Gavin Buckley, the Melbourne-born mayor of Maryland’s state capital Annapolis, this week helped open a drive-through COVID-19 virus testing site for his city’s 38,000 residents.
Despite being months into the pandemic, Annapolis, along with the rest of America, has suffered a chronic shortage of testing kits.
Until this week, the city’s health officials had just 40 per day.
"That’s the frustration for local governments. We were ready, prepared, but the big missing piece is mass testing and tracing," Mr Buckley told The Australian Financial Review.
The local county that surrounds the picturesque historic harbour-side home of America’s storied Naval Academy – less than 40 minutes drive from Washington DC – has recorded almost 1100 confirmed coronavirus cases, with 42 deaths and another six likely fatalities.
That’s almost 70 per cent of Australia’s national tally, for a municipality with barely 600,000 residents.
Maryland governor Larry Hogan, a Republican who has clashed with President Donald Trump over testing, has taken extreme steps to secure his state’s own supply.
On Saturday, a Korean Air Boeing 777 landed at nearby Baltimore Washington International Airport with 500,000 kits arranged by Mr Hogan.
Crises likely understated
Such stories are commonplace across America and they’re fuelling persistent fears the official COVID-19 tally is understating the full extent of the crisis.
The lack of widespread and consistent testing means infections may well be rising faster than many assume, suggesting distancing disruptions will last longer and worsen the sharpest economic downturn since the Great Depression.
Contrary to some of the claims America has "turned the corner", many experts point out the rate of positive test results is still stubbornly high, running at close to 20 per cent, or one in five Americans who seek a diagnosis.
In countries where infection rates have decisively collapsed and testing is more widespread, positive test results have tended to fall below 10 per cent.
Furthermore, having suffered the world’s biggest outbreak – the latest count topped 800,000 cases, with almost 45,000 deaths – the US has also been sluggish in showing a decline in new infections.
That's confounding those who believe that having climbed a steep mountain, the country can now expect a rapid slide down the other side.
The numbers suggest, if anything, America is now stuck on a high and broad mesa.
In the 11 days after reaching their peak of new cases, total numbers fell 81 per cent in South Korea, 35 per cent in Germany and 22 per cent in Italy, according to Johns Hopkins University and New York Times calculations.
The US, by comparison, has only seen a 2 per cent decrease in a comparable time period.
Despite signs that growth in new cases peaked some 17 days ago, America’s daily death rate on Wednesday (AEST) was only just below the 2524 person peak of April 15.
By contrast, Italy’s death rate peaked seven days after growth in infections ended, and it has since fallen from more than 900 fatalities a day to between 400 and 500.
The US anomalies may be the result of some as-yet unknown idiosyncrasy.
But it may also be a sign there's still a lot of bad news to come: that social distancing isn't being observed as tightly as policymakers are hoping and that reopening the economy could exacerbate an already ugly situation.
"The number of confirmed cases in the US is significantly below the actual number of cases, due to severe capacity limitations in diagnostic testing," Pinar Keskinocak, a professor at the Georgia Institute of Technology and a specialist in infectious disease modelling, told the Financial Review.
"We have seen a slowdown in infection spread thanks to, in large part, sheltering in place. [But] the peak is still ahead of us."
"Once people start increasing their activities and social interactions, the number of infections will quickly ramp up."
If such warnings are right, the coming days will provide a crucial test of the Trump administration’s belief that growth in coronavirus deaths will effectively fall to zero by the end of next month or soon after.
In a clear setback, a closely watched computer model maintained by the University of Washington's Institute for Health Metrics and Evaluation – which is frequently referenced by White House experts – this week raised its projected US death toll to August 4 to 65,976 from 60,308, its April 17 estimate.
The final number could be as many as 124,120, according to the institute.
Much of the recent optimism has been fuelled by signs that the rhythm of devastation in New York, America's hardest-hit region, is easing. Equally, however, the expected peak in cases is still weeks away in other regions, such as Michigan or greater Washington DC.
"I do think there's a huge psychological problem when people say 'we're past the peak'," said economist Justin Wolfers. "You've heard this collective sigh of relief that New York has turned a corner, but look at all these other regions.
"There's no corner being turned."
Even in New York, Governor Andrew Cuomo was reluctant on Thursday (AEST) to declare victory, warning the number of people going into the state's hospitals was "still troublingly high".
He urged New Yorkers to continue social distancing and pressed businesses to stick with shutdown orders.
"I get the pressure to reopen," Mr Cuomo said. "But we can't make a bad decision. Frankly, this is no time to act stupidly."
Other leaders are pushing in the opposite direction, insisting on a rapid reopening of their local economies.
Las Vegas mayor Carolyn Goodman said the shutdowns were "total insanity" and that "people are begging us to reopen".
On the risk that allowing customers back into casinos would only accelerate the spread of infections, Ms Goodman told CNN that such issues were "not my job, it's the hospital and health system's job".
"And it's people's responsibility to know when they are sick."
But as angst about the state of the economy puts ever greater pressure on local leaders to reopen, even President Trump appears spooked.
Mr Trump on Wednesday told Georgia governor Brian Kemp that he "strongly disagrees" with the state's decision to open spas, beauty salons, barber shops and tattoo parlours.
"It's just too soon," the President said.
When pressed, it's clear the Trump administration doesn't believe the US economy will get back on its feet until the end of summer.
"We're looking forward to the time we get later in the summer having most of the economy, if not all of the economy, open," Treasury Secretary Steven Mnuchin said.
Mayor Buckley, who owns several restaurant businesses in Annapolis, said the city can't reopen without widespread testing, even as the economic pain of the shutdown deepens.
"May is our biggest month of the year as people come for a whole week and rent houses to watch their kids graduate from the Naval Academy," he said.
"That's been cancelled. One of the biggest tourist weeks of the city has been lost."
That said, the "the craziest thing to do would be to open early".