NEW DELHI -- A fire in a covid-19 hospital ward in western India killed 18 patients early Saturday, while 12 patients died at a hospital in New Delhi after it ran out of oxygen. The country grappling with the worst outbreak yet in the global pandemic stepped up a vaccination drive for all adults even as some states said they don't have enough doses.
India on Saturday set yet another daily global record with 401,993 new cases, taking its tally to more than 19.1 million. Another 3,523 people died in the 24-hour period, raising the overall fatalities to 211,853, according to the Health Ministry. Experts believe both figures are undercounts.
Prime Minister Narendra Modi's government described the pandemic as a "once-in-a-century crisis."
Anthony Fauci, the Biden administration's chief medical adviser, urged India to explore ways its military could help alleviate the calamity, saying in an interview with the Indian Express newspaper that the situation is "like a war."
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He also strongly advised India to implement a nationwide shutdown. "No one likes to lock down the country," he said. But a temporary lockdown "could have a significant impact on the dynamics of the outbreak."
The fire broke out in a covid-19 ward on the ground floor of Welfare Hospital in Bharuch, a town in Gujarat state, and was extinguished within an hour, police said. The cause is being investigated.
Thirty-one other patients were rescued by hospital workers and firefighters, said police officer B.M Parmar. Late last month, a fire in an intensive-care unit killed 13 covid-19 patients in the Virar area on the outskirts of Mumbai.
The 12 patients on high-flow oxygen who died in New Delhi's Batra Hospital after it ran out for 80 minutes included a doctor, said director S.C.L. Gupta. He said the hospital has been facing irregular oxygen supply from manufacturers for more than a week, but it ran out completely for the first time.
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Gupta said the hospital tank was refilled with enough oxygen for 12 hours and would again be looking for replenishment.
A New Delhi news channel said an attorney for the hospital complained to a New Delhi court that is hearing petitions on the issue.
India's government Saturday shifted its faltering vaccination campaign into high gear by saying all adults 18 and older could get shots. Since January, nearly 10% of Indians have received one dose, but only about 1.5% have received both, although India is one of the world's biggest producers of vaccines.
Some states have already said they don't have enough doses for everyone, and even the ongoing effort to inoculate people older than 45 is sputtering.
The state of Maharashtra has said it won't be able to start the expanded vaccinations. The health minister for New Delhi, Satyender Jain, said last week that the city doesn't have enough doses to vaccinate people between 18 and 44.
In a positive development, the country Saturday received its first batch of Sputnik V vaccine, which it is importing from Russia. Moscow has signed a deal with an Indian pharmaceutical company to distribute 125 million doses.
But some experts warned that mass vaccinations at this point could actually worsen the surge in a country that is second only to the United States in its number of infections.
"There's ample evidence that having people wait in a long, crowded, disorderly queue could itself be a source of infection," said Dr. Bharat Pankhania, a senior clinical lecturer specializing in infectious diseases at Britain's University of Exeter. Like Fauci, he urged India to first stop the circulation of the virus by imposing "a long, sustained, strictly enforced lockdown."
Gallery: Hospital fire, virus woes in India
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India's capital extended its week-old lockdown by another week to curb the explosive surge, tweeted Arvind Kejriwal, a top elected official.
All shops and factories will remain closed until next Sunday, except for those that provide essential services such as grocery stores. People are not supposed to leave their homes, except for a handful of reasons like seeking medical care or going to the airport or a railroad station. Daily wage earners and small businesses are expected to suffer a further blow to their livelihoods.
Faced with an unprecedented covid-19 surge that has filled hospitals and crematoriums, Modi held a Cabinet meeting Friday to discuss steps to save the country's crumbling health system by adding hospital beds, resolving issues in production, storage and transport of oxygen, and tackling the shortage of essential medicines.
In a now-familiar scene, television images showed a woman gasping for breath in her car while her family looked for a hospital bed on the outskirts of New Delhi. The 33-year-old woman couldn't find room at three hospitals and died in the car Friday, The Times of India newspaper reported.
