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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.

United Nations, Jun 19: Half of the world's children -- one billion every year -- are affected by physical, sexual or psychological violence, suffering injuries and death because countries have failed to follow established strategies to protect them, the first report of its kind from the UN has said, with experts noting that the coronavirus-related lockdowns have left far too many youngsters stuck with their abusers.

While nearly all countries (88 per cent) have laws in place to protect minors, less than half (47 per cent) say they strongly enforce them, said the Global Status Report on Preventing Violence Against Children 2020 launched on Thursday.

Because countries have failed to follow established strategies to protect children, about one billion are affected each year by physical, sexual or psychological violence, it said.

"There is never any excuse for violence against children," WHO Director-General Tedros Adhanom Ghebreyesus said.

"We have evidence-based tools to prevent it, which we urge all countries to implement. Protecting the health and well-being of children is central to protecting our collective health and well-being, now and for the future," he said.

The report -- launched by the World Health Organisation, the UNICEF, the UNESCO, the Special Representative of the UN Secretary-General on Violence against Children and the End Violence Partnership -- charted progress in 155 countries against the "INSPIRE" framework, a set of seven strategies for preventing and responding to violence against children.

The report signaled a clear need in all countries to scale up efforts to implement them. It included the first ever global homicide estimates specifically for children under 18 years of age -- previous estimates were based on data that included 18 to 19-year olds.

According to the findings, in 2017, around 40,000 children were victims of homicide.

"Violence against children has always been pervasive, and now things could be getting much worse," UNICEF Executive Director Henrietta Fore said.

"Lockdowns, school closures and movement restrictions have left far too many children stuck with their abusers, without the safe space that school would normally offer. It is urgent to scale up efforts to protect children during these times and beyond, including by designating social service workers as essential and strengthening child helplines," she said.

UNESCO Director-General Audrey Azoulay said during the COVID-19 pandemic, and the related school closures, "we have seen a rise in violence and hate online – and this includes bullying".

"Now, as schools begin to re-open, children are expressing their fears about going back to school. It is our collective responsibility to ensure that schools are safe environments for all children. We need to think and act collectively to stop violence at school and in our societies at large," Azoulay said.

Stay-at-home measures including school closures have limited the usual sources of support for families and individuals such as friends, extended family or professionals.

This further erodes victims’ ability to successfully cope with crises and the new routines of daily life. Spikes in calls to helplines for child abuse and intimate partner violence have been observed, the report said.

While online communities have become central to maintain many children's learning, support and play, an increase in harmful online behaviors including cyberbullying, risky online behavior and sexual exploitation have been identified.

“Whilst this report was being finalised, confinement measures and the disrupted provision of already limited child protection services exacerbated the vulnerability of children to various forms of violence," said Najat Maalla M’jid, Special Representative of the UN Secretary-General on Violence against Children.

Of the INSPIRE strategies, only access to schools through enrolment showed the most progress with 54 per cent of the countries reporting that a sufficient number of children in need were being reached in this way.

Between 32 per cent and 37 per cent of the countries considered that victims of violence could access support services, while 26 per cent of the countries provided programmes on parent and caregiver support; 21 per cent of the countries had programmes to change harmful norms; and 15 per cent of the countries had modifications to provide safe physical environments for children, the report said.

Although a majority of countries (83 per cent) have national data on violence against children, only 21 per cent used these to set baselines and national targets to prevent and respond to violence against children, it added.

The report said about 80 per cent of countries have national plans of action and policies but only one-fifth have plans that are fully funded or have measurable targets. A lack of funding combined with inadequate professional capacity are likely contributing factors and a reason why implementation has been slow.

"Ending violence against children is the right thing to do, a smart investment to make - and it's possible. We can and must create a world where every child can thrive," Howard Taylor of the End Violence Partnership said.

Melbourne, Apr 10: Scientists have identified six drug candidates from more than 10,000 compounds that may help treat COVID-19.

The research, published in the journal Nature, tested the efficacy of approved drugs, drug candidates in clinical trials and other compounds.

"Currently there are no targeted therapeutics or effective treatment options for COVID-19," said Professor Luke Guddat from the University of Queensland in Australia.

"In order to rapidly discover lead compounds for clinical use, we initiated a programme of high-throughput drug screening, both in laboratories and also using the latest computer software to predict how different drugs bind to the virus," Guddat said.

The project targeted the main COVID-19 virus enzyme, known as the main protease or Mpro, which plays a pivotal role in mediating viral replication, the researchers said.

This makes it an attractive drug target for this virus, and as people don't naturally have this enzyme, compounds that target it are likely to have low toxicity, they said.

"We add the drugs directly to the enzyme or to cell cultures growing the virus and assess how much of each compound is required to stop the enzyme from working or to kill the virus. If the amount is small, then we have a promising compound for further studies," said Guddat.

After assaying thousands of drugs, researchers found of the six that appear to be effective in inhibiting the enzyme, one is of particular interest.

"We're particularly looking at several leads that have been subjected to clinical trials including for the prevention and treatment of various disorders such as cardiovascular diseases, arthritis, stroke, atherosclerosis and cancer," Guddat said.

Researchers said compounds that are already along the pipeline to drug discovery are preferred, as they can be further tested as antivirals at an accelerated rate compared to new drug leads that would have to go through this process from scratch.

"With continued and up-scaled efforts we are optimistic that new candidates can enter the COVID-19 drug discovery pipeline in the near future," Guddat said.