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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.

Beijing, Jan 21: The Chinese official investigating a pneumonia outbreak stemming from a new coronavirus said the disease can spread from person to person but can be halted with increased vigilance, as authorities on Tuesday confirmed a fourth death.

Zhong Nanshan said there was no danger of a repeat of the Severe Acute Respiratory Syndrome (SARS) epidemic that killed nearly 800 people globally during a 2002-2003 outbreak, which started in China, as long as precautions were taken.

"It took only two weeks to identify the novel coronavirus," state news agency Xinhua quoted Zhong as saying late on Monday.

The outbreak was still in its early stages and China had good surveillance and quarantine systems to help control it, he added.

The outbreak has spread from the central city of Wuhan to cities including Beijing and Shanghai, with more than 200 cases reported so far. Four cases have been reported outside China - in South Korea, Thailand and Japan.

Australia on Tuesday said it would screen passengers on flights from Wuhan amid rising concerns that the virus will spread globally as Chinese travellers take flights abroad for the Lunar New Year holiday starting this week.

Authorities around the globe, including in the United States and many Asian countries, have stepped up screening of travellers from Wuhan.

Chinese authorities confirmed a total of 217 cases of the virus in China as of 6 p.m. (1000 GMT) on Monday, state television reported, 198 of which were in Wuhan.

A fourth person died on Jan. 19, the Wuhan Municipal Health Commission said. The 89-year-old man, who had underlying health diseases including coronary heart disease, developed symptoms on Jan. 13 and was admitted to hospital five days later, it added.

Zhong, who is renowned in China for his work fighting SARS in 2003, confirmed that the virus can pass from person-to-person.

Fifteen medical workers in Wuhan had been diagnosed with pneumonia, with one other suspected case, the Wuhan Municipal Health Commission said. Of the infected staff, one was in critical condition.

In Shanghai, officials on Tuesday confirmed a second case involving a 35-year-man who had visited Wuhan in early January, and said they were monitoring four other suspected cases.

The virus causes a type of pneumonia and belongs to the same family of coronaviruses as SARS. Symptoms include fever and difficulty in breathing, which are similar to many other respiratory diseases and pose complications for screening efforts.

The World Health Organisation (WHO) said on Monday an animal source appeared most likely to be the primary origin of the outbreak and that some "limited human-to-human transmission" occurred between close contacts.

The Geneva-based U.N. agency convened an emergency committee for Wednesday to assess whether the outbreak constitutes an international health emergency and what measures should be taken to manage it.

So far, the WHO has not recommended trade or travel restrictions, but a panel of independent experts could do so or make other recommendations to limit spread.

Islamabad, Jun 24: A plane crash which killed 97 people in Pakistan last month was because of human error by the pilot and air traffic control, according to an initial report into the disaster released Wednesday.

The Pakistan International Airlines (PIA) plane came down among houses on May 22 after both engines failed as it approached Karachi airport, killing all but two people on board.

"The pilot as well as the controller didn't follow the standard rules," the country's aviation minister Ghulam Sarwar Khan said, announcing the findings in parliament.

He said the pilots had been discussing the coronavirus pandemic as they attempted to land the Airbus A320.

"The pilot and co-pilot were not focused and throughout the conversation was about coronavirus," Khan said.

The Pakistani investigation team, which included officials from the French government and the aviation industry, analysed data and voice recorders.

The minister said the plane was "100 percent fit for flying, there was no technical fault".

The county's deadliest aviation accident in eight years came days after domestic commercial flights resumed following a two-month coronavirus lockdown.

Many passengers were on their way to spend the Muslim holiday of Eid al-Fitr with loved ones.