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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 15: Global tensions simmered over the race for a coronavirus vaccine Thursday, as the United States and China traded jabs, and France slammed pharmaceuticals giant Sanofi for suggesting the US would get any eventual vaccine first.

Scientists are working at breakneck speed to develop a vaccine for COVID-19, the disease caused by the virus, which has killed more than 300,000 people worldwide and pummelled economies.

From the US to Europe to Asia, national and local governments are easing lockdown orders to get people back to work -- while fretting over a possible second wave of infections.

Increased freedom of movement means an increased risk of contracting the virus, and so national labs and private firms are labouring to find the right formula for a vaccine.

The European Union's medicines agency offered some hope when it said one could be ready in a year, based on data from clinical trials already underway.

But Marco Cavaleri, the EMA's head of vaccines strategy, acknowledged that timeline was a "best-case scenario," and cautioned that "there may be delays."

The race for a vaccine has exposed a raw nerve in relations between the United States and China, where the virus was first detected late last year in the central city of Wuhan.

Two US agencies warned Wednesday that Chinese hackers were trying to steal COVID-19 vaccine research -- a claim Beijing rejected as "smearing" its reputation.

US President Donald Trump, who has ratcheted up the rhetoric against China, said he doesn't even want to engage with Chinese leader Xi Jinping -- potentially imperilling a trade deal between the world's top two economies.

"I'm very disappointed in China. I will tell you that right now," he said in an interview with Fox Business.

"There are many things we could do. We could do things. We could cut off the whole relationship."

On Capitol Hill, an ousted US health official told Congress that the Trump government had no strategy in place to find and distribute a vaccine to millions of Americans, warning of the "darkest winter" ahead.

"We don't have a single point of leadership right now for this response, and we don't have a master plan," said Rick Bright, who was removed last month as head of the US agency charged with developing a coronavirus vaccine.

The United States has registered nearly 86,000 deaths linked to COVID-19 -- the highest toll of any nation.

World leaders were among 140 signatories to a letter published Thursday saying any vaccine should not be patented and that the science should be shared among nations.

"Governments and international partners must unite around a global guarantee which ensures that, when a safe and effective vaccine is developed, it is produced rapidly at scale and made available for all people, in all countries, free of charge," it said.

But a row erupted in France after drugmaker Sanofi said it would reserve first shipments of any vaccine it discovered to the United States.

The comments prompted a swift rebuke from the French government -- President Emmanuel Macron's office said any vaccine should be treated as "a global public good, which is not submitted to market forces."

Sanofi chief executive Paul Hudson said the US had a risk-sharing model that allowed for manufacturing to start before a vaccine had been finally approved -- while Europe did not.

"The US government has the right to the largest pre-order because it's invested in taking the risk," Hudson told Bloomberg News.

Macron's top officials are scheduled to meet with Sanofi executives about the issue next week.

The search for a vaccine became even more urgent after the World Health Organization said the disease may never go away and the world would have to learn to live with it for good.

"This virus may become just another endemic virus in our communities and this virus may never go away," said Michael Ryan, the UN body's emergencies director.

The prospect of the disease lingering leaves governments facing a delicate balancing act between suppressing the pathogen and getting their economies up and running.

In the US, more grim economic data emerged Thursday, with nearly three million more Americans applying for unemployment benefits.

That takes the overall total to 36.5 million -- more than 10 percent of the US population.

Further signs of the damage to businesses emerged when Lloyd's of London forecast the pandemic will cost the global insurance industry about $203 billion.

European markets closed down, but Wall Street rallied despite the new jobless claims. In a sign of progress, the New York Stock Exchange trading floor was due to reopen on May 26.

The reopening of economies continued in earnest across Europe, where the EU has set out proposals for a phased restart of travel and the eventual lifting of border controls.

"Maybe it's a mistake, but we have no choice. Without tourists, we won't get by!" Enrico Facchetti, a 61-year-old former goldsmith, said of Venice's reopening.

Japan -- the world's third largest economy -- lifted a state of emergency across most of the country except for Tokyo and Osaka.

And Canadian Prime Minister Justin Trudeau said national parks would partially reopen on June 1.

But in Latin America, the virus continued to surge, with a 60 percent leap in cases in the Chilean capital of Santiago.

Authorities said 2,000 new graves were being dug at the main cemetery.

South Sudan reported its first COVID-19 death on Thursday.

And in Bangladesh, the first case was confirmed in the teeming Rohingya refugee camps in Bangladesh, which are home to nearly one million people.

London/Milan, Jun 2: World Health Organization experts and a range of other scientists said on Monday there was no evidence to support an assertion by a high profile Italian doctor that the coronavirus causing the COVID-19 pandemic has been losing potency.

Professor Alberto Zangrillo, head of intensive care at Italy's San Raffaele Hospital in Lombardy, which bore the brunt of Italy's COVID-19 epidemic, on Sunday told state television that the new coronavirus "clinically no longer exists".

But WHO epidemiologist Maria Van Kerkhove, as well as several other experts on viruses and infectious diseases, said Zangrillo's comments were not supported by scientific evidence.

There is no data to show the new coronavirus is changing significantly, either in its form of transmission or in the severity of the disease it causes, they said.

"In terms of transmissibility, that has not changed, in terms of severity, that has not changed," Van Kerkhove told reporters.

It is not unusual for viruses to mutate and adapt as they spread, and the debate on Monday highlights how scientists are monitoring and tracking the new virus. The COVID-19 pandemic has so far killed more than 370,000 people and infected more than 6 million.

Martin Hibberd, a professor of emerging infectious disease at the London School of Hygiene & Tropical Medicine, said major studies looking at genetic changes in the SARS-CoV-2 virus that causes COVID-19 did not support the idea that it was becoming less potent, or weakening in any way.

"With data from more than 35,000 whole virus genomes, there is currently no evidence that there is any significant difference relating to severity," he said in an emailed comment.

Zangrillo, well known in Italy as the personal doctor of former Prime Minister Silvio Berlusconi, said his comments were backed up by a study conducted by a fellow scientist, Massimo Clementi, which Zangrillo said would be published next week.

Zangrillo told Reuters: "We have never said that the virus has changed, we said that the interaction between the virus and the host has definitely changed."

He said this could be due either to different characteristics of the virus, which he said they had not yet identified, or different characteristics in those infected.

The study by Clementi, who is director of the microbiology and virology laboratory of San Raffaele, compared virus samples from COVID-19 patients at the Milan-based hospital in March with samples from patients with the disease in May.

"The result was unambiguous: an extremely significant difference between the viral load of patients admitted in March compared to" those admitted last month, Zangrillo said.

Oscar MacLean, an expert at the University of Glasgow's Centre for Virus Research, said suggestions that the virus was weakening were "not supported by anything in the scientific literature and also seem fairly implausible on genetic grounds."