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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.

Davos, Jan 22: President Donald Trump has said that the US is watching the developments between India and Pakistan over Kashmir "very closely" and repeated his offer to "help" resolve the longstanding dispute between the two neighbours as he met Prime Minister Imran Khan on the sidelines of the World Economic Forum here in the Swiss ski resort.

Addressing the media with the Pakistan Prime Minister prior to their private meeting on Tuesday, President Trump asserted that trade and borders were both critical points for discussion, while Khan said that for him, Afghanistan was the top priority.

Trump told Khan, whom he referred to as "my friend", that he would speak to Prime Minister Narendra Modi about the ongoing Kashmir issue. The US president is expected to visit India in the coming weeks, marking his first visit after taking up his post in the White House.

"What's going on between Pakistan and India … if we can help, we certainly will be willing to. We have been watching it very closely and it's an honour to be here with my friend," he said.

"The Pakistan-India conflict is a very big issue for us in Pakistan and we expect the US to always play its part in deescalating the tensions, because no other country can," Khan said.

President Trump has repeatedly offered to mediate following India's August 5 decision to revoke the special status to Jammu and Kashmir and bifurcate the state into two Union Territories, evoking strong reaction from Pakistan which has been trying to internationalise the Kashmir issue.

New Delhi has defended the move, saying Jammu and Kashmir is an integral part of India and the issue was strictly internal to the country, and the special status provisions only gave rise to terrorism in Jammu and Kashmir.

"The country took the decision of abrogation of Article 370, which had only given separatism and terrorism to that state," Prime Minister Narendra Modi said at a function in October last year.

This is the third meeting between Trump and Khan since Pakistan premier assumed office in 2018 and it came against the backdrop of Pakistan Foreign Minister Shah Mehmood Qureshi's recent trip to the US, amid reports that the US and Afghan Taliban were close to striking a peace deal.

"There are issues we want to talk about. The main issue is Afghanistan because it concerns the US and Pakistan. Fortunately, we are on the same page. Both of us are interested in peace there and an orderly transition in Afghanistan with talks with Taliban and the government," Khan said.

When a reporter asked Trump if he would visit Pakistan considering he was already set to visit India, the US president said he was meeting the Pakistan premier in Davos.

"Well, we're visiting right now. So we don't really have to. I wanted to say that from a relationship standpoint, we got a great relationship. From the standpoint our two countries, we're getting along very well. I would say we've never been closer with Pakistan the way we're right now. And this is a big statement," Trump said.

Khan left for Switzerland to attend the World Economic Forum and meet the world leaders, including President Trump, on the sidelines of the annual event which kicked off at the ski resort town of Davos on Tuesday.

The four-day summit marks the 50th anniversary of the forum.

A total of 53 heads of State are on the guest list. Nearly 3,000 participants from 118 countries are expected to attend the event during which political leaders, business executives, heads of international organisations and civil society representatives are set to deliberate on contemporary economic, geopolitical, social and environmental issues.

May 12: Gunmen stormed a hospital on Tuesday in an ongoing attack in the Afghan capital Kabul, as a suicide blast killed 15 people at a funeral in the country's restive east.

Special forces rescued 80 people including mothers and babies from the Kabul hospital after three gunmen launched a morning assault, killing at least four people, the interior ministry said in a statement.

Heavily armed forces were seen carrying babies wrapped in blankets away from the scene, as the clearance operation continued.

The facility, which has a large maternity ward, is located in the west of the city, home to the capital's minority Shiite Hazara community -- a frequent target of Sunni militants from the Islamic State group.

The flare-up in violence comes as Afghanistan grapples with myriad crises including a rise in militant operations across the country and a surge in coronavirus infections.

A paediatrician who fled the hospital told AFP he heard a loud explosion at the entrance of the building.

"The hospital was full of patients and doctors, there was total panic inside," he said, asking not to be named.

The maternity services at the hospital are supported by humanitarian organisation Doctors Without Borders (MSF).

"Hospitals and health workers must not be attacked. We call on all sides to stop attacking hospitals and health workers," said deputy health minister in the city, Waheed Majroh.

Around an hour later, a suicide bomber killed at least 15 people at the funeral of a local police commander in the country's eastern Nangarhar province, according to provincial spokesman Ataullah Khogyani.

The attacker detonated his explosives in the middle of the ceremony.

Zaher Adel, spokesman for the government hospital in Jalalabad, earlier said 12 bodies had arrived from the blast site and more than 50 people were being treated for injuries.

Amir Mohammad, who was wounded in the blast, said thousands of people had gathered for the funeral, an event which often draws huge crowds in Afghanistan.

The violence comes just a day after four roadside bombs exploded in a northern district of Kabul, wounding four civilians including a child.

The bombings were later claimed by the Islamic State group, according to the SITE intelligence group.

They were just the latest in a string of IS attacks on the capital.

In March, at least 25 people were killed by a gunman at a Sikh temple in Kabul, which was later claimed by the group.

IS is also responsible for an infamous attack in March 2017 on one of the country's largest hospitals, when gunmen disguised as doctors stormed the Kabul building and killed dozens.

In recent months, the jihadist group has suffered mounting setbacks after being hunted by US and Afghan forces as well as Taliban offensives targeting their fighters, but it still retains the ability to launch major assaults on urban centres.

The Taliban have largely refrained from launching large attacks on Afghan cities since February when they signed a landmark withdrawal deal with the US meant to pave the way for peace talks with the Kabul government.

Under the agreement, the Taliban promised not to target forces from the US-led coalition, but made no such pledge toward Afghan troops and have stepped up attacks in the provinces.

The Taliban have denied involvement in both of Tuesday's attacks.