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U.S. and Europe: How Do the Outbreak Patterns Compare? U.S. and Europe: How Do the Outbreak Patterns Compare?
(3 days later)
The United States now leads the world by many measures of the coronavirus outbreak, whether it’s a dubious distinction like the largest number of confirmed cases or a more positive one, like total coronavirus tests.The United States now leads the world by many measures of the coronavirus outbreak, whether it’s a dubious distinction like the largest number of confirmed cases or a more positive one, like total coronavirus tests.
But the United States is one of the most populous nations in the world. It might lead these measures simply because of its size, not because there’s anything unique about its coronavirus outbreak or response.But the United States is one of the most populous nations in the world. It might lead these measures simply because of its size, not because there’s anything unique about its coronavirus outbreak or response.
With so few countries of similar size, one alternative and useful comparison is to Western Europe, defined here as Germany, Italy, Austria and the other countries of mainland Europe to their west, like France and Spain.With so few countries of similar size, one alternative and useful comparison is to Western Europe, defined here as Germany, Italy, Austria and the other countries of mainland Europe to their west, like France and Spain.
Together, these nations have nearly the same population as the United States. Against this populous and wealthy region, the United States loses not only its lead in total tests, but also in total cases. It’s not close: Western Europe has twice as many cases as the United States, and nearly seven times as many coronavirus deaths.Together, these nations have nearly the same population as the United States. Against this populous and wealthy region, the United States loses not only its lead in total tests, but also in total cases. It’s not close: Western Europe has twice as many cases as the United States, and nearly seven times as many coronavirus deaths.
These bleak figures don’t necessarily suggest all is well in the United States. Instead, they might offer a preview of what the tallies will soon look like on the western side of the Atlantic. So far, the numbers of cases and deaths in the United States have advanced at a pace similar to Western Europe’s, but just a week or two behind.These bleak figures don’t necessarily suggest all is well in the United States. Instead, they might offer a preview of what the tallies will soon look like on the western side of the Atlantic. So far, the numbers of cases and deaths in the United States have advanced at a pace similar to Western Europe’s, but just a week or two behind.
The continued quick growth of cases and deaths in Western Europe, even as the death toll nears 30,000, is consistent with statistical models suggesting that the United States is still weeks from its peak.The continued quick growth of cases and deaths in Western Europe, even as the death toll nears 30,000, is consistent with statistical models suggesting that the United States is still weeks from its peak.
If anything, the rate of growth in confirmed cases and deaths is higher in the United States than it was at a comparable point in Western Europe’s outbreak. If this trend continues, it will put the United States on track to eventually overtake Western Europe in confirmed cases and deaths, despite an extra two weeks to prepare.If anything, the rate of growth in confirmed cases and deaths is higher in the United States than it was at a comparable point in Western Europe’s outbreak. If this trend continues, it will put the United States on track to eventually overtake Western Europe in confirmed cases and deaths, despite an extra two weeks to prepare.
It’s hard to be sure whether the United States or Western Europe is doing a better job of slowing the rate of growth, since the rate of testing varies considerably by country. It is still too early in the outbreak for the death toll to provide a stable indication of the prevalence of the virus in the United States. But the early rate of growth in the number of coronavirus fatalities in the United States is similar to the early toll in Europe, or again slightly higher.It’s hard to be sure whether the United States or Western Europe is doing a better job of slowing the rate of growth, since the rate of testing varies considerably by country. It is still too early in the outbreak for the death toll to provide a stable indication of the prevalence of the virus in the United States. But the early rate of growth in the number of coronavirus fatalities in the United States is similar to the early toll in Europe, or again slightly higher.
The figures suggest that the United States squandered its potential advantages, like two additional weeks of lead time for preparation and a single national government with superior resources. The U.S. response has fallen mainly to state and local authorities, yielding an even less unified response than in Western Europe. Most Western European governments have enacted stringent social-distancing measures that go beyond what has been implemented in much of the United States.The figures suggest that the United States squandered its potential advantages, like two additional weeks of lead time for preparation and a single national government with superior resources. The U.S. response has fallen mainly to state and local authorities, yielding an even less unified response than in Western Europe. Most Western European governments have enacted stringent social-distancing measures that go beyond what has been implemented in much of the United States.
