BENGALURU: India recorded the world's highest daily tally of 314,835 COVID-19 infections on Thursday (Apr 22) as a second wave of the pandemic raised new fears about the ability of crumbling health services to cope.
Health officials across northern and western India including the capital, New Delhi, said they were in crisis, with most hospitals full and running out of oxygen.
Doctors in some places were advising patients to stay at home while a crematorium in the eastern city of Muzaffarpur said it was being overwhelmed with bodies and grieving families had to wait their turn.
"Right now there are no beds, no oxygen. Everything else is secondary," Shahid Jameel, a virologist and director of the Trivedi School of Biosciences at Ashoka University, told Reuters.
"The infrastructure is crumbling."
Krutika Kuppalli, assistant professor at the Division of Infectious Diseases, Medical University of South Carolina in the United States, said on Twitter the crisis was leading to a collapse of the healthcare system.
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The previous record one-day rise in cases was held by the United States, which had 297,430 new cases on one day in January, though its tally has since fallen sharply.
India's total cases are now at 15.93 million, while deaths rose by 2,104 to reach a total of 184,657, according to the latest health ministry data.
Television showed images of people with empty oxygen cylinders crowding refilling facilities as they scrambled to save relatives in hospital.
In the western city of Ahmedabad, a man strapped to an oxygen cylinder lay in the back of a car outside a hospital as he waited for a bed, a Reuters picture showed.
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"We never thought a second wave would hit us so hard," Kiran Mazumdar Shaw, executive chairman of the healthcare firm Biocon & Biocon Biologics, wrote in the Economic Times.
"Complacency led to unanticipated shortages of medicines, medical supplies and hospital beds."
Delhi Health Minister Satyendar Jain said there was a shortage of intensive care unit beds, with the city needing about 5,000 more than it could find. Some hospitals had enough oxygen to last 10 hours, others just six hours.
"We can't call this a comfortable situation," he told reporters.
Similar surges of infections elsewhere around the world, in South America in particular, are threatening to overwhelm other health services.
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India has launched a vaccination drive but only a tiny fraction of the population has had the shots.
Authorities have announced that vaccines will be available to anyone over the age of 18 from May 1 but India will not have enough shots for the 600 million people who will become eligible, experts say.
Health experts said India had let its guard down when the virus seemed to be under control during the winter, when new daily cases were about 10,000, and it lifted restrictions to allow big gatherings.
Some experts say new, more infectious virus variants, in particular a "double mutant" variant that originated in India, are largely responsible for the spike in cases but many also blame the politicians.
"The second wave is a consequence of complacency and mixing and mass gatherings. You don't need a variant to explain the second wave," said Ramanan Laxminarayan of the Center for Disease Dynamics, Economics and Policy in New Delhi.
Prime Minister Narendra Modi's government ordered an extensive lockdown last year, in the early stages of the pandemic, but has been wary of the economic costs of tough restrictions.
In recent weeks, the government has come in for criticism for holding packed political rallies for local elections and allowing a religious festival at which millions gathered.
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This week, Modi urged state governments to use lockdowns as a last resort. He asked people to stay indoors and said the government was working to increase the supply of oxygen and vaccines.
Angela Rasmussen, a virologist at the Center for Global Health and Science Security at Georgetown University said the situation in India was "heartbreaking and awful".
"It's the result of a complex mix of bad policy decisions, bad advice to justify those decisions, global and domestic politics, and a host of other complex variables," she said on Twitter.
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