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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, Mar 25: Around 5,000 people have signed up for the phase I clinical trial of recombinant novel coronavirus vaccine in Chinese city Wuhan where the virus first emerged late last year.

The recruitment for participants ended this week with nearly 5,000 volunteers signing up for the trial, state-run Beijing News reported on Wednesday.

A single-centre, open and dose-escalation phase I clinical trial for recombinant novel coronavirus vaccine (adenoviral vector) will be tested in healthy adults aged between 18 and 60 years, according to the ChiCTR (China Clinical Trial Register).

The trial, led by experts from the Academy of Military Medical Sciences, gained its approval on March 16 and the research is expected to last half a year.

Requiring at least 108 participants, the trial will be conducted in Wuhan, capital of Hubei province, the region worst-affected by the virus in the country, state-run China Daily reported.

Participants will experience 14-day quarantine restrictions after being vaccinated and their health condition will be recorded every day.

Chinese scientists are hastening the development of COVID-19 vaccines through five approaches --- inactivated vaccines, genetic engineering subunit vaccines, adenovirus vector vaccines, nucleic acid vaccines and vaccines using attenuated influenza virus as vectors.

So far, most teams are expected to complete preclinical research in April and some are moving forward faster, Wang Junzhi, an academician with the Chinese Academy of Engineering said.

Wang noted that research and development of COVID-19 vaccines in China is not slower than foreign counterparts and has been carried out in a scientific, standardised and orderly way.

China has stepped up the process to finalise vaccines to counter COVID-19 after Kaiser Permanente research facility in Seattle and Washington stole the march and began human trials.

China lifted tough restrictions on the Hubei province on Wednesday after a months-long lockdown as the country reported no new domestic cases.

But there were another 47 imported infections from overseas, the National Health Commission said. In total, 474 imported infections have been diagnosed in China -- mostly Chinese nationals returning home.

Seoul/South Korea, Apr 27: North Korean leader Kim Jong Un is "alive and well", a top security adviser to the South's President Moon Jae-in said, downplaying rumours over Kim's health following his absence from a key anniversary.
"Our government position is firm," said Moon's special adviser on national security Moon Chung-in, in an interview with CNN on Sunday. "Kim Jong Un is alive and well."

The adviser said that Kim had been staying in Wonsan -- a resort town in the country's east -- since April 13, adding: "No suspicious movements have so far been detected."

Conjecture about Kim's health has grown since his conspicuous absence from the April 15 celebrations for the birthday of his grandfather Kim Il Sung, the North's founder -- the most important day in the country's political calendar.

Kim has not made a public appearance since presiding over a Workers' Party politburo meeting on April 11, and the following day state media reported him inspecting fighter jets at an air defence unit.

North Korean leader Kim Jong Un was not gravely ill, two South Korean government sources said on Tuesday, following reports he had undergone a cardiovascular procedure and was now in "grave danger."

His absence unleashed a series of unconfirmed media reports over his condition, which officials in Seoul previously poured cold water on.

"We have nothing to confirm and no special movement has been detected inside North Korea as of now," the South's presidential office said in a statement last week.

South Korea's unification minister Kim Yeon-chul reiterated Monday that remained the case, adding the "confident" conclusion was drawn from "a complex process of intelligence gathering and assessment".

'Grave danger'

Daily NK, an online media outlet run mostly by North Korean defectors, has reported Kim was undergoing treatment after a cardiovascular procedure earlier this month.

Citing an unidentified source inside the country, it said Kim, who is in his mid-30s, had needed urgent treatment due to heavy smoking, obesity and fatigue.

Soon afterwards, CNN reported that Washington was "monitoring intelligence" that Kim was in "grave danger" after undergoing surgery, quoting what it said was an anonymous US official.

US President Donald Trump on Thursday rejected reports that Kim was ailing but declined to state when he was last in touch with him.

On Monday, the official Rodong Sinmun newspaper reported that Kim had sent a message of thanks to workers on the giant Wonsan Kalma coastal tourism project.

It was the latest in a series of reports in recent days of statements issued or actions taken in Kim's name, although none has carried any pictures of him.

Satellite images reviewed by 38North, a US-based think tank, showed a train probably belonging to Kim at a station in Wonsan last week.

It cautioned that the train's presence did not "indicate anything about his health" but did "lend weight" to reports he was staying on the country's eastern coast.

Reporting from inside the isolated North is notoriously difficult, especially regarding anything to do with its leadership, which is among its most closely guarded secrets.

Previous absences from the public eye on Kim's part have prompted speculation about his health.

In 2014 he dropped out of sight for nearly six weeks before reappearing with a cane. Days later, the South's spy agency said he had undergone surgery to remove a cyst from his ankle.