Spain and Italy demanded more European help as they fight still-surging coronavirus infections amid the continent’s worst crisis since the Second World War.

In the US, authorities urged millions in the hard-hit New York City region to stop travelling to keep the virus contained.

From Milan to Madrid to Michigan, medics are making tough choices about which patients to save with the limited breathing machines they have.

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Virus Outbreak ItalyWorkers wearing protective outfits sanitise a neighbourhood in Rome (Mauro Scrobogna/LaPresse/AP)

The confirmed global death toll surpassed 30,000 and new virus epicentres emerged in key US cities like Detroit, New Orleans and Chicago.

Even rural America has not been immune, as virus hotspots erupt in Midwestern towns and in Rocky Mountain ski havens.

Spain and Italy alone account for more than half of the world’s death toll and are still seeing over 800 deaths a day each.

Experts say, however, that virus toll numbers across the world are being seriously under-represented due to limited testing and political decisions about which bodies are being counted.

Unlike the US, France still does not count deaths that take place in nursing homes or in homes among its virus numbers, even though nursing homes are known to be a key coronavirus hotspot around the world.

Virus Outbreak TurkeyA newly prepared cemetery the authorities have set aside for the burial of Covid-19 victims in Istanbul (Emrah Gurel/AP)

‘’Europe must demonstrate that it is able to respond to this historic call,’’ Italian prime minister Giuseppe Conte said.

The crisis “involves all of the economic and social systems of the member states”, he said.

“I will fight until the last drop of sweat, until the last gram of energy, to obtain a strong, vigorous, cohesive European response.”

US President Donald Trump backtracked on a threat to quarantine New York and neighbouring states amid criticism and questions about the legality of such a move.

But the Centres for Disease Control and Prevention issued a travel advisory urging all residents of New York City and others in New York, New Jersey and Connecticut to avoid all non-essential travel for 14 days.

Shocking as that is for Americans, it stopped short of the restrictions imposed in Europe or elsewhere.

Parisians are fined if they try to leave the city and South Africans cannot even walk their dog or buy alcohol.

In Italy, coffins are piling up despite three weeks of strict confinement and burials are being held with only one family member.

Spain’s government moved to tighten its lockdown and ban all non-essential work Sunday as it hit another daily record of 838 dead. The country’s overall official toll is nearly 6,000.

Spain’s emergencies chief expressed hope that “the outbreak is stabilising and may be reaching its peak in some areas”.

But the crisis is pummelling world economies and putting huge strains on national health care systems.

Virus Outbreak SpainPeople line up to buy supplies from a shop in Barcelona, Spain (Emilio Morenatti/AP)

Spanish prime minister Pedro Sanchez called for a more vigorous response from the EU.

“It is the most difficult moment for the EU since its foundation and it has to be ready to rise to the challenge,” Mr Sanchez said.

Spain, Italy, France and six other EU members have asked the union to share the burden of European debt, dubbed coronabonds in the media, to help fight the virus.

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But the idea has met resistance from other members, led by Germany and the Netherlands.

European countries have also resisted sharing masks or other medical equipment with their neighbours for fear that they, too, will need them in mass quantities soon.

Many countries have turned to China, where the outbreak is easing, flying in cargo planes to get masks and other protective medical equipment.

US Virus Outbreak IowaA sign on the front door of the St Anthony’s Catholic Church in Des Moines, Iowa, US Charlie Neibergall/AP)

Worldwide infections surpassed the 660,000 mark, according to a tally by Johns Hopkins University.

The United States leads the world with more than 120,000 reported cases but five other countries have higher death tolls – Italy, Spain, China, Iran and France.

Italy has more than 10,000 deaths, the most of any country.

Egypt shut its beaches as cases in the Middle East surpassed 50,000.

Poland is considering delaying its May 10 presidential election, and Russian prime minister Mikhail Mishustin ordered his country’s borders closed on Monday.

Vietnam cut back domestic airline flights and closed restaurants and other businesses for two weeks. Vietnam has already quarantined nearly 60,000 people who entered from virus-infected nations.

More than 142,000 people have recovered, according to Johns Hopkins University.

Virus Outbreak ChinaTravellers line up for their train at the station in Beijing (Ng Han Guan/AP)

Health officials around the world have been urging people to keep a social distance of two metres from others to slow the spread of the virus but a new report from the Massachusetts Institute of Technology says that might not be enough.

It says a sneeze or cough from an infected person can expel microscopic virus droplets as far as seven or eight metres and those droplets can be suspended in the air for hours.

The researchers said they wanted to warn the public about “the distance, timescale and persistence over which this cloud and its pathological payload can travel”.

As others tightened controls, China eased more restrictions following the ruling Communist Party’s declaration of victory over the coronavirus.

Tube and bus services resumed on Saturday in Wuhan, the city of 11 million people at the centre of the outbreak.

Restrictions that bar Wuhan residents from leaving Hubei province end on April 8.