Countries where COVID-19 is spiralling out of control
On March 11, 2020 the World Health Organisation recognised the spread of coronavirus as a global pandemic.
Italy, Spain, Iran, South Korea, New York and others were hit particularly hard, and although the virus originated in China, the number of cases outside China quickly surpassed it.
Six months into the global pandemic, with 33.2 million cases and 1 million deaths, some countries are being hit again, some harder than others, while others still are hopeful about dodging successive waves of infections.
These are the regions where the pandemic has spiralled out of control - and why certain places lost their grip on the deadly virus.
Cases: 7.14 million
The US lost control of the pandemic almost immediately with a complete lack of federal tesponse to the virus.
New York, which became the nation's epicentre, developed a response to flatten the curve including strict lockdown.
Until recently, New York looked like it might avoid a second wave of the virus but infection rates are beginning to rise.
The biggest problem with the US response to the virus was that it fell to the 50 states to contain the fatal bug at a local level; the Trump administration did not endorse the widespread use of masks or social distancing until well into the pandemic.
Every day, the case count rises by around 40,000 and the death toll by around 800.
Ronald Klain, who co-ordinated the US response to the West African ebola outbreak in 2014, told The Atlantic that America was not prepared soon enough to prevent community spread among its population of 350 million.
"By early February, we should have triggered a series of actions, precisely zero of which were taken."
Cases: 6.07 million
India has reported its six millionth coronavirus case as it surges closer to the United States as the most-infected nation, but authorities have pressed ahead with reigniting the economy, irregardless of the toll.
Even though the Indian government implemented a strict lockdown on March 24, the largest of the Asian countries lost control of the virus through the country's poor medical infrastructure, no social welfare safety net, scant financial stimulus or aid, and the inability to observe social distancing due to population size and patterns.
There was also low testing and almost no contact tracing.
The steep rise in infections came as the country eased its lockdown restrictions in favour of reopening the devastated economy which is fuelled by family businesses and migrant workers.
The Indian government, like America and Brazil, based its approach to the virus not on science but on finance.
"An added issue is the Modi government's willingness to tolerate unscientific thinking," writes Vidya Krishnan, a journalist for The Atlantic.
Cases: 4.7 million
The WHO has warned that coronavirus cases are surging alarmingly in Europe with COVID-19 infections spiking to record numbers and European governments imposing new lockdowns in an effort to stop the second or third waves of the pandemic.
"Weekly cases have now exceeded those reported when the pandemic first peaked in Europe in March," the WHO regional director Hans Kluge said.
France's top scientific body said the country risks losing control of its outbreak and the head of the doctors' union in Germany has said it is already facing a second wave.
Germany recorded its highest daily new cases since April, according to the Robert Koch Institute for disease control.
On Monday, local time, Chancellor Angela Merkel said she was "deeply concerned" by the rapid jump in Germany's coronavirus infections.
France also registered new daily records for September, the health ministry said.
The Czech Republic, which largely doged the first wave, is now seeing rapidly rising cases. Czech prime minister, Andrej Babiš, admitted the government had relaxed public health measures, including making mask wearing mandatory indoors, due to "high societal demand".
Spain, which bore the brunt of the first wave of the pandemic along with Italy, is enduring infection rates that are the highest in the EU.
Causes include opening borders to visitors to boost tourism and coming out of lockdown too soon.
Miguel Hernán, epidemiology professor at Harvard University told El Pais, "The situation is deplorable, but the lack of strategic capacity to manage the pandemic is even more worrying. The swift de-escalation in May and June was only justifiable if it was accompanied by those strategies. It's not surprising that there are more cases with the rise in mobility and tourism, but it is surprising that many areas still lack adequate isolation systems for cases and contact tracing".
Cases: 8.3 million
Brazil lost control of the pandemic as early as May with commentators blaming President Bolsanaro's trivialisation of the virus as a leading cause of community spread.
It is second gaining on the US and India with 4.55 million cases and 140,000 deaths.
