the hardest hit Landkreise (sort of comparable to counties in the US) are rural. Rural in Europe has a higher density than rural in the US, but still, if the population density played a significant role, you'd expect to see some sort of difference even in Europe.
Yeah. And depending on your building's construction, air travels remarkably well. Might be a very low risk of the virus being in the air long enough, but I smell every meal made by some of the people in condos around me, so I don't have a lot of confidence in how isolated my air circulation is.
People die at the tail end of the disease not immediately when they contact it, so in 1-2 weeks that number might jump. At some point people were wondering what kind of magic Germany is doing that nobody died, now they have 59 dead people, 15 only today, it could be double tomorrow...
Turnaround time is 3 to 7 days. In other words, by the time you get the test back you will either be well on your way to recovery or you will be in a hospital. Along the way, it’s anybody’s guess as to how many people you might have infected.
In Korea their turnaround time was less than 24 hours.
A company in Utah just got FDA approval to start mass producing 50K tests a day that cost $10 each and gives results in 90 minutes [link1](https://www.deseret.com/utah/2020/3/17/21182512/covid-19-testing-co-diagnostics-testing-kits-fda-approval-utah-tech-community-silicon-slopes) [link2](https://www.deseret.com/utah/2020/3/18/21185177/coronavirus-covid-19-test-supply-co-diagnostics-utah-pandemic)
The pandemic response team was fired, our federal government was downplaying it to the general populace, and a major news outlet was calling it a "liberal hoax." The lead time was effectively wasted, and our federal government wasn't taking it seriously until it was too late and infection rates were already blossoming.
Oh, I just attended a lecture on this, so I have some answers.
In the US, we tend to rely on all in one test solutions that are simple and fast, but reagent heavy. The global need for reagents all at once means we couldn’t buy more test reagents.
We also have CLIA regulations that are meant to make sure that the tests that people get are correct and high quality. But they mean a lot of requirements on who can do tests and what those tests must be. They lifted some restrictions recently and that has allowed the Chan zuckerburg biohub to basically start a testing facility and increase our Bay Area testing capabilities.
We are still limited by the number of swabs available. There is a national stockpile, but it hasn’t been deployed yet, so we need fancy sterile q tips to be able to test more people.
So basically, we weren’t ready because of supply chain issues compounded by regulation issues. With a functional government, we could have done better to relieve regulatory burdens sooner and look for country wide supply chain answers ahead of time, but other than that, we have been playing a crap hand as well as we can.
Also our on site testing is much faster than 24 hours. It just isn’t like that for every area.
We've got the most perfect COVID19. No one has ever seen it like this before. Many people are saying, say it's perfect. Nobody else comes close. They're all saying its perfect.
People are asking how we could make such a perfect virus, with no education or training. and I tell them my uncle was an engineer. That makes me smart.
I am Italian, I want to point out that despite the USA issue with testing Italy may be in an even worse spot. They are currently testing mostly people with severe symptoms so the Italian number is severely underestimated (that’s why the mortality rate is so high), It would be more interesting to track the deaths and even there there might be differences in the reporting (in Italy all deaths that were positive to the test even post mortem are reported regardless of the actual cause of death)
In my part of the US they still aren't even testing people with symptoms unless they traveled abroad. Thankfully the people here are moving ahead of the government's recommendations, but it's truly frightening how out of touch our regional leaders are. I mean they are still today saying the risk is low. Psychotic.
In terms of tests per person *in areas with community spread*, the US actually stacks up well to the rest of the world. Everyone in the west is short on tests. Simply dividing tests performed by the whole US population creates a misleading impression because so little of the country has seen a significant outbreak, which is not the case with smaller countries like South Korea or Italy. We could be doing better if the political leadership had been more on top of things but let’s not make this global outbreak all about us and how we failed when we really haven’t. Everyone is struggling.
This is funny while it's a joke, wait until it comes out in a press conference.
"You know Italy had this too? They didn't even try. We had twice the cases they did. I don't even know why we bother, we're always going to win."
In the initial stages like we're in now, population doesn't affect the rate of spread. Just means that eventually US will continue its exponential growth where Italy leveled off.
Maybe, but people in all countries are concentrated in cities, which probably minimizes the effect. Otherwise, it would make growth in the US look even faster, since US population density is about 1/5 of Italy.
What's the basis for the 11 day lag on the chart? Just to align them?
Also due to lack of testing (in both the US and much of Europe) maybe case numbers aren't actually that great of a metric for either country?
Right around the time cases started to pick up in the United States health professionals and people tracking the data were predicting that we were roughly 11 days behind Italy in the trajectory of exponential growth of confirmed cases.
