India has become the third country to record more than four million coronavirus infections, setting a new daily record yesterday, with no signs yet of the crisis abating.
The 86,432 cases recorded in 24 hours until 8am yesterday - the highest for any country since the pandemic began and more than China's grand total of 85,112 - took India's tally to 4,023,179 infections.
Worryingly, the country took just 13 days to go from three million to four million cases. It reported its first case on Jan 30 and reached one million cases more than five months later on July 16. It is now third, behind the United States, which has more than 6.1 million cases, and Brazil, which has 4.1 million, a number India could surpass this week at current growth rates.
The rapid rise in cases in India comes at a time when the infection has regained momentum in other countries too.
France, for instance, registered nearly 9,000 new coronavirus cases between last Thursday and Friday, its highest daily figure since the pandemic hit the country in March. Cases in Hungary rose by a record 510 yesterday and three people died as the pandemic gained strength in the eastern part of Europe. And cases in Indonesia rose by more than 3,000 for the fourth consecutive day.
Widespread vaccinations against Covid-19, meanwhile, are not expected until the middle of next year, according to the World Health Organisation.
Dr Dileep Mavalankar, director of the Indian Institute of Public Health in Gandhinagar, Gujarat, told The Sunday Times it is very difficult to prevent further spread of the infection in India at this stage as the chains of transmission are unclear. "If the country's top politicians as well as a top actor like Amitabh Bachchan could get infected despite all the protection they must have, how are you going to protect the common man, who needs to be out working?" he said.
The bright spot is that India's recorded deaths, at 69,561, are low and government officials have cited its low case fatality rate - at 1.73 per cent - as a positive sign. Brazil has reported more than 125,000 deaths and the US over 186,000.
"The main effort now should be in reducing mortality and protecting the most vulnerable," said Dr Mavalankar, noting that mortality is low among the young and that those most at risk are aged over 60 with underlying diseases.
The record daily spike comes at a time when India will see wider relaxations kick in. Metro services resume this week in cities and social gatherings of up to 100 people can go ahead from Sept 21. There are also concerns around behavioural fatigue that has set in, leading many Indians to widely disregard rules mandating the wearing of masks and physical distancing.
While some of the bigger cities that were hard hit in the initial phase of the pandemic may have gone on to attain some level of herd immunity - a serological survey in July found nearly six in 10 of slum dwellers in Mumbai had had the infection - the virus is now spreading into smaller towns and rural areas.
Most of the cases are being reported from the states of Maharashtra, Tamil Nadu, Andhra Pradesh, Karnataka and Uttar Pradesh, with data indicating the virus' spread into smaller towns in these states.
Dr Manoj Murhekar, a member of India's main coronavirus task force and director of the National Institute of Epidemiology, told The Sunday Times that the country's focus now should be on increasing beds with piped oxygen facility in smaller towns and district headquarters that are expected to see an increase in cases. "We must ensure hospitals are not getting overwhelmed by hospitalising the high-risks and home-isolating the mild cases," he said.
The numbers are also set to rise further as the government ramps up testing. More than one million samples are being tested daily and India said on Friday it would allow on-demand testing for everybody.