‘Worst is yet to come’

India became the third country to cross four million coronavirus cases yesterday, also setting a new global record for a daily surge in infections and closing in on Brazil's total as the second-highest in the world.

The 86,432 cases added in the past 24 hours pushed India's total to 4,023,179. India's health ministry also reported 1,089 deaths for a total of 69,561.

Brazil has confirmed 4,091,801 infections while the United States has 6,200,186 people infected, according to Johns Hopkins University.

The pandemic has killed at least 875,703 people worldwide since surfacing in China late last year, according to an AFP count at 1100 GMT yesterday based on official sources. More than 26.6 million cases have been registered worldwide.

The United States has recorded the highest number of deaths with 187,777, followed by Brazil with 125,502, Mexico 66,851 and Britain 41,537 fatalities.

Initially, the virus ravaged India's sprawling and often densely populated cities. It has since stretched to almost every state in India, spreading through villages and smaller cities where access to healthcare is crippled.

With a population of nearly 1.4 billion people, India's massive caseload does not surprise experts. The country's delayed response to the virus forced the government to implement a harsh lockdown in late March. For more than two months, the economy remained shuttered, buying time for the underfunded healthcare system to prepare for the worst.

But with the economic cost of the restrictions rising, authorities saw no choice but to reopen activities.

Most of India's cases are in western Maharashtra state and the four southern states of Tamil Nadu, Andhra Pradesh, Telangana and Karnataka.

'Worst is yet to come'

In rural Maharashtra, the worst-affected state with 863,062 cases and 25,964 deaths, doctors said measures like wearing masks and washing hands had now largely been abandoned.

"There is a behavioural fatigue now setting in," said Dr SP Kalantri, the director of a hospital in the village of Sevagram.

He said the past few weeks had driven home the point that the virus had moved from India's cities to its villages.

"The worst is yet to come," said Kalantri. "There is no light at the end of the tunnel."

Even as testing in India has increased to more than a million a day, a growing reliance on screening for antigens or viral proteins is creating more problems.

These tests are cheaper and yield faster results but are not as accurate. The danger is that the tests may falsely clear many who are infected with COVID-19.

In Uttar Pradesh, India's most populous state with a limited healthcare system, the situation is already grim. With a total 253,175 cases and 3,762 deaths, the heartland state is staring at an inevitable surge and with a shortage of hospital beds and other health infrastructure.

Sujata Prakash, a nurse in the state's capital, Lucknow, has recently tested positive for the coronavirus. But the hospital ward where she worked diligently refused her admission because there were no empty beds. She waited for more than 24 hours outside the surgical ward, sitting on patients' chairs, before she was allotted one.

"The government can shower flower petals on the hospitals in the name of corona warriors, but can't the administration provide a bed when the same warrior needs one?" said Prakash's husband, Vivek Kumar.

Others have not been so lucky.

When journalist Amrit Mohan Dubey fell sick this week, his friends called the local administration for an ambulance. It arrived two hours late and by the time Dubey was taken to hospital, he died.

"Had the ambulance reached in time, we could have saved Amrit," said Zafar Irshad, a colleague of the journalist.