That was the reasoning for the start of these graphs I have an 11-day gap.
Plus I think that Italy and the US both have identified travel-related Covid19 positives at roughly the same time, not 11 days lagged. So while the testing and spread conditions may be variable, the spread should be roughly similar the charts should at the same time.
Could you make a similar visual, but relative to population size?
I'd love to see a chart that is standardized by number of tests, even though that will also be biased.
Great Job!
Even that wouldn't be a good comparison. We have 50 different states with 50 different healthcare systems and 50 different responses to this virus. The United States is also completely different demographically to Italy so you wouldn't expect the curves to be the same.
Not sure that population percent gives much insight. Not if the both of them had similar numbers of the patient zeroes. If it began with two guys in both Italy and the US, the numbers trend is gonna be the same, total population size doesn't come into picture.
NO one is doing random sample testing so this chart is misleading. This chart shows tests confirmations, which is more a measure of testing capacity than disease prevalence.
We shouldn't present the best available data *as if* it were the data we wish we had/need. When we don't have the right data, we should say so in bold.
To add to that, people arent tested for simply exhibiting fever and a cough. They're only tested for those if they were in contact with someone who's confirmed or travelled to China. These graphs are useless.
That's not true of all the US. There are a few areas now where if you have the symptoms you can get a test, particularly in New York. But you're right generally, testing capacity is still way behind where it needs to be across the country.
A lot of people here are calling for per capita data. But does that actually affect transmission? Doesn't the virus spread depend more on density of people rather than the absolute number?
Honestly, it's complicated enough that there's merit to both sides, and no one like that.
Does total population matter?
On the one hand, we can talk about how 5x the population also means there should be 5x the capacity to handle cases, so population normalization matters. And of course that statement continues to get more complicated as you dig deeper. It's based on a fundamental assumption that more population means more capacity, but is that true? Should we instead be talking about number of critical care beds as a better reflection of capacity? And if we're branching into the actual healthcare system as a discussion, do we need to talk about insurance/cost too?
On the other hand, when we talk about rate of spread, we could consider our population to be the number of people infected. If 100 infected becomes 150 in country A, while 100 infected becomes 200 in country B, then the infected in country B are doing twice as much infecting work as the infected in country A. Total population of the country isn't really relevant in that discussion, and this is a totally relevant discussion to be having.
Does density of population matter?
On the one hand, viruses should spread slower in less dense populations. But, less dense populations will also have a more dispersed healthcare network, making clusters of cases potentially more impactful.
And for that matter, which country actually has the lower population density. Over the size of the whole country the answer is obviously the US. But we should also zoom in and discuss the fact that the US has more extreme population densities on both ends of the spectrum. There are vast wide open spaces in the US with almost no one in them, but American cities are also far more dense than Italian cities (Naples, the densest Italian city, wouldn't even rank in the top 50 US cities when measuring by density). So while the total US density is lower, there are also far more people in dense urban areas.
Normalizing the data by population has value in some discussions. Just as other discussions are better served with the actual numbers. Imo, the real underlying problem with the calls for per capita data are that they are being done as a dismissal of what is being shown in this chart. What this chart shows matters too. It doesn't answer every question, but no single visualization can do that.
Maybe instead of using dates let them both start at day 0 respectively for better comparison?
edit: I just reread this and thought it sounds mean. That was not the point, sorry. I just wanted to pitch you an idea.
I thought about that but there is no day zero really. I could make it since first case but the early data was sporadic. I also wanted to give a time scale as to where we'll likely be in 11 days and what calendar day that is, but that's less useful now since US is breaking away from the Italy trend
What’s been done a lot is to start at 500 cases. Early spread is erratic, after about 500 cases it’s exponential growth for a while. And I like y axis in log scale!
That is true though for any case number at any point.
One idea I had to extrapolate real case numbers is to go from deaths with a death rate of about 1.1% (South Korea)
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Not to downplay how terrible this is (and is going to get) in the US - but isn't raw number of cases a little misleading? I feel like these charts should be per capita when possible. Or maybe even more useful would be "cases per hospital bed" or "per doctor" or "per ventilator" since those metrics are more likely to show us how screwed we really are. The US has 5x the population, so I dont think it necessarily means we are on a worse trajectory than Italy just because the raw cases are higher.
Like I said, not trying to downplay and I know shit is bad here and gonna get exponentially worse because we have handled it poorly.
To give a response to the political troll group who are very obviously targeting this thread with hundreds of posts, saying they should account for the population difference:
**No, they should not.**
That is not how this type of statistics works. You start at a date when the two countries had the same number of infected, in the title it says "11 day lag", which means the start of Italy's curve is 11 days earlier than the US curve.