Western Europe appears to have had more success in testing as well. It has conducted at least twice as many tests as the United States, and probably far more. (Much of that European data is out of date, as many nations do not appear to frequently update their published figures on testing).Western Europe appears to have had more success in testing as well. It has conducted at least twice as many tests as the United States, and probably far more. (Much of that European data is out of date, as many nations do not appear to frequently update their published figures on testing).
There is no guarantee that current trends will continue. But if you’re looking to compare the United States to anywhere in the world, Western Europe is your best bet.There is no guarantee that current trends will continue. But if you’re looking to compare the United States to anywhere in the world, Western Europe is your best bet.
Western Europe, as we are defining it, has a population of 320 million, nearly the same as the population of the United States, at 330 million. Its population is affluent and distributed fairly similarly to the United States, with a mix of urban and rural areas and no single city dominating the population. And as in the United States, some parts of Europe, like the Lombardy region of Italy, have suffered severe coronavirus outbreaks while other parts have largely gone unscathed.Western Europe, as we are defining it, has a population of 320 million, nearly the same as the population of the United States, at 330 million. Its population is affluent and distributed fairly similarly to the United States, with a mix of urban and rural areas and no single city dominating the population. And as in the United States, some parts of Europe, like the Lombardy region of Italy, have suffered severe coronavirus outbreaks while other parts have largely gone unscathed.
Updated June 5, 2020 Updated June 12, 2020
Touching contaminated objects and then infecting ourselves with the germs is not typically how the virus spreads. But it can happen. A number of studies of flu, rhinovirus, coronavirus and other microbes have shown that respiratory illnesses, including the new coronavirus, can spread by touching contaminated surfaces, particularly in places like day care centers, offices and hospitals. But a long chain of events has to happen for the disease to spread that way. The best way to protect yourself from coronavirus — whether it’s surface transmission or close human contact — is still social distancing, washing your hands, not touching your face and wearing masks.
So far, the evidence seems to show it does. A widely cited paper published in April suggests that people are most infectious about two days before the onset of coronavirus symptoms and estimated that 44 percent of new infections were a result of transmission from people who were not yet showing symptoms. Recently, a top expert at the World Health Organization stated that transmission of the coronavirus by people who did not have symptoms was “very rare,” but she later walked back that statement.So far, the evidence seems to show it does. A widely cited paper published in April suggests that people are most infectious about two days before the onset of coronavirus symptoms and estimated that 44 percent of new infections were a result of transmission from people who were not yet showing symptoms. Recently, a top expert at the World Health Organization stated that transmission of the coronavirus by people who did not have symptoms was “very rare,” but she later walked back that statement.
A study by European scientists is the first to document a strong statistical link between genetic variations and Covid-19, the illness caused by the coronavirus. Having Type A blood was linked to a 50 percent increase in the likelihood that a patient would need to get oxygen or to go on a ventilator, according to the new study.A study by European scientists is the first to document a strong statistical link between genetic variations and Covid-19, the illness caused by the coronavirus. Having Type A blood was linked to a 50 percent increase in the likelihood that a patient would need to get oxygen or to go on a ventilator, according to the new study.
The unemployment rate fell to 13.3 percent in May, the Labor Department said on June 5, an unexpected improvement in the nation’s job market as hiring rebounded faster than economists expected. Economists had forecast the unemployment rate to increase to as much as 20 percent, after it hit 14.7 percent in April, which was the highest since the government began keeping official statistics after World War II. But the unemployment rate dipped instead, with employers adding 2.5 million jobs, after more than 20 million jobs were lost in April.The unemployment rate fell to 13.3 percent in May, the Labor Department said on June 5, an unexpected improvement in the nation’s job market as hiring rebounded faster than economists expected. Economists had forecast the unemployment rate to increase to as much as 20 percent, after it hit 14.7 percent in April, which was the highest since the government began keeping official statistics after World War II. But the unemployment rate dipped instead, with employers adding 2.5 million jobs, after more than 20 million jobs were lost in April.
