Asia surpassed 10 million infections of coronavirus on Saturday, the second-heaviest regional toll in the world, according to a Reuters tally. Cases continue to mount in India despite a slowdown and sharp declines elsewhere.

Behind only Latin America, Asia accounts for about one-fourth of the global caseload of 42.1 million of the virus. With over 163,000 deaths, the region accounts for some 14% of the global COVID-19 toll.

The Reuters tally is based on official reports by different countries. The true numbers of cases and deaths are likely much higher, experts say, given deficiencies in testing and potential underreporting in many countries.

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Despite the Asian spikes, the region overall has reported improvement in handling the pandemic in recent weeks, with daily caseloads slowing in places like India – a sharp contrast to the COVID-19 resurgence seen in Europe and North America.

Within the region, South Asia led by India is the worst affected, with nearly 21% of the reported global coronavirus cases and 12% of deaths.

India is the worst-hit country in the world after the United States. India is reporting more than 57,000 cases of the virus a day and averaging 764 COVID-19 deaths a day.

The country has reported nearly 7.8 million infections, behind the U.S. tally of 8.5 million, and nearly 118,000 deaths, versus 224,128 in the United States. Unlike the recent U.S. surge, however, India’s slowdown saw the lowest daily caseload in nearly three months on Wednesday.

But India’s infections may surge again, doctors fear, with a holiday approaching and winter bringing more severe pollution from farmers burning stubble, worsening the breathing difficulties that many COVID-19 patients suffer.

India’s eastern neighbour Bangladesh is Asia’s second-worst hit country, with nearly 400,000 cases. But daily infections have slowed to 1,453, less than 40% of the July peak.

Despite Asia’s patchy record, a World Health Organization expert said on Monday that Europe and North America should follow the example of Asian states in persevering with anti-COVID measures and quarantine restrictions for infected people.

Mike Ryan, head of the UN agency’s emergency programme, said the global death toll from COVID-19 could double to 2 million before a successful vaccine is widely used and could be even higher without concerted action to curb the pandemic.