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Known total of global COVID-19 infections has surpassed 200 million

A health care worker put on her protective gear as she prepared to attend to a COVID-19 patient at the Intensive Care Unit (ICU) of the Hospital del Mar in Barcelona on Wednesday.JOSEP LAGO/AFP via Getty Images

The known total of global coronavirus infections surpassed 200 million Wednesday, a daunting figure that also fails to capture how far the virus has embedded itself within humanity.

While always an imperfect measure of a virus that causes no symptoms in large parts of the populations it infects, case counts have provided a useful tool for much of the pandemic — like a flashing red light in the cockpit of a jetliner warning of imminent danger.

A surge in case numbers has in most cases been followed by a crush of people crowding emergency rooms and, several weeks later, a rise in fatalities.

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The official tally stands at more than 614,000 deaths in the United States. More than 550,000 in Brazil. More than 425,000 in India. Mexico has recorded more than 240,000 fatalities, and Peru nearly 200,000. Britain, Colombia, France, Italy and Russia have all recorded well more than 100,000 deaths. The global toll as of Wednesday was 4.2 million, itself a rough estimate given the discrepancies in the way nations record COVID-19 deaths.

As the coronavirus continues to find new hosts across the planet, the emergence of the delta variant — thought to be twice as infectious as the initial form of the virus — is adding fuel to a fire that has never stopped raging. Fully vaccinated people are protected against the worst outcomes of COVID-19 caused by the delta variant.

In the week of July 19-25, nearly 4 million cases were recorded by the World Health Organization, many of them occurring in countries lacking vaccines. More than 69,000 people died over that same week.

Despite countless lockdown restrictions and radical shifts in individual behaviors, the virus continues to spread at a staggering pace.

Some countries, like Australia, once had success keeping case counts low thanks to geographic isolation and strict lockdown measures. But that may not be possible with the delta variant; Australia’s largest city, Sydney, is scheduled to be under lockdown until at least Aug. 28 as it tackles a continuing delta outbreak. And governments have faced increasingly angry protests while enforcing lockdowns on weary populations and struggling businesses, and imposing new vaccine requirements.

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During the past six months — as the world raced to 200 million cases in half the time it took to reach 100 million — the calculus for measuring the danger of the moment has become more nuanced.

In countries where vaccines are scarce, the math of the pandemic remains unchanged. When Indonesian authorities reported nearly 57,000 new cases on one day in early July — seven times as many as a month earlier — they also reported a record 1,205 deaths, bringing the country’s official toll from the pandemic to more than 71,000.

But in rich nations with ample vaccine supplies, public health officials are watching to see how mass inoculation campaigns have severed the link between case counts and pressure on health care systems. In Spain and Britain for example, cases have begun declining after the delta variant drove numbers to concerning heights. But in other countries like Malaysia and Thailand, that climb is continuing.

In the United States, with about 93 million people eligible for shots who have chosen not to get them, experts say that a rise in cases this winter is inevitable.

The spread of the virus among the vaccinated is one of the most intensively watched in rich nations, and much remains unknown. Are there differences in breakthrough infections depending on which vaccine is administered? How long does it take for protection to fade? And when does the number of cases indicate a flood of patients that could overwhelm health care systems?

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Public health officials are confident that there is little evidence to suggest that the virus has found a way to escape the main goal of vaccines: preventing serious sickness and death.

But there is also agreement that hundreds of millions of cases are now an inescapable part of our world of 7 billion people. And with dramatic gaps in vaccination between wealthier and poorer nations, there is the extra challenge of funneling doses to those who remain unprotected. The WHO Wednesday called for a moratorium on booster shots until the end of September in an effort to help all countries inoculate 10% of their populations.

“We have to understand that this virus is now endemic and that we have to be thinking about our long-term strategies for dealing with it as a global phenomenon,” said Robert West, a professor emeritus of health psychology at University College London who is a subcommittee member of SAGE, a scientific body advising Britain’s government on policy.

“It is now inevitable that we’re going to be looking at tens, if not thousands, of deaths a year from this virus for the foreseeable future,” he said, “in the same way that we see deaths from other causes.”

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