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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.

Paris, Apr 17: The number of coronavirus-related deaths in France has increased by 753 to 17,920 over the past 24 hours, with the total case count now standing at 108,847, Jerome Salomon, the head of the state health agency, said on Thursday.

On Wednesday, the country reported a total of 106,206 cases, including a record 1,438 new fatalities. Salomon specified that it was not the daily death toll, as the data had been compiled over the last three-day weekend.

"The total number of victims since March 1 is 17,920," Salomon said at a briefing on Thursday.
He noted that 11,060 of them had died in hospitals, and 6,860 others in social and medical-social facilities.

President Emmanuel Macron on Monday extended nationwide movement restrictions, which had been introduced due to the epidemic, until May 11. Afterwards, the country is set to gradually reopen kindergartens, schools and universities.

Feb 22: A 20-year-old Chinese woman from Wuhan, the epicentre of the coronavirus outbreak, travelled 400 miles(675 km) north to Anyang where she infected five relatives, without ever showing signs of infection, Chinese scientists reported on Friday, offering new evidence that the virus can be spread asymptomatically.

The case study, published in the Journal of the American Medical Association, offered clues about how the coronavirus is spreading, and suggested why it may be difficult to stop.

"Scientists have been asking if you can have this infection and not be ill? The answer is apparently, yes," said Dr. William Schaffner, an infectious disease expert at Vanderbilt University Medical Center, who was not involved in the study.

China has reported a total of 75,567 cases of the virus known as COVID-19 to the World Health Organization (WHO) including 2,239 deaths, and the virus has already spread to 26 countries and territories outside of mainland China.

Researchers have reported sporadic accounts of individuals without any symptoms spreading the virus. What's different in this study is that it offers a natural lab experiment of sorts, Schaffner said.

"You had this patient from Wuhan where the virus is, travelling to where the virus wasn't. She remained asymptomatic and infected a bunch of family members and you had a group of physicians who immediately seized on the moment and tested everyone."

According to the report by Dr Meiyun Wang of the People's Hospital of Zhengzhou University and colleagues, the woman travelled from Wuhan to Anyang on Jan. 10 and visited several relatives. When they started getting sick, doctors isolated the woman and tested her for coronavirus. Initially, the young woman tested negative for the virus, but a follow-up test was positive.

All five of her relatives developed COVID-19 pneumonia, but as of Feb. 11, the young woman still had not developed any symptoms, her chest CT remained normal and she had no fever, stomach or respiratory symptoms, such as cough or sore throat.

Scientists in the study said if the findings are replicated, "the prevention of COVID-19 infection could prove challenging."

Key questions now, Schaffner said, are how often does this kind of transmission occur and when during the asymptomatic period does a person test positive for the virus.