NEW DELHI: The active COVID-19 cases in India breached the 11 lakh-mark for the first time after a record high of over 1.5 lakh new infections, threatening to stretch the health infrastructure to the brink, while a massive vaccination push, dubbed by Prime Minister Narendra Modi as the beginning of another major war against coronavirus, was launched on Sunday.
The active caseload was at its highest at 10,17,754 on September 18, 2020 and had dipped to 1,35,926 on February 12, 2021, before rising again.
Five states -- Maharashtra, Chhattisgarh, Karnataka, Uttar Pradesh and Kerala -- cumulatively account for 70.82 percent of India's active COVID-19 cases, while Maharashtra alone accounts for 48.57 percent, the Union Health Ministry said.
Amid an unprecedented burden on health infrastructure in 15 states and Delhi, which are witnessing an upward trajectory, authorities have started reserving more hospitals for COVID patients and taking steps to address any shortage of medical supplies, besides enhancing curbs on the movement of people.
The Centre announced a ban on export of Remdesivir, used in coronavirus treatment, and its Active Pharmaceutical Ingredients.
It also asked all domestic manufacturers to display on their website details of their stockists and distributors.
There were reports of shortage of drugs from states like Maharashtra, Madhya Pradesh and Gujarat.
India's COVID-19 tally of cases climbed to 1,33,58,805, and the death toll increased to 1,69,275 with 839 daily new fatalities, the highest since October 18, 2020, the data updated by Health Ministry on Sunday morning showed.
The total active caseload has increased to 11,08,087 and it now comprises 8.29 per cent of the country's total infections.
According to a PTI tally, the total cases had climbed to 1,35,09,746 by Sunday night, with 11,89,238 active cases.
While the cumulative number of COVID-19 vaccine doses administered in the country has crossed 10 crore after 85 days, the 'Tika Utsav' or a special 'vaccination festival' was started till April 14.
"Anyone eligible for the vaccine should get the jab, and for this the society and administration have to make full efforts," Prime Minister Modi said pitching for "zero vaccine waste" and urging the people to follow COVID-appropriate behaviour.
"This festival is, in a way, the beginning of another major war against corona. We have to lay special emphasis on personal hygiene as well as social hygiene," he said.
As the special drive was started, Congress and some other parties demanded a ban on the export of the vaccines, citing complaints of shortage by states, and the removal of age restriction on those eligible for the jab. At present, people above 45 years of age can get vaccinated.
Maharashtra and Andhra Pradesh have formally informed the Centre about their fast depleting stock of COVID-19 vaccines, while Chhattisgarh and Odisha said they too are facing a similar shortage.
In Odisha, authorities said at least 900 session sites remained shut on Sunday owing to shortage of COVID-19 vaccines, while West Bengal official said several hospitals have either stopped the inoculation drive or are using the limited stock available.
The Centre had earlier asserted that there was no shortage of vaccine and the performance of some of these states in the vaccination exercise was below par.
Among the states displaying an upward graph in daily new cases were Tamil Nadu, Madhya Pradesh, Gujarat, Haryana, Rajasthan, Punjab, Telangana, Uttarakhand, Andhra Pradesh and West Bengal.
Most of the such states have reimposed restrictions, including the closure of schools, night curfew, weekend and local shutdowns, while ruling out a total lockdown.
But as the latest wave of patients continues to flood hospitals, there are some signs of a rethink.
Maharashtra Chief Minister Uddhav Thackeray and his Delhi counterpart Arvind Kejriwal have said that a lockdown will be the only option if the infections don't abate and the health system shows signs of collapsing.
Kejriwal on Sunday said the COVID-19 situation in the national capital is "very serious". The city recorded 10,774 fresh COVID-19 cases on Sunday, the highest single-day spike so far, with 48 more fatalities.
"The fourth wave is more dangerous than the previous wave," he told a press conference, and urged the people not to step out unless there is urgent work.
The chief minister said that his government does not want to impose lockdown in Delhi but such a situation may arise if there is a rush to the hospitals and beds are unavailable for serious patients.
"We need your cooperation. If your cooperation is received and the situation of hospitals is under control, there will be no need to impose lockdown in Delhi. But, if beds in the hospitals fell short and are unavailable, then lockdown may have to be imposed," he said.
Speaking at an all-party meeting held virtually to discuss the COVID-19 situation in the state on Saturday, Maharashtra Chief Minister Uddhav Thackeray had indicated the imposition of a strict lockdown in the state given the alarming rise in COVID-19 cases.
