The worst-affected Western countries have been hit by a tenfold surge in the number of Covid-19 infections and fatalities over 10 days as they struggle to cope under the onslaught of a pandemic that has killed more than 10,000 worldwide. Italy has overtaken China in reporting more than 4,000 deaths, while Spain passed Iran to record close to 20,000 people testing positive in a further reflection of the severity of Europe’s outbreak, which has driven Britain to extend its social distancing measures to most of the year. The situation in the US continued to worsen, as California imposed an indefinite statewide “stay-in-place” order on its 40 million residents, becoming the first state to restrict people’s movements. New York also instituted strict new measures on Friday. “We’re all in various levels of quarantine and it’s hard,” said Governor Andrew Cuomo. New lockdowns have also been announced across the globe, from India and Argentina to the wealthy German region of Bavaria, further straining the global economy. Even though China – the world’s second biggest economy – recorded no new domestic cases for two days in a row on Friday, critics have questioned the accuracy of its data due to concerns that the numbers are influenced by political considerations and that people with mild symptoms are being excluded. Official figures show the pandemic has taken more than 10,000 lives so far, around half of which are in Europe with 3,400 or so in Asia. It has also left many more in intensive care, put unprecedented pressure on medical workers and caused shortages of hospital beds, ventilators and protective equipment. “We have seen too many people die,” said Margaret Harris, of the World Health Organisation’s coronavirus response team, warning that “when you have an explosion of cases, you are already way behind your curve.” Coronavirus: China expert lambasts Italy’s ‘lax’ response to pandemic The worldwide toll of coronavirus infections has doubled to 200,000 within just 12 days – compared to 12 weeks that took it to get to 100,000 from zero. In Italy – the epicentre in Europe – it took 11 days for the death toll to expand tenfold to reach 3,405. More worrying trends have been seen in France and Spain, as there were only nine-day and eight-day lapses respectively before the death tolls increased by a similar factor. France recorded 108 new deaths on Thursday, taking the total to 372 or an increase of almost 41 per cent from Wednesday. Spain’s death toll on Friday was 1,002, with the health ministry warning that the data “is very likely underestimating the reality”. “Among the seriously ill patients, death is a reality,” Fernando Simon, director of the Spanish health ministry’s emergency coordination centre, told reporters on Friday. “We try to give the best guarantee of survival, but there are some that cannot be guaranteed.” Italy’s death rate stood at a staggering 8.3 per cent, which is more than double the 4 per cent figure recorded in China or the latest worldwide average of 4.18 per cent based on WHO statistics. In Milan, one of the worst-hit cities in Italy, the government was changing tactics on Friday, asking people who show minor symptoms to seek help from family doctors instead of hospitals, which have already been overloaded and understaffed. “Anyone who has a fever and is at home is now very likely to have Covid-19. Getting them to the hospital would be unmanageable,” said Vittorio Demicheli, an epidemiologist with Milan’s health authorities. Sun Shuopeng, vice-president of China’s Red Cross who heads a delegation sent to help advise Italy said the country’s medical system was facing enormous pressure as it lacks human resources. Speaking after a visit to Rome, he told Chinese news portal Thepaper.cn that the median age of those who had died in the capital was 81. “It is very difficult to take care of elderly patients, especially when some of them already suffer from chronic illnesses,” he said. Italy has a well-developed primary care system and people rely on family doctors more than hospitals, Sun said. “But in the current situation where a centralised system is needed to deal with the virus, the available medical personnel are not enough to meet such a high demand,” he added. At a press conference in Milan on Thursday, Sun also said the lockdown measures imposed by Italy are not strict enough, saying that public transport is still running and people are still gathering in hotel. Coronavirus: Grim toll as Italy’s Covid-19 deaths surpass those of China “We really have to stop our usual economic activities and our usual human interactions. We have to stay at home and make every effort to save lives,” he said. Prime Minister Giuseppe Conte has also been criticised by local officials in Lombardy, the worst hit region, for failing to impose tighter restrictions on people. Professor Walter Ricciardi, scientific adviser to Italy’s minister of health, attributed the country’s far higher mortality rate to demographics. The median age of hospitalised Italian patients was 67, compared with 46 in China, according to Ricciardi. Italy is home to the world’s second oldest population after Japan. But if age is a critical factor, scientists are also trying to explain why Japan’s rate of infection and mortality is significantly lower than that of Italy. “Italy’s mortality rate is almost triple Japan’s,” said Professor Yoko Tsukamoto, a professor of infection control at the Health Sciences University of Hokkaido. “Part of the reason is if you get tested [in Italy], you get quarantined, so it means that they don’t have enough beds for relatively non-severe patients.” Coronavirus: border closures hamper Italy’s fight against Covid-19 Leung Chi-chiu, chairman of the advisory committee on communicable diseases at the Hong Kong Medical Association said, the ageing population in Italy had surely contributed to its high death rate and also created a huge burden on its public health system. “Europe and the US share the same problem, the government has attempted to close off borders, but they are not able to implement it in a way that is absolute enough. They need to push it to the extreme to ensure it is effective,” Leung said. More active testing in different countries has been attributed to the surge of the number of infections and deaths related to the coronavirus. But the WHO advice for countries to do as many tests as possible faced criticism on Friday, with Finland arguing that testing people with mild symptoms would be a waste of health care resources. Britain, on the other hand, announced plans to expand Covid-19 testing in the face of public pressure. Prime Minister Boris Johnson announced that the government would increase the number of tests to 10,000 a day initially, with a goal of reaching 25,000 tests a day within four weeks. Addressing availability of medical resources, WHO director general Tedros Adhanom Ghebreyesus criticised the European Union for a ban on medical supply exports. “If there is political commitment … we need to have free cross border mobility and we should not ban exports” of medical equipment, Tedros said in a press conference on Friday. “The shortage of supply of [personal protective equipment] could not be addressed without political commitment,” he added. Tedros also called on young people to take social responsibility and abide by social distancing policies. “You’re not invincible,” Tedros said in an address to younger people. “This virus could put you in the hospital for weeks and even kill you.” “Even if you don’t get sick, the choices you make about where you go could be the difference between life and death for someone else,” he added. 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