Well, the biggest factors are who is tested and who contracts it. As for testing, Italy told those who were mildly symptomatic to not come in and get tested. Their denominator is a fraction of what it should be. Germany may be testing everyone who is symptomatic. Then there's the question of who is contracting it. If the Germans who are contracting it are young and relatively healthy, then the mortality rate will be very low. Italy has a terrible health care system, especially primary care, and a lot of people got cross-contaminated within the healthcare system. Many of those people were already sick/poor health/other comorbidities, thus they were higher risk. If it goes around a nursing home, you have to expect a much higher mortality rate than if it goes around a college campus. Yeah, all true. This is why I wish people would look at context when there is a spike in cases. More positives in and of itself is not a bad thing. It means we're testing more people, finding them and isolating them. People should not use total cases to compare us to Italy. If we're finding more infected because we're getting better and more efficient at testing, that's a good thing. I'm more concerned with the deaths, if they start to spiral out of control then that's much more of a sign of the health care system getting overwhelmed.