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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.

May 8: Thousands of migrants have been stranded “all over the world” where they face a heightened risk of COVID-19 infection, the head of the UN migration agency International Organization for Migration (IOM) has said.

IOM Director-General António Vitorino said that more onerous health-related travel restrictions might discriminate disproportionately against migrant workers in future.

“Health is the new wealth,” Vitorino said, citing proposals by some countries to introduce the so-called immunity passports and use mobile phone apps designed to prevent the spread of the new coronavirus.

“In lots of countries in the world, we already have a system of screening checks to identify the health of migrants, above all malaria, tuberculosis… HIV-AIDS, and now I believe that there will be increased demands in health controls for regular migrants,” he said on Thursday.

Travel restrictions to try to limit the spread of the pandemic has left people on the move more vulnerable than ever and unable to work to support themselves, Vitorino told journalists via videoconference.

“There are thousands of stranded migrants all over the world.

 “In South-East Asia, in East Africa, in Latin America, because of the closing of the borders and with the travel restrictions, lots of migrants who were on the move; some of them wanted to return precisely because of the pandemic,” he said.

They are blocked, some in large groups, some in small, in the border areas, in very difficult conditions without access to minimal care, especially health screening, Vitorino said.

“We have been asking the governments to allow the humanitarian workers and the health workers to have access to (them),” he said.

Turning to Venezuelan migrants, who are believed to number around five million amidst a worsening economic crisis in the country, the IOM chief said “thousands… have lost their jobs in countries like Ecuador and Colombia and are returning back to Venezuela in large crowds without any health screening and being quarantined when they go back”.

In a statement, the IOM highlighted the plight of migrants left stranded in the desert in west, central and eastern Africa, either after having been deported without the due process, or abandoned by the smugglers.

The IOM’s immediate priorities for migrants include ensuring that they have access to healthcare and other basic social welfare assistance in their host country.

Among the UN agency’s other immediate concerns is preventing the spread of new coronavirus infection in more than 1,100 camps that it manages across the world.

They include the Cox’s Bazar complex in Bangladesh, home to around one million mainly ethnic Rohingya from Myanmar, the majority having fled persecution.

So far, no cases of infection have been reported there, the IOM chief said, adding that preventative measures have been communicated to the hundreds of thousands of camp residents, while medical capacity has been boosted.

Beyond the immediate health threat of COVID-19 infection, migrants also face growing stigmatization from which they need protection, Vitorino said.

Allowing hate speech and xenophobic narratives to thrive unchallenged also threatens to undermine the public health response to COVID-19, he said, before noting that migrant workers make up a significant percentage of the health sector in many developed countries including the UK, the US and Switzerland.

Populist narratives targeting migrants as carriers of disease could also destabilise national security through social upheaval and countries’ post-COVID economic recovery by removing critical workers in agriculture and service industries, he said.

Remittances have already seen a 30 per cent drop during the pandemic, Vitorino said, citing the World Bank data, meaning that some USD 20 billion has not been sent home to families in countries where up to 15 per cent of their gross domestic product comes from pay packets earned abroad.

Vitorino, in a plea, urged to give the health of migrants as much attention as that of the host populations in all countries.

“It is quite clear that health is the new wealth and that health concerns will be introduced in the mobility systems - not just for migration - but as a whole; where travelling for business or professional reasons, health will be the new gamechanger in town.

“If the current pandemic leads to a two or even three-tier mobility system, then we will have to try to solve the problem – the problem of the pandemic - but at the same time we have created a new problem of deepening the inequalities,” he said.

New Delhi, Mar 11: Congress leader Rahul Gandhi on Wednesday accused Prime Minister Narendra Modi of “destabilising” the elected Congress government in Madhya Pradesh.

Gandhi also said the PM may have “missed” noticing the 35 per cent crash in global oil prices and asked him to pass on the benefit to Indians by slashing petrol prices.

“Hey @PMOIndia, while you were busy destabilising an elected Congress Govt, you may have missed noticing the 35 per cent crash in global oil prices.

“Could you please pass on the benefit to Indians by slashing #petrol prices to under 60 per litre? Will help boost the stalled economy,” the former Congress chief said on twitter.

Congress' prominent youth leader Jyotiraditya Scindia quit the party on Tuesday and appeared set to join the BJP amid a rebellion in Madhya Pradesh by his supporters, pushing the 15-month-old Kamal Nath government to the brink of collapse.

On Tuesday morning, as much of India was celebrating Holi, Scindia met senior BJP leader and Union Home Minister Amit Shah, following which he called on Prime Minister Narendra Modi at his 7, Lok Kalyan Marg residence.