NEW DELHI — In sheer numbers, it is the worst surge since the pandemic began – and it is still gathering speed.

After a devastating week of soaring infections, India reported more than 400,000 new cases Saturday, a global record. Experts believe that number will climb even higher in the coming days, an unimaginable burden for a health system already under siege with hospitals issuing pleas for oxygen.

India’s experience underscores a sobering paradox: Even as the United States and Europe move away from the darkest days of the pandemic, other countries are engaged in a desperate struggle against the virus.

The powerful resurgence of infections in India – a country where cases had ebbed just months earlier – is also a reminder that the coronavirus is far from controlled around the world, even with vaccination rates climbing in many countries.


COVID-19 patients receive oxygen outside a Gurdwara, a Sikh house of worship Saturday in New Delhi, India. Amit Sharma/Associated Press

It remains unclear how large a role coronavirus variants are playing in the pandemic’s grip on India. But the staggering numbers themselves are leaving the country increasingly isolated. On Friday, the United States said it would restrict travel from India. Dozens of countries have begun sending aid to bolster hospitals overwhelmed by patients and short on crucial supplies.

In India’s capital, New Delhi, a hospital treating coronavirus patients ran out of oxygen on Saturday. It took an hour for fresh supplies to arrive. In the meantime, at least eight patients died, among them one of the hospital’s own doctors, said S.C.L. Gupta, the medical director of Batra Hospital.

The incident marks the second time in recent days in which an oxygen shortage at a Delhi hospital proved fatal. On April 23, a different hospital ran out of oxygen and 26 critically ill coronavirus patients died.

In New Delhi, people are waiting for hours at crematoriums to perform funeral rites for their loved ones. Dozens of pyres are being packed closely together in scenes that are without precedent. Every day people are dying outside hospitals, unable to access care.

Anthony Fauci, the Biden administration’s chief medical adviser, urged India to explore ways its military could help alleviate the calamity, saying the situation is “like a war” in an interview with the Indian Express newspaper.


A woman receives the AstraZeneca vaccine for COVID-19 at a hospital Saturday in Prayagraj, India. Rajesh Kumar Singh/Associated Press

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.”

India had announced that it would open its vaccination program to all adults over the age of 18 starting Saturday, but in many parts of the country there were not enough doses available to expand the program. Several state governments said they did not know when they would obtain the necessary supplies.

The oxygen shortages and the chaotic rollout of the latest phase of the vaccine drive are adding to a deepening sense of crisis. Epidemiologists have said that the number of daily cases in India could reach 500,000 within weeks.

India has reported more than 300,000 new cases each of the past 10 days, bringing its total number of infections in the pandemic to 19 million. More than 3,500 people died in the most recent 24-hour period, according to data from the Health Ministry on Saturday.

The figure is an undercount, experts say. Recent reports from crematoriums and cemeteries in different cities and states indicate that a significant number of covid-19 deaths are missing from official statistics.


Pallets of oxygen tanks sit in the 60th Aerial Port Squadron warehouse on Tuesday at Travis Air Force Base, Calif. The United States is donating medical supplies to assist India in its fight against COVID-19. The donation of 440 oxygen cylinders and regulators, one million N95 masks and one million COVID-19 rapid diagnostic kits, will be transported to India aboard a U.S. Air Force C-5M Super Galaxy. Alexander Merchak/U.S. Air Force via AP

Several hard-hit areas of the country – including Delhi and the state of Maharashtra – have already announced lockdowns. On Saturday, the Delhi government said it would extend its shutdown for a third week. In a nationwide address on April 20, Indian Prime Minister Narendra Modi said that such measures were “a last option” that should be avoided.

On Friday, Modi met with his Cabinet of ministers, which released a statement saying that the situation was a “once in a century crisis.” The cabinet reviewed measures to ramp up hospital beds, oxygen supply and stocks of essential medicines.

Two military transport planes carrying oxygen cylinders, rapid diagnostic tests and medical-grade masks from the United States arrived in Delhi on Friday. More aid is on its way, both governments said.

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 on 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 on April 25. 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 came 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 another 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.

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