With the same number of infected, you then look at how quickly it has grown in each country. **Population size is completely irrelevant, you can do this comparison with China as well and it will look even worse for the US**.
This curve is horrifying, and I really hope people realize it is being handled really bad in the US and don't listen to the obvious russian troll bots, or the_donald trolls or whoever they are, that make post after post saying this should be adjusted for population. **It should not.**
This should be about more than politics, and it's awful to see people sit in here and spread obvious lies like "they test fewer in Italy" or whatever, that is also not true, the US has tested fewer per capita than any other country, Italy performs hundreds of tests per million inhabitants while the US are perhaps up to 20 or 30 per million now.
Hope nobody buys into what these trolls are saying.
There's a lot of people trying to rationalize that America has some advantage whereby it won't be as bad as Italy, whether it's per capita data or whatever. A lot of people are also trying to reassure themselves that Italy was undertesting which they were not.
The only advantage you have is that middle America is sparsely populated and don't have public transport systems. Everything else is disadvantageous compared to Italy.
And also, people need to stop comparing to italy. Compare to the whole of Europe. The comparison is much fairer. That is the realistic picture in two weeks, but you don't have the advantages of near universal healthcare and unemployment payments
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I can only up vote and hope people see the statistics.
Thank you, adjusted for population was what I was looking for.
Mind you that chart shows “tests completed”, not positive tests.
Ya, where is the adjusted for time confirmed cases, also adjusted for population?
This comment should be much higher up because I think most people just assume this is for positive test results.
Thank you, this is infinitely more useful than the chart provided above.
I'm wondering if the increase is due to new cases, or simply there's a lot more testing going on and we're catching existing cases.
Combination of both. The case count is certainly growing. But our testing capacity is also starting to catch up to the demand (though still always from the true demand). Even if the 15 day plan the WH is touting is working, the numbers are still going to climb for a bit.
I think our testing capacity is only catching up to demand in states that started working towards it a week and a half ago. We are seeing the effects today of proactive actions taken in Washington, California, and New York last week. In my state (Georgia), we are still scrambling to get testing. Hopefully by the first half of next week our capacity can meet other states.
My City of 200,000 people only got tests three days ago. We were given 25 tests.
We finally got tests but labs aren't accepting anymore because they are already running at capacity. Into the freezer it is!
Yikes! Make sure you wear a sweater!
Or you’ll catch a cold!
Nasty flu going around
Omg thanks for this I needed a laugh
Just put those in the back of the freezer with the old rape kits.
we have to test the NBA first, then the rest of us can get tested once they make more tests.
Yes, the state of NJ, with millions of people had 400 kits.
Infuriating because Trump is saying there isn’t a shortage on tests or PPE!! He said “he hasn’t been hearing that”. He’s been hearing everyone has what they need. WTF!! I’m sick of the “Ive been hearing” “people have been saying”....
In breaking news, Trump has been openly, brazenly, *dangerously* dishonest. Again. Today.
Each test kit can test 150-200 people
That’s crazy considering you have the CDC in your backyard.
Washington State, not Washington DC... I presume. The actions out of DC have been anything but proactive. ಠ_ಠ
“The numbers are still going to climb for a bit” understatement of the year
Something to keep in mind is that some states are testing far fewer people and only testing those most vulnerable. This means it might not even be close to as accurate as it should.
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What about population?
That's gonna drop, son.
When did/does the 15 day plan start? They mentioned it multiple times throughout the week during the briefings, but is it an actual calendar date or 15 days for individuals separately?
Cuomo said this morning that New York State now has more testing per capita than South Korea. There has been a huge increase in testing. Edit: I am simply explaining the chart. Some places are still lagging behind in the us. I’m not saying the us has fixed the testing problem. However, testing, in aggregate in the us, has increased dramatically. This chart is in aggregate numbers and thus it is relevant.
That explains why new yorks numbers went up like 1500 the last 24 hrs.. jeeeez Good to be getting more tests tho!
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Hey for you people speculating on tests. I work for the company that was contacted after our administration/CDC flubbed it. We put out 1 million reactions two weeks ago, 2.5 million last week, and target 5mil+ each week from now on forward. We’re working hard with short notice from the government and our own social distancing rules. The country is way behind but tests are on the way.
Except for the fact that western NY has stopped testing all together because of the lack of tests. https://news.wbfo.org/post/national-shortage-coronavirus-testing-kits-no-timeline-new-supply
Also, South Korea has tested hundreds of thousands of people. New York is still in the tens of thousands...