"The number of patients is increasing so fast that if we do not decide on a lockdown today, a lockdown-like situation will automatically arise tomorrow," he said.
The state, which has already announced a slew of curbs, including night curfew, recorded 63,294 new coronavirus cases on Sunday, its highest single-day rise since the pandemic broke out.
As the number of active cases reaches a new high, states are grappling with the pressure on health facilities.
In Indore, Madhya Pradesh, kin of patients uploaded videos and messages on social media complaining about shortage of beds and key medicines like Remdesivir.
Indore District Medical and Health Officer Dr BS Satya said patient influx into local hospitals was very high, adding that 70 per cent of the 6,800 beds were occupied.
He said Remdesivir consignments were coming in at present and their distribution was taking place as per guidelines, though he admitted that supply was a problem, which should hopefully end soon.
Several areas in the state have been witnessing harried people queuing up outside medical stores for Remdesivir, a drug used in the treatment.
A senior Madhya Pradesh official on Sunday said a sizeable batch of the drug has arrived and will be distributed to medical facilities as per requirement.
The Chhatttisgarh government has directed that 80 percent of the total oxygen produced will be supplied for medical purposes to hospitals.
The state health department on Sunday issued a notification in this regard under the Epidemic Diseases Act.
Delhi government hospitals have been directed to engage fourth and fifth year MBBS students to meet the increased demand for manpower, while the tenure of senior and junior residents is being extended and vacant posts will be filled, officials said.
The Punjab Health Department has asked private hospitals to defer elective surgeries till April 30 to meet the increasing demand for beds and charge government-fixed rates for the treatment of coronavirus patients.
The Uttar Pradesh government announced imposition of night curfew in districts reporting over 100 daily cases or 500 active cases and extended closure of all schools till April 30.
At the meeting chaired by Chief Minister Yogi Adityanath, it was decided to conduct at least one lakh-PCR tests daily.
Ahead of Navratri and Ramzan, the state government has said that not more than five persons should be allowed to enter religious places.
The state recorded highest-ever single-day spike of 15,353 cases, while 67 fresh deaths pushed the toll to 9,152.
The Gujarat government has already imposed restrictions on people's movement during the night in 20 cities of the state, including Surat.
The latest surge of COVID-19 has also sparked concerns of a repeat of migrant workers' exodus from the worst affected states.
Industry sources in Tamil Nadu said the sector was recovering from the jolt of the first wave of coronavirus but now some workers have again reportedly left for their natives early last week as they feared being stranded if a lockdown was imposed.
A severe spike in COVID-19 cases in Mumbai and talk of a "complete lockdown" like last year, has made the national highway number 3 skirting past Madhya Pradesh's commercial hub Indore a prime route for wary migrants returning home to states like Uttar Pradesh and Bihar.
The number of motorcycles, black-and-yellow mini trucks and autorickshaws, teeming with migrants, have been on the rise over the past few days on a bypass road connected to this route, popularly known as Mumbai-Agra road.
"The virus outbreak has once again got very severe in Mumbai. There might be a lockdown and it may, like last year, render us jobless. So we have decided to return home," said Ramsharan Singh (40), who was on his way back to Ballia in Uttar Pradesh in an autorickshaw.
While there are no clear answers to the COVID flare-up, top scientists say the complex interplay of mutant strains, a hugely susceptible population made more vulnerable by elections and other public events and the lowering of guard are primarily to blame.
Virologists Shahid Jameel and T Jacob John said that not following COVID-19 protocol, including informing people they must continue with precautions even after being vaccinated, and a sluggish vaccination drive are among the factors responsible.
Jameel said the interplay of mutants and vaccines over the next couple of months will decide the future of Covid in India and the world.
The intensity of the surge also suggests that there were a huge number of susceptible people after the first wave, the director of the Trivedi School of Biosciences at Ashoka University in Haryana told PTI.
The Centre had warned last week that the next four weeks are critical.
In a blog addressed to the people of the country, the prime minister on Sunday urged them to remember four things, including "each one, vaccinate one"- helping those getting vaccinated who are less educated and elderly and who cannot go for the jab themselves, and "each one, treat one"- helping those who do not have the means or do not know about the facilities available for vaccination.
He also spoke of "each one, save one", saying emphasis should on wearing mask so as to save oneself and others too.
"Our success will be determined by our awareness of the micro containment zone. Our success will be determined by not leaving the house when there is no need. Our success will also depend on whether we wear masks and follow other rules," he said, adding that it will also depend on getting those eligible for vaccine inoculated.