Coronavirus cases have hit 10 million worldwide, with 500,000 deaths. Where do we go from here?

The number of confirmed coronavirus cases around the world hit 10 million on Sunday, a sobering milestone that experts say proves the pandemic is still not being contained on a global scale.

Those same experts also say the rate of infection, which has accelerated over the past month, could be slowed if countries start learning from each other.

As of Sunday, there have been 10,004,643 lab-confirmed cases since the novel coronavirus was first detected in Wuhan, China last December. Half a million people have also died as a result of COVID-19, the respiratory disease caused by the virus. The numbers are based on public health data compiled by Johns Hopkins University.

Through the first few months of this year, the steady rise in cases came largely from China and other countries in East Asia, along with most of Europe, the Middle East and North America.

But as most of those countries slowly gained control and began “flattening the curve,” other nations that had once seen low infection rates replaced them as coronavirus hotspots.

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Brazil has now surpassed a million cases, while Russia and India have exploded past half a million. Latin America in particular has been hit hard, with Brazil, Mexico, Colombia and other nations posting multiple new records in daily case counts since May.

At the same time, the United States — the most infected country on the planet, with roughly 2.5 million confirmed cases — has seen a dramatic upswing this month, with records being broken daily over the past week. States in the south and west of the country like Texas, Arizona and Florida that were more aggressive in reopening their economies have replaced previous epicentres like New York, erasing the progress that was made during the period of widespread lockdowns.

Those factors have led to a quickening rate of growth in worldwide cases, with roughly a million new cases being added a week at a time, compared to over 10 days apart earlier this year.

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“It’s kind of a scary thing,” said Stephen Hoption Cann, an infectious disease expert in the School of Population and Public Health at the University of British Columbia.

“It’s this combination of places that thought they had flattened the curve opening up, and countries that really haven’t taken this seriously and there’s been no social distancing. People in Russia were saying, ‘Oh, it’s no problem here,’ and now they’re just exploding. It’s unfortunate.”

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Making matters worse, experts say the confirmed case data is only the tip of the iceberg. Officials in the U.S., for example, recently estimated the actual number of infections may be around 20 million — roughly 10 times the official count.

Daniel Coombs, a UBC mathematics professor who specializes in modelling the growth and control of pandemics, suggests that could likely apply to the rest of the world.

“My off-the-cuff guess would be 100 million cases globally, at minimum,” he said, adding the rate likely differs from country to country. Those that have had success stories, like New Zealand, may only have triple the number of confirmed cases.

“But then other countries like India, which still hasn’t even gotten started on mass testing, there might be a factor of 20 times more. So those countries, it’s very hard to say where they’re at without widespread testing.”

Coombs says while it may lead to increased case numbers that some world leaders may want to avoid, widespread testing is key to figuring out where the next wave of infections is coming from and where to focus public health resources.

“Information is power,” he said. “It’s a way, maybe not out of the issue but around a lot of issues and finding a way toward mitigating future losses.”

What happens next?

Experts say countries seeing sharp upticks in cases need to take the lessons of nations that have already borne the brunt of the pandemic: flatten the curve, impose quarantines, and test as much as possible.

But others say those earlier hotspots aren’t out of the woods, especially as people get fed up with months of economic lockdowns and physical distancing.

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“We know those things work, but it’s also incredibly expensive to do, because our economy relies so much on us being physically together,” said Caroline Colijn, an expert in the epidemiology of pathogens at Simon Fraser University.

“People are sick of it and they don’t want to be sitting locked down anymore. But we also don’t have anywhere close to the herd immunity we need to counter a virus that we know spreads so easily from person to person. It’s a really difficult situation to be in.”

Making it more difficult is that countries starting to reopen are still getting a sense of what mitigation measures could work as people begin to congregate more.

“The only thing we know that’s worked so far is this severe amount of distancing,” Colijn said. “So now we’re trying to figure out, is it masks? Is it Plexiglass barriers? Is it the (contact tracing) apps? Is it staying two metres apart?

“These are all being tried out, and none of them are being tried anywhere on their own. We can’t separate them out and point to one and say, ‘Yes, masks, that’s the deal, we’ll do that.’ Our modelling is showing different things work in different places, but we don’t have the full picture yet.”

Countries that have yet to flatten the curve are having to focus on different priorities. In India, experts are advising the government to prioritize reducing mortality over containing the spread of the virus. Researchers in Brazil, where the pandemic first sprung up in urban centres, are pushing for testing checkpoints on highways as people in the highly infected rural interior bring the virus back into cities to get treatment, creating what experts call a “boomerang effect.”

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But Hoption Cann says those nations also need to learn from those that have, for now, suffered the worst of the pandemic — one that all countries could have prepared for sooner.

“We’ve known through past pandemics and epidemics that animals carry these diseases, but countries still didn’t ban their sale in markets,” he said, referring to the widely accepted origin of COVID-19 from a Wuhan live market. “We had the chance to stock up on supplies, and we didn’t.

“I think people are going to look back on this and say, you know, a lot of lives could have been saved if it was done differently.”

—With files from the Associated Press and Reuters