LONDON — Two months ago, when there were roughly one million confirmed coronavirus cases and the primal politics of survival was sweeping the world, shutting down was the order of the day.
This week, the number of cases soared past seven million, with 136,000 new infections detected on Sunday alone, the highest single-day total since the pandemic began.
The order of the day? Reopening.
Terrified after watching economies built over the course of decades hollow out in a matter of weeks, countries seem to be saying, in effect: Enough.
For health officials who have been watching the virus with alarm as it began claiming a foothold in continent after continent, it is a dizzying moment.
“This is not the time for any country to take its foot off the pedal,” Tedros Adhanom Ghebreyesus, the director general of the World Health Organization, warned at a news conference in Geneva this week. The crisis, he said, is “far from over.”
While infection rates in the hardest-hit cities in United States and Europe may have slowed, the virus remains deeply woven into the fabric of the world. Indeed, the global peak of infection may still be months away.
In the absence of a vaccine or even effective treatments, the only proven strategy against the coronavirus to date has been limiting human contact. Cities around the world have done just that, reaping the benefits as new infections dwindled and then gingerly lifting movement restrictions.
But it is not that simple. In the longer term, as outbreaks wax and wane, public health officials say, there might need to be a period of repeated closings and openings. And that could prove a much harder sell.
Amid economic pain unlike anything seen in generations, there simply may not be the same political will, or even desire, to shut things down again. And while the public largely went along with restrictions (which were often not really enforceable on a wide scale, in any case), it remains to be seen if citizens would be so accommodating a second time around.
The virus itself is certainly anything but accommodating. It is now spreading exponentially in parts of the developing world where fragile health care systems may soon be overwhelmed if the numbers continue to spike.
On Tuesday, the United States’ top infectious disease expert, Dr. Anthony S. Fauci, delivered a grim assessment — he described Covid-19 as his “worst nightmare” — and a warning. “In a period of four months, it has devastated the whole world,” Dr. Fauci said. “And it isn’t over yet.”
Of the 136,000 new cases reported on Sunday, three-quarters of them were in just 10 countries, most in the Americas and South Asia. They include India, Brazil, Mexico and South Africa.
The Pan American Health Organization on Tuesday painted a dire picture for Latin America and the Caribbean. The crisis, said the organization’s director, Dr. Carissa F. Etienne, “has pushed our region to the limit.”
It is spreading swiftly in some countries ruled by leaders who are used to suppressing information to shape the public narrative.
In Russia, Moscow lifted its lockdown orders this week even as the number of detected infections continued to climb steadily.
In Brazil, President Jair Bolsonaro’s government took another approach: It stopped reporting the cumulative toll of the virus altogether, before a Supreme Court justice ordered it be reinstated.
And in Mexico, the government is not reporting hundreds, possibly thousands, of deaths in Mexico City. It has dismissed anxious officials who have tallied more than three times as many fatalities in the capital than the government publicly acknowledges, according to officials and confidential data.
Mexico’s president, Andrés Manuel López Obrador, has struggled to balance a response to the coronavirus with the economic needs of a country in which over half of the population lives hand-to-mouth, working informal jobs, without a safety net.
Now, Mexico is starting to bustle again as the country gradually reopens.
Even some countries that moved against the virus head on are losing ground. Among them is India.
“There will be a total ban of coming out of your homes,” Prime Minister Narendra Modi told his citizens on March 24. “Every state, every district, every lane, every village will be under lockdown.”
The ambition was staggering. India is a country of 1.3 billion, and hundreds of millions of its citizens are destitute, with countless millions living in packed urban areas with poor sanitation and weak public health care.
Despite the swift action, the country is now grappling with a sharp surge of infections.
In just 24 hours, India reported 10,000 new cases, for a total of at least 266,500, surpassing Spain to become one of the five countries with the highest caseloads. Public health experts are warning of a looming shortage of hospital beds and doctors.
But this week, Indians can once again dine out, shop and pray at religious sites.
Manish Sisodia, a government official in New Delhi, warned that the capital was likely to have 500,000 coronavirus cases by the end of July, based on the current rate of infection.
