NEW DELHI (REUTERS) - India's coronavirus deaths crossed a quarter million on Wednesday (May 12) in the deadliest 24 hours since the pandemic began, as the disease rampaged through the countryside, overloading a fragile rural healthcare system.
Boosted by highly infectious variants, the second wave erupted in February to inundate hospitals and medical staff, as well as crematoriums and mortuaries. Experts are still unable to say with certainty when the figures will peak.
Deaths swelled by a record 4,205 while infections rose 348,421 in the 24 hours to Wednesday, carrying the tally past 23 million, health ministry data showed. Experts believe the actual numbers could be five to 10 times higher, however.
India's Covid-19 infection curve may be showing early signs of flattening, but the decline in the number of new infections is likely to be slow, said Dr Shahid Jameel, a top Indian virologist.
"It is still too early to say whether we have reached the peak," he was quoted as saying by the Indian Express newspaper. "There is some indication of the cases plateauing. But we must not forget that this is a very high plateau. We seem to be plateauing around 400,000 cases a day."
India, with a population of 1.4 billion, accounts for half of cases and 30% of deaths worldwide, the World Health Organization said in its latest weekly report.
The full impact of the B.1.617 variant found in India, which the agency has designated as being of global concern, is not yet clear, it added.
Drugs and medical oxygen are in short supply.
Dr Balram Bhargava, head of the Indian Council of Medical Research (ICMR), said in an interview that lockdown restrictions should remain in place in all districts where the rate of infection is above 10 per cent of those tested.
Currently, three-fourths of India's 718 districts have what is known as a test-positivity rate above 10 per cent, including major cities like New Delhi, Mumbai and the tech hub of Bengaluru.
Dr Bhargava's comments are the first time a senior government official has outlined how long lockdowns, which already encompass large parts of country, need to continue to rein in the crisis in India.
Referring to the capital, one of India's hardest hit cities where the positivity rate reached around 35 per cent but has now fallen to about 17 per cent, Dr Bhargava said: "If Delhi is opened tomorrow, it will be a disaster."
Daily infections are shooting up in the countryside in comparison to big towns, where they have slowed after last month's surge, experts say.
More than half the cases this week in the western state of Maharashtra were in rural areas, up from a third a month ago.
That share is nearly two-thirds in the most populous, and mainly rural, state of Uttar Pradesh, government data showed.
Television showed images of people weeping over the bodies of loved ones in ramshackle rural hospitals while others camped in wards tending to the sick.
A pregnant woman was taking care of her husband who had breathing difficulties in a hospital in Bhagalpur in the eastern state of Bihar that is seeing a surge its health system could barely have handled at the best of times.
"There is no doctor here, she sleeps the whole night here, taking care of her husband," her brother told India Today television.
In a corridor outside, two sons were wailing over the body of their father, saying repeatedly that he could have been saved if only he had been given a bed in an intensive care unit.
At the general hospital in Bijnor, a town in northern Uttar Pradesh, a woman lay in a cot next to a garbage can and medical waste.
"How can someone get treated if the situation is like this?" asked her son, Sudesh Tyagi. "It is a hell out here."
In a report published on Wednesday, the World Health Organisation said the B1617 variant first identified in India had been detected in at least 44 countries so far.
The global health body has classified it as a "variant of concern" that requires heightened tracking and analysis.
Vaccines are also running short, especially in Maharashtra state around the financial centre of Mumbai and in Delhi, two of India's hardest-hit regions.
India's second wave of the pandemic has increased calls for a nationwide lockdown and prompted more and more states to impose tougher restrictions that have hurt businesses and the wider economy.
An outpouring of support in the last two weeks has seen the Singapore Red Cross (SRC) raise over $3.2 million to help India in its Covid-19 fight.
A public appeal on April 28 saw organisations and individuals contributing towards SRC's efforts to secure much-needed equipment, including oxygen concentrators, oxygen cylinders and ventilators as well as hygiene and medical kits, which have been sent to India and distributed throughout the country by the local Indian Red Cross Society.