The coronavirus pandemic will worsen if governments fail to provide a clear and comprehensive strategy to suppress transmission, the World Health Organisation (WHO) has warned.

Director general Tedros Adhanom Ghebreyesus said on Monday there would be “no return to the ‘old normal’ for the foreseeable future” and that “too many countries were headed in the wrong direction”.

His stark message came as 230,000 Covid-19 cases were reported to the WHO on Sunday, with almost 80% occurring in 10 countries and 50% in just two.

Dr Tedros said said the epicentre of the pandemic remains in the Americas where more than 50% of the world’s cases have been recorded.

He told a WHO press briefing: “The virus remains public enemy number one, but the actions of many governments and people do not reflect this.”

He said “mixed messages” from leaders were “undermining” people’s trust in attempts to control the pandemic.

He warned that if governments do not implement a comprehensive strategy to suppress transmission and if people do not follow social distancing or hand washing guidelines, the virus will continue to spread.

Dr Tedros said: “If the basics aren’t followed, there is only one way this pandemic is going to go. It’s going to get worse and worse and worse.”

Countries that overcame the initial peak of the outbreak are now “struggling” with a second wave of cases after easing restrictions, he added.

“It would appear that many countries are losing gains made as proven measures to reduce risk are not implemented or followed,” Dr Tedros said.

However, he said many countries in Europe had demonstrated it was possible to bring large outbreaks under control.

“Where countries have effectively suppressed the virus, leaders are opening up their societies on a data-driven, step-by-step basis, with a comprehensive public health approach, backed by a strong health workforce and community buy-in.”

Mike Ryan, executive director of the WHO’s health emergencies programme, said it was still not fully known whether people who had the virus would be immune to it in the future.

He said: “We need to learn to live with this virus. Expecting we will eradicate this virus in the coming months is not realistic.

“Also believing that magically we will get a perfect vaccine that everyone will have access to is also not realistic.”

Dr Tedros said governments must focus on reducing death rates and transmission, while communities must follow public health advice.