First, the number of COVID-19 cases is likely underestimated — even in Italy — due to inadequate testing. That means mild or asymptomatic cases are undercounted, artificially inflating the case-fatality rate. The best data we have comes from South Korea, which screened nearly 400,000 people. That country’s case-fatality rate is 1.7%. In Germany, it’s 1.3%.
Second, U.S. critical care infrastructure is vast. The U.S. has 34.2 critical care (ICU) beds per 100,000 people — the highest in the world — compared to 12.5 in Italy (and 29.2 in Germany). Of course, hospitals and supply chains for medical equipment will still be stressed, but the U.S. has an infrastructure advantage.
Third, infectious disease models, which attempt to predict how widespread and how deadly COVID-19 will be, vary considerably. According to FiveThirtyEight, experts predict anywhere from thousands to 1 million American deaths. The consensus is 200,000 American deaths, but even that figure comes with a hefty dose of uncertainty.