While Australia continues its march towards eased restrictions, most regions around the world are heading in the opposite direction.
UPDATED
On Thursday, as Victoria was taking its first steps out of one of the world’s longest lockdowns, the World Health Organization’s (WHO) Europe director Dr Hans Kluge revealed the region had recorded 1.5 million cases over the past week, sending its overall total past 10 million.
Earlier, on 23 October, more than 500,000 cases were recorded globally in a single day – the first time this had occurred since the pandemic began. Since then, that total has been surpassed twice, topping out at more than 530,000 on 26 October and showing no signs of slowing down.
The record numbers represent five coronavirus cases per second over the past week, with the surge being driven by major outbreaks in Europe, the Middle East, the Americas, and South Asia.
Hopes of a quick recovery are also slim. According to Burnet Institute epidemiologist Professor Michael Toole, of the 120 countries that have experienced clear second waves or late first waves, only six have emerged with varying degrees of success – Australia, South Korea, Japan, Hong Kong, Vietnam and Singapore.
So with cases and deaths exploding in almost every corner of the globe, newsGP takes a look at which areas are most affected, and where the worst may still be yet to come.
Europe
Europe passed 250,000 total deaths on 26 October, while the total number of confirmed cases has surpassed 10 million.
Over the past week, at least 20 countries in the region reported all-time daily record case numbers, with a number – including the Czech Republic, Poland and Georgia – posting numbers 25–30x higher than their initial waves.
Elsewhere, hard-hit countries that suffered through major waves in March and April, such as the UK, Spain, France, Italy, Germany and Sweden are also suffering, with many now reporting record deaths and more than 20,000 cases each day.
The surge means the EU’s healthcare systems are at risk of being overwhelmed unless authorities act quickly, the head of the European Commission, Ursula von der Leyen, said.
The Commission has made $364 million (€220 m) available to finance the transfer of COVID-19 patients across EU countries to help healthcare systems in the most affected countries cope, and the Netherlands has already begun airlifting patients across the border to Germany.
Belgium has the highest number of cases per capita in Europe, and the ‘impossible’ situation has deteriorated to such an extent that infected doctors and nurses are continuing to work to help prop up the failing health system.
Ireland, France, Germany and the Netherlands have all imposed national lockdowns, while night curfews have been imposed in Brussels, Paris, Prague, Athens and Rome. Parts of the UK have also gone into lockdown, and Spain has extended its state of emergency by another six months, allowing regional governments to limit mobility, impose curfews and shut their borders with other regions.
Sweden – which infamously avoided imposing restrictions during its first wave – has also applied more stringent recommendations in some places, including its two largest cities Stockholm and Gothenburg, advising people to avoid indoor environments such as shops and gyms.
Meanwhile, Turkey has become the eighth country in Europe to record more than 10,000 deaths, with Health Minister Fahrettin Koca describing the situation in capital city Istanbul as ‘scary’.
Despite the record cases, the WHO recently said nationwide lockdowns should be treated as a ‘last-resort option’.
North America
As 30 October, the US has surpassed nine million cases – around one fifth of the global total of nearly 45 million.
The world’s third most populous country is now adding around 80,000 cases to its total each day, and the rate is rising in 47 of the 50 US states, 20 of which are posting record numbers. The country set a new daily record on 31 October, surpassing 100,000 infections in a single 24-hour period for the first time, according to Reuters, beating the previous record total of 91,000 posted a day earlier.
White House coronavirus taskforce member and director of the National Institute of Allergy and Infectious Diseases, Dr Anthony Fauci, recently described the numbers as ‘stunning’ and said the US needs to make masks compulsory.
‘We are on a very difficult trajectory. We’re going in the wrong direction,’ he said.
More than 500,000 new cases have been reported in the past week alone, while the state of Illinois (population 12.6 million) has recorded more cases in seven days than Australia has since January.
Elsewhere, Canada reported another 2951 new cases on Thursday, almost reaching the record 3004 daily cases it had reported the previous Sunday.
The new cases account for slightly more than 3% of the 92,328 tests completed over the past day, according to provincial health data.