In a sign of the desperation in India's capital, a lawyer named Amit Sharma submitted a petition to the Delhi High Court pleading for help finding a bed in an intensive-care unit for his severely ill brother-in-law.
In the middle of the hearing Friday, Sharma told the judges that his brother-in-law had died and no more efforts would be required. "I have completely failed," Sharma said, according to media reports.
"No, the state has failed," one of the judges replied, after a moment of stunned silence. "We all have failed."
Volunteers are attempting to do what they can. Srinivas BV, president of the youth wing of the opposition Congress party, is leading an effort to answer distress calls on social media and the messaging platform WhatsApp. A couple of weeks ago, his group was still managing to help patients get beds in government hospitals. Now that too is proving nearly impossible.
"People are dying not because of [the virus] but because they're not getting basic treatment in time," he said.
One of them was Raja Ram Tiwari, a 64-year old retiree who used to work for India's state broadcaster. His condition worsened last Sunday. His son, Shantanu, spent hours the next day running around the city trying to secure an oxygen cylinder on the black market, where he was told it would cost $800 or more.
That evening, after calling dozens of hospitals, the family found a facility willing to admit Tiwari in a neighboring state, 60 miles away. Shantanu withdrew his father's life savings to pay for the treatment and took his mother's gold jewelry to sell in case more was needed.
He got his father into a taxi, but five minutes into the ride Tiwari started to have trouble breathing. They went directly to the nearest hospital. It was too late: Doctors stepped outside to see Tiwari and told Shantanu his father was dead.
At the first crematorium Shantanu tried, there were already 11 bodies in line before it opened early in the morning. He went to a larger one, hoping it would have more capacity. When he arrived there at 3 a.m., it was conducting a mass cremation of dozens of bodies that had arrived earlier that day.
Shantanu watched for hours as he waited for his father's turn. "I have never seen a night so silent and the sky lit with so many pyres," he said.
'PEOPLE LIKE MODI'
Independent health experts and political analysts say that Modi's overconfidence and his domineering leadership style bear a huge share of the responsibility for his nation's crisis.
Critics say his administration was determined to cast an image of India as back on track and open for business despite lingering risks. At one point, officials dismissed warnings by scientists that India's population remained vulnerable and had not achieved herd immunity, as some in his administration were suggesting, said people familiar with those conversations.
The growing distress across India has tarnished Modi's aura of political invulnerability, which he won by steamrolling the opposition and leveraging his personal charisma to become India's most powerful politician in decades. Opposition leaders are on the attack, and his central hold on power has increasingly made him the target of scathing criticism online.
With parliamentary elections three years away and no signs of a loss of loyalty for his government, Modi's power seems secure. His government has stepped up efforts to get supplies to desperate patients and broadened eligibility for scarce vaccines to more age groups. Still, analysts say that his dominance means that more people will hold him personally responsible for the sickness and death exploding across the country.
Although India is a vaccine powerhouse, producing vaccines to protect the world, it didn't purchase enough doses to protect itself. Instead, while vaccination rates remained low at home, New Delhi exported more than 60 million shots to bolster its standing on the world stage.
Even as infections rose, Modi let big groups gather to help his ruling Bharatiya Janata Party and burnish its Hindu nationalist credentials. His government allowed a Hindu festival with millions of worshippers to take place. He campaigned in state elections without a mask at rallies of thousands of maskless supporters.
Modi surrounded himself with allies rather than experts, analysts said. Officials felt too intimidated to point out mistakes, the analysts said, or to call into doubt his claims that the pandemic was over. His party and his allies also have moved to silence critics, ordering Facebook, Instagram and Twitter to take down critical posts and threatening to arrest people for pleading for oxygen.
Modi's party and the government declined to answer specific questions from The New York Times but listed actions the government has taken, including Modi holding more than a dozen meetings in April with air force officers, pharmaceutical executives and many others.
Modi is likely to hold on to power, thanks to weak opposition and his ability to fire up his Hindu nationalist base. Even his image has changed; Modi has lost the baseball cap and chic sunglasses he wore a year ago and grown his hair and beard long, reminiscent for some of a Hindu sage.
