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Coronavirus: How the pandemic in US compares with rest of world

Two days after the US recorded its first case of coronavirus, Donald Trump said the situation was «totally under control» and assured the public it was «going to be just fine».

Fast forward four months and the virus has spread across all 50 states, leaving a death toll of 100,000 from more than 1.6 million confirmed cases.

We’ve taken a look at how those figures compare to other countries around the world and how the situation could develop over the next few months.

How does the situation in the US compare?

President Trump points at a chart showing mortality rates at a White House briefing in April - 17 April 2020Image copyrightREUTERSImage captionPresident Trump points at a chart showing mortality rates at a White House briefing in April

The death toll in the US became the highest in the world in early April and has risen dramatically since then.

President Donald Trump initially said «50 to 60,000» people could die during the outbreak but in May he said he was hopeful the toll would be lower than 100,000. That benchmark has now been hit though and there are still about 1,000 deaths a day on average.

Rather than focus on deaths, Mr Trump has preferred to cite the mortality rate – that is the number of people that have died relative to the country’s population – as evidence that the US has dealt with the virus more effectively than some other nations.

The chart below shows the countries with the highest death tolls and, to the right, their mortality rate. You can see that by that measure there are several countries where a greater proportion of the population has died during the coronavirus outbreak.

Chart showing the ten countries with the highest death tolls and the mortality rates for each. The US has seen 100,000 deaths, a rate of 30 people per 100,000 population. Belgium has seen 9,000 deaths, a rate of 82 people per 100,000 population. The UK has seen 37,000 deaths, a rate of 56 people per 100,000 population.

Belgium, with a population of 11.5 million, has seen 82 people in every 100,000 die during its coronavirus outbreak while the US, with a population of around 330 million, has seen nearly 30 people in every 100,000 die.

But if you look at New York – the worst-hit state in the US – the mortality rate there is close to 150 people in every 100,000, which shows that there is a lot of variation across the US.

One of the problems with comparing countries is that many of them report deaths in different ways. Belgium, for instance, includes deaths where coronavirus was suspected of being present but was never confirmed with a test. Some US states record deaths this way, but not all.

There have also been questions over whether official data from some countries can be trusted. Critics of China in particular have accused it of under-reporting the scale of its outbreak.

Another issue is that countries could be at different stages of an outbreak. In many European countries it’s clear that daily cases numbers are coming down significantly and they are past the peak. But you can’t say the same for the US at the moment

New York over the worst, but is the US?

Several countries in Europe had outbreaks around the same time as the US and all of them have seen the number of deaths grow quickly, peak and then fall away. The US has not.

One of the reasons the number of daily deaths in the US has plateaued rather than fallen is the sheer size of the country – rather than one large outbreak, there have been multiple centres of infection that developed at different times and spread at different rates.

In New York, the virus struck early, spread quickly and peaked in early April. In the rest of the US, however, the number of daily deaths has been slow to fall.

A chart showing how the number of daily deaths in New York compares to the number in the rest of the US.

Some other states that were badly affected early on, like Louisiana and Michigan, have also seen a substantial drop in the number of daily deaths like that in New York.

But as the situation in those states has improved, others have worsened. About a third of all states saw more deaths last week compared to the week before, with Rhode Island, Mississippi and Ohio seeing some of the largest percentage increases.

US leads the way in testing, but only now

President Trump at a briefing on coronavirus testing in the Rose Garden of the White House - 11 May 2020Image copyrightEPAImage captionPresident Trump has been keen to highlight the high rate of testing in the US in recent weeks

In recent weeks, President Trump has been keen to talk about the number of tests being done in the US. The most recent data says the US has carried out about 15 million so far.

That figure puts the US way ahead of other countries, but when it comes to using testing to try to control the virus, there is more to it than the total number you’ve conducted.

Countries that did a lot of testing early in the pandemic, and followed it up by tracing the contacts of anyone who was infected, have been most successful in slowing the spread.

In South Korea, for example, they ramped up testing early on in the outbreak and managed to contain the virus. Less than 300 people have died with coronavirus in the country, which has a population of about 50 million.

Chart showing the the total number of tests per 100,000 people for Italy, the US and South Korea. Italy has the highest rate, with the US just behind. South Korea's rate is much lower, but was higher than both other countries earlier on in their outbreak.

But as the chart above shows, it wasn’t until several weeks after the first death in the US that officials really stepped up testing.

The top US health official for infectious diseases, Anthony Fauci, admitted in early March that the testing system was «currently failing» and that the US was not able to supply tests «easily, the way people in other countries are doing it».

The number of daily tests shows the US is well past those initial problems, but progress can still be made. If the 15m figure is accurate, that would still only be 4.5% of the population

So what happens next in the US?

People at a protest against a state-wide stay-at-home order in Boston, Massachusetts - 4 May 2020Image copyrightGETTY IMAGESImage captionSeveral states saw protests against stay-at-home orders in early May

The death toll is still rising, albeit at a slower rate, and one model that has been cited by the White House predicts it could be at nearly 150,000 by August – although its projections have come in low in the past.

One of the issues with making projections is that no one is quite sure what effect the gradual reopening of the US economy will have on the spread of the virus.

At one point, more than 90% of the US population was under mandatory lockdown orders, but the majority of states have now begun to loosen their stay-at-home restrictions.

Map showing the total number of coronavirus cases by US state. At the moment, the overwhelming majority have been in the northeast of the country

The White House has outlined a set of criteria for states to meet before they begin reopening, including seeing a downward trajectory of case numbers for two weeks. But a group of public health experts say only a couple of states are hitting the targets.

Dr Fauci has warned states that they will see «little spikes that might turn into outbreaks» if they reopen before getting the virus under control.

But his advice has contradicted that of President Trump, who is keen to get the US economy restarted ahead of his re-election campaign. The latest figures show that nearly a quarter of the American workforce have lost their jobs since the outbreak began.

Asked earlier this month whether lives would be lost to reopen the country, Mr Trump said: «Will some people be affected badly? Yes. But we have to get our country opened and we have to get it open soon.»

Even if states continue to ease restrictions, it’s unclear whether the American public will be eager to return to shops and restaurants just yet. A recent poll by the Pew Research Center found that 70% of Americans were concerned that states would reopen too quickly.

https://www.bbc.com/

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