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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.

Washington, Apr 24: President Donald Trump has favoured a phased reopening of the US economy, devastated by the coronavirus pandemic, which has claimed nearly 50,000 lives and infected over eight lakh people in the country.

More than 95 per cent of the country's 330 million people are under stay-at-home order as a result of the social mitigation measures, including social distancing, being enforced till May 1.

Trump on Thursday indicated that the stay-at-home order might be extended beyond May 1, but vehemently advocated the need to gradually open up the economy.

In the past few weeks, more than 26 million Americans have filed for unemployment benefits and the figure is soon likely to cross 40 million.

Both the World Bank and the International Monetary Fund (IMF) have projected a negative growth in the US in 2020.

To keep America gaining momentum, every citizen needs to maintain the vigilance, and we all understand that very well we've gone over it many, many times this includes practising good hygiene, maintaining social distance, and the voluntary use of face covering, Trump said.

Safe and phased reopening of our economy -- it's very exciting, but it does not mean that we are letting down our guard at all in any way; on the contrary, continued diligence is an essential part of our strategy to get our country back to work to take our country back, he told reporters at his daily White House news conference on coronavirus.

The data and facts on the ground suggest that the US is making great progress, he said.

In 23 states, new cases have declined. In the peak week, 40 per cent of the American counties have seen a rapid decline in new cases. As many as 46 states report a drop in patients showing coronavirus-like symptoms, he said.

Trump said the US is very close to finding a vaccine for COVID-19.

We are very close to testing... when testing starts it takes a period of time but we will get it done, he said.

According to Vice President Mike Pence, data continues to show promising signs of progress in the New York Metro area, New Jersey, Connecticut, Detroit and New Orleans. All appear to be passed their peak and we are seeing consistent declines in hospitalisation and cases in regions across the country, he said.

Lahore, Jul 10: The Punjab government enforced smart lockdown in seven cities of the province for 15 days with an immediate effect from Thursday night, The News International reported.

The Primary and Secondary Healthcare Department on Thursday issued a notification under the Punjab Infectious Diseases Ordinance 2020, about enforcement of lockdown in Lahore, Multan, Faisalabad, Gujranwala, Sialkot, Gujrat and Rawalpindi, till July 24 midnight.

In Lahore, the lockdown will be enforced in A2 Block Township, EME Society, Main Bazaar Chungi Amr Sadhu, Punjab Government Servants Housing Scheme, Wapda Town, C-Block Jauhar Town and Green City.

The basic necessities of life will remain available in smart lockdown areas. "The purpose of the smart lockdown is to minimise movement of people in hotspots of positive coronavirus cases," said Capt (retd) Muhammad Usman, Secretary, Primary and Secondary Healthcare Department.

The country registered 2,751 new COVID-19 cases during the last 24 hours, taking the tally to 243,599 on Friday. The province-wise breakup includes 85,261 cases in Punjab, 100,900 cases in Sindh, 29,406 in Khyber Pakhtunkhwa, 11,099 in Balochistan, 13,829 in Islamabad, 1,619 in Gilgit-Baltistan and 1,485 in Pakistan-occupied Kashmir.

The death toll due to the virus reached 5,058 with 75 more deaths reported over the last 24 hours, as per data cited by Radio Pakistan.