For the first time, India has recorded more than 4,000 Covid-19 related deaths as cases continue to surge across the country and two more states go into lockdown.
Saturday's record of 4,187 deaths takes the country's official death toll from the virus to nearly 240,000, although the true figure is believed to be much higher.
A further 401,000 new infections were also confirmed in the last 24 hours, meaning India has recorded over 400,000 new cases for three consecutive days.
Two southern states in India became the latest to declare lockdowns, as pressure mounts on Prime Minister Narendra Modi to implement a nationwide shutdown.
At over 300,000, Karnataka's capital of Bengaluru has the highest active caseload of any Indian city.
But experts warn the worst is still ahead as India's third largest city buckles under oxygen shortages, overrun hospitals and crowded crematoriums.
A woman mourns after her husband died due to the coronavirus disease (COVID-19) outside a mortuary of a COVID-19 hospital in Ahmedabad, India, May 8, 2021. Saturday's record of 4,187 deaths takes the country's official death toll from the virus to nearly 240,000, although the true figure is believed to be much higher
Relatives in PPE follow as healthcare workers pull a stretcher carrying the body of a person who died from the COVID-19 at a mortuary in Ahmedabad, India, May 8, 2021
A man mourns after his father died due to the coronavirus disease outside a mortuary of a COVID-19 hospital in Ahmedabad, India, May 8, 2021
For the first time, India has recorded more than 4,000 Covid-19 related deaths as cases continue to surge across the country and two more states go into lockdown. Family members along with medical workers shift a COVID19 patient to Level-3 ward of Swaroop Rani Nehru hospital in Prayagraj on Saturday
In Tamil Nadu state, the lockdown announcement followed a daily record of more than 26,000 cases on Friday.
Infections have swelled in India since February in a disastrous turn blamed on more contagious variants as well as government decisions to allow massive crowds to gather for religious festivals and political rallies.
On Saturday, India reported 401,078 confirmed cases, including a record high of 4,187 deaths. Overall, India has more than 21.8 million confirmed infections and nearly 240,000 deaths. Experts say even those dramatic tolls are undercounts.
Researchers at the University of Washington's Institute for Health Metrics and Evaluation warned on Thursday that the true toll is likely 700,000 and could top 1million by the end of the month, having doubled in just over six weeks.
Due to India's huge population of almost 1.4 billion, the country is struggling to give Covid-19 vaccines to enough people to stem the spread of the virus.
While the country has vaccinated over 131 million people - second only to the United States' total figure of almost 150 million - that only represents around 9.5 percent of its total population.
One doctor in Bengaluru said he's had to reject patients 'left, right and center' as his hospital struggled to find more oxygen.
'The problem is the demand is so high that we need constant oxygen,' Dr. Sanjay Gururaj, the medical director at Shanti Hospital and Research Center, said.
The hospital is sending a truck twice a day to oxygen plants on the outskirts of the city to bring back 12 jumbo oxygen cylinders. 'In normal times, this would have lasted over two weeks - now, it lasts just over a day,' he added.
Two southern states in India became the latest to declare lockdowns, as pressure mounts on Prime Minister Narendra Modi to implement a nationwide shutdown. Pictured: A woman mourns after her husband died due to the coronavirus, outside a mortuary of a COVID-19 hospital in Ahmedabad, India, May 8, 2021
Pictured: A woman receives the AstraZeneca vaccine for COVID-19 as others await their turn at a medical college in Prayagraj, India, Saturday, May 8, 2021
A man who has contracted Covid-19 rests inside the ICU ward of a hospital treating coronavirus patients on May 06, 2021 in Bengaluru, India. At over 300,000, Karnataka's capital of Bengaluru has the highest active caseload of any Indian city
Tweet every 30 seconds for oxygen or hospital bed in India
Pleas for oxygen, hospital beds, ventilators, access to intensive care units and even Covid-19 tests have inundated the Twitter feeds of Indian users in recent weeks.
Analysis by Reuters of Twitter data shows one tweet is being sent every 30 seconds by someone using #SOS or the word 'urgent' in relation to Covid, as they appeal to social media for help.
The pleas on Twitter only provide a small glimpse into what is happening in the world's second-most populous nation, where Prime Minister Narendra Modi's government has come under criticism for its handling of the crisis.
While Twitter is not as widely used as Facebook or WhatsApp in India, it is proving to be a more valuable tool during the pandemic, largely because of its re-tweet function that can quickly amplify pleas for help through users' networks of contacts.
'Twitter is having to do what the government helpline numbers should be doing,' wrote Twitter user Karanbir Singh.