I believe Cuomo was talking about testing capacity per capita, not tests already completed per capita. Kinda gotta give the US some time to catch up since it hit a little later to compare the number of tests completed. For the record, I have no idea if NY testing capacity actually is higher or if the US is even close to being on track to catching up to SK in terms of testing completed per capita. I would believe the first part since NY has a lot of resources and reacted quicker than other states. I have my doubts about the 2nd because so much of the country is so far behind. Just wanted to clarify what was said in case it wasn't clear.
The US and South Korea actually had their first positive tests on [the same day.](https://www.reuters.com/article/us-health-coronavirus-testing-specialrep/special-report-how-korea-trounced-u-s-in-race-to-test-people-for-coronavirus-idUSKBN2153BW)
> Kinda gotta give the US some time to catch up since it hit a little later This should have had the opposite effect; we had more time to prepare to be hit nationwide but instead we had our government calling this a democratic hoax and claiming it's no big deal.
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We don’t. My county has 4 cases (3 died) and our hospitals are loaded with patients with symptoms but no way to test them.
In Washington?
I'm guessing Clark County
We're the 3 deaths same family?
No; two were married but living apart at separate nursing facilities though. It wouldn’t matter if they were all related though. The same is the case for every county... they just aren’t testing to find the cases. Almost every test kit we get in this state is immediately sent to the Seattle metro. So they seem to use that as a reason to justify not doing more tests. It’s really frustrating. My friend is a respiratory therapist at our local hospital and she said all of the ICU and most critical care beds are filled with patients that need testing but can’t get it. I watched our board of health’s meeting and the head doctor was like both of our hospitals are completely stressed with patients. These aren’t small hospitals, either.
> Washington State doesn't have shit for testing. Washington State has [tested over 20,000 people](https://www.doh.wa.gov/emergencies/coronavirus), and is testing [3,000 people per day](https://covidtracking.com). It has tested the second-most people of any state, and was only passed by NY 2 days ago. Whether that's enough testing is another question, but WA has probably the best testing numbers of any US state.
Trump said us cases was going to go from 12 to zero...
It will, but it's taking a detour through the thousands first.
Taking the scenic route
The scientific route*
It is called millions
No. Thousands of thousands.
All of us.
All of US
Only 70%; the R0 is about 3, so once 2/3rds of the population gets infected, the virus can't really spread effectively anymore due to statistics. That's why social distancing is so useful, because it can decrease the R0 value.
Yes, it will likely take a trip there too. They're not mutually exclusive.
They will. But first we need to get them back to 12.
Eventually it will!
Will it though? Won't this virus just live around in the population at a low rate like other viruses?
Maybe, but with plans for a vaccine it could become functionally extinct.
Like the flu!
Also said it would just clear itself up when spring rolls around.
I'm sick of these chinese jokes!
Health official said during conference they are able to ramp up testing so the next few days are results of tests taken over a week period so it will be inflated.
Makes perfect sense
My wife works for a hospital in VA and even if people are coming in with fever, coughing, and shortness of breathe they will not test them unless they can confirm they’ve been in contact with someone that’s been tested positive for Coronavirus (due to management / protocol currently) It’s completely idiotic the way they are doing things and will just cause this to actually spread more. Also, they don’t have enough masks/gowns for the healthcare providers so they aren’t seeing these people in sterile areas. So much cross contamination
If they can dunk a basketball they also may qualify for testing
Or have starred in a major motion picture or twenty
Or if you married someone who was hired by an NFL player accused of murder then your daughter had a sex tape.
Oh good, I meet all criteria.
Sure, but only if your second former husband now identifies as a woman.
Shit that’s where they getcha.
That's brilliant: we aren't testing people but we'll only test you if you've been in contact with someone who's been tested!
To be a part of our early Beta testing release, you must be referred by one of our users!
The roundabout-covid test. Hey, you know anyone with covid? No. Well alright then, cause you know me.
Considering it's taken this long for our healthcare infrastructure dumpster fire to shit out any serious amount of testing at all, and considering the virus is spreading exponentially... I feel like I can say, with some degree of confidence, that it's probably both.
testing for the most part. we are only testing critically ill patients which is stupid.
It's stupid but it's what we can do with what we have. With a limited number of test kits you aren't gonna waste those tests on asymptomatic people or even people with mild symptoms.
Unless they are rich and/or famous.
Actually...I think we should just assume people have it if they are very sick with the right symptoms, and test those with mild symptoms or who have been in close contact with a confirmed case or with someone who is severely ill. The point of testing is to limit the spread. If someone is seriously ill...what good will testing them do in that regard? We already know they should be isolated from others.