Mass protests against police brutality that have brought thousands of people onto the streets in cities across America are raising the specter of new coronavirus outbreaks, prompting political leaders, physicians and public health experts to warn that the crowds could cause a surge in cases. While many political leaders affirmed the right of protesters to express themselves, they urged the demonstrators to wear face masks and maintain social distancing, both to protect themselves and to prevent further community spread of the virus. Some infectious disease experts were reassured by the fact that the protests were held outdoors, saying the open air settings could mitigate the risk of transmission.Mass protests against police brutality that have brought thousands of people onto the streets in cities across America are raising the specter of new coronavirus outbreaks, prompting political leaders, physicians and public health experts to warn that the crowds could cause a surge in cases. While many political leaders affirmed the right of protesters to express themselves, they urged the demonstrators to wear face masks and maintain social distancing, both to protect themselves and to prevent further community spread of the virus. Some infectious disease experts were reassured by the fact that the protests were held outdoors, saying the open air settings could mitigate the risk of transmission.
Exercise researchers and physicians have some blunt advice for those of us aiming to return to regular exercise now: Start slowly and then rev up your workouts, also slowly. American adults tended to be about 12 percent less active after the stay-at-home mandates began in March than they were in January. But there are steps you can take to ease your way back into regular exercise safely. First, “start at no more than 50 percent of the exercise you were doing before Covid,” says Dr. Monica Rho, the chief of musculoskeletal medicine at the Shirley Ryan AbilityLab in Chicago. Thread in some preparatory squats, too, she advises. “When you haven’t been exercising, you lose muscle mass.” Expect some muscle twinges after these preliminary, post-lockdown sessions, especially a day or two later. But sudden or increasing pain during exercise is a clarion call to stop and return home.Exercise researchers and physicians have some blunt advice for those of us aiming to return to regular exercise now: Start slowly and then rev up your workouts, also slowly. American adults tended to be about 12 percent less active after the stay-at-home mandates began in March than they were in January. But there are steps you can take to ease your way back into regular exercise safely. First, “start at no more than 50 percent of the exercise you were doing before Covid,” says Dr. Monica Rho, the chief of musculoskeletal medicine at the Shirley Ryan AbilityLab in Chicago. Thread in some preparatory squats, too, she advises. “When you haven’t been exercising, you lose muscle mass.” Expect some muscle twinges after these preliminary, post-lockdown sessions, especially a day or two later. But sudden or increasing pain during exercise is a clarion call to stop and return home.
States are reopening bit by bit. This means that more public spaces are available for use and more and more businesses are being allowed to open again. The federal government is largely leaving the decision up to states, and some state leaders are leaving the decision up to local authorities. Even if you aren’t being told to stay at home, it’s still a good idea to limit trips outside and your interaction with other people.States are reopening bit by bit. This means that more public spaces are available for use and more and more businesses are being allowed to open again. The federal government is largely leaving the decision up to states, and some state leaders are leaving the decision up to local authorities. Even if you aren’t being told to stay at home, it’s still a good idea to limit trips outside and your interaction with other people.
Touching contaminated objects and then infecting ourselves with the germs is not typically how the virus spreads. But it can happen. A number of studies of flu, rhinovirus, coronavirus and other microbes have shown that respiratory illnesses, including the new coronavirus, can spread by touching contaminated surfaces, particularly in places like day care centers, offices and hospitals. But a long chain of events has to happen for the disease to spread that way. The best way to protect yourself from coronavirus — whether it’s surface transmission or close human contact — is still social distancing, washing your hands, not touching your face and wearing masks.
