Horrors ahead, India warned; 220,000 death toll likely short

Virus cases top 20 million

FILE - In this April 30, 2021, file photo, a relative of a person who died of COVID-19 mourns at a crematorium in Jammu, in Jammu, India. COVID-19 infections and deaths are mounting with alarming speed in India with no end in sight to the crisis. People are dying because of shortages of bottled oxygen and hospital beds or because they couldn’t get a COVID-19 test. (AP Photo/Channi Anand, File)
FILE - In this April 30, 2021, file photo, a relative of a person who died of COVID-19 mourns at a crematorium in Jammu, in Jammu, India. COVID-19 infections and deaths are mounting with alarming speed in India with no end in sight to the crisis. People are dying because of shortages of bottled oxygen and hospital beds or because they couldn’t get a COVID-19 test. (AP Photo/Channi Anand, File)

NEW DELHI -- 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 "horrible."

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. The true figures are believed to be far higher.

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 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 2½ times as many deaths as India, at close to 580,000.

India's 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.

Prime Minister Narendra Modi has been sharply criticized by many for underplaying the virus earlier this year, and on Tuesday the opposition leader Rahul Gandhi said a national lockdown was desperately needed, calling it "the only option."

Gandhi accused authorities of helping the virus spread. "A crime has been committed against India," he wrote on Twitter.

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Modi has been reluctant to impose strict nationwide lockdown measures like the ones last spring, which remained in place for months.

Dr. Ashish Jha, dean of Brown University's 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.

"I've 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,'" he said.

Jha said the focus needs to be on "classic" public health measures: targeted shutdowns, more testing, universal mask-wearing and avoiding large gatherings.

"That is what's going to break the back of this surge," 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. "Enough is enough," it said.

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.

With aid being shipped from countries like the United States and Britain, there was hope among weary residents that the situation could start easing.

Eight oxygen generator plants from France, each of which can supply 250 hospital beds, were earmarked for six hospitals in Delhi and one each in Haryana and Telangana, states in northern and southern India.

One of the generators was installed at the Narayana hospital in Delhi within hours of being delivered, according to The Times of India. Italy has also donated an oxygen generation plant and 20 ventilators.

As criticism has mounted over the delay in dispatching oxygen concentrators and other equipment, the government announced Monday that it was waiving all duties and taxes on lifesaving equipment and relief material that had been donated. But authorities have faced calls for more transparency on the deployment of the international aid shipments.

The Indian Red Cross receives all shipments that arrive by air, then hands them over to a government agency in charge of distributing the supplies based on regional requests. Authorities have released a list of hospitals that received aid shipments, but did not specify which equipment was going where.

AUSTRALIA

Meanwhile, backlash intensified Tuesday to Australia's threat to jail or fine citizens fleeing India, prompting Prime Minister Scott Morrison to play down the risk of penalties after a former cricket star accused him of having "blood" on his hands for abandoning thousands of Australians in the coronavirus-hit country.

The government's announcement that citizens returning to Australia after recently spending time in India could face five years in jail, a $50,000 fine or both has sparked criticism from across the political spectrum.

Former cricket star Michael Slater was commentating on Indian Premier League cricket matches when an Australian ban on flights from the South Asian country went into effect last week.

"If our Government cared for the safety of Aussies they would allow us to get home," Slater tweeted on Monday. "It's a disgrace!! Blood on your hands PM. How dare you treat us like this. How about you sort out quarantine system. I had government permission to work on the [Indian Premier League] but I now have government neglect."

Slater was reportedly able to leave India for the Maldives, but will not be allowed back into Australia for another two weeks, under the new rules.

Morrison called Slater's accusation "absurd" but appeared to back down on the threat to jail or fine Australians fleeing India.

"I think the likelihood of anything like that occurring is pretty much zero," Morrison told Australia's Nine Network on Tuesday morning, saying the country had yet to jail anyone under emergency biosecurity powers that went into effect last year. "So, I think people need to look at this in perspective."

Doctors have demanded the policy be reversed. Advocates argue it violates human rights. Legal scholars say it probably runs afoul of the law. Political opponents have dubbed it "racist." Several members of Morrison's conservative coalition government have come out against it. And even right-wing columnists have slammed the sanctions.

VIETNAM

Additionally, Vietnam is keeping people in quarantine centers longer than the 14-day period in its latest step to prevent the spread of coronavirus amid the emergence of cases being traced to overseas travelers.

Provinces were instructed by the health ministry to "temporarily keep" in quarantine until further notice people who have completed the 14-day isolation, according to a post on the government website. Three patients in Vinh Phuc were found to be carrying a virus variant first detected in India, the health ministry said.

Authorities are scrutinizing cases including that of an Indian national who checked into a hospital in Hanoi on May 3 and tested positive for covid-19 earlier on Tuesday. This was after he had completed the required 14-day quarantine when he arrived in Vietnam on April 17. He isolated in a hotel in the coastal city of Haiphong and tested negative twice after ending quarantine.

The Hanoi government has placed the apartment building that's home to about 1,500 people including the Indian national under temporary lockdown, according to the city's health department. Authorities are also keeping a close watch on the case of a hotel staff member in Danang whose transmission is still unknown, Tuoi Tre newspaper reported.

Information for this article was contributed by Aniruddha Ghosal and Danica Kirka of The Associated Press; by Shalini Venugopal Bhagat of The New York Times; by Michael E. Miller of The Washington Post; and by Nguyen Dieu Tu Uyen and Nguyen Xuan Quynh of Bloomberg News (WPNS).