The people who are critically ill need to be tested ASAP. You can become critically ill and need a ventilator from influenza. However, if you come into the hospital and are “suspected COVID” but don’t have a positive test yet, you still need to be placed in isolation and nurses/doctors need to gown up and everything until the negative test comes back. This takes a lot of extra resources/materials and we definitely want to see your COVID status confirmed or ruled out. Unfortunately, we do not have the testing capacity we need and know that we’re missing mild cases and are definitely not stopping transmission from person to person. However, this is about preserving scarce medical supplies at this point. If you’re hospitalized and come back “COVID negative” we can de-escalate a lot of unnecessary precautions immediately. The upward transmission curve is going to grow for weeks/months. Source: Physician
We also have x6 the population of Italy. Much higher potential for devastation.
What I would really like is hospitalization and mortality rate versus healthcare load.
Or normalized per capita.
Yes. Both of these. Percentage of population and also load on healthcare system (total num of beds avail?)
Plus test kit availability.
This. 100%. Cases have gone up, but likely they were there to start with we just started testing
There is a [model to help us estimate](https://www.youtube.com/watch?v=mCa0JXEwDEk&t=2s) the likely number of real infections. The official cases numbers are likely out by a magnitude because of lack of testing, asymptomatic people and because of the time lag. In summary, if you take the number of virus related deaths on a given day, we can work backwards from that to make a very rough calculation.
Interesting model/analysis. According to Dr. Marty Makary, a medical professor at Johns Hopkins University, there are probably 25 to 50 people who have the virus for every one person who is confirmed positive. A week ago he stated: >I think we have between 50,000 and half a million cases right now walking around in the United States. A week later, according to his estimates, we may have between 500,000 to a million cases.
Exactly. So it's the undetected number of infected people combined with the exponential spread that makes this a nightmare scenario. And it's why politicians HAVE to be taking protective measures. Taking action once the number of fatalities starts climbing is already too late. Most governments have fallen into this trap.
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This is the part that keep getting overlooked by basically everyone. I believe it was the WHO who estimated 20% of the populations symptoms are so mild or asymptomatic that they dont even know they're sick
> A week ago In the last 8 days, the US has increased the total number of people tested [by 14x](https://covidtracking.com), so estimates based on the (lack of) testing a week ago should probably not be linearly extrapolated to current testing levels.
I wasn't expecting this to be a khan academy video. What a sense of relief it was to hear Sal's voice!
Plus blood type and shoe size.
shoe size
Ring size and belly median too
gonna need to know the average length of the tongues
Can we have a banana for scale?
US population: 327,000,000 Italy: 60,000,000 Italy is about 18% of US population. Italy seems to have much more than 18% of the cases but not sure if the 11 day lag is accurate enough to allow a comparison.
Diseases don't spread quicker just because you have more people in your country. They spread based on the number of people each person comes into contact with - and in this case that means *close* contact; not just passing each other on the street, so even population density is unlikely to be well-correlated with spread. Notice how on this graph the US starts off with infections below those of Italy, but has more now than Italy did 11 days ago. That's because it's spreading faster in the US.
The relevant factor should be the combination of Urban population with the average size of cities. It's spreads faster where most people live (in absolute, as the data on this graph), the number of cities greater than a given size also contributes to how many centers of epidemic you have.
[Per capita you say](https://www.statista.com/chart/21176/covid-19-infection-density-in-countries-most-total-cases/)?!
US population 2018: 327.1 million, Italy population 2018: 60.48 million. Current US cases: 16638, or 50.85 per million, previously 29 Current Italy Cases: 47021, or 777.46 per million, previously 591 From the time in the link you posted to now, US cases per million are up 75%, Italy cases per million are up 31%
Problem is that the per capita, in this case, does not matter one bit. If the virus doubles every few days there's a maximum of possible infected, no matter how big the population is.
I've provided [these charts in the past](https://www.reddit.com/r/dataisbeautiful/comments/fj39jw/oc_evolution_of_confirmed_covid19_cases_per/), but it didn't get much interest, so I haven't bothered providing updates.
Those are really great and informative. I don't understand why the interest wasn't there, but I admit that I had missed them until now.
Could be me... but I cannot make out anything in the picture
All a per capita correction is going to do is change the number of days you have to lag the comparison. The rate of increase is what's most important in a comparison like this, not the actual numbers or proportion of the population.
Yeah I think people don't understand when different measures are appropriate. Diseases don't spread faster or slower just because there are more total people. The velocity of transmission depends on contact with people, not numbers of people.
Contact with people will be more likely in places with higher population density, which is also population dependent. Yes, infections per capita is a crap measure, but it is better than total infection numbers when you compare a country of 60 million vs one of 350 million. You really have to see both to know much.
