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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.

London, May 9: Air India's first evacuation flight from London will be taking off for Mumbai today.

The screening of passengers is underway.

"Air India's first evacuation flight from London taking off for Mumbai today at 1200. Flight is 100% booked! Shubh Yatra. Please stay in touch. GoI working to send more evacuation flights!" High Commission of India, London said in a tweet.

On Monday, India announced had that it will begin phased repatriation of its citizens stranded abroad from May 7.

The government said that Air India will operate 64 flights in the first week from May 7 to May 13 to bring back around 15,000 Indian nationals.

On day three of the 'Vande Bharat Mission', flights carrying Indians from the Gulf countries, the United Kingdom, Bangladesh and Malaysia will arrive in India.

Wuhan, Jun 9: China on Tuesday dismissed as "incredibly ridiculous" a Harvard study, which pointed to a surge in traffic outside Wuhan hospitals from August 2019 suggesting that the coronavirus hit the area far earlier than reported.

A whitepaper on coronavirus released by China on Sunday said the virus was first noticed on December 17 and Chinese virologists confirmed human-to-human transmission on January 19, prompting authorities to impose lockdown of Wuhan from January 23.

US President Donald Trump and leaders of several countries have accused China of not being transparent in reporting the deadly disease, leading to huge human casualties and economic crisis across the world.

The new study by Harvard researchers says satellite images show an increase in traffic outside five hospitals in Wuhan from late August to December.

The traffic spike coincided with a rise in online searches for information on symptoms like "cough" and "diarrhoea".

China said the study was "ridiculous" and based on "superficial" information, BBC reported.

It is believed that the virus first appeared in China some time in November. Authorities reported a cluster of pneumonia cases with an unknown cause to the World Health Organization (WHO) on December 31.

"Clearly, there was some level of social disruption taking place well before what was previously identified as the start of the novel coronavirus pandemic," Dr John Brownstein, who led the research, told ABC news.

The study has not been peer-reviewed.

The researchers examined commercial satellite data from outside five Wuhan hospitals, comparing data from late summer and autumn 2018 to the same time period in 2019.

In one case, researchers counted 171 cars parked at one of Wuhan''s largest hospitals, Tianyou Hospital, in October 2018.

Satellite data from the same time in 2019 showed 285 vehicles in the same place, an increase of 67 per cent.

A surge in online searches for words associated with the symptoms of coronavirus on the Chinese search engine Baidu seemed to emerge at the same time.

"This is all about a growing body of information pointing to something taking place in Wuhan at the time," Dr Brownstein said.

"Many studies are still needed to fully uncover what took place and for people to really learn about how these disease outbreaks unfold and emerge in populations. So this is just another point of evidence," he said.

Asked for her reaction at the media briefing, Chinese Foreign Ministry spokeswoman Hua Chunying dismissed the findings as "incredibly ridiculous".

"I think it is ridiculous, incredibly ridiculous, to come up with this conclusion based on superficial observations such as traffic volume," she said.

"(I have) Not seen the research you mentioned. If the conclusion is drawn based on traffic volumes (and) other superficial observations, it won’t be a sound conclusion," she said and referred to the allegations about the COVID-19 originating from the Wuhan Institute of Virology (WIV) by Trump.

"That allegation was proved to be wrong," she said.

When pointed out that China says it respects science based inquiry and Harvard is one of the top universities in the world, Hua said, "on the origin of virus there are lot of conspiracy theories against China”.

"That is very unfair. At the moment, the pressing task is to enhance coordination to contain the spread of the virus. Someday, I am sure the truth will be out. China deserves a fair and objective evaluation," she said and referred to the whitepaper released by the Chinese government detailing evolution of coronavirus in Wuhan and how Beijing handled the situation.

Recently, the World Health Assembly (WHA), the decision-making body of Geneva-based World Health Organization (WHO), passed a resolution to probe the origin of the virus. China also backed the resolution.

As of Monday, the overall confirmed cases on the mainland had reached 83,043, including 58 patients who were still being treated, with no one in severe condition, China’s National Health Commission, (NHC) said.

Altogether 78,351 people had been discharged after recovery and 4,634 people had died of the disease, it said.