If you look at Italy with about 100 thousands detected cases and over 10 thousand dead & if you assume the peak has already been reached ( no guaranty here, despite the curb flattening ) you can expect at about to 200 thousands cases and over 20 thousand death within a couple of month.
If you take into account the size of the US population ( about 5 time italy population ) you can see that those numbers are to be expected.
On the other hand the USA have many advantages over Europe resulting from its size, lack of rapid public transports and a younger population. Many states also had a little more time to prepare for the pandemic.
> The more efficient & cheaper it is to move from one city to the next the higher the possibility of multiple major clusters (ie. Northern Italy with its dense web of rather large cities ). Big cities on the costs will be exposed, but the large distances between other cities, the lack of infrastructures and the systematic use of personal cars might help limit the spread of the virus.
> The older the population is, the worst it is. Paradoxically the higher the life expectancy the higher the risk of a high mortality rate ( if the epidemic is not contained at an early stage). In Europe , France Italy and Spain have the highest numbers of "4th age people" and centenarians while the USA are comparatively younger with a lower life expectancy.
Basically some of the elderly who are most at risk in Europe are already dead in the USA.
> Being a federal state may be a hindrance at time but it has its perks as it can allow pertinent responses more adapted to the local constraints.
I speculate that the number of available critical beds tend to be higher in countries were it is an issue managed locally ( federation as opposed to centralized states ). This may be due to the fact that it harder for politicians to allow rationalization to prevail. The closure of a small local hospital service, even if it is clearly underused will easily induce reaction from the locals and forced their local politicians to keep the status quo via incentives & subsidies if necessary.
In the EU, due to the austerity policy championed by Germany & the Netherlands over the last 15 to 20 years the public hospitals supply chain was streamlined and became increasingly reliant on import from china.
Hospitals were ask to reduce their costs. This resulted in a stagnation of the number of intensive care beds ( which is largely sufficient to face a normal situation but that can quickly get saturated in the context of a pandemic ).
Those policies were not only however always due to budgetary constraints. One of the worst case in europe is the UK. There, the conservatives happily butchered the NHS, despite not being a member of the Euro-zone.
On the other hand, at least on paper, the US have more bed available per capita. The question will be whether you will fully take advantage of this resource. It requires strong logistics and some kind of federal coordination.
I explained in another post about this crucial aspect of the crisis in France. Even the military was integrated to the response to the pandemic. Its now-how when dealing with large scale pandemic in Africa is now used to move patients out of overflowed regions and establish air bridges and specialized field hospitals if needed.
Basically the actual numbers should be lower but this prediction could end up being true if no coordination is establish at the federal level when the crisis unfold.
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