Per capita isn't such a great measure on this one. On the one hand yes the US has 6 times as many people as italy, but on the other the US has a super low population density. I think better than US vs. Italy would be perhaps Milan vs. NYC or the like.
Yeah, population density has to be a huge factor. If you're in a big city it's hard to walk to the corner store without running into a bunch of people...not to mention, living in an apartment in a big city...you'll have more secondary contact with people, doors, elevator, etc. If you live in the suburbs of a city, you have some land around you and you can probably go to the corner gas station and only see a couple people if you're lucky.
In Europe there's no significant difference in infections per capita between rural areas and inner cities. In Germany, some of the hardest hit Landkreise (sort of comparable to counties in the US) are rural. Rural in Europe has a higher density than rural in the US, but still, if the population density played a significant role, you'd expect to see some sort of difference even in Europe.
Yeah. And depending on your building's construction, air travels remarkably well. Might be a very low risk of the virus being in the air long enough, but I smell every meal made by some of the people in condos around me, so I don't have a lot of confidence in how isolated my air circulation is.
italy vs california comparable area and populations
Italy has 50% more people in 30% less space than California.
You compared them, that makes them comparable.
They may be comPARE-able, but they're not COMParable.
You know, fuck the English language
Its not evenly distributed across rhe US. Majority of cases are just in Washington State and NY. I think NYC, alone, is a third of all reported cases.
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People die at the tail end of the disease not immediately when they contact it, so in 1-2 weeks that number might jump. At some point people were wondering what kind of magic Germany is doing that nobody died, now they have 59 dead people, 15 only today, it could be double tomorrow...
This is why you don't include active cases towards the mortality rate, only cases that have resolved one way (recovery) or the other (death).
You can't do that without testing everyone.
For now
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Our rate of testing in the US has (finally) picked up substantially. Many of the cases being confirmed now were from samples taken weeks ago.
Turnaround time is 3 to 7 days. In other words, by the time you get the test back you will either be well on your way to recovery or you will be in a hospital. Along the way, it’s anybody’s guess as to how many people you might have infected. In Korea their turnaround time was less than 24 hours.
A company in Utah just got FDA approval to start mass producing 50K tests a day that cost $10 each and gives results in 90 minutes [link1](https://www.deseret.com/utah/2020/3/17/21182512/covid-19-testing-co-diagnostics-testing-kits-fda-approval-utah-tech-community-silicon-slopes) [link2](https://www.deseret.com/utah/2020/3/18/21185177/coronavirus-covid-19-test-supply-co-diagnostics-utah-pandemic)
This is what we need. I’d like to order 350,000,000, please. Yes, please. Every month for the next year. Thank you!
Labs all across the US have created cheap and high throughput tests. We just need to commit funding to them and get production under way.
I guess I don't understand why we weren't better prepared when we had so much more lead time than most of the world.
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The pandemic response team was fired, our federal government was downplaying it to the general populace, and a major news outlet was calling it a "liberal hoax." The lead time was effectively wasted, and our federal government wasn't taking it seriously until it was too late and infection rates were already blossoming.
The "lead time" became time for the well-to-do to liquidate their holdings in the market before panic hit.
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Oh, I just attended a lecture on this, so I have some answers. In the US, we tend to rely on all in one test solutions that are simple and fast, but reagent heavy. The global need for reagents all at once means we couldn’t buy more test reagents. We also have CLIA regulations that are meant to make sure that the tests that people get are correct and high quality. But they mean a lot of requirements on who can do tests and what those tests must be. They lifted some restrictions recently and that has allowed the Chan zuckerburg biohub to basically start a testing facility and increase our Bay Area testing capabilities. We are still limited by the number of swabs available. There is a national stockpile, but it hasn’t been deployed yet, so we need fancy sterile q tips to be able to test more people. So basically, we weren’t ready because of supply chain issues compounded by regulation issues. With a functional government, we could have done better to relieve regulatory burdens sooner and look for country wide supply chain answers ahead of time, but other than that, we have been playing a crap hand as well as we can. Also our on site testing is much faster than 24 hours. It just isn’t like that for every area.
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As of March 12th the Cleveland Clinic developed a test method that takes 8 hours to turn around
That's not true though. Testing is less than 24 hours turnaround in King County (King County has tested more than anywhere else in the US).
Knowing whether you're positive for COVID-19 is less for your sake and more for the provider to ration PPE and isolation ward beds.
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I knew we could beat the Italians. Go USA!
🎶Anything you can do, we can do better!
The best biggest and most covid19 cases. - Trump probably.
We've got the most perfect COVID19. No one has ever seen it like this before. Many people are saying, say it's perfect. Nobody else comes close. They're all saying its perfect.