Rajnish Sinha, the owner of an event management company in Delhi, was able to secure space for his 75-year-old father-in-law on a stretcher in a missionary hospital only after an eight-hour search. He tested positive for the coronavirus on Tuesday.
Frequently Asked Questions and Advice
Updated June 5, 2020
Does asymptomatic transmission of Covid-19 happen?
So far, the evidence seems to show it does. A widely cited paper published in April suggests that people are most infectious about two days before the onset of coronavirus symptoms and estimated that 44 percent of new infections were a result of transmission from people who were not yet showing symptoms. Recently, a top expert at the World Health Organization stated that transmission of the coronavirus by people who did not have symptoms was “very rare,” but she later walked back that statement.
How does blood type influence coronavirus?
A study by European scientists is the first to document a strong statistical link between genetic variations and Covid-19, the illness caused by the coronavirus. Having Type A blood was linked to a 50 percent increase in the likelihood that a patient would need to get oxygen or to go on a ventilator, according to the new study.
How many people have lost their jobs due to coronavirus in the U.S.?
The unemployment rate fell to 13.3 percent in May, the Labor Department said on June 5, an unexpected improvement in the nation’s job market as hiring rebounded faster than economists expected. Economists had forecast the unemployment rate to increase to as much as 20 percent, after it hit 14.7 percent in April, which was the highest since the government began keeping official statistics after World War II. But the unemployment rate dipped instead, with employers adding 2.5 million jobs, after more than 20 million jobs were lost in April.
Will protests set off a second viral wave of coronavirus?
Mass protests against police brutality that have brought thousands of people onto the streets in cities across America are raising the specter of new coronavirus outbreaks, prompting political leaders, physicians and public health experts to warn that the crowds could cause a surge in cases. While many political leaders affirmed the right of protesters to express themselves, they urged the demonstrators to wear face masks and maintain social distancing, both to protect themselves and to prevent further community spread of the virus. Some infectious disease experts were reassured by the fact that the protests were held outdoors, saying the open air settings could mitigate the risk of transmission.
How do we start exercising again without hurting ourselves after months of lockdown?
Exercise researchers and physicians have some blunt advice for those of us aiming to return to regular exercise now: Start slowly and then rev up your workouts, also slowly. American adults tended to be about 12 percent less active after the stay-at-home mandates began in March than they were in January. But there are steps you can take to ease your way back into regular exercise safely. First, “start at no more than 50 percent of the exercise you were doing before Covid,” says Dr. Monica Rho, the chief of musculoskeletal medicine at the Shirley Ryan AbilityLab in Chicago. Thread in some preparatory squats, too, she advises. “When you haven’t been exercising, you lose muscle mass.” Expect some muscle twinges after these preliminary, post-lockdown sessions, especially a day or two later. But sudden or increasing pain during exercise is a clarion call to stop and return home.
My state is reopening. Is it safe to go out?
States are reopening bit by bit. This means that more public spaces are available for use and more and more businesses are being allowed to open again. The federal government is largely leaving the decision up to states, and some state leaders are leaving the decision up to local authorities. Even if you aren’t being told to stay at home, it’s still a good idea to limit trips outside and your interaction with other people.
What’s the risk of catching coronavirus from a surface?
Touching contaminated objects and then infecting ourselves with the germs is not typically how the virus spreads. But it can happen. A number of studies of flu, rhinovirus, coronavirus and other microbes have shown that respiratory illnesses, including the new coronavirus, can spread by touching contaminated surfaces, particularly in places like day care centers, offices and hospitals. But a long chain of events has to happen for the disease to spread that way. The best way to protect yourself from coronavirus — whether it’s surface transmission or close human contact — is still social distancing, washing your hands, not touching your face and wearing masks.
What are the symptoms of coronavirus?
Common symptoms include fever, a dry cough, fatigue and difficulty breathing or shortness of breath. Some of these symptoms overlap with those of the flu, making detection difficult, but runny noses and stuffy sinuses are less common. The C.D.C. has also added chills, muscle pain, sore throat, headache and a new loss of the sense of taste or smell as symptoms to look out for. Most people fall ill five to seven days after exposure, but symptoms may appear in as few as two days or as many as 14 days.
