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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, May 4: Anxious for an economic recovery, President Donald Trump fielded Americans' questions about decisions by some states to allow nonessential businesses to reopen while other states are on virtual lockdown due to the coronavirus.

After more than a month of being cooped up at the White House, Trump returned from a weekend at the Camp David presidential retreat in Maryland and participated in a “virtual” town hall, hosted Sunday night by Fox News Channel, from inside the Lincoln Memorial.

He pushed for an economic reopening, one his advisers believe will be essential for his reelection chances this November.

“We have to get it back open safely but as quickly as possible," Trump said.

The president acknowledged fear on both sides of the issue, some Americans worried about getting sick while others are concerned about losing jobs.

Though the administration's handling of the pandemic, particularly its ability to conduct widespread testing, has come under fierce scrutiny, the president defended the response and said the nation was ready to begin reopening.

“I'll tell you one thing. We did the right thing and I really believe we saved a million and a half lives,” the president said.

But he also broke with the assessment of his senior adviser and son-in-law, Jared Kushner, saying it was “too soon to say" if the federal government was overseeing a “success story."

Trump's impatience also flashed. While noting that states would go at their own pace in returning to normal, with ones harder hit by the coronavirus going slower, he said that “some states frankly I think aren't going fast enough" and singled out Virginia, which has a Democratic governor and legislature.

And he urged the nation's schools and universities to return to classes this fall.

But many public health experts believe that cannot be done safely until a vaccine is developed.

Trump declared Sunday that he believed one could be available by year's end although his own pandemic task force has predicated it could be another 18 months.

Federal guidelines that encouraged people to stay at home and practice social distancing expired late last week.

Debate continued over moves by governors to start reopening state economies that tanked after shopping malls, salons and other nonessential businesses were ordered closed in attempt to slow a virus that has killed more than 66,000 Americans, according to a tally of reported deaths by Johns Hopkins University.

The U.S. economy has suffered, shrinking at a 4.8 per cent annual rate from January through March, the government estimated last week. It was the sharpest quarterly drop since the 2008 financial crisis.

Roughly 30.3 million people have filed for unemployment aid in the six weeks since the outbreak forced employers to shut down and slash their workforces. It was the worst string of layoffs on record.

Larry Kudlow, Trump's top economic adviser, on Sunday predicted a “spectacular 2021” — with “the right set of policies” — on top of a rebound from July through December of this year.

He said on CNN's "State of the Union" that the administration would "pause” to review the effectiveness of trillions in economic relief spending before making any decision on whether additional aid is needed.

House Speaker Nancy Pelosi, D-Calif., said Thursday that state and local governments are seeking up to USD 1 trillion for coronavirus costs, The Senate planned to reopen Monday, despite the Washington area's continued status as a virus hot spot and with the region still under stay-at-home orders.

The House remains shuttered. The pandemic is forcing big changes at the tradition-bound Supreme Court: The justices will hear arguments, beginning Monday, by telephone for the first time since Alexander Graham Bell patented his invention in 1876.

Congressional Republicans are resisting calls by Democrats for emergency spending for states and local governments whose revenue streams all but dried up in recent weeks.

The GOP is counting on the country's reopening and the rebound promised by Trump as their best hope to forestall another big round of virus aid.

The leaders of California and Michigan are among governors under public pressure over lockdowns still in effect while states such as Florida, Georgia and Ohio are reopening.

Michigan Governor Gretchen Whitmer, a Democrat, said Sunday that the armed protesters who demonstrated inside her state's Capitol “depicted some of the worst racism” and “awful parts” of US history by showing up with Confederate flags, nooses and swastikas.

Trump had tweeted “LIBERATE” and named Michigan and other states in mid-April. In a new tweet Friday, he urged Whitmer to “make a deal” with the protesters. “These are very good people, but they are angry.

They want their lives back again, safely!” Trump said.

Despite the opposition of Michigan's Republican-controlled Legislature, Whitmer has extended a state of emergency declaration and directed most businesses statewide to remain closed.

Some people participating in other public protests across the US have not kept their distance from one another and have rallied without masks, not heeding public health recommendations.

Deborah Birx, coordinator of the White House coronavirus task force, called that behavior “devastatingly worrisome.”

She said people will feel guilty for the rest of their lives if they end up infected and unwittingly spread the virus to vulnerable family members.

“We need to protect each other at the same time we're voice our discontent,” she told CNN's “State of the Union.”

An overwhelming majority of Americans support stay-at-home orders and other efforts to slow the virus' spread, according to a recent survey from The Associated Press-NORC Center for Public Affairs Research.

Asked about states that are reopening before they meet benchmarks laid out in federal guidelines she helped write, Birx said the guidelines “are a pretty firm policy of what we think is important from a public health standpoint.”

She added that she and others have made it clear that people must continue practising social distancing, “scrupulous” hand washing and other measures to protect themselves and others.

Fox News Channel said it asked viewers to submit questions about reopening the country on the network's Twitter, Facebook and Instagram accounts for a chance to appear on the rare broadcast from the Lincoln Memorial. Trump spoke from the memorial's steps last July Fourth.