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UN, May 26: Countries could see a "second peak" of coronavirus cases during the first wave of the pandemic if lockdown restrictions were lifted too soon, the World Health Organization (WHO) has warned.

Mike Ryan, the WHO's head of emergencies, told a briefing on Monday that the world was "right in the middle of the first wave", the BBC reported.

He said because the disease was "still on the way up", countries need to be aware that "the disease can jump up at any time".

"We cannot make assumptions that just because the disease is on the way down now that it's going to keep going down," Ryan said.

There would be a number of months to prepare for a second peak, he added.

The stark warning comes as countries around the world start to gradually ease lockdown restrictions, allowing shops to reopen and larger groups of people to gather.

Experts have said that without a vaccine to give people immunity, infections could increase again when social-distancing measures are relaxed.

Ryan said countries where cases are declining should be using this time to develop effective trace-and-test regimes to "ensure that we continue on a downwards trajectory and we don't have an immediate second peak".

Also on Monday, Tedros Adhanom Ghebreyesus, WHO Director-General, said that a clinical trial of hydroxychloroquine (HCQ) on COVID-19 patients has come to "a temporary pause", while the safety data of the the anti-malaria drug was being reviewed.

According to the WHO chief, The Lancet medical journal on May 22 had published an observational study on HCQ and chloroquine and its effects on COVID-19 patients that have been hospitalized, reports Xinhua news agency.

The authors of the study reported that among patients receiving the drug, when used alone or with a macrolide, they estimated a higher mortality rate.

"The Executive Group of the Solidarity Trial, representing 10 of the participating countries, met on Saturday (May 23) and has agreed to review a comprehensive analysis and critical appraisal of all evidence available globally," Tedros said in a virtual press conference.

The developments come as the total number of global COVID-19 cases has increased to 5,508,904, with 346,508 deaths, according to the Johns Hopkins University.

Washington DC, May 19: US President Donald Trump has threatened to permanently halt funding for the World Health Organisation (WHO) if it did not commit to improvements within 30 days, and to reconsider the membership of the United States in the global health body.

On Monday, Trump wrote a letter to WHO Director-General Tedros Ghebreyesus that read, "If WHO doesn't commit to major substantive improvements within the next 30 days, I will make my temporary freeze of US funding to WHO permanent and reconsider our membership in the organisation."

Trump had temporarily suspended US' contribution to the WHO last month, accusing it of promoting China's "disinformation" about the coronavirus outbreak, although WHO officials denied the accusation and Beijing said that it was transparent and open.

"The only way forward for the WHO is if it can actually demonstrate independence from China. My administration has already started discussions with you on how to reform the organisation. But action is needed quickly. 

We do not have time to waste," Trump said in the letter.

"I cannot allow American taxpayer dollars to continue to finance an organisation that, in its present state, is so clearly not serving America's interests," he added.

On Monday, the WHO said that an independent review of the global coronavirus response would begin at the earliest and it received backing from China, where the virus was first discovered.

May 5: Global coronavirus deaths reached 250,000 on Monday after recorded infections topped 3.5 million, a news agency tally of official government data showed, although the rate of fatalities has slowed.

North America and European countries accounted for most of the new deaths and cases reported in recent days, but numbers were rising from smaller bases in Latin America, Africa and Russia.

Globally, there were 3,062 new deaths and 61,923 new cases over the past 24 hours, taking total cases to 3.58 million.

That easily exceeds the estimated 140,000 deaths worldwide in 2018 caused by measles, and compares with around 3 million to 5 million cases of severe illness caused annually by seasonal influenza, according to the World Health Organization (WHO).

While the current trajectory of COVID-19 falls far short of the 1918 Spanish flu, which infected an estimated 500 million people, killing at least 10% of patients, experts worry the available data is underplaying the true impact of the pandemic.

The concerns come as several countries begin to ease strict lockdowns that have been credited with helping contain the spread of the virus.

"We could easily have a second or a third wave because a lot of places aren't immune," Peter Collignon, an infectious diseases physician and microbiologist at Canberra Hospital, told Reuters. He noted the world was well short of herd immunity, which requires around 60% of the population to have recovered from the disease.

The first death linked to COVID-19 was reported on Jan. 10 in Wuhan, China after the coronavirus first emerged there in December. Global fatalities grew at a rate of 1-2% in recent days, down from 14% on March 21, according to the Reuters data.

DEATH RATE ANOMALIES

Mortality rates from recorded infections vary greatly from country to country.

Collignon said any country with a mortality rate of more than 2% almost certainly had underreported case numbers. Health experts fear those ratios could worsen in regions and countries less prepared to deal with the health crisis.

"If your mortality rate is higher than 2%, you've missed a lot of cases," he said, noting that countries overwhelmed by the outbreak were less likely to conduct testing in the community and record deaths outside of hospitals.

In the United States, around half the country's state governors partially reopened their economies over the weekend, while others, including New York Governor Andrew Cuomo, declared the move was premature.

In Britain, Prime Minister Boris Johnson, who battled COVID-19 last month, has said the country was over the peak but it was still too early to relax lockdown measures.

Even in countries where the suppression of the disease has been considered successful, such as Australia and New Zealand which have recorded low daily rates of new infections for weeks, officials have been cautious.

Australian Prime Minister Scott Morrison has predicated a full lifting of curbs on widespread public adoption of a mobile phone tracking app and increased testing levels.