Common symptoms include fever, a dry cough, fatigue and difficulty breathing or shortness of breath. Some of these symptoms overlap with those of the flu, making detection difficult, but runny noses and stuffy sinuses are less common. The C.D.C. has also added chills, muscle pain, sore throat, headache and a new loss of the sense of taste or smell as symptoms to look out for. Most people fall ill five to seven days after exposure, but symptoms may appear in as few as two days or as many as 14 days.Common symptoms include fever, a dry cough, fatigue and difficulty breathing or shortness of breath. Some of these symptoms overlap with those of the flu, making detection difficult, but runny noses and stuffy sinuses are less common. The C.D.C. has also added chills, muscle pain, sore throat, headache and a new loss of the sense of taste or smell as symptoms to look out for. Most people fall ill five to seven days after exposure, but symptoms may appear in as few as two days or as many as 14 days.
If air travel is unavoidable, there are some steps you can take to protect yourself. Most important: Wash your hands often, and stop touching your face. If possible, choose a window seat. A study from Emory University found that during flu season, the safest place to sit on a plane is by a window, as people sitting in window seats had less contact with potentially sick people. Disinfect hard surfaces. When you get to your seat and your hands are clean, use disinfecting wipes to clean the hard surfaces at your seat like the head and arm rest, the seatbelt buckle, the remote, screen, seat back pocket and the tray table. If the seat is hard and nonporous or leather or pleather, you can wipe that down, too. (Using wipes on upholstered seats could lead to a wet seat and spreading of germs rather than killing them.)If air travel is unavoidable, there are some steps you can take to protect yourself. Most important: Wash your hands often, and stop touching your face. If possible, choose a window seat. A study from Emory University found that during flu season, the safest place to sit on a plane is by a window, as people sitting in window seats had less contact with potentially sick people. Disinfect hard surfaces. When you get to your seat and your hands are clean, use disinfecting wipes to clean the hard surfaces at your seat like the head and arm rest, the seatbelt buckle, the remote, screen, seat back pocket and the tray table. If the seat is hard and nonporous or leather or pleather, you can wipe that down, too. (Using wipes on upholstered seats could lead to a wet seat and spreading of germs rather than killing them.)
Taking one’s temperature to look for signs of fever is not as easy as it sounds, as “normal” temperature numbers can vary, but generally, keep an eye out for a temperature of 100.5 degrees Fahrenheit or higher. If you don’t have a thermometer (they can be pricey these days), there are other ways to figure out if you have a fever, or are at risk of Covid-19 complications.Taking one’s temperature to look for signs of fever is not as easy as it sounds, as “normal” temperature numbers can vary, but generally, keep an eye out for a temperature of 100.5 degrees Fahrenheit or higher. If you don’t have a thermometer (they can be pricey these days), there are other ways to figure out if you have a fever, or are at risk of Covid-19 complications.
The C.D.C. has recommended that all Americans wear cloth masks if they go out in public. This is a shift in federal guidance reflecting new concerns that the coronavirus is being spread by infected people who have no symptoms. Until now, the C.D.C., like the W.H.O., has advised that ordinary people don’t need to wear masks unless they are sick and coughing. Part of the reason was to preserve medical-grade masks for health care workers who desperately need them at a time when they are in continuously short supply. Masks don’t replace hand washing and social distancing.The C.D.C. has recommended that all Americans wear cloth masks if they go out in public. This is a shift in federal guidance reflecting new concerns that the coronavirus is being spread by infected people who have no symptoms. Until now, the C.D.C., like the W.H.O., has advised that ordinary people don’t need to wear masks unless they are sick and coughing. Part of the reason was to preserve medical-grade masks for health care workers who desperately need them at a time when they are in continuously short supply. Masks don’t replace hand washing and social distancing.
