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Here at home, various aspects of daily life are slowly returning to a degree of normality, even if our battle is far from over.

I still have the odd moment when I look around at everyone wearing masks and think ‘this is surreal’, but we tend to adapt to our ‘new normal’ pretty rapidly.

In various parts of the world, however, the spread of COVID-19 is far from under control, and the number of confirmed worldwide deaths has just passed the one million mark.

Via Worldometer, here are the top 10 countries, ranked by confirmed cases:

As things stand, the COVID-19 pandemic is now on a par with the 1889-90 global influenza pandemic, and Dr Mike Ryan, head of emergencies at the World Health Organisation, is worried about what lies ahead.

Speaking with the Telegraph, Ryan has said it’s “not impossible” that deaths could surpass two million before a vaccine is found, and he’s not alone – but more on that later.

In South Africa, our current death toll has come in well under some of the early predictions, but we have also instituted one of the world’s strictest lockdowns.

Now a number of European countries, along with the UK, have reimposed social distancing restrictions and second lockdowns in the face of a recent growth in cases.

The first expert to offer a prediction is Devi Sridhar, professor of global public health, University of Edinburgh:

“Realistically, we’re still going to see more cases and deaths to come, especially as we hit winter in the northern hemisphere.

“In developing countries, it’s hard to predict what will happen. In Africa, the pandemic has not hit as we predicted. Having read across the literature, there’s not one proven conclusion…

“There’s a six to seven-week lag between a case and a death, so I think we will continue to see numbers climbing – these big increases in cases here and in Europe will see deaths later down the line. The pandemic has a way to go, so sadly an increase is inevitable.”

In the UK alone, the Government’s chief scientific advisers have warned that unless stricter measures are put in place, COVID-19 cases could hit 50 000 a day by next month, with around 200 new deaths a day.

Martin McKee, professor of European public health, London School of Hygiene and Tropical Medicine, points to the current doubling of case numbers each week as a major issue, as well as how we count confirmed deaths:

“There is also a lot of variation in how people record deaths – you have to be very careful with the data. In the UK, reporting is changed so a death is counted as someone who dies within 28 days of having a positive test. But that’s not that reliable. What everyone is now recognising is that the best way to measure deaths is excess all-cause mortality.”

If South Africa was to use excess deaths as a measure of COVID-19 deaths, our numbers would be far higher.

Charlie Whittaker, researcher in infectious disease epidemiology, Imperial College, London, is also worried:

“As we’ve seen across Europe, a lot of the gains that we’ve made in terms of suppressing the virus and reducing mortality are fragile. And we’re by no means out of the woods just yet…

“[Limitations in testing] highlights the extent to which Covid-19 might have spread unobserved across many parts of the world that don’t have the necessary systems in place to accurately capture patterns of mortality.”

Various prediction models are attempting to map out how the virus will spread from here on out, although due to the variables involved, they tend to predict only a few weeks ahead.

The Institute for Health Metrics and Evaluation (IHME) has extended that to the end of the year, and those numbers are worrying:

At the most conservative estimate, the global death toll is expected to pass two million by the turn of the New Year.

The team project that some of the hardest-hit world regions will include South Asia, Europe and Central Asia, with deaths anticipated to climb above 600,000 in each region.

As has been stated many times before, predictions are still a guessing game, with so many variables in play and so much that we still don’t know about the virus.

Having spent in excess of six months under various lockdown levels, you get the feeling that any attempt to reintroduce stricter measures in South Africa would be met with considerable pushback from the general public.

I guess all we can do is keep up the precautionary measures we’ve been following since late March, and hope that we avoid that second surge which seems certain to strike other parts of the world.

[source:telegraph]