Overall, Canada – which has a population of 37.6 million – has completed more than 11.5 million tests (Australia has performed 8.7 million), 228,301 of which have been positive.
More than 191,000 people have recovered, but the country recently surpassed 10,000 total deaths.
Yesterday, the EU and Canada vowed to ‘deepen their cooperation’ and exchange of information on COVID-19 vaccines including research, access, procurement and distribution. They also agreed to further advance their discussions on health matters.
One of the worst hit countries in the world, Mexico, is also struggling with ongoing community transmission and at the time of publication had recorded more than 900,000 cases. Its more than 90,000 deaths represent the fourth highest total in the world, and its health ministry has said the actual death toll may actually be underestimated by around 50,000.
However, Mexican President Andres Manuel Lopes Obrador has resisted pressure to impose lockdowns, labelling them representative of an ‘authoritarian urge’ from authorities.
South America
South America and the Caribbean have recorded in excess of 9.5 million cases and 291,000 deaths. Brazil has been hit particularly hard, with its 5.5 million cases and 158,000 deaths both comprising more than half the continent’s totals.
Its leader Jair Bolsonaro has constantly downplayed the threat of coronavirus, calling a ‘little flu’ and criticising state governors who impose lockdowns.
Instead, he has pinned his hopes on a vaccine, which Brazil expects to have by June 2021. There are four vaccines currently being tested in Brazil, including Oxford University/AstraZeneca’s candidate, another from China’s Sinovac Biotech, and vaccines from Pfizer and Johnson & Johnson.
The country may also have recorded its first confirmed reinfection case, and Brazilian researchers are also investigating at least another 95 possible instances.
Argentina and Colombia have also recorded more than one million cases and 30,000 deaths each, while Peru has undergone one of the world’s longest lockdowns.
The latter announced that it is extending restrictions aimed at containing the spread of the coronavirus for at least another month, which include a night-time curfew, a ban on social gatherings and mandatory wearing of face masks in public.
Asia
Asia, the world’s largest and most populous continent, is experiencing mixed fortunes.
Countries like China, Taiwan, Thailand, Laos, Cambodia and East Timor all emerged from their first wave months ago and currently have minimal community transmission.
Likewise, South Korea, Singapore, Hong Kong, Vietnam and Japan have successfully navigated their way through second waves.
According to Professor Toole, South Korea’s decentralised healthcare system, in which local government areas conducted drive-in testing and contact tracing, along with care and support for those who had challenges in self-isolating, helped them to overcome outbreaks. It also pioneered the use of registering QR codes at retail and hospitality venues.
Meanwhile, Japan conducted ‘upstream’ contact tracing that looked for people who had been close to cases before as well as after they had symptoms – a system now employed in Victoria and NSW.
However, other countries and regions have not fared as well.
India’s confirmed number of coronavirus cases has passed eight million to be second only behind the US, with infection peaking between mid-July and mid-September when it recorded four million cases.
Infection rates have slowed since that peak – where daily cases reached 97,894 and deaths approached 1300 per day – but other parts of Asia are still showing no sign of slowing down.
Indonesia’s case numbers and deaths are the worst in South-East Asia, and at least 130 doctors and 92 nurses have died there as a result of the disease.
Iran meanwhile, is in the midst of a second wave and on Wednesday reported record daily deaths for the second day in a row.
The Middle East’s worst-hit country recorded 415 deaths in 24 hours and an ‘unprecedented’ rise in hospitalisations, prompting a health ministry spokesperson to declare the country is in a ‘full-scale war with the coronavirus’.
The latest fatalities raised the total virus deaths in the country of 80 million people to 33,714, from more than 559,000 cases.
Many other countries in the Middle East have also witnessed a recent surge in COVID-19 cases, according to AFP.
Neighbouring Iraq has eased a lockdown that was imposed early in the pandemic, even as deaths have topped 11,000 out of 460,000 confirmed cases.
Many regions across the globe are struggling to break transmission links, resulting in surging cases.
Meanwhile, Jordan recorded its daily highest total on Tuesday of more than 3800 cases and 44 deaths, pushing the overall tally to 668 dead out of 58,855 declared cases. The kingdom has taken a series of measures to curb its second wave, including imposing a night-time curfew.