The state's oxygen shortages prompted the high court on Wednesday to order the federal government to increase the daily liquid medical oxygen supplied to Karnataka.
The ruling came after 24 COVID-19 patients died in a government hospital on Monday. It's unclear how many of them died due to the lack of oxygen, but an investigation is ongoing.
Experts caution that the surge in Bengaluru is fast eclipsing other hard-hit cities like the capital, New Delhi, and Mumbai.
Cases have increased 100-fold since February, said Murad Banaji, a mathematician modelling COVID-19 growth in India, citing official data.
Test positivity has jumped to over 30 percent, which indicates the infection is much more widespread than confirmed figures, he added.
'Disaster was looming by early March, when cases started to shoot up,' he said. 'Bangalore is more than a ticking time bomb right now - it is in the middle of an explosion.' Bengaluru was previously known as Bangalore.
Much of the focus in recent weeks has been on northern India, led by New Delhi, where television stations have broadcast images of patients lying on stretchers outside hospitals and of mass funeral pyres that burn throughout the night.
The situation unfurling in Karnataka has thrown attention to other southern states also battling a rise in cases. Daily cases have breached the 20,000 mark for the past three days in Andhra Pradesh state, leading to new restrictions there.
Kerala, which emerged as a blueprint for tackling the pandemic last year, began a lockdown on Saturday.
Pictured: A medical worker inoculates a woman with a dose of the Covaxin Covid-19 coronavirus vaccine at a vaccination centre in KC General government hospital in Bangalore on May 7, 2021
With daily cases crossing 40,000, the state is aggressively boosting resources, including converting hundreds of industrial oxygen cylinders into medical oxygen, said Dr. Amar Fetle, the state's officer for COVID-19.
'The magnitude of cases from last year to now is vastly different,' he said, adding that increasing numbers have meant more hospitalizations and more strain on health care systems, with hospitals running nearly full.
'It's become a race between occupancy and how fast we can add beds. We're trying to stay ahead of the virus as best as we can.'
It's clear infections are rapidly rising across the southern region, but there has been 'less visible outcry' than in the north because of relatively better health infrastructure and government initiatives that address problems at the community level, said Jacob John, professor of community medicine at Christian Medical College, Vellore.
But while the virus has ripped through large cities in waves, smaller towns and villages, where health care is less accessible, are now exposed.
'These places are quickly getting affected, which means we may not have sustained the worst yet in south India,' he said.
A man runs to escape the heat of funeral pyres burning at a cremation ground in Delhi
Indian variant officially labelled 'variant of concern' in Britain
In Britain, it was announced by health officials that India's variant is now officially a 'variant of concern'.
Public Health England say the variant — linked to an explosion of cases in India — is 'at least' as infectious as the current dominant Kent strain.
Cases of the variant, scientifically called B.1.617.2, have more than doubled in a week. It has now been spotted 520 times, with hotspots in Bolton and London.
Health officials are confident vaccines currently being used should still work against the variant but are carrying out urgent tests to be certain.
Scientists have grouped the Indian variant into three separate sub-strains, with type 2 quickly spreading in the UK. It has been found in schools, care homes and places of worship, it was reported today.
The other two are genetically similar strains — B.1.617.1 and B.1.617.3 — and aren't currently considered variants of concern. But PHE said their status will be kept 'under constant review'.
Despite being more infectious, health chiefs don't believe the variant is deadlier than original coronavirus strains.
The move to make the Indian variant one 'of concern' means officials can now put in place tougher measures to contain the strain, including ordering door-to-door tests and boosting contact tracing.
All residents living in areas where the variant is spreading in the community will be asked to get a test, even if they don't have symptoms.
The Department of Health has announced it will start surge testing in Bolton in the BL3 postcode and has asked residents to book a test online or on the phone so they can go for one at a site or have one delivered to them at home. Surge testing in London has not yet been announced.
Prime Minister Boris Johnson said Friday that tracking of the Indian variant will be 'absolutely ruthless'.
On Friday, the country's main opposition leader Rahul Gandhi issued the dire warning as he called on Prime Minister Modi to begin a second national lockdown.
Mr Gandhi said India's huge and genetically diverse population provides 'fertile ground' for the virus to mutate into more infectious and deadly forms, causing devastation not just within its borders but across the globe.
India has already produced one Covid mutant that is thought to be more infectious than previous strains and which has spread overseas, but high infection rates mean the virus has plenty of chances to mutate again and become more dangerous.
Mr Modi has so-far resisted calls to go into a second national shutdown fearing the economic impacts, and has instead relied on states to decide their own measures while focusing nation efforts on distributing medicines and ramping up vaccines.
