Global analysis of daily new COVID-19 cases reveals many staticphase countries including the United States potentially with unstoppable epidemic

BACKGROUND The coronavirus disease 2019(COVID-19)pandemic is hitting many countries.It is hypothesized the epidemic is differentially progressing in different countries.AIM To investigate how the COVID-19 epidemic is going on in different countries by analyzing representative countries.METHODS The status of COVID-19 epidemic in over 60 most affected countries was characterized.The data of daily new cases of each country were collected from Worldometer.The data of daily tests for the United States,Italy,and South Korea were collected from the Website of One World Data.Levels of daily positive COVID-19 tests in the two most affected states of the United States(New York and New Jersey)were collected from the website of the COVID Tracking Project.Statistics were analyzed using Microcal Origin software with ANOVA algorithm,and significance level was set at a P value of 0.05.RESULTS The COVID-19 epidemic was differentially progressing in different countries.Comparative analyses of daily new cases as of April 19,2020 revealed that 61 most affected countries can be classified into four types:Downward(22),upward(20),static-phase(12),and uncertain ones(7).In particular,the 12 static-phase countries including the United States were characterized by largely constant numbers of daily new cases in the past over 14 d.Furthermore,these static-phase countries were overall significantly lower in testing density(P=0.016)but higher in the level of positive COVID-19 tests than downward countries(P=0.028).These findings suggested that the testing capacity in static-phase countries was lagging behind the spread of the outbreak,i.e.,daily new cases(confirmed)were likely less than daily new infections and the remaining undocumented infections were thus still expanding,resulting in unstoppable epidemic.CONCLUSION Increasing the testing capacity and/or reducing the COVID-19 transmission are urgently needed to stop the potentially unstoppable,severing crisis in static-phase countries.