Funeral services workers in Brazil are working overtime to keep up with the demand as the nation has been hit with a shortage of coffins.
Latin American countries in general, after weathering months of the virus, are starting to re-open but it is too soon, according to the WHO's Regional Director Carissa Etienne.
Ms Etienne warned the region is at risk of losing control of the pandemic at a time when COVID-19 still requires major interventions to slow its spread.
Speaking during a virtual briefing from Washington with other health directors, Ms Etienne said cases of COVID-19 on Colombia's border with Venezuela have increased tenfold in the last two weeks because people have resumed their normal social lives.
Cases and death rates are climbing in Mexico, Ecuador, Costa Rica and Bolivia, she said.
Israel appeared to get the virus under control in May, but with the easing of restrictions and people returning to schools and workplaces, cases rose again. The head of the nation's coronavirus Experts Panel declared that Israel had lost control of the pandemic.
"In today's situation, with 1,000 infected [daily], we can no longer disrupt the chain of infection - even if there were a working system to do that, and there isn't," said Prof. Eli Waxman.
"The number of confirmed carriers today means that even if we stop the spread [today], the next three weeks will see 300 seriously ill," said Waxman. "If we stop the spread in a week, that's 600 more, and a week after that is already 1,200 - that endangers our hospitalisation system's capabilities, puts the whole system in danger of collapse."
"Since we've lost control of the pandemic, we can't stop it except through social distancing. We need immediate social distancing orders geared toward minimising the major risks, but with actions whose economic cost isn't high."
The Middle East in general as an estimated 50,000 cases.
The number of cases in Iran alone is approaching 36,000 and since late February, the Islamic Republic has been the Middle East's COVID-19 epicentre.
Lebanon's caretaker Prime Minister Hassan Diab said the country was at risk of losing control of its coronavirus outbreak, which was worsened by the deadly Beirut port explosion. "The number of cases is increasing greatly, and if this continues, we will lose control of this epidemic," Mr Diab said.
Liberian president George Weah sacked the country's top health official over his handling of coronavirus testing.
England is on the "edge of losing control" of the spread of coronavirus, according to a member of the British government's Scientific Advisory Group for Emergencies (SAGE).
People who can work from home should continue to do so says SAGE Adviser and former Government Chief Scientific Adviser Sir Mark Walport.
Experts have warned that the country is losing its battle to contain the virus because there was no unified government response from the beginning.
Additionally, young people during the Northern summer insisted on going out; and lockdowns were mainly imposed when regional hot spots flared up, such as in England's North.
Boris Johnson's approach came under fire as a "whack-a-mole strategy", according to Carl Heneghan, professor of evidence-based medicine at the University of Oxford and director of the Centre for Evidence-Based Medicine.
"If it proves impossible to rid our planet altogether of COVID-19, could it still be eliminated from specific countries or regions? This would require what we are lacking in Britain at the moment: a coherent governmental response. Yet if one is forthcoming, there is hope: viral disease such as polio has been eliminated in many countries across the world (it is not eradicated as it is still endemic in some countries such as Nigeria)."
Under pressure, Mr Johnson implemented new measures including: Pubs, bars and restaurants to close at 10pm, people to work from home wherever possible, face masks compulsory,
weddings reduced from 30 to 15, crowdless sporting events, 'rule of six' applied to gatherings.
The new lockdown may last six months.
"The evidence is hospitalisations are increasing, it is a worry and the concern is what happens if we don't do something," Dr Mike Tildesley, from the University of Warwick, told the BBC.
Dr Tildesley is part of the government's disease modelling group of scientists which has been discussing circuit-breakers.
Daily coronavirus cases in Scotland hit a four-month high, the latest Scottish Government figures of nearly 25,000 cases show.
First Minister Nicola Sturgeon has warned tighter "circuit breaker" COVID restrictions are now likely to be imposed as the country faces the risk of an exponential surge in infections.
Ms Sturgeon said Scotland was on the same track as France with cases "quite rapidly" increasing among the elderly, saying the number of coronavirus tests coming back positive in Scotland were approaching the World Health Organisation's danger level.
