India reported more than 300,000 new coronavirus cases for a 12th straight day on Monday, taking its overall caseload to just shy of 20 million, while deaths from COVID-19 rose by 3,417.
With 368,147 new cases over the past 24 hours, India's total infections stand at 19.93 million, while total fatalities are 218,959, according to health ministry data.
Medical experts say real numbers across the country of 1.35 billion may be five to 10 times higher than the official tally.
Combined with surges in Brazil and Canada, the global death toll is approaching 3.2 million despite many nations ramping up their vaccination drives.
Hospitals have filled to capacity, medical oxygen supplies have run short and morgues and crematoriums have been swamped as the country deals with the surge in cases.
At least 11 states and union territories have imposed some form of restrictions to try and stem infections, but Prime Minister Narendra Modi's government is reluctant to impose a national lockdown, concerned about the economic impact.
Anthony Fauci, the top US pandemic advisor, said in comments published Saturday that the whole of India should go into lockdown to fight this wave, an opinion shared by experts.
"In my opinion, only a national stay at home order and declaring medical emergency will help to address the current healthcare needs," Bhramar Mukherjee, an epidemiologist with the University of Michigan, said on Twitter.
"The # of active cases is accumulating, not just the daily new cases. Even the reported numbers state there are around 3.5M active cases."
The spike in infections is India’s biggest crisis since Mr Modi took office in 2014. Mr Modi has been criticised for not taking steps earlier to curb the spread and for letting millions of largely unmasked people attend religious festivals and crowded political rallies in five states during March and April.
A forum of scientific advisers set up by the government warned Indian officials in early March of a new and more contagious variant of the coronavirus taking hold in the country, five scientists who are part of the forum told Reuters.
Despite the warning, four of the scientists said the federal government did not seek to impose major restrictions to stop the spread of the virus.
It remains to be seen how his handling of the crisis might affect Mr Modi or his party politically. The next general election is due in 2024. Mr Modi's party was defeated in India's West Bengal state in results declared on Sunday, although it won in the neighbouring state of Assam.
Leaders of 13 opposition parties on Sunday signed a letter urging Mr Modi to immediately launch free national vaccination and to prioritise oxygen supply to hospitals and health centres.
Long queues were seen at vaccination centres in Indian cities this weekend, with people desperate to be inoculated against a disease that has overwhelmed the healthcare system as well as crematoriums and graveyards.
Social media platforms have been flooded with pleas from people looking for oxygen cylinders, medicines and hospital beds as the COVID-19 wave causes widespread shortages.
Long queues are forming at vaccination centres in Indian cities, with people desperate to be inoculated. Source: LightRocket
Several states have postponed widening a vaccination drive for adults that was to start on Saturday due to a lack of vaccines. The national health ministry says states have 10 million vaccines stockpiled and 2 million more coming in the next three days.
Despite being the world's biggest producer of vaccines, India does not have enough for itself - undermining a plan to ramp up and widen inoculation from Saturday. Only about 9 per cent of its 1.4 billion people have had a dose.
India has struggled to increase capacity beyond 80 million doses a month due to lack of raw materials and a fire at the Serum Institute, which makes the AstraZeneca vaccine.
International aid pours into India
The United States, Russia and Britain sent emergency supplies including oxygen generators, face masks and vaccines.
Aid from France reached India on Sunday, including eight oxygen generator plants and 28 ventilators, adding to the ventilators from Germany that arrived the previous night.
The UK, which has already sent 495 oxygen concentrators and 200 ventilators, said it was sending a further 1,000 oxygen ventilators.
A group of British doctors also staged their own intervention by offering long-distance telemedicine from Britain to take the pressure off their Indian colleagues and allow them to concentrate on Covid patients.
The Indian COVID-19 variant has now reached at least 17 countries including Britain, Switzerland and Iran, leading several governments to close their borders to people travelling from India.
