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Washington, Jun 9: When epidemiologists talked about "flattening the curve," they probably didn't mean it this way: the US hit its peak coronavirus caseload in April, but since that time the graph has been on a seemingly unending plateau.

That's unlike several other hard-hit countries which have successfully pushed down their numbers of new cases, including Spain and Italy, which now have bell-shaped curves.

Experts say the prolonged nature of the US epidemic is the result of the cumulative impact of regional outbreaks, as the virus that started out primarily on the coasts and in major cities moves inward.

Layered on top of that are the effects of lifting lockdowns in parts of the country that are experiencing rising cases, as well as a lapse in compliance with social distancing guidelines because of economic hardship, and in some cases a belief that the threat is overstated.

"The US is a large country both in geography and population, and the virus is at very different stages in different parts of the country," Tom Frieden, a former director of the Centers for Disease Control and Prevention told AFP.

The US saw more than 35,000 new cases for several days in April. While that figure has declined, it has still been exceeding 20,000 regularly in recent days.

By contrast, Italy was regularly hitting more than 5,000 cases per day in March but is currently experiencing figures in the low hundreds.

"We did not act quickly and robustly enough to stop the virus spreading initially, and data indicate that it travelled from initial hotspots along major transport routes into other urban and rural areas," added Frieden, now CEO of the non-profit Resolve to Save Lives.

To wit: the East Coast states of New York, New Jersey and Massachusetts accounted for about 50 percent of all cases until about a month or so ago -- but now the geographic footprint of the US epidemic has shifted to the Midwest and southeast, including Florida.

Another key problem, said Jennifer Nuzzo, an epidemiologist at Johns Hopkins, is that the United States is still not doing enough testing, contact tracing and isolation.

After coming late to the testing party -- for reasons ranging from technical issues to regulatory hurdles -- the US has now conducted more COVID-19 tests than any other country.

It even has one of the highest per capita rates per country of 62 per 1,000 people, according to the website ourworldindata.org -- better than Germany (52 per 1,000) and South Korea (20 per 1,000).

But according to Nuzzo, these numbers are misleading, because "the amount of testing that a country should do should be scaled to the size of its epidemic.

"The United States has the largest epidemic in the world so obviously we need to do a lot more testing than any other country."

For Johns Hopkins, the more important metric is the positivity rate -- that is, out of all tests conducted, how many came back positive for COVID-19.

As of June 7, the United States had an average daily positivity rate of 14 percent, well above the World Health Organization guideline of 5 percent over two weeks before social distancing guidelines should be relaxed.

By contrast, Germany, which has tested far fewer people in relation to its population, has a positivity rate of 5 percent.

Even if testing were scaled up, carrying out tests in of itself does very little good without the next steps -- finding out who was exposed and then asking them to isolate.

Here also, too many US states are lagging woefully behind.

Texas, which is experiencing a surge in cases after relaxing its lockdown, is a case in point. The state targeted hiring a modest 4,000 tracers by June, but according to local reports is still more than a thousand shy of even that goal.

Opt-in app based efforts have also been slow to get off the ground.

Then there is the fact that some people are growing tired of lockdowns, while others don't have the economic luxury of being able to stay home for prolonged periods.

The government sent some 160 million Americans a single stimulus check of up to $1,200 back in April but it's not clear whether more will be forthcoming.

Still others, particularly in so-called red states under Republican leadership, have chafed under restrictions and mask-wearing guidelines that they see as an affront to their personal freedom.

"The US is kind of on the extreme of the individual liberty side," Sten Vermund, dean of the Yale School of Public Health, told AFP.

Part of this has to do with mixed messaging from Republican leaders, including President Donald Trump, said Nuzzo.

"We have had at the highest political level an assertion that this is a situation that's been overblown, and that maybe certain protective behaviors are not necessary," she said.

More recently, tens of thousands of people across the country have taken to the streets to protest the killing on an unarmed black man by police, risking coronavirus infection to demonstrate against the public health threat of racialized state violence.

Geneva, Jul 11: The World Health Organization said Friday that it is still possible to bring coronavirus outbreaks under control, even though case numbers have more than doubled in the past six weeks.

WHO chief Tedros Adhanom Ghebreyesus said the examples of Italy, Spain, South Korea and India's biggest slum showed that however bad a outbreak was, the virus could still be reined in through aggressive action.

"In the last six weeks cases have more than doubled," Tedros told a virtual press conference in Geneva.

However, "there are many examples from around the world that have shown that even if the outbreak is very intense, it can still be brought back under control," said Tedros.

"And some of these examples are Italy, Spain and South Korea, and even in Dharavi -- a densely packed area in the megacity of Mumbai -- a strong focus on community engagement and the basics of testing, tracing, isolating and treating all those that are sick is key to breaking the chains of transmission and suppressing the virus."

The novel coronavirus has killed at least 555,000 people worldwide since the outbreak emerged in China last December, according to a tally from official sources compiled by AFP on Friday.

Nearly 12.3 million cases have been registered in 196 countries and territories.

"Across all walks of life, we are all being tested to the limit," Tedros said, "from countries where there is exponential growth, to places that are loosening restrictions and now starting to see cases rise.

"Only aggressive action combined with national unity and global solidarity can turn this pandemic around."

May 18: Risk managers expect a prolonged global recession as a result of the coronavirus pandemic, a report by the World Economic Forum showed on Tuesday.

Two-thirds of the 347 respondents to the survey - carried out in response to the outbreak - put a lengthy contraction in the global economy top of their list of concerns for the next 18 months.

Half of risk managers expected bankruptcies and industry consolidation, the failure of industries to recover and high levels of unemployment, particularly among the young.

“The crisis has devastated lives and livelihoods. It has triggered an economic crisis with far-reaching implications and revealed the inadequacies of the past," said Saadia Zahidi, managing director of the World Economic Forum.

Environmental goals risk being discarded as a result of the pandemic, the report said, but governments should try to carve out a "green recovery".

"We now have a unique opportunity to use this crisis to do things differently and build back better economies that are more sustainable, resilient and inclusive," Zahidi said.

The report was compiled by the World Economic Forum’s Global Risks Advisory Board together with Marsh & McLennan Companies Inc and Zurich Insurance Group.

Risk managers were surveyed between April 1 and 13.