The world surpasses 20 million COVID-19 cases: A look at the milestones and setbacks

The world hit the latest bleak milestone this week in the historic pandemic: 20 million confirmed cases of COVID-19 and more than 730,000 deaths.

Just one day earlier, the U.S. had reached 5 million cases, though experts agree the number is actually much greater – potentially 10 times higher than what's been reported, according to federal data. Still, the U.S. has remained the most infected country, with the highest reported case and death count. 

Dr. Anthony Fauci, the director of the National Institute of Allergy and Infectious Diseases, said on Aug. 6 the overall response to the pandemic in the U.S. has allowed the daily case count to plateau at an "unacceptable level," warning that the virus will continue to "smolder" without a unified effort to stop it the virus.

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USA TODAY has tracked the nation's successes, setbacks and major news since the first case was confirmed in January in Washington state. Below, we break down the milestones in case and death counts:

Aug. 10: 20 million cases worldwide 

While the world reached 20 million cases of COVID-19, according to the tally kept by Johns Hopkins University, health officials believe the actual number is much higher given testing limitations and the fact that as many as 40% of all those who are infected have no symptoms.

A day later, Russia said it has registered a coronavirus vaccine and declared it ready for use, despite less than two months of human testing and not completing final trials. President Vladimir Putin claimed the vaccine, developed by the Moscow-based Gamaleya Institute, underwent the “necessary tests” and even announced the vaccine was administered to one of his daughters. The World Health Organization has said all vaccine candidates should go through full stages of testing before being rolled out. In the U.S., the federal government has spent more the $9 billion to develop and manufacture candidate vaccines.

Aug. 9: 5 million cases

The U.S. surpassed 5 million confirmed cases of COVID-19 as the death toll nears 163,000.

The milestone comes after President Donald Trump said the U.S. has the virus "under control," describing his administration's response to the pandemic as "incredible" in an interview with Axios aired on HBO on Aug. 3. 

Trump repeated his claim that the high number of cases in the U.S. is due to the high rate of testing – though the interviewer argued many other nations did not have to test as much because they had the virus better contained and that testing was not to blame for the rising number of hospitalizations and deaths. 

July 29: 150,000 deaths

The CDC reported long-term effects of the disease are likely in COVID-19 patients. And more than 150 health professionals called for another shutdown in an open letter to U.S. leaders. 

"Tell the American people the truth about the virus, even when it’s hard. Take bold action to save lives — even when it means shutting down again," the letter, spearheaded by the nonprofit U.S. Public Interest Research Group, said.

July 23: 4 million cases

The U.S. case count doubled in a little more than a month. The death toll approached 144,000. 

While more COVID-19 testing was being done than ever before, bottlenecks appeared as labs and states bid against each other for limited supplies. Experts said many tests become irrelevant after delayed results

June 11: 2 million cases

Cases reached 2 million about 6 weeks  after confirmed infections surpassed 1 million.  

More than a dozen states and Puerto Rico saw cases spike at a faster rate in summer months. Experts said the unexpected uptick in cases could be due to lifting restrictions, isolated outbreaks and the virus catching up to communities that had not been affected. 

May 27: Death toll surpasses 100,000

On May 13, data compiled by Johns Hopkins University showed the national curve flattening. Starting May 18, several states began to lift their restrictions, then Memorial Day saw more travel, family gatherings and relaxed social distancing.

The result: Deaths from the coronavirus surpassed 100,000.

According to polls, half of Americans said they were unsure they would get a vaccine.

April 28: 1 million cases, more than 50,000 dead

Over the course of four months, the U.S. reached 1 million cases and more than 50,000 deaths. Experts cautioned the number of cases was probably much higher because not all people infected by the coronavirus were tested.

"The million (cases) is clearly way under what the actual number will be because of all the issues of testing and all the people with mild symptoms that haven’t been tested," said Dr. Steven Corwin, president and CEO of NewYork-Presbyterian Hospital.

John Hopkins University tracking found the U.S. had the 33rd-highest mortality rate out of the 134 countries.

April 1: 200,000 confirmed cases

For the first time, 1,000 people died in a single day, bringing the national death toll above 5,000, according to Johns Hopkins University. 

Two days later, the Centers for Disease Control and Prevention reversed its guidance advising Americans to not wear face masks  to save them for medical professionals. President Donald Trump said the new guidance to wear face masks was voluntary: "I don't think I'm going to be doing it," he said. The mask guidance came as research revealed that asymptotic people spread the disease without knowing they had it. 

Unemployment rates hit record highs at the end of March and early April. 

March 26: US leads world with 100,000 cases

A day after the U.S. became the world's most-infected nation, the country passed 100,000 cases and had more than 1,000 deaths.

Trump signed the largest relief package in U.S. history, promising $1,200 checks to eligible Americans and additional amounts for families. The package included hundreds of billions of dollars of support for companies to keep a payroll during the pandemic.

March 11: 1,000 cases

Trump announced a ban on travelers from Europe, and U.S. cases jumped from 100 to more than 1,000 in eight days. 

The World Health Organization declared COVID-19 a pandemic. "We cannot say this loudly enough, or clearly enough, or often enough: all countries can still change the course of this pandemic," Tedros Adhanom Ghebreyesus, director-general of the WHO, said in a statement.

Jan. 21: First-known US case

The first case of COVID-19 in the U.S. was reported Jan. 21 soon after the CDC began implementing health screenings in airports. China had 548 confirmed cases, and South Korea had one. A few weeks later, two people died, on Feb. 6 and 17, and tests done in April determined they were positive for the coronavirus. 

Contributing: William Cummings, Courtney Subramanian, Joel Shannon, Ryan Miller, Jessica Flores, Grace Hauck, Adrianna Rodriguez, Jayne O'Donnell and Ken Alltucker