US President Donald Trump and Democratic challenger Joe Biden offered sharply contrasting views on the coronavirus pandemic at the final presidential debate, seeking to persuade the few remaining undecided voters 11 days before the 3 November election.

Mr Trump adopted a more restrained tone than he did during the chaotic first presidential debate last month, when he repeatedly interrupted Mr Biden.

But last night's clash still featured plenty of personal attacks between two men who evince little respect for each other, and Mr Trump kept fact-checkers busy by levelling unfounded corruption accusations at Mr Biden and his family.

The televised encounter in Nashville, Tennessee, represented one of Mr Trump's last remaining opportunities to reshape a campaign dominated by a pandemic that has killed more than 221,000 people in the United States.

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Mr Trump has trailed Mr Biden in opinion polls for months, though the contest is tighter in some battleground states likely to decide the election.

"Anyone who's responsible for that many deaths should not remain president of the United States of America," Mr Biden said.

Mr Trump defended his approach to the outbreak and said the country could not afford to close businesses again, even amid fresh surges.

"We're learning to live with it," said Mr Trump, who has played down the virus for months. "We have no choice."

"Learning to live with it?" Mr Biden retorted. "Come on. We're dying with it."

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Mr Trump asserted that a vaccine was potentially "weeks" away. Most experts, including administration officials, have said a vaccine is unlikely to be widely available until mid-2021. 

Several US states, including the election swing state of Ohio, reported record single-day increases in Covid-19 infections yesterday, evidence the pandemic is accelerating anew. 

"He is going to destroy the oil industry..."will you remember that, Texas? Will you remember that, Pennsylvania?" - Donald Trump

Mr Trump, whose instinct remains to run as an outsider, portrayed Mr Biden as a career politician whose nearly 50-year record was insubstantial. But Mr Biden returned again and again to Mr Trump's nearly four years as president, pointing to the economic damage the virus has done to people's lives.

After an opening segment on the pandemic, the clash pivoted to rapid-fire exchanges over whether either candidate had improper foreign entanglements. 

Mr Trump repeated his accusations that Mr Biden and his son Hunter engaged in unethical practices in China and Ukraine. No evidence has been verified to support the allegations, and Mr Biden called them false and discredited. 

 "There's a reason why he's bringing up all this malarkey" -  Joe Biden

Mr Trump's effort to uncover dirt on Hunter Biden's Ukraine business ties led to the president's impeachment.

The president and his children have been accused of conflicts of interest of their own since he entered the White House in 2017, most involving the family's international real estate and hotel businesses.

Mr Biden defended his family and said unequivocally that he had never made "a single penny" from a foreign country, before pivoting to accuse Mr Trump of trying to distract Americans.

"There's a reason why he's bringing up all this malarkey," Mr Biden said, looking directly into the camera. "It's not about his family and my family. It's about your family, and your family's hurting badly."

He accused Mr Trump of avoiding paying taxes, citing a New York Times investigation that reported Mr Trump's tax returns show he paid almost no federal income tax over more than 20 years.

"Release your tax returns or stop talking about corruption," Mr Biden said. 

Mr Trump, who has broken with decades of precedent in refusing to release his tax returns, said he had paid "millions". He again said he would release his returns only once a longstanding audit was completed.

The candidates clashed over healthcare, China policy and - after months of anti-racism protests - race relations, with Mr Biden saying Mr Trump was "one of the most racist presidents" in history.

"He pours fuel on every single racist fire," Mr Biden said. "This guy has a dog whistle as big as a foghorn."

Mr Trump responded by criticising Mr Biden's authorship of a 1994 crime bill that increased incarceration of minority defendants while asserting that he had done more for Black Americans than any president with the "possible" exception of Abraham Lincoln in the 1860s.

Clash over healthcare

Mr Biden criticised Mr Trump's effort to persuade the US Supreme Court to invalidate the 2010 Affordable Care Act, the sweeping healthcare reform passed when Mr Biden was vice president in President Barack Obama's administration.

"People deserve to have affordable healthcare, period," Mr Biden said, noting that the law prevented insurance companies from denying coverage to people with pre-existing conditions.

Mr Trump said he wanted to replace the ACA with something "much better" that would offer the same protections, even though the administration has yet to propose a comprehensive healthcare plan despite a promise to do so for years.

During a segment on climate change, Mr Biden said his environmental plan would "transition from the oil industry" in favour of renewable energy sources, prompting Mr Trump to go on the attack. 

"He is going to destroy the oil industry," Mr Trump said. "Will you remember that, Texas? Will you remember that, Pennsylvania?"

Relatively few voters have yet to make up their minds, and Mr Trump's window to influence the outcome may be closing. A record 47 million Americans have already have cast ballots, eclipsing total early voting from the 2016 election.

The contentious first debate, when the two men traded insults, was watched by at least 73 million viewers. Mr Trump passed up another planned debate last week after it was switched to a virtual format following his Covid-19 diagnosis.