After barely weeks of relative normality, surging coronavirus cases have forced governments around the world to reimpose local lockdown restrictions and roll back the reopening of bars, restaurants and other businesses, affecting hundreds of millions of people.

In the US, nearly two dozen states have paused or reversed their reopening plans as coronavirus cases have spiked. On Tuesday, California recorded more than 11,000 new coronavirus cases, the state’s highest single-day total since the start of the pandemic.

In India, the northern state of Bihar, home to 125 million people, imposed a 15-day lockdown on Tuesday to combat the spread of the coronavirus. Hours later, the southern city of Bengaluru, home to some 13 million people and a major IT hub for international corporations, began a week-long lockdown as well.

The city, once hailed for its success at containing the coronavirus, has since become a case study for what can go wrong if authorities and residents lower their guard too quickly.

Venezuela’s capital of Caracas was also ordered into a strict lockdown on Wednesday, while in Spain, some 160,000 people in the Catalonia region became the first in the country to return to confinement, as authorities scrambled to control a fresh surge of coronavirus infections just weeks after the nationwide lockdown was lifted.

Under the reimposed restrictions, residents of the city of Lleida and nearby towns are allowed to leave their homes only for essential activities. Barcelona is also considering reimposing lockdown restrictions after coronavirus cases there tripled in a week.

These measures follow similar moves in Australia, where last week authorities forced approximately 5 million people into a six-week lockdown in Melbourne amid a spike in cases there. Officials in Australia’s two most populous states, Victoria and New South Wales, said on Wednesday that even harsher restrictions may be imposed if the outbreak is not controlled quickly.

On Thursday, Victoria recorded 317 new coronavirus cases, a daily record, and the state’s health officer warned that the local outbreak may still not have reached its peak.

The UK, as well, is pursuing what Boris Johnson has characterised as “whack-a-mole strategy” to suppress the virus.

While much of the country is going back to pubs and dining out in restaurants with friends and family, health secretary Matt Hancock said this week that “targeted action” is being taken to combat more than 100 local outbreaks across the country.

“Each week, there are more than 100 local actions taken across the country — some of these will make the news but many more are swiftly and silently dealt with,” Hancock said.

The UK government has not detailed what counts as an outbreak. Justice secretary Robert Buckland told the BBC this week that each case would differ, but “I think we know it when we see it.”

Leicester was the first city to be placed under lockdown at the end of June, due to a surge of coronavirus infections there. On Thursday, Hancock said “some, but not all” restrictions in the city would be relaxed as virus rates “still remain well above the national average and the average for surrounding areas”.

“The crucial thing is to make sure we are ready to crack down on local flare-ups,” Johnson said last month. 

The increasing number of local lockdowns highlights the fact that, without a vaccine, living with the coronavirus will likely involve a constantly shifting balance between lifting restrictions when cases fall and reimposing them as outbreaks flare.

Government officials should be “ready to move backwards or forwards,” depending on the number of cases they are seeing, Dr. Michael Ryan, executive director of the World Health Organisation’s Health Emergencies Program, said at a news conference last Friday.

“If we want to avoid, after a lockdown, having major epidemics, we need to watch out for the small clusters and we need to extinguish those clusters quickly,” Ryan said.

Gavin Newsom, the governor of California, has likened the state’s reopening process to a “dimmer switch” that can be adjusted gradually as circumstances allow.

“Nothing is constant,” Newsom said on Monday, as the state announced one of the most sweeping rollbacks in the country. “Nothing is linear as it relates to infectious disease.”

Germany has characterised its own approach as an “emergency brake” that triggers renewed local restrictions if infections pick up again in a certain area. Those restrictions were reimposed for the first time last month, after more than 1,500 workers at a meat processing plant in the state of North Rhine-Westphalia tested positive for the coronavirus.

Targeting local outbreaks may help countries avoid the nationwide lockdowns that have thrown the global economy into crisis. But the constantly shifting rules have been confusing for residents, and have made planning difficult for business owners.

“I was getting the restaurant ready, moving furniture around, ordering screens, masks and visors,” Shaf Islam, the owner of a fine dining Indian restaurant in Leicester, told HuffPost UK. “I was looking forward to the week, and then we got a phone call at 9am asking if I knew the restaurant might not be able to open.”

“I think it’s very unfair,” he added. “We’re almost being used as a guinea pig in Leicester.”

Officials in Leicester have said that the government failed for weeks to share detailed coronavirus testing data with them, and that the decision to lock down the entire city was a disproportionate response.

“It’s very clear when you look at the data it’s a couple of areas of the city that have got a higher than average transmission of the virus,” mayor Peter Soulsby told the BBC this week. “Certainly the way the city’s been locked down in its entirety, and even beyond its boundaries, is not justified.”

In Melbourne, as well, the government deployed hundreds of police officers to place nine public housing towers under “hard lockdown” this month, after a number of residents tested positive for coronavirus. Under the hastily imposed restrictions, the buildings’ 3,000 residents were banned from leaving their homes for any reason. 

The government said that the draconian response was necessary in order to prevent coronavirus infections from spreading. But many residents said the government failed to provide them with food and medical care.

“I looked outside from my window and no nurses, no cleaners, no food – just lots of cops,” one resident told Reuters. “This is not a lockdown, this is a lockup.”

At the WHO briefing last Friday, Ryan argued that the success of the targeted lockdowns would require close cooperation between local and national officials, as well as residents.

“Ultimately, it comes down to communities and individuals, and how we protect ourselves and how we protect others,” he said. “It requires a very strong partnership, a trusting partnership between communities and authorities. A trusting partnership based on honesty, based on transparency, based on regular information that everybody can trust, and based on a sustained effort by everybody.”

He added: “We all want to avoid whole countries going back into total lockdown. That is not a desire that anybody has.”

With reporting by HuffPost UK, HuffPost India, HuffPost Australia and Reuters.