India saw record new jumps in Covid-19 cases and deaths on Thursday, dashing tentative hopes that a catastrophic recent surge that has stretched hospitals to the limit might be easing.
Health ministry numbers showed 3,980 deaths in the past 24 hours, taking the national total to 230,168, and 412,262 new cases, taking India's caseload since the pandemic began over 21 million.
Many experts suspect that with low levels of testing and poor record-keeping for cause of death -- and crematoriums overwhelmed in many places -- the real numbers could be much higher.
The rise follows several days of falling case numbers that had raised government hopes that the virus surge may have been easing.
Having hit a high of 402,000 last Friday, the daily number of cases eased to as low as 357,000 before creeping up again on Tuesday.
Senior health ministry official Lav Aggarwal had told reporters on Monday that there was a "very early signal of movement in the positive direction".
The sharp rise in cases since late March has overwhelmed hospitals in many places, with fatal shortages of beds, drugs and oxygen.
Prime Minister Narendra Modi's government has resisted imposing a new lockdown although several regions including the capital New Delhi, Bihar and Maharashtra have imposed local shutdowns.
Until now the worst-hit areas have been Delhi and Maharashtra but other states including West Bengal, Kerala and Karnataka are now reporting sharp rises.
Kerala's chief minister Pinarayi Vijayan announced on Twitter Thursday a week-long lockdown in the southern state of 35 million people, which has one of India's best health care systems.
West Bengal, which controversially just completed an eight-phase election, on Wednesday announced tighter curbs including a suspension of local trains. Weddings are still allowed, however, with a maximum of 50 people.
K. Vijay Raghavan, the Indian government's principal scientific advisor, said Wednesday that the country of 1.3 billion had to be ready for another wave of infections after the current one.
"Phase 3 is inevitable given the high levels of circulating virus. But it is not clear on what timescale this phase 3 will occur. We should prepare for new waves," Raghavan told a news conference.
With the government facing criticism as patients die outside hospitals, consignments of oxygen and equipment have been arriving from the United States, France, Britain, Russia and other countries in recent days.
But India will need yet more oxygen from other countries to fight the surge until numbers stabilise, another government official said Monday.
"We did not and do not have enough oxygen," the top government official said, speaking on condition of anonymity. "If we could get more oxygen more lives would be saved."
Overnight, 11 people died in a hospital near the southern city of Chennai after pressure dropped in oxygen lines, the Times of India reported, the latest in a string of similar incidents.
The International Federation of Red Cross and Red Crescent Societies called for "urgent" international action to prevent "a worsening human catastrophe" across South Asia.
It highlighted the case of Nepal, where it said "many hospitals are full and overflowing" with Covid-19 patients and the daily caseload is 57 times higher than one month ago.
The National Centre for Disease Control (NCDC) said on Wednesday meanwhile that the UK strain of Covid-19 was declining but that the Indian variant known as B.1.617 was being increasingly detected.
It stopped short of saying the Indian variant was to blame for the current rise.
"The current surge in cases over the last one and a half months in some states show a co-relation with the rise in the B.1.617 lineage", local media quoted NCDC chief Sujeet Singh as saying.
The World Health Organization (WHO) has said the B.1.617 variant has now been reported in more than a dozen countries.
But it has not said whether the variant is more transmissible, deadlier or able to evade vaccines.