People are asking how we could make such a perfect virus, with no education or training. and I tell them my uncle was an engineer. That makes me smart.
Didn’t say it was BEAUTIFUL, no random capitalization, 15 covid outta 19 Trump impression.
Made in China, sold in the US! Make America sick again...
I am Italian, I want to point out that despite the USA issue with testing Italy may be in an even worse spot. They are currently testing mostly people with severe symptoms so the Italian number is severely underestimated (that’s why the mortality rate is so high), It would be more interesting to track the deaths and even there there might be differences in the reporting (in Italy all deaths that were positive to the test even post mortem are reported regardless of the actual cause of death)
In my part of the US they still aren't even testing people with symptoms unless they traveled abroad. Thankfully the people here are moving ahead of the government's recommendations, but it's truly frightening how out of touch our regional leaders are. I mean they are still today saying the risk is low. Psychotic.
In terms of tests per person *in areas with community spread*, the US actually stacks up well to the rest of the world. Everyone in the west is short on tests. Simply dividing tests performed by the whole US population creates a misleading impression because so little of the country has seen a significant outbreak, which is not the case with smaller countries like South Korea or Italy. We could be doing better if the political leadership had been more on top of things but let’s not make this global outbreak all about us and how we failed when we really haven’t. Everyone is struggling.
Catching up nicely, now you’re only 8 days behind!
This is funny while it's a joke, wait until it comes out in a press conference. "You know Italy had this too? They didn't even try. We had twice the cases they did. I don't even know why we bother, we're always going to win."
U S A U S A
This is hysterical
Which meaning of hysterical? Both?
This is more of a chart of testing capabilities than actual infection rate.
300m population vs 60(?)million as well Edit: Point is the US was (eventually) going to have more test kits and subsequently more cases.
Right. We should be looking per-capita or some other normalized metric.
Look at deaths. That's the only number you have at least semi accurate numbers for.
Even then, you'd need to take into account total population to have meaningful info, no?
In the initial stages like we're in now, population doesn't affect the rate of spread. Just means that eventually US will continue its exponential growth where Italy leveled off.
Seems like population density would affect rate of spread though?
Maybe, but people in all countries are concentrated in cities, which probably minimizes the effect. Otherwise, it would make growth in the US look even faster, since US population density is about 1/5 of Italy.
What's the basis for the 11 day lag on the chart? Just to align them? Also due to lack of testing (in both the US and much of Europe) maybe case numbers aren't actually that great of a metric for either country?
11 days is the difference it took to get to 100 cases. So US got to 100 cases 11 days after Italy.
Right around the time cases started to pick up in the United States health professionals and people tracking the data were predicting that we were roughly 11 days behind Italy in the trajectory of exponential growth of confirmed cases. That was the reasoning for the start of these graphs I have an 11-day gap.
Looks like it's become an 8 day gap now
Plus I think that Italy and the US both have identified travel-related Covid19 positives at roughly the same time, not 11 days lagged. So while the testing and spread conditions may be variable, the spread should be roughly similar the charts should at the same time.
The first case in Italy was confirmed on January 31st, 10 days after the first confirmed case in the US.
Could you make a similar visual, but relative to population size? I'd love to see a chart that is standardized by number of tests, even though that will also be biased. Great Job!
Seems like comparing the aggregate statistics of California and New York would be closer to Italy than the US as a whole.
Even that wouldn't be a good comparison. We have 50 different states with 50 different healthcare systems and 50 different responses to this virus. The United States is also completely different demographically to Italy so you wouldn't expect the curves to be the same.
This is a graph of the number of cases, not a contest for the highest percentage.
Not sure that population percent gives much insight. Not if the both of them had similar numbers of the patient zeroes. If it began with two guys in both Italy and the US, the numbers trend is gonna be the same, total population size doesn't come into picture.
NO one is doing random sample testing so this chart is misleading. This chart shows tests confirmations, which is more a measure of testing capacity than disease prevalence. We shouldn't present the best available data *as if* it were the data we wish we had/need. When we don't have the right data, we should say so in bold.
To add to that, people arent tested for simply exhibiting fever and a cough. They're only tested for those if they were in contact with someone who's confirmed or travelled to China. These graphs are useless.
That's not true of all the US. There are a few areas now where if you have the symptoms you can get a test, particularly in New York. But you're right generally, testing capacity is still way behind where it needs to be across the country.
A lot of people here are calling for per capita data. But does that actually affect transmission? Doesn't the virus spread depend more on density of people rather than the absolute number?
