ROME: From the marbled halls of Italy to the wheat fields of Kansas, health authorities are increasingly warning that the question isn’t whether a second wave of coronavirus infections and deaths will hit, but when — and how badly.

In India, which partly relaxed its lockdown this week, health authorities scrambled Wednesday to contain an outbreak at a huge market. Hard-hit New York City shut down its subway system overnight for disinfection. Experts in Italy, which just began easing some restrictions, warned lawmakers that a new surge of virus infections and deaths is coming, and they urged intensified efforts to identify victims, monitor their symptoms and trace their contacts.

Germany warned of a second and even a third wave and threatened to re-impose virus restrictions if new cases can’t be contained. German Chancellor Angela Merkel met Wednesday with the country’s 16 governors to discuss further loosening restrictions that have crippled Europe’s largest economy.

“There will be a second wave, but the problem is to which extent. Is it a small wave or a big wave? It’s too early to say,” said Olivier Schwartz, head of the virus and immunity unit at France’s Pasteur Institute. France, which hasn’t yet eased its lockdown, has worked up a “re-confinement plan” to ready for that second wave.

Many areas are still struggling with the first wave. Brazil for the first time locked down a large city, the capital of Maranhão state. Across the ocean, the number of confirmed coronavirus cases in Africa has shot up 42% in the past week. Infections were expected to surpass 50,000 there on Wednesday.

An Associated Press analysis, meanwhile, found that US infection rates outside the New York City area are in fact rising, notably in rural areas. It found New York’s progress against the virus was overshadowing increasing infections elsewhere.

“Make no mistakes: This virus is still circulating in our community, perhaps even more now than in previous weeks,” said Linda Ochs, director of the Health Department in Shawnee County, Kansas.

The virus is known to have infected more than 3.6 million and killed more than 251,000 people, according to a tally by Johns Hopkins that all experts agree is an undercount because of limited testing, differences in counting the dead and concealment by some governments.

The U.S. has seen over 71,000 deaths amid its 1.2 million confirmed infections, and Europe has endured over 144,000 reported deaths.

“Burying both parents at the same time? It’s hard,” said Desmond Tolbert, who lost his mother and father in rural Georgia. Because they had the virus, he couldn’t be with them when they died.

President Donald Trump, with his eye on being reelected in November, is pushing hard to ease state stay-at-home orders and resuscitate the US economy, which has seen over 30 million workers lose their jobs in less than two months. Trump is expected to wind down the country’s coronavirus task force, possibly within weeks, despite concerns that states aren’t being careful enough as they reopen.

A century ago, the Spanish flu epidemic’s second wave was far deadlier than its first, in part because authorities allowed mass gatherings from Philadelphia to San Francisco.

As Italy’s lockdown eased this week, Dr. Silvio Brusaferro, president of the Superior Institute of Health, urged “a huge investment” of resources to train medical personnel to monitor possible new cases. He said tracing apps — which are being built by dozens of countries and companies — aren’t enough to manage future waves of infection.

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