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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.

Apr 12: India and other South Asian countries are likely to record their worst growth performance in four decades this year due to the coronavirus outbreak, the World Bank said on Sunday.

The South Asian region, comprising eight countries, is likely to show economic growth of 1.8 per cent to 2.8 per cent this year, the World Bank said in its South Asia Economic Focus report, well down from the 6.3 per cent it projected six months ago.

India's economy, the region's biggest, is expected to grow 1.5 per cent to 2.8 per cent in the fiscal year that started on April 1. The World Bank has estimated it will grow 4.8 per cent to 5 per cent in the fiscal year that ended on March 31.

"The green shoots of a rebound that were observable at the end of 2019 have been overtaken by the negative impacts of the global crisis," the World Bank report said.

Other than India, the World Bank forecast that Sri Lanka, Nepal, Bhutan and Bangladesh will also see sharp falls in economic growth.

Three other countries - Pakistan, Afghanistan and the Maldives - are expected to fall into recession, the World Bank said in the report, which was based on country-level data available as of April 7.

Measures taken to counter the coronavirus have disrupted supply chains across South Asia, which has recorded more than 13,000 cases so far - still lower than many parts of the world.

India's lockdown of 1.3 billion people has also left millions out of work, disrupted big and small businesses and forced an exodus of migrant workers from the cities to their homes in villages.

In the event of prolonged and broad national lockdowns, the report warned of a worst-case scenario in which the entire region would experience an economic contraction this year.

To minimize short-term economic pain, the Bank called for countries in the region to announce more fiscal and monetary steps to support unemployed migrant workers, as well as debt relief for businesses and individuals.

India has so far unveiled a $23 billion economic plan to offer direct cash transfers to millions of poor people hit by its lockdown. In neighbouring Pakistan, the government has announced a $6 billion plan to support the economy.

"The priority for all South Asian governments is to contain the virus spread and protect their people, especially the poorest who face considerable worse health and economic outcomes," said senior World Bank official Hartwig Schafer.

Jan 28: China said on Tuesday that 106 people had died from a new coronavirus that is spreading across the country, up from the previous toll of 81.

The number of total confirmed cases in China rose to 4,515 as of Jan. 27, the National Health Commission said in a statement, up from 2,835 reported a day earlier.

The United States warned against travel to China on Monday and Canada issued a more narrow travel warning as the death toll from the spreading coronavirus passed 100, with tens of millions stranded during the biggest holiday of the year and global markets rattled.

Global stocks fell, oil prices hit three-month lows, and China's yuan dipped to its weakest level in 2020 as investors fretted about damage to the world's second-biggest economy from travel bans and the Lunar New Year holiday, which China extended in a bid to keep people at home.

The health commission of China's Hubei province said on Tuesday that 100 people had died from the virus as of Jan. 27, according to an online statement, up from the previous toll of 76, with the number of confirmed cases in the province rose to 2,714.

Other fatalities have been reported elsewhere in China, including the first in Beijing, bringing the deal toll to 106 so far, according to the People's Daily. The state newspaper put the total number of confirmed cases in China at 4,193, though some experts suspect a much higher number.

On Monday, US President Donald Trump offered China whatever help it needed, while the State Department said Americans should "reconsider" visiting all of China due to the virus.

Canada, which has two confirmed cases of the virus and is investigating 19 more potential cases, warned its citizens to avoid travel to China's Hubei province, at the heart of the outbreak.

Authorities in Hubei province are taking increasing flak from the public over their initial response to the virus. Chinese Premier Li Keqiang visited the city of Wuhan, epicentre of the outbreak, to encourage medical workers and promise reinforcements.

Visiting Wuhan in blue protective suit and mask, Li praised medics, said 2,500 more workers would join them in the next two days, and visited the site of a new hospital to be built in days.

The most senior leader to visit Wuhan since the outbreak, Li was shown on state TV leading medical workers in chants of "Wuhan jiayou!" - an exhortation to keep their strength up.

China's ambassador to the United Nations, following a meeting with UN Secretary-General António Guterres on Monday, said "the Chinese government attaches paramount importance to prevention and control of the epidemic, and President Xi Jinping has given important instructions. ...

"China has been working with the international community in the spirit of openness, transparency and scientific coordination," he said.

Guterres said in a statement, "The UN appreciates China's effort, has full confidence in China's ability of controlling the outbreak, and stands ready to provide any support and assistance."

MOUNTING ANGER

On China's heavily censored social media, officials have faced mounting anger over the virus, which is thought to have originated from a market where wildlife was sold illegally.

Some criticised the governor of Hubei province, of which Wuhan is the capital, after he corrected himself twice during a news conference over the number of face masks being produced.

"If he can mess up the data multiple times, no wonder the disease has spread so severely," said one user of the Weibo social media platform.

In rare public self-criticism, Wuhan Mayor Zhou Xianwang said the city's management of the crisis was "not good enough" and indicated he was willing to resign.

The central Chinese city of 11 million people is in virtual lockdown and much of Hubei, home to nearly 60 million people, is under travel curbs.

Elsewhere in China, people from the region faced questioning about their movements. "Hubei people are getting discriminated against," a Wuhan resident complained on Weibo.

Cases linked to people who travelled from Wuhan have been confirmed in a dozen countries, from Japan to the United States, where authorities said they had 110 people under investigation in 26 states. Sri Lanka was the latest to confirm a case.

INVESTORS WORRIED

Investors are worried about the impact. The consensus is that in the short term, economic output will be hit as authorities limit travel and extend the week-long New Year holiday — when millions traditionally travel by rail, road and plane - by three days to limit spread of the virus.

Asian and European shares tumbled, with Japan's Nikkei average sliding 2%, its biggest one-day fall in five months. Demand spiked for safe-haven assets such as the Japanese yen and Treasury notes. European stocks fell more than 2%.

The US S&P 500 closed down nearly 1.6%.

"China is the biggest driver of global growth so this couldn't have started in a worse place," said Alec Young, FTSE Russell's managing director of global markets research.

During the 2002-2003 outbreak of Severe Acute Respiratory Syndrome (SARS), which originated in China and killed nearly 800 people globally, air passenger demand in Asia plunged 45%. The travel industry is more reliant on Chinese travellers now.

Chinese-ruled Hong Kong, which has had eight cases, banned entry to people who had visited Hubei recently.

Some European tour operators cancelled trips to China, while governments around the world worked on repatriating nationals.

Officially known as 2019-nCoV, the newly identified coronavirus can cause pneumonia, but it is still too early to know just how dangerous it is and how easily it spreads.

"What we know about this virus it that transmission occurs through human contact but we are speaking of close contact, i.e. less than a meter," said Jerome Salomon, a senior official with France's health ministry.

"Crossing someone (infected) in the street poses no threat," he said. "The risk is low when you spend a little time near that person and becomes higher when you spend a lot of time near that person."