
Data Analysis Shows That US Is Significantly Outpacing Italy - gsibble
https://covid.bio/growth
======
shaggy
Please if you're going to create stuff like this provide some context and
answer questions like "What does this actually mean?". Without those things,
this is just another scary looking title and graph that will make people more
panicky than they already are. Given the ramp up in testing seen in my state,
the large jump up to the cases in the graph isn't surprising. We know that the
US has a far higher population than Italy and that testing rates in the US
have been very low. Large spikes in confirmed cases are obviously going to
happen as the testing ramps up. _That 's_ when we can start drawing
conclusions and make better decisions. When we have a more clear picture of
how widespread this is and what that actually means. What's the R0 and what's
the mortality rate? On the other hand, if we accept that there are far more
infected people right now than we know, the logical conclusion is that the
mortality rate is low, otherwise there'd be dead people everywhere.

~~~
fabian2k
The huge issue with the numbers is that they always lag behind the actual
situation right now. There is a delay of around 5 days until symptoms show,
and something on top of that until you get tested and until the test is
processed. And the deaths lag even further behind, it takes very roughly
something like 3-4 week to die as far as I've read.

The deaths of today are the people that were infected 4 weeks ago, 4 week is
an eternity on an exponential curve like this.

------
j7ake
I think the differences in testing policies make it difficult to compare the
absolute numbers. I think in a week or two it will be more meaningful to
compare deaths rather than cases, because deaths seem to be more uniformly
reported than cases.

~~~
_nalply
Yes, I gave up on case numbers. Seeming CFR differences between countries are
mostly artifacts of testing policies.

------
andrewmutz
Should we be comparing this in a per capital manner? USA population is five
times Italy's.

~~~
fabian2k
At the beginning of the epidemic and the exponential growth the size of the
population doesn't really matter, the number of available people isn't the
limiting factor. The structure of the population probably matters quite a bit,
but the total number of people in a somewhat arbitrary region probably
doesn't. Unless containment measures prevent it, at the beginning you'll
always have exponential growth no matter the size of the country.

I'm certainly not an expert, but I would assume that the individual, isolated
outbreaks would be the most interesting numbers. Below a certain level they
can be potentially contained by targeted measures, above a certain number of
infected people you can't do any contact tracing or similar stuff anymore. And
hospital resources are location-bound, there is only a limited amount of
resource sharing you can do across the country.

~~~
dr_kiszonka
I agree with your points. I am still a little surprised that the US outpaces
Italy, because the social distance there is traditionally much shorter than in
the US, e.g., people kiss each other on the cheeks, and give each other hugs
more frequently than what I observed in the US.

------
xhkkffbf
It is very dangerous to draw any conclusions from the number of cases in the
US. They follow the number of tests that are done and those are limited by the
test kits available.

I spoke with one doctor in upstate New York. She said that the local hospital,
Albany Medical Center, was stopping community testing and going back to the
old procedure of only testing people who met a narrow range of parameters.
(Exposure, travel, etc.) Then she said, "So it looks like we'll start
plateauing."

The rate of case growth will vary with the rate of testing.

~~~
EvanAnderson
_Then she said, "So it looks like we'll start plateauing."_

Could you qualify how that statement is to be read? Is that an observation
about what the results are going to look like as a result of limited testing,
or is it a statement about the intention beind behind decreased testing (to
make the number _appear_ to be plateauing artificially).

Aside: 'Plateauing' is a funny word to type with all those vowels together.

~~~
xhkkffbf
She did not suggest anything about the intention. Only that wide-open testing
would yield many more positives than tightly controlled testing. And if
they're going to tighten testing that will reduce growth in positive cases.

------
crazygringo
But since testing in the US has been so extremely limited... should we be
worried that the actual conclusion here is that "US is _far_ outpacing Italy"?

Of course I'm not sure how available or limited testing is in Italy either.

~~~
DenisM
If you're willing to accept a lot of hidden cases you will have to accept a
much lower mortality rate. Just saying.

~~~
sgc
For now.

------
kevin1894
Doesn't this data need to be normalized per-capita? It looks like it is just
number of cases, and that doesn't get you a comparable. US population is about
5 times that of Italy.

~~~
gsibble
I'm not trying to show percentage of infected, but the spread over time. And
it's spreading a lot faster in the US and/or we are testing significantly.

------
baxtr
I really wonder what the difference between these countries is:

\- Germany: 15,320 cases / 44 deaths

\- France: 10,947 cases / 243 deaths

\- Spain: 17,963 cases / 830 deaths

