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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 23: China is putting on lockdown a city of 11 million people considered the epicenter of the new coronavirus outbreak that has killed 17 and infected nearly 600 people, as health authorities around the world work to prevent a global pandemic.

The previously unknown coronavirus strain is believed to have emerged late last year from illegally traded wildlife at an animal market in the central Chinese city of Wuhan. Cases have been detected as far away as the United States, stoking fears the virus is already spreading worldwide.

Wuhan's local government said it would shut down all urban transport networks and suspend outgoing flights from the city as of 10 a.m. (0200 GMT) Thursday, state media reported, adding that the government is urging citizens to not leave the city in the absence of special circumstances.

Contrasting with its secrecy over the 2002-03 Severe Acute Respiratory Syndrome (SARS), which killed nearly 800 people, China's communist government has this time given regular updates to try to avoid panic as millions of people travel for the Chinese Lunar New Year holiday.

Chinese authorities have confirmed 571 cases and 17 deaths as of end-Wednesday, state television reported on Thursday. There are eight other known cases around the world - Thailand has confirmed four cases, while the United States, Taiwan, South Korea and Japan have each reported one.

Vice Premier Sun Chunlan said during a visit to Wuhan that authorities needed to be open about the spread of the virus and their efforts to contain it, the official Xinhua news agency reported on Thursday, comments likely to reassure global health experts.

After a meeting at its Geneva headquarters on Wednesday, the World Health Organization (WHO) said it would decide on Thursday whether to declare the outbreak a global health emergency, which would step up the international response.

If it does so, it will be the sixth international public health emergency to be declared in the last decade.

WHO Director-General Tedros Adhanom Ghebreyesus told reporters in Geneva that China's actions so far were "very strong" but called in Beijing to take "more and significant measures to limit or minimise the international spread".

"We stressed to them that by having a strong action not only they will control the outbreak in their country but they will also minimise the chances of this outbreak spreading internationally. So they recognise that," he said.

A senior U.S. State Department official also called on China to "play a bigger role in global health so they taking more and significant measures to limit or minimise the international spread".

"The lack of transparency in the past, especially with SARS ... gives us concern that that may be the case here," the official said, adding however that there were "positive signs that they have taken action in Wuhan".

Fears of a pandemic initially spooked markets but they regained their footing on Wednesday, with investors citing the robust response from authorities as reassuring.

VIRUS SPREADING

The outbreak began in Wuhan, a major transportation hub as well as central China's main industrial and commercial centre, and has now spread to other major population centers including Beijing, Shanghai and Hong Kong.

There is no known cure for the virus. Symptoms include fever, difficulty in breathing and cough, similar to many other respiratory illnesses, and can cause pneumonia.

Chinese authorities are still investigating the origins of the virus, though they confirmed the outbreak began at a market in Wuhan with illegal wildlife transactions and that it can spread from one person to another via respiratory transmission. Among confirmed patients are 15 medical workers, further adding to worries about a possible global pandemic.

Many Chinese were canceling trips, buying face masks, avoiding public places such as cinemas and shopping centers, and even turning to an online plague simulation game as a way to cope.

Airports globally stepped up screening passengers from China and the European Centre for Disease Control and Prevention (ECDC) said in a risk assessment that further global spread of the virus was likely.

Britain joined other countries including Australia in advising citizens against all but essential travel to Wuhan.

Beijing, Feb 9: After making sure everyone's face mask is on and sanitizer is to hand, the Qiao family heads out to Jingshan Park, a former royal sanctuary beside the Forbidden City in China's capital Beijing.

Snow has fallen for a second day, a rare event in the city of 21.5 million that would normally bring hundreds of thousands of people out to take photos and play. But the streets are empty and the parks are so quiet the only sound is of birds chirping.

It's not just Beijing. Shanghai, China's financial hub, and other cities in the world's most populous nation have turned into ghost towns after the government extended a holiday and asked residents not to go out because of the coronavirus.

"We know the situation of the coronavirus is severe. But the epicentre is far away, so we think it should be fine here ... It's a God-given chance to enjoy this family moment with snow and without work," said Mr Qiao, who has an 11-year-old daughter.

The epidemic has killed 722 people and infected nearly 32,000 in China as of February 8. More than three-quarters of the cases are in the central Hubei province where the virus originated - more than 1,000 km (620 miles) from Beijing.

Only a few people are brave enough to come out. A security guard at Jingshan Park said there were less than a third of the number of tourists than usual, even with the rare snowfall.

Even at one of the best spots for snapping photos of snowy Beijing just outside the Forbidden City, there's barely a crowd, while the usual tour buses and groups of people speaking different dialects are nowhere to be seen.

"Last year when it snowed, I took a few hours off work to come down here to take a picture and the crowd was several layers deep," said a man in his 30s who gave his surname as Yang. "But this year, I am not at all worried about finding a space to take a photo. The virus is keeping people indoors."

Security guards along Wangfujing street, a popular pedestrianised shopping area in downtown Beijing, said it was normally so crowded during the holiday period that it was hard to move around.

"Look at it now, there are more security guards and street cleaners than tourists!" said one of the guards.

Businesses, including shops, bars and restaurants, have been severely hit by the epidemic as the government has banned mass gatherings and even group meals in an effort to curb the spread of the coronavirus.

"You would have to wait outside for a table on a normal day," said a waitress at a restaurant with more than 50 tables. Just five were taken at the peak lunch hour.

Only a handful of the more than 100 restaurants along Beijing's famous food street, Guijie, were open, and the remaining outlets were wondering how long they can hold out.