How can I protect myself while flying?
If air travel is unavoidable, there are some steps you can take to protect yourself. Most important: Wash your hands often, and stop touching your face. If possible, choose a window seat. A study from Emory University found that during flu season, the safest place to sit on a plane is by a window, as people sitting in window seats had less contact with potentially sick people. Disinfect hard surfaces. When you get to your seat and your hands are clean, use disinfecting wipes to clean the hard surfaces at your seat like the head and arm rest, the seatbelt buckle, the remote, screen, seat back pocket and the tray table. If the seat is hard and nonporous or leather or pleather, you can wipe that down, too. (Using wipes on upholstered seats could lead to a wet seat and spreading of germs rather than killing them.)
How do I take my temperature?
Taking one’s temperature to look for signs of fever is not as easy as it sounds, as “normal” temperature numbers can vary, but generally, keep an eye out for a temperature of 100.5 degrees Fahrenheit or higher. If you don’t have a thermometer (they can be pricey these days), there are other ways to figure out if you have a fever, or are at risk of Covid-19 complications.
Should I wear a mask?
The C.D.C. has recommended that all Americans wear cloth masks if they go out in public. This is a shift in federal guidance reflecting new concerns that the coronavirus is being spread by infected people who have no symptoms. Until now, the C.D.C., like the W.H.O., has advised that ordinary people don’t need to wear masks unless they are sick and coughing. Part of the reason was to preserve medical-grade masks for health care workers who desperately need them at a time when they are in continuously short supply. Masks don’t replace hand washing and social distancing.
What should I do if I feel sick?
If you’ve been exposed to the coronavirus or think you have, and have a fever or symptoms like a cough or difficulty breathing, call a doctor. They should give you advice on whether you should be tested, how to get tested, and how to seek medical treatment without potentially infecting or exposing others.
How do I get tested?
If you’re sick and you think you’ve been exposed to the new coronavirus, the C.D.C. recommends that you call your healthcare provider and explain your symptoms and fears. They will decide if you need to be tested. Keep in mind that there’s a chance — because of a lack of testing kits or because you’re asymptomatic, for instance — you won’t be able to get tested.
“This is just the beginning of the coming disaster,” Mr. Sinha said. He said, “Only God can save us.”
In Latin America, cases are surging both in countries that took early isolation measures, like Peru and Bolivia, and in those that ignored many public recommendations, like Brazil and Nicaragua.
Governments, forced to choose between watching citizens die of the virus or watching them die of hunger, are loosening lockdowns.
“We go to bed without eating, giving nothing to our children,” said María Camila Salazar, 22, a mother of two who lives in Medellín, Colombia’s second-largest city.
Ms. Salazar and her family, like millions across Latin America, collect cardboard, glass and plastic for a living, selling it by the kilo. Their buyers closed amid the country’s lockdown, just as she gave birth to her second child.
Colombia’s president, Iván Duque, recently relaxed lockdown rules, allowing local officials to make the final call on regulations. The country’s caseload then spiked.
In South Africa, health officials recorded more than half the country’s current cases in the past two weeks alone. With 51,000 confirmed cases, it has the most in Africa.
“Like many South Africans, I, too, have been worried as I watch these figures keep rising,” President Cyril Ramaphosa wrote in his weekly letter to the nation.
Still, the country is reopening, and most members of South Africa’s work force have now returned to their jobs.
Mr. Ramaphosa said the lockdown had achieved the goal of giving hospitals time to prepare, an assertion that may be tested in coming days.
It appears clear that the playbook for slowing the spread of the virus used in Western Europe and the United States may not work everywhere. Societies with informal economies simply cannot enforce lockdowns without running the risk of societal collapse.
But even those countries that have made progress after being hit hard by the first wave of the virus are by no means out of the woods. Social-distancing rules in many places — and adherence to them — remain haphazard, little match for the most basic of human desires: to connect.
Sameer Yasir contributed reporting from New Delhi, and Julie Turkewitz from Bogotá, Colombia.