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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.

Beijing, May 18: China has reported 25 new COVID-19 patients, the health authorities said on Monday, as 14 asymptomatic cases were detected in Wuhan, the first epicentre of the coronavirus where officials are doing mass testing of the city's entire 11 million population, taking the number of such cases in the city to 337, the highest in the country.

The death toll in China remained at 4,634 on Sunday with no new fatalities reported.

China's National Health Commission (NHC) reported seven new confirmed cases of COVID-19 and 18 asymptomatic cases on Sunday.

Jilin province where the government has implemented strict control measures in the last few days following reports of clusters of cases in Jilin city reported two cases on Sunday, while Shanghai city has reported one.

As of Sunday, the overall confirmed cases in China had reached 82,954, including 82 patients who are still being treated, and 78,238 people who have been discharged after recovery.

Also on Sunday, 18 new asymptomatic cases including two from abroad were reported in China, taking the total number under medical observation to 448, the NHC said.

Asymptomatic cases pose a problem as the patients are tested COVID-19 positive but develop no symptoms such as fever, cough or sore throat. However, they pose a risk of spreading the disease to others.

Wuhan which is undergoing mass testing of the city's entire over 11 million population to determine the prevalence of the virus has reported no new confirmed cases, but 14 new asymptomatic infections, taking the number of such cases in the city to 337, the highest in the country, according to the figures released by the local health commission on Sunday.

The death toll in Hubei province stood at 4,512, including 3,869 in Wuhan.

The province so far has reported 68,134 confirmed COVID-19 cases in total, including 50,339 in Wuhan, according to the officials figures.

As the cases dropped, China on Sunday exempted people in Beijing from wearing masks, signalling that the virus is under control in the national capital.

As the virus is abating in the country, China is opening up all its business including entertainment centres like Shanghai Disneyl and to show that it has managed to control the dreaded virus while the world is struggling with it with lockdowns and massive casualties.

The novel coronavirus which originated in Wuhan in December last year has claimed 315,185 lives and infected over 4.7 million people globally, according to Johns Hopkins University data.

Washington, May 30: The United States will end its relationship with the World Health Organization over the body’s handling of the coronavirus pandemic, U.S. President Donald Trump said on Friday, accusing the U.N. agency of becoming a puppet of China.

The move to quit the Geneva-based body, which the United States formally joined in 1948, comes amid growing tensions between Washington and Beijing over the coronavirus outbreak. The virus first emerged in China’s Wuhan city late last year.

Speaking in the White House Rose Garden, Trump said Chinese officials “ignored their reporting obligations” to the WHO about the virus - that has killed hundreds of thousands of people globally - and pressured the agency to “mislead the world.”

“China has total control over the World Health Organization despite only paying $40 million per year compared to what the United States has been paying which is approximately $450 million a year,” he said.

Trump’s decision follows a pledge last week by Chinese President Xi Jinping to give $2 billion to the WHO over the next two years to help combat the coronavirus. The amount almost matches the WHO’s entire annual program budget for last year.

Trump last month halted funding for the 194-member organization, then in a May 18 letter gave the WHO 30 days to commit to reforms.

“Because they have failed to make the requested and greatly needed reforms, we will be today terminating our relationship with the World Health Organization and redirecting those funds to other worldwide and deserving urgent global public health needs,” Trump said on Friday.

It was not immediately clear when his decision would come into effect. A 1948 joint resolution of Congress on U.S. membership of the WHO said the country “reserves its right to withdraw from the organization on a one-year notice.”

The World Health Organization did not immediately respond to a request for comment on Trump’s announcement. It has previously denied Trump’s assertions that it promoted Chinese “disinformation” about the virus.

“It’s important to remember that the WHO is a platform for cooperation among countries,” said Donna McKay, executive director of Physicians for Human Rights. “Walking away from this critical institution in the midst of an historic pandemic will hurt people both in the United States and around the world.”

‘ABSOLUTELY CRITICAL’

The United States currently owes the WHO more than $200 million in assessed contributions, according to the WHO website. Washington also gives several hundred million dollars annually in voluntary funding tied to specific WHO programs such as polio eradication, HIV, hepatitis and tuberculosis.

Amesh A. Adalja, a senior scholar at Johns Hopkins Center for Health Security, said that in practice Trump’s decision was unlikely to change the operations of the WHO.

“From a symbolic or moral standpoint it’s the wrong type of action to be taking in the middle of a pandemic and seems to deflect responsibility for what we in the U.S. failed to do and blame the WHO,” said Adalja.

When Trump halted funding to the WHO last month, two Western diplomats said the U.S. suspension was more harmful politically to the WHO than to the agency’s current programs, which are funded for now.

The WHO is an independent international body that works with the United Nations. U.N. Secretary-General Antonio Guterres said last month that the WHO is “absolutely critical to the world’s efforts to win the war against COVID-19.”

When asked about Trump’s decision, a U.N. spokesman said: “We have consistently called for all states to support WHO.”

Trump has long scorned multilateralism as he focuses on an “America First” agenda. Since taking office, he has quit the U.N. Human Rights Council, the U.N. cultural agency, a global accord to tackle climate change and the Iran nuclear deal. He has also cut funding for the U.N. population fund and the U.N. agency that aids Palestinian refugees.

“The WHO is the world’s early warning system for infectious diseases,” said U.S. Representative Nita Lowey, a Democrat who chairs the House Committee on Appropriations. “Now, during a global pandemic that has cost over 100,000 American lives, is not the time to put the country further at risk.”