If you’ve been exposed to the coronavirus or think you have, and have a fever or symptoms like a cough or difficulty breathing, call a doctor. They should give you advice on whether you should be tested, how to get tested, and how to seek medical treatment without potentially infecting or exposing others.If you’ve been exposed to the coronavirus or think you have, and have a fever or symptoms like a cough or difficulty breathing, call a doctor. They should give you advice on whether you should be tested, how to get tested, and how to seek medical treatment without potentially infecting or exposing others.
If you’re sick and you think you’ve been exposed to the new coronavirus, the C.D.C. recommends that you call your healthcare provider and explain your symptoms and fears. They will decide if you need to be tested. Keep in mind that there’s a chance — because of a lack of testing kits or because you’re asymptomatic, for instance — you won’t be able to get tested.If you’re sick and you think you’ve been exposed to the new coronavirus, the C.D.C. recommends that you call your healthcare provider and explain your symptoms and fears. They will decide if you need to be tested. Keep in mind that there’s a chance — because of a lack of testing kits or because you’re asymptomatic, for instance — you won’t be able to get tested.
The fundamental similarity of the coronavirus outbreaks in the United States and Western Europe is difficult to glean from many of the comparisons recently being made between the United States and individual countries. Popular charts of growth in coronavirus cases or deaths over time, for instance, measure the outbreak in terms of raw numbers, without an adjustment for population, and show the many nations of Western Europe well beneath the United States. The gap closes quickly if the nations of Western Europe are combined.The fundamental similarity of the coronavirus outbreaks in the United States and Western Europe is difficult to glean from many of the comparisons recently being made between the United States and individual countries. Popular charts of growth in coronavirus cases or deaths over time, for instance, measure the outbreak in terms of raw numbers, without an adjustment for population, and show the many nations of Western Europe well beneath the United States. The gap closes quickly if the nations of Western Europe are combined.
Of course the two places are not identical. Western Europe has a higher population density, which may increase the rate of community spread. It has an older population, which may increase its mortality rate. On the other hand, the United States has higher rates of many of the health problems that predict coronavirus mortality, controlling for age, like Type 2 diabetes and obesity.Of course the two places are not identical. Western Europe has a higher population density, which may increase the rate of community spread. It has an older population, which may increase its mortality rate. On the other hand, the United States has higher rates of many of the health problems that predict coronavirus mortality, controlling for age, like Type 2 diabetes and obesity.
Most obviously, the United States is one country, while Western Europe consists of many. But that difference may not amount to much: Western Europe has open borders in ordinary circumstances, while the lack of a centralized federal response in the United States has left much of the pandemic response to states and local governments.Most obviously, the United States is one country, while Western Europe consists of many. But that difference may not amount to much: Western Europe has open borders in ordinary circumstances, while the lack of a centralized federal response in the United States has left much of the pandemic response to states and local governments.
The United States might have an even less uniform series of social distancing policies than Western Europe, where most countries have ordered national lockdowns. Western European countries have even closed their borders, potentially slowing the spread of the virus within Western Europe in a way that American states have not yet tried to replicate (although some states have sought to tighten borders).The United States might have an even less uniform series of social distancing policies than Western Europe, where most countries have ordered national lockdowns. Western European countries have even closed their borders, potentially slowing the spread of the virus within Western Europe in a way that American states have not yet tried to replicate (although some states have sought to tighten borders).
No two countries or regions are exactly alike. But over all, it is not obvious that either population was vastly more vulnerable at the outset of the pandemic, and the United States possessed the clearest advantage of all: two additional weeks to prepare. At the moment, it does not have much to show for it.No two countries or regions are exactly alike. But over all, it is not obvious that either population was vastly more vulnerable at the outset of the pandemic, and the United States possessed the clearest advantage of all: two additional weeks to prepare. At the moment, it does not have much to show for it.
Data sources: New York Times database of coronavirus cases; local governments; the Center for Systems Science and Engineering at Johns Hopkins University; World Health Organization.Data sources: New York Times database of coronavirus cases; local governments; the Center for Systems Science and Engineering at Johns Hopkins University; World Health Organization.