"He's just a unique political animal," said Milan Vaishnav, director of the South Asia program at the Carnegie Endowment for International Peace. "He has this charisma, an allure, a magnetism, a very compelling personal story, and he has enormous personal credibility with the average voter."
Even now, Vaishnav added, "people like Modi, and they will find ways to justify it."
Information for this article was contributed by Ashok Sharma, Aniruddha Ghosal, Maria Cheng, Daria Litvinova and Krutika Pathi of The Associated Press; by Joanna Slater and Shams Irfan of The Washington Post; and by Jeffrey Gettleman, Hari Kumar, Karan Deep Singh and Sameer Yasir of The New York Times.
A health worker displays test kits showing positive covid-19 results Saturday after screening election officials and poll workers on the eve of state elections in Gauhati, India.
Relatives prepare to cremate COVID-19 victims at a ground that has been converted into a crematorium in New Delhi, India, Saturday, May 1, 2021. India on Saturday set yet another daily global record with 401,993 new cases, taking its tally to more than 19.1 million. Another 3,523 people died in the past 24 hours, raising the overall fatalities to 211,853, according to the Health Ministry. Experts believe both figures are an undercount. (AP Photo/Amit Sharma)
A worker carries wood on a hand cart as multiple funeral pyres of COVID-19 victims burn at a crematorium on the outskirts of New Delhi, India, Saturday, May 1, 2021. India on Saturday set yet another daily global record with 401,993 new cases, taking its tally to more than 19.1 million. Another 3,523 people died in the past 24 hours, raising the overall fatalities to 211,853, according to the Health Ministry. Experts believe both figures are an undercount. (AP Photo/Ishant Chauhan)
This photo shows inside the Welfare Hospital after a deadly fire in Bharuch, western India, Saturday, May 1, 2021. The fire in a COVID-19 ward of the hospital killed multiple patients early Saturday, as the country grappling with the worst outbreak yet steps up a vaccination drive for all its adults even though some states say don't have enough jabs. (KK PRODUCTIONS via AP)
Relatives carry the body of a person who died of COVID-19 as multiple pyres of other COVID-19 victims burn at a crematorium in New Delhi, India, Saturday, May 1, 2021. India on Saturday set yet another daily global record with 401,993 new cases, taking its tally to more than 19.1 million. Another 3,523 people died in the past 24 hours, raising the overall fatalities to 211,853, according to the Health Ministry. Experts believe both figures are an undercount. (AP Photo/Amit Sharma)
A wreath lies on the coffin of a COVID-19 victim before his cremation in Jammu, India, Friday, April 30, 2021. Indian scientists appealed to Prime Minister Narendra Modi to publicly release virus data that would allow them to save lives as coronavirus cases climbed again Friday, prompting the army to open its hospitals in a desperate bid to control a massive humanitarian crisis. (AP Photo/Channi Anand)
Charred furniture and other items are seen after a deadly fire at the Welfare Hospital in Bharuch, western India, Saturday, May 1, 2021. The fire in a COVID-19 ward of the hospital killed multiple patients early Saturday, as the country grappling with the worst outbreak yet steps up a vaccination drive for all its adults even though some states say don't have enough jabs. (AP Photo/Viral Rana)
A woman receives the AstraZeneca vaccine for COVID-19 at a hospital in Prayagraj, India. Saturday, May 1, 2021. In hopes of taming a monstrous spike in COVID-19 infections, India opened vaccinations to all adults Saturday, launching a huge inoculation effort that was sure to tax the limits of the federal government, the country's vaccine factories and the patience of its 1.4 billion people. (AP Photo/Rajesh Kumar Singh)
Shashank Shekhar, 18, left, stands with his sisters displaying their vaccination cards after receiving COVID-19 vaccine at a hospital in Prayagraj, India. Saturday, May 1, 2021. In hopes of taming a monstrous spike in COVID-19 infections, India opened vaccinations to all adults Saturday, launching a huge inoculation effort that was sure to tax the limits of the federal government, the country's vaccine factories and the patience of its 1.4 billion people. (AP Photo/Rajesh Kumar Singh)