CHICAGO (AP) – The United States (US) death toll from the coronavirus eclipsed Italy’s for the highest in the world, surpassing 20,000, as Chicago and other cities across the Midwest braced for a potential surge in victims and moved to snuff out smoldering hot spots of contagion before they erupt.

With the New York area still deep in crisis, fear mounted over the spread of the scourge into the nation’s heartland.

Twenty-four residents of an Indiana nursing home hit by COVID-19 have died, while a nursing home in Iowa saw 14 deaths. Chicago’s Cook County has set up a temporary morgue that can take more than 2,000 bodies. And Chicago Mayor Lori Lightfoot has been going around telling groups of people to “break it up.”

In Europe, countries used roadblocks, drones, helicopters, mounted patrols and the threat of fines to keep people from travelling over Easter weekend. With infections and deaths slowing in Italy, Spain and other places on the Continent, governments took tentative steps toward loosening the weeks-long shutdowns.

Glorious weather across Europe posed an extra test of people’s discipline.

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“Don’t do silly things,” said Domenico Arcuri, Italy’s special commissioner for the virus emergency. “Don’t go out, continue to behave responsibly as you have done until today, use your head and your sense of responsibility.”

In Japan, healthcare facilities were getting stretched thin amid a surge in coronavirus patients, with the Japanese Association for Acute Medicine and the Japanese Society for Emergency Medicine warning of a “collapse of emergency medicine.”

Their statement said many hospitals were turning away people, rushed by ambulance, including those suffering strokes, heart attacks and external injuries. Some of those who were turned away later tested positive for the coronavirus.

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Masks and surgical gowns were running short, the statement said. Japan has nearly 7,000 coronavirus cases and about 100 deaths, but the numbers are growing. The government has declared a state of emergency, asking people to stay home.

The outbreak’s centre of gravity has shifted from China to Europe and the United State s, which now has by far the largest number of confirmed cases – over a half-million – and a death toll higher than Italy’s count of nearly 19,500, according to the tally kept by Johns Hopkins University.