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Beijing, Apr 17: China denied Friday it had covered up the extent of its coronavirus outbreak, as it responded to growing questions from Western powers led by the United States.

A foreign ministry spokesman acknowledged that the virus's rapid spread had contributed to undercounting that resulted in China raising its death toll earlier Friday, but he added "there has never been any concealment, and we'll never allow any concealment."

The allegations China is too close to the World Health Organization (WHO), were an attempt at "smearing" Beijing, Zhao said.

US President Donald Trump has questioned China's handling of the pandemic and whether it had been completely transparent since the virus emerged in the central city of Wuhan late last year.

On Thursday, British Foreign Secretary Dominic Raab and French President Emmanuel Macron also expressed doubts about China's virus response.

These doubts were spotlighted again on Friday when authorities in Wuhan, which has borne the brunt of Chinese deaths, abruptly raised its death toll by 50 percent -- or 1,290 deaths -- to a new total of 3,869.

That also pushed the nationwide death toll up sharply to 4,632, based on official national data released earlier in the day.

Wuhan authorities cited several reasons for the missed cases, including that the city's medical staff were overwhelmed in the early days as infections climbed, leading to "late reporting, omissions or mis-reporting".

Zhao said such miscounting was to be expected in the initial stages of a major disease outbreak.

US President Donald Trump -- under fire himself for initially denying the seriousness of the pandemic -- has accused the WHO of doing the same and being too trusting of China's assurances over the outbreak.

On Tuesday he announced a suspension of US funding to the world body.

Asked about the US allegations, Zhao defended the WHO and China.

"I think they are all smearing China and cooking up stories about China," he said, without specifying which countries he was referring to.

China has largely brought the contagion under control domestically via tough measures including the unprecedented lockdown of Wuhan and tens of millions of people in surrounding areas, but not before it spread worldwide.

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.

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.