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Explainer: Rise in global Covid-19 toll and its implications

SINGAPORE — The total number of Covid-19 cases has crossed the 14.5 million mark globally, with more than 600,000 dead, driven by a resurgence in infections in the United States, Brazil and India.

Explainer: Rise in global Covid-19 toll and its implications

The Statue of Liberty is pictured as New York enters Phase 4 of reopening.

  • One expert said exponential growth in Covid-19 cases shows that the situation is “spiralling out of control”
  • Based on current evidence, the transmissibility and severity of Covid-19 have not changed, said the WHO
  • Uptrend expected to continue until control measures such as mask wearing, contact tracing and isolation resume


SINGAPORE — The total number of Covid-19 cases has crossed the 14.5 million mark globally, with more than 600,000 dead, driven by a resurgence in infections in the United States, Brazil and India.

The numbers in these countries make for grim reading.

India last Friday became the third country in the world to have more than one million Covid-19 cases, with scientists saying the number is far from peaking.

A day before, Brazil crossed the two million mark, less than a month after the country hit one million cases on June 20.

The US? It has reported a total of 3.7 million confirmed cases, with more than 140,000 dead.

Globally, daily records were broken twice over the weekend.

The reasons for the spikes varied across countries.

Some were attributed to the lack of safe distancing measures and the reluctance to mandate the wearing of masks, such as in certain cities in the US.

In other territories, rising numbers were seen as governments ease restrictions earlier imposed to curb the spread of the coronavirus.

TODAY spoke to several experts to find out if the global spike in Covid-19 cases is part of an upward trend that is likely to persist in the coming months.


Professor Alex Cook, who is the vice-dean of research at the National University of Singapore's Saw Swee Hock School of Public Health, said that the exponential growth in the number of Covid-19 cases shows that the situation is “spiralling out of control”.

“During the period when many countries were in lockdown, the number of new cases was closer to a plateau. The daily number of cases is higher now than in previous months, so the situation overall looks worse.”

Prof Cook also noted that places such as Hong Kong, where the situation was seemingly well under control, are starting to see a new wave of outbreaks.

Dr Leong Hoe Nam, an infectious diseases specialist at Mount Elizabeth Novena Hospital, believes that the virus is “likely to stay” because people are not taking the right precautions.

In response to TODAY’s queries, the World Health Organization (WHO) said that while cases have been on the rise overall, new deaths seem to be relatively stable.


Professor Paul Tambyah, president of the Asia Pacific Society of Clinical Microbiology and Infection, said that the Covid-19 situation has improved significantly with more testing in more countries. This has allowed for the detection of more cases in most countries, he added.

“We now have better diagnostic tests and also a much better understanding of the disease. We also know more about how to treat patients with the disease and the mortality rate has declined globally even as more cases are being detected.” 

In its statement, WHO said that the Americas remain the hardest-hit region right now, contributing to more than half of the new cases.

The Southeast Asian and African regions are also seeing rapid growth in the number of cases. Among them, the US, Brazil and India remain the three most affected countries in recent days.

Dr Leong noted that certain regions are doing better than others.

In Southeast Asia, however, most countries are doing poorly with the exception of Singapore, Malaysia, Thailand and Vietnam.

“It will come to a disparate situation, where some countries are very good and some countries very bad,” Dr Leong said.


On the rising number of cases globally, Prof Cook said that it could be due to more testing or the relaxation of physical distancing policies without adequate measures to replace them.

Similarly, Prof Tambyah said that it is hard to explain the increased numbers without knowing the number of people tested.

“The increase in cases seems to be concentrated on a few hot spots — the southern United States in contrast with New York, where case numbers are dropping.”

The numbers in Eastern Europe have been rising while in Southern Europe they are decreasing, he observed.


Dr Leong foresees this situation to remain, if not worsen, in the next few months until the whole world “smartens up”.

Prof Cook listed three scenarios that must happen for the present situation to improve.

The first is for the epidemic to spread throughout the population until it can no longer spread any more, which might lead to up to 80 per cent of the population being infected.

The second is to have good controls in place: A lockdown where necessary, followed by tracing, testing and isolating of cases. However, Prof Cook cautioned that Hong Kong is an example of how even the best-managed outbreaks can still flare up.

The third scenario is for a vaccine to be created, which could replace natural immunity with vaccination-derived herd immunity.

From a public health perspective, Prof Cook believes that the best scenario is for countries to implement good controls to minimise the spread of the virus before administering a vaccine when it becomes available.

“However, it does look as if many countries are hurtling down the first path,” he added.

WHO said that based on current evidence, the transmissibility and severity of Covid-19 have not changed.

Prof Tambyah said that the worsening of the trend might not necessarily be a bad thing because he believes that the detection of more cases will allow for better control through isolation and quarantine.


Prof Tambyah said that with better detection of cases, it is likely that control of the disease globally will improve if contact tracing, isolation and quarantine can be rolled out.

“There will also be more opportunities for clinical trials on new therapeutics and vaccines, which can hopefully prevent a resurgence in areas where numbers are low,” he added.

Professor Cook agreed, saying he suspects that the world will continue to observe an uptrend until effective control measures such as mask wearing, rigorous testing, contact tracing, isolation and lockdowns resume.


On how the increased numbers will affect the rest of the world, Prof Tambyah said that there is a “critical need” to detect all cases.

“With more surveillance and active identification of cases, we can better understand the spread of the disease. This would allow both high-incidence and low-incidence countries to control the disease better,” he added.

Dr Leong pointed to Australia for insights and predictions of what might likely happen to the northern hemisphere.

He foresees that the northern hemisphere might experience a third wave of Covid-19 when winter begins in November, as the weather gets colder and drier — conditions that facilitate better virus transmission.

However, he added that the world can look to the east for solutions.

“China enforced a strict mask-only rule with aggressive testing and lockdown. Even in winter (February), it controlled the outbreak,” he said.

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