But a growing chorus of politicians, medical experts and judges has warned he is running out of options as the country's healthcare system stretches past breaking point with no end to the surge in sight.
'India is home to one out of every six human beings on the planet. The pandemic has demonstrated that our size, genetic diversity and complexity make India fertile ground for the virus to rapidly mutate, transforming itself into a more contagious and more dangerous form,' Mr Ghandi said.
'Allowing the uncontrollable spread of the virus in our country will be devastating not only for our people but also for the rest of the world.'
Researchers' calculations on India's true death toll are based on a statistical model that takes into account 'excess mortality' data - meaning deaths that occur above established averages.
The figure will therefore include deaths that are missed in government counts, such as in India which only includes deaths in hospital and with a positive test - despite both hospital beds and test kits being in short supply.
But the data is controversial because it also mops up a lot of deaths that are either not directly related to Covid, or have nothing to do with the virus at all.
Based on their calculations, India will top 1million Covid deaths by May 27 having taken until April 12 to reach 500,000.
Another model, developed by the Indian Institute of Science in Bangalore, estimates that the official toll could be above 400,000 by early June.
Their analysis suggests government's figures will hit 404,000 by June 11, having doubled from around 201,000 on April 27 - again, a little over six weeks.
It means India could end up with the world's highest Covid death toll, even if excess mortality isn't taken into account.
America currently has the world's highest official toll, which stands at 594,000.
Pictured: A health worker takes a nasal swab sample of a policeman to test for COVID-19 in Prayagraj, India, Saturday, May 8, 2021
With the crisis showing no sign of slowing and the country's healthcare system stretched past collapse, medical experts, political opponents and some Supreme Court justices have said nationwide measures appear to be the only solution.
Over the past month, nearly a dozen out of India's 28 federal states have announced less stringent restrictions than the nationwide lockdown imposed for two months in March last year.
Modi, who held consultations with top elected leaders and officials of the worst-hit states on Thursday, has so far left the responsibility for fighting the virus to poorly equipped state governments.
Dr. Randeep Guleria, a government health expert, said a complete, aggressive lockdown is needed in India just like last year, especially in areas where more than 10 percent of those tested have contracted COVID-19.
Rahul Gandhi, an opposition Congress party leader, in a letter to Modi on Friday reiterated his demand for a total lockdown, warning 'the human cost will result in many more tragic consequences for our people.'
He said the government should not worry about the economic cost of a shutdown and provide critical financial and food support to the poor.
Srinath Reddy, president of the Public Health Foundation of India, a public-private consultancy, acknowledged that different states were experiencing different intensities of the epidemic, but said a 'coordinated countrywide strategy' was still needed.
According to Reddy, decisions need to be based on local conditions but should be closely coordinated by the center. 'Like an orchestra which plays the same sheet music but with different instruments,' he said.
Anthony Fauci, President Joe Biden's chief medical adviser, also suggested that a complete shutdown in India may be needed two to four weeks to help ease the surge of infections.
Modi, who held consultations with top elected leaders and officials of the worst-hit states on Thursday, has so far left the responsibility for fighting the virus to poorly equipped state governments. Pictured: Modi during a campaign rally on March 7, 2021
'As soon as the cases start coming down, you can vaccinate more people and get ahead of the trajectory of the outbreak of the pandemic,' Fauci said in an interview with the Indian television CNN News18 news channel on Thursday. He did not provide specifics of what a shutdown should entail.
He said it appears there are at least two types of virus variants circulating in India. He said B117, which is the U.K. variant, tends to be concentrated in New Delhi and that the 617 variant is concentrated in the worst-hit western Maharashtra state.
'Both of those have increasing capability of transmitting better and more efficiently than the original Wuhan strain a year ago,' Fauci said.
Modi imposed a two-month stringent lockdown last year on four hours' notice. It stranded tens of millions of migrant workers who were left jobless and fled to villages with many dying along the way. Experts say the decision helped contain the virus and bought time for the government.
India's economy contracted by 23 percent in April-June quarter last year and showed recovery as the restrictions were eased. The International Monetary Fund's projection of 12.5 percent growth in 2021-22 financial year, beginning April, is expected to suffer again with the surge in infections.
WHAT DO WE KNOW ABOUT THE INDIA VARIANTS?
Real name: B.1.617 — now divided into B.1.617.1; B.1.617.2; B.1.617.3
When and where was it discovered?
The variant was first reported by the Indian government in February 2021.
But the first cases appear to date back to October 2020.
Its presence in the UK was first announced by Public Health England on April 15. There have since been at least 400 cases spotted in genetic lab testing.
What mutations does it have?
It has 13 mutations that separate it from the original Covid virus that emerged in China — but the two main ones are named E484Q and L452R.
