NEW DELHI 鈥� COVID-19 infections and deaths are mounting with alarming speed in India with no end in sight to the crisis and a top expert warning that the coming weeks in the country of nearly 1.4 billion people will be 鈥渉orrible.鈥�
India's official count of coronavirus cases surpassed 20 million Tuesday, nearly doubling in the past three months, while deaths officially have passed 220,000. Staggering as those numbers are, the true figures are believed to be far higher, the undercount an apparent reflection of the troubles in the health care system.
The country has witnessed scenes of people dying outside overwhelmed hospitals and funeral pyres lighting up the night sky.
Infections have surged in India since February in a disastrous turn blamed on more contagious variants of the virus as well as government decisions to allow massive crowds to gather for Hindu religious festivals and political rallies before state elections.
The reported caseload is second only to that of the U.S., which has one-fourth the population of India but has recorded over 32 million confirmed infections. The U.S. has also reported more than 2 1/2 times as many deaths as India, at close to 580,000.
India鈥檚 top health official, Rajesh Bhushan, refused to speculate last month as to why authorities weren鈥檛 better prepared. But the cost is clear: Many people are dying because of shortages of bottled oxygen and hospital beds or because they couldn鈥檛 get a COVID-19 test.
India鈥檚 official average of newly confirmed cases per day has soared from over 65,000 on April 1 to about 370,000, and deaths per day have officially gone from over 300 to more than 3,000.
On Tuesday, the health ministry reported 357,229 new cases in the past 24 hours and 3,449 deaths from COVID-19.
Dr. Ashish Jha, dean of Brown University鈥檚 School of Public Health in the U.S., said he is concerned that Indian policymakers he has been in contact with believe things will improve in the next few days.
鈥淚鈥檝e been ... trying to say to them, `If everything goes very well, things will be horrible for the next several weeks. And it may be much longer,鈥樷�� he said.
Jha said the focus needs to be on 鈥渃lassic鈥� public health measures: targeted shutdowns, more testing, universal mask-wearing and avoiding large gatherings.
鈥淭hat is what鈥檚 going to break the back of this surge,鈥� he said.
The death and infection figures are considered unreliable because testing is patchy and reporting incomplete. For example, government guidelines ask Indian states to include suspected COVID-19 cases when recording deaths from the outbreak, but many do not do so.
Municipal records for this past Sunday show 1,680 dead in the Indian capital were treated according to the procedures for handing the bodies of those infected with COVID-19. But in the same 24-hour period, only 407 deaths were added to the official toll from New Delhi.
The New Delhi High Court announced it will start punishing government officials if supplies of oxygen allocated to hospitals are not delivered. 鈥淓nough is enough,鈥� it said.
The deaths reflect the fragility of India鈥檚 health system. Prime Minister Narendra Modi鈥檚 party has countered criticism by pointing out that the underfunding of health care has been chronic.
But this was all the more reason for authorities to use the several months when cases in India declined to shore up the system, said Dr. Vineeta Bal of the Indian Institute of Science Education and Research.
鈥淥nly a patchwork improvement would鈥檝e been possible,鈥� she said. But the country 鈥渄idn鈥檛 even do that.鈥�
Now authorities are scrambling to make up for lost time. Beds are being added in hospitals, more tests are being done, oxygen is being sent from one corner of the country to another, and manufacturing of the few drugs effective against COVID-19 is being scaled up.
The challenges are steep in states where elections were held and unmasked crowds probably worsened the spread of the virus. The average number of daily infections in West Bengal state has increased by a multiple of 32 to over 17,000 since the balloting began.
鈥淚t鈥檚 a terrifying crisis,鈥� said Dr. Punyabrata Goon, convener of the West Bengal Doctors鈥� Forum.
Goon added that the state also needs to hasten immunizations. But the world鈥檚 largest maker of vaccines is short of shots, the result of lagging manufacturing and raw material shortages.
Experts are also worried the prices being charged for shots will make it harder for the poor to get vaccinated. On Monday, opposition parties urged the government make vaccinations free to all Indians.
India is vaccinating about 2.1 million people daily, or around 0.15% of its population.
鈥淭his is not going to end very soon,鈥� said Dr. Ravi Gupta, a virus expert at the University of Cambridge in England. 鈥淎nd really ... the soul of the country is at risk in a way.鈥�
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Associated Press writer Danica Kirka in London contributed to this report.
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The Associated Press Health and Science Department receives support from the Howard Hughes Medical Institute鈥檚 Department of Science Education. The AP is solely responsible for all content.
Aniruddha Ghosal, The Associated Press
