U.S. and Europe: How Do the Outbreak Patterns Compare?

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.

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.

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.

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. The outbreak is still too early 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.

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.

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.

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.

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).

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.