America has been testing people for the coronavirus at a slower rate than most other developed countries, yet the data also shows the rate of people diagnosed with Covid-19 in the US is steadily rising, more quickly than our peers abroad.

So we don’t yet know the full extent of the outbreak, but America has quickly become one of the epicenters for the coronavirus pandemic. The US could soon become the nation with the most Covid-19 cases in the world, overtaking China and Italy.

America’s health system was less prepared for a pandemic than other rich nations. The US’s high uninsured rate, high out-of-pocket health care costs, and low medical system capacity combined to make the country more vulnerable to a pathogen before the coronavirus ever came to our shores. America’s lax response in the early days of the outbreak only compounded those problems.

“Everyone working in this space would agree that no matter how you measure it, the US is far behind on this,” Jen Kates, director of global health and HIV policy at the Kaiser Family Foundation, told Vox of the coronavirus response.

Here’s how the number of confirmed cases in the US compares to select other countries, based on days since each country reached 100 confirmed cases, according to data we analyzed from the Johns Hopkins University coronavirus dashboard.

Note that the chart uses a log scale, meaning that the Y axis goes up in equal distances between 100, 1,000, and 10,000 to mimic the exponential rate at which a contagion like the coronavirus spreads.

Here’s that same chart on a traditional linear scale.

As of March 24, the Johns Hopkins research data shows approximately 437,000 confirmed cases worldwide, about 55,000 of which were in the US. The actual number of cases is likely much higher. More than 20,000 people have died across the world from Covid-19, including more than 675 in the United States.

As you can see, the confirmed cases in the US have now surpassed Iran and Italy at the same point in their outbreaks and have far outpaced places like Hong Kong and Singapore, where the governments mobilized more quickly. Japan’s case numbers also appear to be quite low, though the government there has been criticized over not having enough tests to properly judge the true number of cases. On the other hand, the number of deaths in Japan (41) is small compared to the hardest-hit countries, suggesting better containment there than some European nations or the US.

As America implements dramatic measures to control the spread of Covid-19, with schools and businesses closing and general social distancing underway, we are still struggling to understand the full scope of the outbreak because of the slow start of testing in the US. It has undeniably hindered our response.

“The testing failure is putting additional strain on our already challenged health system,” Cynthia Cox, director of the Peterson-Kaiser Health System Tracker, said. “The combination of all of these factors will make the US worse off than similar countries.”

Testing is not only important because it gets people diagnosed and appropriate treatment if they do have an infection. It also establishes how widespread a virus actually is. Experts know the size of the problem, they know the rate at which people are being hospitalized or dying, and they can follow its movements.

But the United States has faltered in rolling out coronavirus tests, putting us far behind our economic peers in tracing the outbreak. A manufacturing problem with the test kits that were initially sent out in the field, and a delay in approving commercial tests, set the nation back in stopping or slowing down Covid-19.

Even as testing and testing capacity has ramped up in the US, as of March 25, America still trails other countries in the share of its population being tested for the coronavirus. There have been about 367,000 tests conducted in the US for its population of 329 million.

The number of tests conducted in the US did leap from 58,000 on March 19 to 367,000, a reflection of the increased capacity. But the US started behind the rest of the world in responding to Covid-19 — and is still catching up.

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