Among Arab countries in the Gulf, Saudi Arabia has been worst-hit with more than 346,000 infections and 5300 deaths.
In Israel and the Palestinian territories, more than 363,000 cases have been reported, with recent measures including lockdowns and partial curfews.
Africa
According to the BBC, the reported death rate per capita in Africa has so far been low compared with other parts of the world, despite the poor health infrastructure in many African countries.
The WHO has indicated this could be partly be due to the relatively young population – more than 60% of Africans are under the age of 25 – while other experts have said experience in epidemic control from previous outbreaks has also helped.
Around 9600 cases were reported there in the past 24 hours, bringing the total to 1,737,550.
However, testing in Africa is still limited compared to other regions.
‘Most African countries are focused on testing travellers, patients or contacts, and we estimate that a significant number of cases are still missed,’ WHO Regional Director for Africa Professor Matshidiso Moeti said.
Professor Moeti also said the rollout of new rapid diagnostic tests for COVID-19 could be a ‘game-changer’ for its fight against the coronavirus, but warned that increased testing could also drive up confirmed case numbers.
Of the 54 countries on the continent, 10 account for approximately 75% of the total tests conducted – South Africa, Morocco, Ethiopia, Egypt, Kenya, Nigeria, Cameroon, Rwanda, Uganda and Ghana.
Around half have a ratio lower than the African Centres for Disease Control and Prevention (CDC) benchmark of at least 10 tests for every positive case. In many countries, there is also insufficient data available on testing to know how much is being done.
Interestingly, leading scientists in South Africa believe the country has established a form of herd immunity as a result of lockdowns imposed on densely packed townships earlier this year, where social distancing was practically impossible.
The country’s leading vaccinologist, Professor Shabir Mahdi, told Sky News that he believes the coronavirus has stimulated a level of immunity in approximately 12–15 million people, resulting in a drop in cases from mid-July.
‘The only plausible way to explain it is that some sort of herd immunity has been reached when combined with the use of non-pharmaceutical interventions … like the wearing of masks, physical distancing, ensuring ventilation when indoors and so on,’ he said.
To support his theory, Professor Mahdi pointed to results from work conducted by researchers in Cape Town, who began testing for traces of the virus in blood samples provided at local clinics by pregnant women and HIV patients.
The samples revealed that 40% of respondents had developed coronavirus antibodies, with the majority being unaware that they had been infected.
Despite this, Health Minister Zwelini Mkhize has warned that the country could be experiencing another rise in positive cases in some provinces.
The Western Cape province – where Cape Town is located – recorded a 42% increase in cases during the week leading up to 21 October, with the rise potentially linked to a single event at a bar or club.
Research earlier this year from the South African Medical Research Council (SAMRC) has also indicated that the number of people who have died due to coronavirus could be higher than was reported – excess deaths rose by 46,759 between May and mid-October.
Oceania
Pacific Island nations represent the last bulwark against coronavirus infection, with 10 yet to report a single case of COVID-19.
However, a recent surge in French Polynesia – which opened its border and relaxed restrictions in July to stimulate tourism – has some worried that the streak may not continue. Three more people died there overnight, taking the death toll to 29, while there are currently 2391 active cases in the community.
Cases have increased by 41% in the past week, and are now over 300 a day, while more than 80 people are in hospital with coronavirus symptoms, including 24 in intensive care.
All but 62 of the 7262 cases were detected after the borders were reopened, and with President Édouard Fritch the most high profile case, having contracted the disease in France.
The Marshall Islands have also recently recorded their first cases, while the US’ Andersen Air Base has been linked to a large number of cases on Guam.
The situation there deteriorated to the point where people were waiting more than three days for a bed to become available, forcing the memorial hospital to set up a tent in the carpark to treat patients, because its wards are overwhelmed. Guam has recorded 4466 cases and 76 deaths.
Globally, only the small and remote island nations and territories of Kiribati, Micronesia, Nauru, Palau, Samoa, American Samoa, Tonga, Tuvalu, Cook Islands, Niue, Norfolk Island, Tokelau and Vanuatu are believed to be still free of the virus.
Correction: This article originally stated Copenhagen is in Sweden.