Covid-19 cases may hit 287,000 a day

India on Monday overtook Russia to record the world's third-highest number of coronavirus infections at nearly 700,000, even as its hardest-hit state said it will allow hotels to reopen.

Health ministry data from the world's second-most populous country showed more than 23,000 new cases on Monday, down slightly from Sunday's record increase of almost 25,000.

There have been 20,642 deaths in India since the first case was detected in January.

India now trails only the United States (3.05 million) and Brazil (1.67 million) in the number of Covid-19 cases and it has recorded eight times as many cases as China, where the virus was identified late last year.

But its death rate per 10,000 people is still a low 0.15, compared with 3.97 in the United States and 6.65 in the United Kingdom. Mainland China stands at 0.03.

Researchers at the Massachusetts Institute of Technology said on Tuesday that the worst of the Covid-19 pandemic is far from over and India might witness a huge surge in cases in the coming months unless a vaccine or a drug is found to control the disease.

According to them, India could be the worst-affected country in the world with 287,000 cases daily by the end of next year.

Officials said they had reversed a decision to reopen the Taj Mahal, India's most famous tourist attraction, in the city of Agra, following a rise in new cases in the area. Some other monuments in and around the capital New Delhi opened on Monday, albeit with very few visitors.

India is pushing ahead with relaxations to its more than two-month lockdown amid grim economic forecasts. Delhi, along with Maharashtra, home to India's financial capital Mumbai, and Tamil Nadu account for about 60 per cent of the total coronavirus cases in the country.

"With the spurt of cases that has happened in the last week, we are definitely entering a worrisome phase of the epidemic," said Dr Preeti Kumar, a vice-president at the Public Health Foundation of India.

"In India, this is a concentrated epidemic, it is very urban-centric. The way the virus has been spiking in our densely populated big cities indicates the epidemic will continue here for some time."

Maharashtra - the worst-hit state with nearly 210,000 cases - said it would let hotels outside containment zones reopen at 33 per cent capacity from Wednesday and issued guidelines for staff and guests.

India is also seeing an uptick in cases in states such as Kerala, Karnataka and Assam, which until recently had been relatively unscathed.

"This is showing up as an urban health challenge," said Dr Rajib Dasgupta, a professor of community health at the Jawaharlal Nehru University in New Delhi, noting it is exposing weaknesses in the public health system. Hospitals in densely populated cities such as Mumbai, Chennai and Delhi are struggling to cope with the epidemic.

Mumbai, which accounts for about a quarter of India's 20,100 deaths, has suffered a new surge in infections, forcing authorities to build makeshift hospitals and quarantine facilities.

Schools, hotels, a planetarium and a stadium used to host National Basketball Association games last year have all been repurposed and on Tuesday four new field hospitals - including 700 beds inside the Mahalaxmi horse racing track - were opened.

Health workers have complained about severe staff shortages, with some senior doctors and nurses avoiding the front lines because of their vulnerability to the virus due to age or conditions such as diabetes.

Dr Taha Mateen, managing director of the HBS hospital in Bengaluru, said in a video, which went viral, that it has "been a virtual bloodbath" in the ward, with only him and another doctor willing to work on Covid-19 cases. "I have beds, I have ventilators, I have all the equipment. I have another 30 beds like this but I don't have doctors working here," said Dr Mateen, pleading for other doctors to offer their services.

A study by the Indian Council of Medical Research has predicted India would not hit its Covid-19 peak until mid-November.

However, Dr Randeep Guleria, director of the All India Institute of Medical Science, was more optimistic about Delhi's prospects. "If the number of cases in Delhi continues to be static or decreases over the next few weeks, and the decline is at a sustained pace, then we can say that we may pass the peak in August," he said.

Reuters, AFP