FILE - In this May 1, 2021, file photo, 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. COVID-19 infections and deaths are mounting with alarming speed in India with no end in sight to the crisis. People are dying because of shortages of bottled oxygen and hospital beds or because they couldn’t get a COVID-19 test. (AP Photo/Amit Sharma, File)
FILE - In this May 1, 2021, file photo, 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. COVID-19 infections and deaths are mounting with alarming speed in India with no end in sight to the crisis. People are dying because of shortages of bottled oxygen and hospital beds or because they couldn’t get a COVID-19 test. (AP Photo/Amit Sharma, File)
FILE - In this April 29, 2021, file photo, relatives react to heat emitting from the multiple funeral pyres of COVID-19 victims at a crematorium in the outskirts of New Delhi, India. COVID-19 infections and deaths are mounting with alarming speed in India with no end in sight to the crisis. People are dying because of shortages of bottled oxygen and hospital beds or because they couldn’t get a COVID-19 test. (AP Photo/Amit Sharma, File)
FILE - In this April 29, 2021, file photo, relatives react to heat emitting from the multiple funeral pyres of COVID-19 victims at a crematorium in the outskirts of New Delhi, India. COVID-19 infections and deaths are mounting with alarming speed in India with no end in sight to the crisis. People are dying because of shortages of bottled oxygen and hospital beds or because they couldn’t get a COVID-19 test. (AP Photo/Amit Sharma, File)
FILE - In this May. 3, 2021, file photo, relatives of a person who died of COVID-19 mourn outside a field hospital in Mumbai, India. COVID-19 infections and deaths are mounting with alarming speed in India with no end in sight to the crisis. People are dying because of shortages of bottled oxygen and hospital beds or because they couldn’t get a COVID-19 test. (AP Photo/Rafiq Maqbool, File)
FILE - In this May. 3, 2021, file photo, relatives of a person who died of COVID-19 mourn outside a field hospital in Mumbai, India. COVID-19 infections and deaths are mounting with alarming speed in India with no end in sight to the crisis. People are dying because of shortages of bottled oxygen and hospital beds or because they couldn’t get a COVID-19 test. (AP Photo/Rafiq Maqbool, File)
FILE - In this April 28, 2021, file photo, a Kashmiri man receives a vaccine for COVID-19 at a primary health center in Srinagar, Indian controlled Kashmir. COVID-19 infections and deaths are mounting with alarming speed in India with no end in sight to the crisis. (AP Photo/Dar Yasin, File)
FILE - In this April 28, 2021, file photo, a Kashmiri man receives a vaccine for COVID-19 at a primary health center in Srinagar, Indian controlled Kashmir. COVID-19 infections and deaths are mounting with alarming speed in India with no end in sight to the crisis. (AP Photo/Dar Yasin, File)
FILE - In this May 3, 2021, file photo, a man walks carrying a refilled cylinder as family members of COVID-19 patients wait in queue to refill their oxygen cylinders at Mayapuri area in New Delhi, India. COVID-19 infections and deaths are mounting with alarming speed in India with no end in sight to the crisis. People are dying because of shortages of bottled oxygen and hospital beds or because they couldn’t get a COVID-19 test. (AP Photo/Ishant Chauhan, File)
FILE - In this May 3, 2021, file photo, a man walks carrying a refilled cylinder as family members of COVID-19 patients wait in queue to refill their oxygen cylinders at Mayapuri area in New Delhi, India. COVID-19 infections and deaths are mounting with alarming speed in India with no end in sight to the crisis. People are dying because of shortages of bottled oxygen and hospital beds or because they couldn’t get a COVID-19 test. (AP Photo/Ishant Chauhan, File)
Indians crowd a vegetable market in Jammu, India, Tuesday, May 4, 2021. COVID-19 infections and deaths are mounting with alarming speed in India with no end in sight to the crisis. (AP Photo/Channi Anand)
Indians crowd a vegetable market in Jammu, India, Tuesday, May 4, 2021. COVID-19 infections and deaths are mounting with alarming speed in India with no end in sight to the crisis. (AP Photo/Channi Anand)
FILE - In this May. 3, 2021, file photo, health workers sit in the waiting area of vaccination center which has been closed because of shortage of the COVID-19 vaccine in Mumbai, India. COVID-19 infections and deaths are mounting with alarming speed in India with no end in sight to the crisis. People are dying because of shortages of bottled oxygen and hospital beds or because they couldn’t get a COVID-19 test. (AP Photo/Rafiq Maqbool, File)
FILE - In this May. 3, 2021, file photo, health workers sit in the waiting area of vaccination center which has been closed because of shortage of the COVID-19 vaccine in Mumbai, India. COVID-19 infections and deaths are mounting with alarming speed in India with no end in sight to the crisis. People are dying because of shortages of bottled oxygen and hospital beds or because they couldn’t get a COVID-19 test. (AP Photo/Rafiq Maqbool, File)
FILE - In this April 30, 2021, file photo, health workers attend to COVID-19 patients at a makeshift hospital in New Delhi, India. COVID-19 infections and deaths are mounting with alarming speed in India with no end in sight to the crisis. People are dying because of shortages of bottled oxygen and hospital beds or because they couldn’t get a COVID-19 test. (AP Photo/File)
FILE - In this April 30, 2021, file photo, health workers attend to COVID-19 patients at a makeshift hospital in New Delhi, India. COVID-19 infections and deaths are mounting with alarming speed in India with no end in sight to the crisis. People are dying because of shortages of bottled oxygen and hospital beds or because they couldn’t get a COVID-19 test. (AP Photo/File)
Relatives bury the body of a COVID-19 victim at a graveyard in New Delhi, India, Tuesday, May 4, 2021. 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. (AP Photo/Ishant Chauhan)
Relatives bury the body of a COVID-19 victim at a graveyard in New Delhi, India, Tuesday, May 4, 2021. 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. (AP Photo/Ishant Chauhan)

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