Scientists suspect these two alterations can help it to transmit faster and to get past immune cells made in response to older variants.
PHE officials said it has split into three distinct virus types, with types 1 and 3 both having the E484Q mutation but type 2 missing the change, despite having all the other hallmarks of the variant.
Public Health England has divided the Indian variant into three sub-types because they aren't identical. Type 1 and Type 3 both have a mutation called E484Q but Type 2 is missing this, despite still clearly being a descendant of the original Indian strain. It is not yet clear what separates Type 1 and 3
Is it more infectious and can it evade vaccines?
The L452R mutation is also found on the Californian variant (B.1.429), even though the two evolved independently. It is thought to make the American strain 20 per cent more infectious than the original Wuhan version – even with the extra 20 per cent it is likely slower than the Kent variant.
The E484Q mutation is very similar to the one found in the South African and Brazil variants known as E484K, which can help the virus evade antibodies.
The South African variant is thought to make vaccines about 30 per cent less effective at stopping infections, but it's not clear what effect it has on severe illness.
Professor Sharon Peacock, of PHE, claimed there was 'limited' evidence of E484Q's effect on immunity and vaccines. Lab studies have suggested it may be able to escape some antibodies, but to what degree remains uncertain.
Early research suggests both the AstraZeneca vaccine, known as Covishield in India, and the Pfizer jab, still work against the variant, as well as India's own jab, Covaxin. A paper published by SAGE last week suggested two doses of the Pfizer vaccine is good enough to protect against all known variants.
How deadly is it?
Scientists still don't know for sure. But they are fairly certain it won't be more deadly than the current variants in circulation in Britain.
This is because there is no evolutionary benefit to Covid becoming more deadly. The virus's sole goal is to spread as much as it can, so it needs people to be alive and mix with others for as long as possible to achieve this.
And, if other variants are anything to go by, the Indian strain should not be more lethal.
There is still no conclusive evidence to show dominant versions like the Kent and South African variants are more deadly than the original Covid strain - even though they are highly transmissible.
Doctors in India claim there has been a sudden spike in Covid admissions among people under 45, who have traditionally been less vulnerable to the disease.
There have been anecdotal reports from medics that young people make up two third of new patients in Delhi. In the southern IT hub of Bangalore, under-40s made up 58 percent of infections in early April, up from 46 percent last year.
There is still no proof younger people are more badly affected by the new strain.
Should we be worried?
Scientists are unsure exactly how transmissible or vaccine-resistant the Indian variant is because it hasn't been studied thoroughly.
The fact it appears to have increased infectivity should not pose an immediate threat to the UK's situation because the current dominant Kent version appears equally or more transmissible.
It will take a variant far more infectious strain than that to knock it off the top spot.
However, if the Indian version proves to be effective at slipping past vaccine-gained immunity, then its prevalence could rise in Britain as the immunisation programme squashes the Kent variant.
Why has B.1.617.2 been designated as a variant of concern?
Scientists believe this variant can spread more quickly than two other related variants seen in India.
It is thought to be at least as transmissible as the variant detected in Kent last year, known as B117, which is now dominant in the UK.
Dr Susan Hopkins, Covid-19 strategic response director at PHE, said: 'We are monitoring all of these variants extremely closely and have taken the decision to classify this as a variant of concern because the indications are that this VOC-21APR-02 is a more transmissible variant.'
PHE said there is currently 'insufficient evidence' to indicate that any of the variants recently detected in India cause more severe disease or make the vaccines available any less effective.
How many cases have been detected in the UK?
According to data by PHE released on Friday, there are, at present, 520 confirmed cases of the B.1.617.2 variant in the UK, from 202 over the last week.
The report also showed 261 cases of B.1.617.1 and nine cases of B.1.617.3.
The cases are spread across the country, with the majority in two areas – the North West, mainly in Bolton, and London.
PHE said around half of these cases are related to travel or contact with a traveller.
PHE health protection teams are working with local authorities, public health officials and NHS Test and Trace to detect cases and limit onward spread.
Surge testing is expected to be deployed where there is evidence of community transmission.
Is B16172 variant driving the second wave in India?
India reported 412,262 new Covid-19 cases and 3,980 Covid-19-related deaths on Thursday — both new single-day records.
In the past 30 days, the country has recorded 8.3million cases.
However, it remains unclear whether the new coronavirus variants are driving the second wave.
Experts say large gatherings, and lack of preventive measures such as mask-wearing or social distancing, are playing a key role in the spread of the virus.
Although India has the world's biggest vaccine making capacity, the country has partially or fully immunised less than 10 per cent of its 1.35billion people.
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