The First Minister asked Boris Johnson to convene a meeting of the UK-wide Cobra emergency group this weekend to discuss the "deteriorating situation".
"The virus could get out of our grip again - but it hasn't happened yet and we have time to prevent it from happening."
National Clinical Director Jason Leith said the principle cause of the rise in cases had come from "household mixing".
If Scotland goes into circuit breaker lockdown this will mean nationwide rules in-line with Britain's.
Rapid increases in new COVID-19 cases could quickly spiral out of control, public health officials said while hesitating to call it a second wave yet.
Canada's top public health official, Dr. Theresa Tam, said daily case counts are increasing at an alarming rate.
"The ongoing increase in new cases being reported daily continues to give cause for concern," Chief Public Health Officer Theresa Tam said in a statement.
Officials in major provinces blame social gatherings for the spike.
"With continued circulation of the virus, the situation could change quickly and we could lose the ability to keep COVID-19 cases at manageable levels."
On Monday, local time, Ontario reported 700 new cases of COVID-19, with 344 new cases in Toronto.
These figures beat the previous high of 640 cases in late April.
On Monday, local time, Quebec Premier Francois Legault called a news conference ahead of the highest COVID-19 alert level.
Deaths: 8,700 approx.
After weathering the early months of the pandemic, several Southeast Asian nations are now seeing major spikes in COVID-19 cases.
In Indonesia, the Ministry of Health reported some of the highest case numbers in the region.
Indonesia's local leaders fear that the rising number of infections could overwhelm the nation's health system especially in Jakarta where new cases have averaged 1,000 per day over the past month.
The virus spiralled out of control after the Widodo government ignored science and touted remedies such as mangosteen juice or prayer to charm necklaces as cures.
The Philippines is also on the brink of losing control of the pandemic. On September 17, the Philippine health authorities announced rising numbers and even 78 staff and members of parliament have tested positive for COVID-19.
Low testing and contact tracing, scepticism of science, and a lack of co-ordinated government response are being blamed for the spike.
AVOIDING NEW WAVES OF COVID
As some regions fight to beat back a tide of new infections other areas are having success - for now.
China seems to have returned to business as usual and Wuhan, which was the pandemic's ground zero last December, has almost returned to normal with bars and nightclubs full of people.
There have been no recorded cases of community transmission in Wuhan since May.
China's mainland has not recorded any local cases for a month as it appears the Communist state has almost wiped out the coronavirus, if reports are to be believed. The cases being reported by China's authorities are imported.
New Zealand has had small outbreaks of COVID-19 after declaring it eliminated. Strict travel bans, border closure, quarantine and test and trace systems have enabled the nation to bring the outbreaks under control.
Coronavirus restrictions eased across New Zealand with all cities outside of Auckland moved to COVID-19 Alert Level 1.
Some restrictions remain in place for Auckland: face coverings will still be required on public transport and on planes while for the rest of New Zealand, face coverings will no longer be mandatory but will be encouraged on planes and public transport.
Pakistan was on the edge of a devastating COVID-19 outbreak in May when the government decided to lift its lockdown at the height of community spread. For a country with a population of 220 million, Pakistan's numbers have remained relatively low.
The Agha Khan University Hospital and the World Health Organisation have estimated that 11 per cent of Pakistanis have developed COVID-19 antibodies.
Epidemiologist Dr. Rana Jawad Asghar interprets the findings to be in line with global studies suggesting 11 to 20 per cent of the population in most countries have been exposed to the virus. "The 11 per cent could also represent the most vulnerable of the population and the remaining may not be susceptible to the virus," he added.
South Korea was one of the first countries to say it was experiencing a second wave of the pandemic. but cases seem to have been brought under control with the daily rate of inflections slowing.
In both waves, South Korea isolated infected patients, supported those in quarantine, traced contacts thoroughly.
Experts believe officials had learned their lesson with MERS and did not waste a moment responding to COVID-19 immediately.
Originally published as Countries where COVID-19 is spiralling out of control