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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, Feb 1: The Indian economy experienced some abrupt slowdown in 2019 due to turbulence in non-banking financial institutions and major reform measures such as GST and demonetisation, but it is not in a recession, IMF Managing Director Kristalina Georgieva has said.

"The Indian economy indeed has experienced an abrupt slowdown in 2019. We had to revise our growth projections, downwards to four percent for last year. We are expecting 5.8 per cent (growth rate) in 2020 and then an upward trajectory to 6.5 percent in 2021," Georgieva told a group of foreign journalists here on Friday.

"It appears that the main reason for this slowdown was the non-banking financial institutions experiencing a turbulence," she said on the eve of Union Finance Minister Nirmala Sitharaman presenting the annual budget in Parliament on Saturday.

She said India had undertaken some important reforms that over the longer term would be beneficial for the country, but they do have some short-term impact.

"For example, coming with the unified tax system, and the demonetisation that took place. These are steps that over time are beneficial, but of course they might, might be somewhat disruptive over short term," Georgieva said in response to a question.

The International Monetary Fund (IMF) Managing Director said that there is not a lot of fiscal space in India. “But we also recognise that the policies of the government on that side, on the fiscal side have been prudent. We will see how the reading of the budget, the submission of the budget goes, tomorrow,” she said.

In the medium-term, she said, the IMF remains optimistic about India. “This is why we see that upswing potential for the growth in the country,” she said.

Georgieva said that the current economic slowdown cannot be described as a recession. "No.... You're far from that. But it is a significant slowdown, not the recession," she said.

The IMF managing Director noted that the consumption in India also slowed down and that contributed to the overall slowdown in the economy. The IMF would be keen to see what India does to get relatively sound macroeconomic fundamentals to pay off in terms of better growth trajectory, she said ahead of the budget.

One thing that is important for India is that budgetary revenue have been below target. "The country knows that. The finance minister knows it. They need to increase budgetary revenue collection so they can improve their fiscal position. I said it's tight on the spending side, but I also want to stress that there is room to improve collection on the revenue side," she said.

May 12: Gunmen stormed a hospital on Tuesday in an ongoing attack in the Afghan capital Kabul, as a suicide blast killed 15 people at a funeral in the country's restive east.

Special forces rescued 80 people including mothers and babies from the Kabul hospital after three gunmen launched a morning assault, killing at least four people, the interior ministry said in a statement.

Heavily armed forces were seen carrying babies wrapped in blankets away from the scene, as the clearance operation continued.

The facility, which has a large maternity ward, is located in the west of the city, home to the capital's minority Shiite Hazara community -- a frequent target of Sunni militants from the Islamic State group.

The flare-up in violence comes as Afghanistan grapples with myriad crises including a rise in militant operations across the country and a surge in coronavirus infections.

A paediatrician who fled the hospital told AFP he heard a loud explosion at the entrance of the building.

"The hospital was full of patients and doctors, there was total panic inside," he said, asking not to be named.

The maternity services at the hospital are supported by humanitarian organisation Doctors Without Borders (MSF).

"Hospitals and health workers must not be attacked. We call on all sides to stop attacking hospitals and health workers," said deputy health minister in the city, Waheed Majroh.

Around an hour later, a suicide bomber killed at least 15 people at the funeral of a local police commander in the country's eastern Nangarhar province, according to provincial spokesman Ataullah Khogyani.

The attacker detonated his explosives in the middle of the ceremony.

Zaher Adel, spokesman for the government hospital in Jalalabad, earlier said 12 bodies had arrived from the blast site and more than 50 people were being treated for injuries.

Amir Mohammad, who was wounded in the blast, said thousands of people had gathered for the funeral, an event which often draws huge crowds in Afghanistan.

The violence comes just a day after four roadside bombs exploded in a northern district of Kabul, wounding four civilians including a child.

The bombings were later claimed by the Islamic State group, according to the SITE intelligence group.

They were just the latest in a string of IS attacks on the capital.

In March, at least 25 people were killed by a gunman at a Sikh temple in Kabul, which was later claimed by the group.

IS is also responsible for an infamous attack in March 2017 on one of the country's largest hospitals, when gunmen disguised as doctors stormed the Kabul building and killed dozens.

In recent months, the jihadist group has suffered mounting setbacks after being hunted by US and Afghan forces as well as Taliban offensives targeting their fighters, but it still retains the ability to launch major assaults on urban centres.

The Taliban have largely refrained from launching large attacks on Afghan cities since February when they signed a landmark withdrawal deal with the US meant to pave the way for peace talks with the Kabul government.

Under the agreement, the Taliban promised not to target forces from the US-led coalition, but made no such pledge toward Afghan troops and have stepped up attacks in the provinces.

The Taliban have denied involvement in both of Tuesday's attacks.