NEW DELHI: Relatives attend the funeral of a COVID-19 victim at a crematorium. Adnan Abidi/Reuters

India’s COVID-19 Crisis Is What the World Feared

India is suffering the world’s largest COVID-19 surge, and the effects are reverberating worldwide as the country restricts its vaccine exports. International offers of aid are multiplying.

NEW DELHI: Relatives attend the funeral of a COVID-19 victim at a crematorium. Adnan Abidi/Reuters

No country has experienced as devastating a wave of COVID-19 infections as India is now. It set a new record for single-day infections last week, overtaking the United States, and it accounts for almost half of new cases worldwide. Experts say a combination of factors gave rise to the explosion in cases: new variants of the virus, including one first detected in India, that are thought to be more transmissible; a weak government response; and large public gatherings. Images from across the country show the tremendous toll.

A crowd of Hindu holy men take a holy dip in the Ganges River
HARIDWAR: State governments allowed large religious gatherings, such as this one during the Kumbh Mela, or Pitcher Festival, despite the spike in infections in April. Anushree Fadnavis/Reuters
SILIGURI: Political parties continued to hold rallies, such as this one for the All India Trinamool Congress in a village on the outskirts of the city, without enforcing social distancing or mask wearing. Diptendu Dutta/AFP/Getty Images

A Health System Buckles

The nearly vertical curve in COVID-19 cases has overwhelmed health facilities. Hospitals have run out of beds and oxygen supplies are exhausted, leaving many without access to a critical form of treatment.

The average deaths per day are nearing 2,500, and the number continues to climb, pushing cremation facilities and cemeteries past their limits. Overall, the Indian government has reported around 195,000 deaths from COVID-19, but analysts say the total is likely much greater.

A man fans his mother who is receiving oxygen,  in the back of a car
GHAZIABAD: Manoj Kumar sits beside his mother, Vidhya Devi, as she receives oxygen inside her car at a Sikh temple. The temple began offering free oxygen to hundreds of patients desperate for relief as they waited for hospital beds. Danish Siddiqui/Reuters
A sick women lays down on the sidewalk front of a COVID-19 hospital in Kolkata
KOLKATA: The scene in front of a hospital for COVID-19 patients. Debarchan Chatterjee/NurPhoto/Getty Images
NEW DELHI: Relatives of a COVID-19 victim mourn at a crematorium. Adnan Abidi/Reuters
AHMEDABAD: Outside a mortuary, a woman mourns with her son after her husband died from COVID-19. Journalists and health experts warn that the number of dead is being severely undercounted as officials try to prevent panic. Amit Dave/Reuters

Experts say that in the months before this surge, while the outbreak was under control and reported cases were low, Prime Minister Narendra Modi’s government missed an opportunity to bolster a weak and chronically underfunded health system. A failure to coordinate a national response, mixed messaging around safety measures, and low testing rates all contributed to the current catastrophe, they say. The government is now accused of censoring online criticism about how it has managed the outbreak, with officials countering that they are combating pandemic-related misinformation.

Cemetary workers wearing PPE suits sort logs of wood for the funeral pyres
NEW DELHI: Cemetery workers at a crematorium on the outskirts of the capital move logs for funeral pyres needed to perform the last rites of COVID-19 victims. Some residents say they had to keep their loved ones’ bodies at home for days while they searched for space at cremation facilities. Anindito Mukherjee/Getty Images
A drone shot of a mass cremation of victims who died due to the coronavirus disease
NEW DELHI: Some crematoriums are continuously running their furnaces. Facilities have begun performing mass cremations, such as this one in the capital city. Danish Siddiqui/Reuters

A Global Vaccine Dilemma

The ripple effects of such a devastating surge are being felt beyond India, which is among the world’s top vaccine suppliers. The country has effectively halted its vaccine exports, and the Serum Institute of India—the world’s largest vaccine maker—said it will not be able to deliver tens of millions of doses of the Oxford-AstraZeneca vaccine to the global COVAX initiative due to increased demand at home. Many low- and middle-income countries are relying on the Serum Institute for their COVAX vaccine deliveries.

MUMBAI: Notices announcing that Covishield, the India-made version of the Oxford-AstraZeneca vaccine, is out of stock are taped outside a vaccination center. The central government announced it would provide hundreds of millions of dollars to ramp up manufacturing amid a severe vaccine shortage. Indranil Mukherjee/AFP/Getty Images

A Global Response Mobilizes

Many parts of India, including the capital city of New Delhi and tech hub Bengaluru, have imposed prolonged lockdowns to try to get a handle on the outbreak. Cities are also reopening field hospitals used earlier in the pandemic, and the central government is diverting oxygen supplies from the military and industries to the health-care system. The armed forces have also been deployed to assist the national response.

A deserted view of Sadar Bazar wholesale market
NEW DELHI: The Sadar Bazar wholesale market is deserted amid the capital city’s lockdown, which allows only essential services to remain open and was extended another week as the outbreak raged. Naveen Sharma/SOPA Images/LightRocket/Getty Images

Other countries are rallying to provide aid. Australia, China, Pakistan, the United Kingdom, and the United States are among those that have pledged assistance or already sent medical equipment. President Joe Biden announced that the United States will release vaccine-manufacturing materials that had been under export restrictions, as well as deliver its stock of the Oxford-AstraZeneca vaccine to other countries in need of doses, likely including India. The World Health Organization is also boosting its support.

A worker seen refilling medical oxygen cylinders at a charging station
NEW DELHI: Countries including Germany and Saudi Arabia have provided oxygen generation plants and liquid oxygen amid severe shortages. Here, a worker refills oxygen cylinders at a charging station. Naveen Sharma/SOPA Images/LightRocket/Getty Images

Additional Resources

For the Atlantic, Yasmeen Serhan explains why the outbreak in India is everyone’s problem.

PBS Newshour shows India’s health-care system on the brink of collapse.

A worker at New Delhi’s largest crematorium speaks with VICE News.

Quartz India and TIME offer ways to help India fight the crisis.

Mandakini Gahlot writes in Foreign Affairs that Indians are paying the price for government inaction.