(AP) — The confirmed number of coronavirus cases in the U.S. reached 5 million Sunday, by far the highest in the world, according to the tally kept by Johns Hopkins University.

However, health officials believe that for every reported case, there are roughly 10 times as many people infected, given the limits on testing and the large number of mild infections that have unreported or unrecognized.

The bleak milestone was reached as new cases in the U.S. run at about 54,000 a day. While that’s down from a peak of well over 70,000 in the second half of July, cases are rising in nearly 20 states, and deaths are climbing in most. Many Americans have resisted wearing masks and social distancing.

Many in Europe have been watching what has been happening in America.

Even the European Commission president, Ursula von der Leyen, has taken the unusual step of criticizing the U.S. when she urged Washington to reconsider its decision to break ties with the WHO. She also issued veiled criticism of U.S. efforts to buy up stocks of any vaccine that might prove effective, vowing the EU will work to provide access to everyone “irrespective of where they live.”

Many Europeans point proudly to their national health care systems that not only test but treat COVID-19 for free, unlike the American system, where the virus crisis has only exacerbated income and racial inequalities in obtaining health care.

“The coronavirus has brutally stripped bare the vulnerability of a country that has been sliding for years,” wrote Italian author Massimo Gaggi in his new book “Crack America” (Broken America), about U.S. problems that long predated COVID-19.

Gaggi said he started writing the book last year and thought then that the title would be taken as a provocative wake-up call. Then the virus hit.

“By March the title wasn’t a provocation any longer,” he said. “It was obvious.”

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