By Michael Jarvis, UK Correspondent
The new rising trend in COVID-19 cases across the globe gives pause for long serious thought and reflection.
This is especially so for the Cayman Islands and other small Caribbean states.
The challenge lies in the pace of re-opening borders which were closed literally (and metaphorically) to keep COVID-19 at bay while trying to suppress the risk of community spread.
Regional governments are now confronted with the competing and almost mutually exclusive options of whether and how much to open at a time when the virus is surging again.
With economies left reeling and health services under severe stress, finding the right balance in the 'lives and livelihoods debate' is a huge challenge as the pandemic creeps towards a painful first anniversary.
In many countries across the globe, the pandemic is already surging to higher levels in a shorter time-frame than the initial outbreak.
While attention is on the emerging second wave, in parts of the United States they are already talking about a third wave with reports of the virus spreading rapidly in some states and predictions that at the current pace deaths could reach 300,00 by the end of the year.
The seven day average of new cases over the past week is 70,000 with around 45,000 hospitalised with the illness, the highest number since August. To date, over 226,000 people have died from COVID-19 in the United States.
UK AND EUROPE
In the UK and across Europe, the pattern is similarly concerning with concerns that the second wave could be deadlier than the first.
The central government and regional authorities in the UK are seeing an upsurge in cases forcing higher alert levels with stiff restrictions, including targeted lockdowns.
Close to 23,000 new cases have been recorded in just the past fortnight alone. The fatality rate is also increasing with 367 deaths on the day of going to press, the highest daily number since the second wave started.
There was a drastic fall-off in deaths in the UK attributed to COVID-19 between July and September but numbers are beginning to rise again.
Since the outbreak of the pandemic, more than 900,000 people in the UK have contracted the virus with more than 45,000 succumbing to it.
The vast majority of countries are now declaring more cases each day than they did during the first wave earlier this year.
There are new surges in the EU with serious spikes being recorded in Spain, France and Germany as well as worrying rates in Italy, Belgium and the Netherlands.
Cases in Spain are up by a third with more than 200,000 confirmed over the last two weeks alone.
The Spanish government has declared a state of emergency, imposing a curfew and limiting most gatherings to six people.
The government was also looking at extending an 11pm to 6am curfew from 15 days to six months.
In Germany, “a light lockdown" has been instituted for November as a first step to combat the new wave, suggesting that it could be intensified, while in France, which has seen a record 100,000 new cases, a four-week national shutdown is also being considered.
Italy which suffered heavily in the first outbreak has put new restrictions in place as cases are on the rise. The government says its heath services tested to the limits earlier this year and once more under severe strain.
A similar picture was emerging in Belgium and Portugal.
In the Netherlands, the number of cases also continues to increase, although at a slower rate.
Officials there say this is probably due to tough measures that were implemented at the end of September and in mid-October. However, the number of patients in hospital is still increasing rapidly.
New Zealand which has been praised for its suppression of the virus reported just two new cases on Wednesday said to be travellers.
The country has only 66 active cases and has recorded just 1,587 since the outbreak started.
Next door in Australia, the city of Melbourne was this week coming out of a four-month lockdown after recording no new Covid-19 cases for the first time since June.
The lockdown enforced home confinement, travel restrictions, businesses closures and people working remotely where possible.
Australia has had 905 deaths from the disease.
Just this week, Canada reported that it had reached ‘grim milestone’ of 10,000 COVID-19 deaths as the country battles a second wave.
Japan which has experienced an earlier second wave of infections has started to gradually relax some restrictions, although tough measures remain in place.
It is currently undecided when tourists will again be able to enter the country, but it has been reported that the government is considering a gradual reopening starting from around spring 2021.
Japan on Tuesday recorded 648 cases nationwide with cumulative death toll up to 1,746 from 98,146 cases.
Tough control measures in countries such as Singapore and South Korea have meant that the virus has had a smaller impact.
Singapore has had 57, 987 cases with only 28 deaths while South Korea has recorded 26,146 and 462 deaths.
In the Philippines with 371,630 confirmed COVID-19 cases and 7,039 deaths, the country has the second-highest number of infections and fatalities in Southeast Asia behind Indonesia.
Just a little over a week ago, the country lifted a ban on overseas travel for Filipino tourists, ending a restriction in effect since July.
India which has recorded over 7 million cases and around 115,000 deaths, still accounts for only 10% of the world's deaths from the virus despite having a sixth of the world's population and a sixth of reported cases.
It recorded more than a million active cases but since then the numbers have been declining.
Across the African continent the comparatively low rate of the outbreak continues to puzzle medical experts. However, the virus continues to spread putting the health services of African countries under intense pressure.
News from Russia indicates that the country confirmed over 16,000 cases by midweek, bringing its official number of cases to 1,563,976. A record 346 people have died in the past 24 hours.
Meanwhile, in China the epicentre of the COVID-19 outbreak is reporting that after 85,307 cases, and 4,634 deaths, the country is reporting very few daily cases compared to the rest of the world.
The World Health Organisation(WHO) in a midweek update said there have been 43,540,739 confirmed cases of COVID-19 globally with 1,160,650 deaths.