~~~
danielbln
There are various discussions and theories especially as to the low death
rates in Germany. Germany has had distributed testing capabilities very early
(end of January) and has performed a large amount of testing compared to other
European countries, which means cases are cought early and not when they hit
the ICU. Other theories are the large amount of ICU beds, local medical
production facilities, still ongoing contact tracing and some other things.
The expectation however is that the death rate will go up a fair bit.

~~~
thu2111
Also - different reporting strategies. Germany is not always reporting someone
as a CV death if the dominating factor was something else, whereas Italy
reports them all as CV deaths. Or at least that's a widespread theory I've
seen. It's hard to imagine such a huge difference can be down purely to
testing.

I think the next days will see people dig into these stats and start a more
complex discussion about what exactly it means to die of this virus, what
exactly capacity means in a world where doctors can go to enormous lengths to
save every life in quiet times but can't in crisis times. Just comparing raw
numbers doesn't tell us the whole story.

------
vnchr
The basis for “significant outpacing” is only one day / data point. Previous
days follow Italy closely.

Besides that, we have a much larger total population. We’ve asserted counter-
measures earlier. We are able to change our course based on our observed
response of Italy.

This seems irresponsible to reactively share a “trend” based on a single data
point of notable deviation.

------
DenisM
I feel like comparing large countries should require some normalization.

How would the results change if we split the US into two countries - US East
and US West? The current number of cases would be cut in half(?) but the
"start" date would be pushed forward.

------
jcheng
The total population of these two countries is pretty different though.

~~~
rolltiide
r0 doesn’t take per capita into account

clusters originally were isolated

Eventually this will matter though for absolute numbers, but our healthcare
capacity is the bigger issue its not really a contest

------
bioinformatics
Why is no one comparing the North of Italy with the South?

Why is no one comparing Madrid to the rest of Spain?

Germany and France have a very similar curve to Spain, Italy and even China,
with a much smaller population as US.

------
mistermann
It would be useful to know what "shows" means in this context. The normal
meaning doesn't work.

Now, imagine a world where a large percentage of reality is presented to
people in this manner, what might be the result? Does it look anything like
what we've been living in for quite some time now, where it seems nobody can
agree on what is actually _true_?

I may be way off base, but I think this is a much bigger issue than people
realize, but it requires some effort _and the will_ to see it.

------
ghettoimp
This seems like a really nice chart. I haven't seen the data "normalized" to
start date like this before.

~~~
thanatropism
I made one in logarithmic units. But it's on a teeny digital ocean instance
and Streamlit, so please don't trample on it.

[http://covid.superlabs.club:8501](http://covid.superlabs.club:8501)

------
bargl
Wouldn't data like this make more sense in a per capita comparison? I get that
we're outpacing Italy, but are we outpacing.

US population is about Italy, Spain, Germany, France, UK, and Netherlands put
together.

For that matter does China even register compared to the impact this is having
on Italy on a per capita basis?

~~~
Bertio
Also I think you have to look at the clusters (in a state) as independent
threads growing in parallel. It makes more sense to compare individual state
to European countries of similar population.

~~~
bargl
Very true. The most basic modeling of by country is not helpful, it'd be far
better to show it by city, metro area, etc. And as you said each area has
their own start date.

Shoot in the US most metro areas have their own quarantine date too.

------
catherd
If you look at China and South Korea, they both took about 11 days between
crossing 100 cases to having a strong effect on their case# curve. (18 if you
ignore the roughly 7 day incubation + getting tested period)

With incubation time removed:

Italy: 19 days from crossing 100, and counting

Iran: 15 days and counting

Spain: 11 days and counting

France: 12 days and counting

US: 9 days and counting

------
microdrum
\- Why would you report absolute numbers?

\- You know that private labs are widely not reporting negative results back
to CDC, right? (See Alexis Madrigal)

\- We just activated testing in general availability yet virus has been here
for months

This is bad statistics, and should be removed.

------
donatj
Absolute numbers seems like a bad comparison on a country with 6 times as many
people.

------
CubsFan1060
Adding death's would be interesting. Especially Italy vs. Germany.

------
beckingz
How is day zero chosen? Unclear if this is a reasonable comparison.

~~~
xhkkffbf
Yes, a very fair point. At the left when the tail is sooo thin, it's easy to
move it left and right by quite a few days. When there aren't many cases, it's
hard to choose a "day zero."

------
jacquesm
Testing in Italy is _also_ limited.

~~~
adrr
Italy has a decent testing coverage. US has almost no coverage.

[https://www.nytimes.com/interactive/2020/03/17/us/coronaviru...](https://www.nytimes.com/interactive/2020/03/17/us/coronavirus-
testing-data.html)

~~~
jacquesm
The US is terrible. But Italy is still limited, the only country that I'm
aware of that is able to test everybody they need to test is South Korea.
Everywhere else there are still pre-qualifications.

~~~
hackandtrip
Italy did test a lot during the first days over 100 cases; after, since the
number were so high, it limited testing to people with symptoms. I think most
countries are straight out testing a small fraction of people with symptoms.

