Global COVID snapshot: Case ‘explosion’ as records fall

With cases and deaths continuing to explode in almost every corner of the globe, newsGP takes another look at which areas are most affected, and where the worst may still be yet to come.

Last 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 26 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 barrier has been passed another three times, topping out at more than 685,000 on 4 November and showing no signs of slowing down.
 
The record numbers mean the world is currently recording more than five coronavirus cases per second, with the surge being driven by major outbreaks in Europe, the Middle East, the Americas, and South Asia.
 
Reuters’ coronavirus tracker estimates 54 countries are currently at or near the peak of their infection curve.
 
Hopes of a quick recovery are 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.  
 
Europe
Europe passed 250,000 total deaths on 26 October and will soon surpass 300,000, while the total number of confirmed cases has reached 11.6 million (as of 5 November).
 
At least 20 countries in the region have been reporting 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 infections each day.
 
The WHO has warned the region faces an ‘explosion’ of cases, with Dr Kluge telling AFP the mortality rate is also starting to rise ‘little by little’.   
 
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.
 
The Czech Republic, Ireland, France, the UK, Germany and the Netherlands have all imposed national lockdowns, while various restrictions have been imposed in Italy, Belgium, Portugal, Greece and Denmark. Spain has also 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 applied more stringent recommendations in some places, including its two largest cities Stockholm and Gothenburg, advising people to work from home, and avoid public transport and 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 of 6 November, the US has recorded 9.65 million confirmed infections – around one fifth of the global total of 48.6 million – after posting a record 120,000 new cases overnight.
 
The world’s third most populous country posted 100,000 daily cases for the first time on 4 November, and the infection rate is rising in 47 of the 50 US states – 20 of which are posting record numbers.
 
According to Reuters, the US accounts for one in every 18 infections and one in every 11 deaths reported globally each day.
 
White House coronavirus task force 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.
 
Daily cases have increased by more than 50% over the past fortnight, according to the New York Times, and deaths have increased by 21% over the same period. The state of Illinois (population 12.6 million) recently recorded more cases in a week than Australia has since January.
 
Elsewhere, Canada reported a record 4672 cases on 3 November, and its seven-day (3233) and three-day (3792) moving averages for daily cases are both the highest they have ever been.
 
The new cases account for more than 3.7% of the 84,530 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 12.085 million tests (Australia has performed 8.97 million), 251,338 of which have been positive (2.07%).
 
Nearly 208,000 people have recovered, but the country recently surpassed 10,000 total deaths.
 
Last week, 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 nearly 950,000 cases. Its more than 93,000 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 those in power.
 
South America
South America has recorded nearly 9.9 million cases and more than 300,000 deaths. Brazil has been hit particularly hard, with its 5.6 million cases and 161,000 deaths both comprising more than half of 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 are the other South American countries to have 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 is approaching 8.4 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 has reported more than 400 deaths in each of the past five days, including a record high of 440.

The Middle East’s worst-hit country is experiencing an ‘unprecedented’ rise in hospitalisations, prompting a health ministry spokesperson to declare the country is in a ‘full-scale war with the coronavirus’. Yesterday, President Hassan Rouhani announced new ‘severe’ restrictions for areas with major outbreaks that will last for at least the next two weeks.
 
The latest fatalities raised the total virus deaths in the country of 80 million people to almost 37,000, from 655,000 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 nearly 490,000 confirmed cases.


Many regions across the globe are struggling to break transmission links, resulting in surging cases. 

Meanwhile in Jordan, rates of new COVID cases have risen to among the highest in the world, just a few months after the kingdom relaxed most public health restrictions having believed it had eliminated community transmission.
 
As recently as late June, Jordan was counted alongside New Zealand, Thailand and Vietnam as a coronavirus success story, after going weeks without detecting infections in the community and registering around 1100 cases and 11 deaths as of late July.
 
But its second wave has seen the government announce new records for daily case numbers (5877) and deaths (62), pushing the overall tally to 1069 dead out of 95,864 declared cases.
 
The surge means the country’s death and case totals have increased by more than one third in the past week alone – (an addition of 401 and 37,000 respectively), forcing the kingdom to take a series of restrictive measures, including imposing a night-time curfew and mandatory mask wearing in public.
 
Among Arab countries in the Gulf, Saudi Arabia has been worst-hit with nearly 350,000 infections and almost 5500 deaths.
 
In Israel and the Palestinian territories, more than 374,000 cases have been reported, with recent measures including lockdowns, mandatory mask wearing in public, 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 14,200 cases were reported there in the past 24 hours, bringing the total to 1.83 million.
 
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 recently.
 
Professor Moeti said the rollout of new rapid diagnostic tests for COVID-19 could be a ‘game-changer’ for its fight against the coronavirus, but flagged 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.
 
The official total of coronavirus deaths in South Africa currently stands at 19,667.
 
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. At least nine people have died in the past week, taking the death toll to 38, with another 26 patients in intensive care.
 
Cases have increased dramatically in the past fortnight, with President Édouard Fritch this week revealing the small overseas collectivity of France now has the fourth-highest infection rate in the world.
 
All but 62 of the 7262 cases were detected after the borders were reopened – including more than 700 in a single 24-hour period last week – with President Fritch himself 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.
 
At one stage, 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 were 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.
 
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