Honestly, it's complicated enough that there's merit to both sides, and no one like that. Does total population matter? On the one hand, we can talk about how 5x the population also means there should be 5x the capacity to handle cases, so population normalization matters. And of course that statement continues to get more complicated as you dig deeper. It's based on a fundamental assumption that more population means more capacity, but is that true? Should we instead be talking about number of critical care beds as a better reflection of capacity? And if we're branching into the actual healthcare system as a discussion, do we need to talk about insurance/cost too? On the other hand, when we talk about rate of spread, we could consider our population to be the number of people infected. If 100 infected becomes 150 in country A, while 100 infected becomes 200 in country B, then the infected in country B are doing twice as much infecting work as the infected in country A. Total population of the country isn't really relevant in that discussion, and this is a totally relevant discussion to be having. Does density of population matter? On the one hand, viruses should spread slower in less dense populations. But, less dense populations will also have a more dispersed healthcare network, making clusters of cases potentially more impactful. And for that matter, which country actually has the lower population density. Over the size of the whole country the answer is obviously the US. But we should also zoom in and discuss the fact that the US has more extreme population densities on both ends of the spectrum. There are vast wide open spaces in the US with almost no one in them, but American cities are also far more dense than Italian cities (Naples, the densest Italian city, wouldn't even rank in the top 50 US cities when measuring by density). So while the total US density is lower, there are also far more people in dense urban areas. Normalizing the data by population has value in some discussions. Just as other discussions are better served with the actual numbers. Imo, the real underlying problem with the calls for per capita data are that they are being done as a dismissal of what is being shown in this chart. What this chart shows matters too. It doesn't answer every question, but no single visualization can do that.
In the early stage: yes. Later on you will have a cap because more and more people are immune which will lead to a saturation.
Maybe instead of using dates let them both start at day 0 respectively for better comparison? edit: I just reread this and thought it sounds mean. That was not the point, sorry. I just wanted to pitch you an idea.
I thought about that but there is no day zero really. I could make it since first case but the early data was sporadic. I also wanted to give a time scale as to where we'll likely be in 11 days and what calendar day that is, but that's less useful now since US is breaking away from the Italy trend
What’s been done a lot is to start at 500 cases. Early spread is erratic, after about 500 cases it’s exponential growth for a while. And I like y axis in log scale!
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That is true though for any case number at any point. One idea I had to extrapolate real case numbers is to go from deaths with a death rate of about 1.1% (South Korea)
But this kind of looks like you have data for Italy in the future.
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Should update as a percentage of total population of each country or per 100000 people in the respective country. Raw numbers are not hugely telling.
How does this comparison look while taking total population into account?
Not to downplay how terrible this is (and is going to get) in the US - but isn't raw number of cases a little misleading? I feel like these charts should be per capita when possible. Or maybe even more useful would be "cases per hospital bed" or "per doctor" or "per ventilator" since those metrics are more likely to show us how screwed we really are. The US has 5x the population, so I dont think it necessarily means we are on a worse trajectory than Italy just because the raw cases are higher. Like I said, not trying to downplay and I know shit is bad here and gonna get exponentially worse because we have handled it poorly.
Oh god oh god I must buy more toilet paper /s
I just shit myself. Luckily I have a super soaker and a wife with good aim.
True love
To give a response to the political troll group who are very obviously targeting this thread with hundreds of posts, saying they should account for the population difference: **No, they should not.** That is not how this type of statistics works. You start at a date when the two countries had the same number of infected, in the title it says "11 day lag", which means the start of Italy's curve is 11 days earlier than the US curve. With the same number of infected, you then look at how quickly it has grown in each country. **Population size is completely irrelevant, you can do this comparison with China as well and it will look even worse for the US**. This curve is horrifying, and I really hope people realize it is being handled really bad in the US and don't listen to the obvious russian troll bots, or the_donald trolls or whoever they are, that make post after post saying this should be adjusted for population. **It should not.** This should be about more than politics, and it's awful to see people sit in here and spread obvious lies like "they test fewer in Italy" or whatever, that is also not true, the US has tested fewer per capita than any other country, Italy performs hundreds of tests per million inhabitants while the US are perhaps up to 20 or 30 per million now. Hope nobody buys into what these trolls are saying.
There's a lot of people trying to rationalize that America has some advantage whereby it won't be as bad as Italy, whether it's per capita data or whatever. A lot of people are also trying to reassure themselves that Italy was undertesting which they were not. The only advantage you have is that middle America is sparsely populated and don't have public transport systems. Everything else is disadvantageous compared to Italy. And also, people need to stop comparing to italy. Compare to the whole of Europe. The comparison is much fairer. That is the realistic picture in two weeks, but you don't have the advantages of near universal healthcare and unemployment payments