India coronavirus cases surge past one million mark as deaths hit new record

India is world's third-worst affected country, and cases continue to rise at alarming rate

The number of confirmed coronavirus cases in India has crossed one million, the country's health ministry said early on Friday, after states reported large daily increases.

Government data showed another 34,956 cases were added in the last 24 hours, as well as a new record daily death toll of 687.

India is now the third-worst affected country in the world in terms of coronavirus cases, having overtaken Russia 10 days ago. Some forecasts suggest that with its huge population and fragile health system, India could end up with the world's worst outbreak by the end of 2021.

The outbreak in India was significantly delayed after prime minister Narendra Modi ordered one of the world's strictest nationwide lockdowns. But cases have soared since the measures were lifted to save the country's floundering economy, and a number of states and cities are now reimposing their own local lockdowns to try and bring the situation back under control.

The country's total tally ticked above one million to 1,003,832 overnight as states declared their tallies for Thursday - but the landmark was conspicuously absent from the Ministry of Health's updates on social media.

The ministry instead highlighted the number of active Covid-19 cases in the country, which it said was falling as a percentage of total cases at just over 331,000. It called this the country's "actual Covid caseload today".

And in another Twitter post on Friday morning, officials observed that on a per capita basis, India's 658 cases per million people was 16 times lower than the US, and ranks the country 106th in the world.

Mr Modi and his administration have repeatedly touted their success in locking down the country early, even as surges in major cities like Delhi and Mumbai have threatened to overwhelm hospitals.

The government was strongly criticised for a lack of testing in the early stages of the outbreak, but has since loosened its strict testing criteria and is now second in the world on number of people checked for Covid-19, behind only the US.

Experts warn that while the outbreaks in some major cities appear to have peaked, other states are yet to see the worst of the outbreak. Dr Anant Bhan, a global health researcher, told the Associated Press that India was likely to see "a series of peaks," as the infection spread in rural areas.

Bihar, an eastern state with a population of 128 million people that is one of India's poorest and least developed, announced a new two-week lockdown to contain the virus on Thursday.

A number of states, including most populous Uttar Pradesh and the wealthy coastal tourist destination Goa, have ordered weekend curfews in a bid to reduce social mixing while keeping up economic activity.

The city of Chennai is only just emerging from a second strict lockdown, imposed after a spike in cases in Tamil Nadu saw it become the worst-affected southern state.

And the city of Bangalore, the tech hub of India, ordered another week-long local lockdown from Tuesday after cases continued to jump.

How did India get to one million cases?

India confirmed its first case on 30 January, at a time when there were already large numbers of suspected infections under observation in several travel hubs including Delhi.

The first confirmed patient was a female student returning to Kerala state from university in Wuhan, China, where Covid-19 is believed to have originated.

Kerala would go on to have some of the earliest clusters of cases in India, including in an Indian family visiting from the Middle East, but the state’s strong health system helped it keep a tight control of the situation. Today Kerala has had just over 10,000 cases and only 37 deaths.

Confirmed cases rose very slowly, in part because of a lack of testing. At the end of January there was still just a single lab in the country able to test for Covid-19, and even as capacity increased the government stuck by strict protocols making it very difficult for suspected cases to qualify for a test.

India banned international travellers from entering the country on 12 March, at a time when there were still only 72 confirmed cases. The move was considered at the time to be one of the most cautious responses by a national government, and suggested the Modi administration had a good idea that the reality was considerably worse than the official figures would suggest.

On 13 March, the country reported its first death of a Covid-19 patient, in a case which highlighted the vulnerabilities of the Indian public health response. It involved a 76-year-old man who travelled back to Karnataka state from Saudi Arabia, and whose family was able to transfer him around several hospitals after he started displaying clear symptoms.

By 20 March, experts were already warning that India likely had a huge number of undetected cases, criticising the lack of testing for leaving the country to fight the crisis blind. One expert said modelling suggested there would be as many as 300 million cases by the end of July.

Prime minister Modi announced what was initially a three-week national lockdown on the evening of 23 March, just four hours before it was to be enforced.

The lockdown was, compared to similar measures around the world, exceptionally strict. From 24 March, all of the country’s 1.4 billion people were told they could only leave their homes to buy essential food and medicine, with exemptions only for key workers like healthcare personnel. There was no concept of daily exercise, and a mandatory order for masks to be worn at all times outside the home would follow.

The lockdown slowed down the virus spread - but had a devastating economic and humanitarian cost. Thrust out of work with hours’ notice and no clear reassurances of support from government, millions of migrant labourers started flooding out of cities to return to their home states and villages. Scores of people died making dangerous journeys, often covering hundreds of miles on foot due to the suspension of public transport.

The measures were extended for another five weeks once the initial period expired, as India looked on with horror at the speed of the virus’s spread elsewhere in the world.

But by May the government decided it had no choice but to reopen the country, even with cases rapidly rising. Restrictions were loosened gradually week by week, until the reopening of malls, restaurants and religious gatherings on 8 June suggested the lockdown was over in all but name. At this point the country had already jumped above Italy and Spain into fifth in the world with 258,000 cases.

India hit the half a million cases mark on Saturday 27 June, almost five months after its first confirmed case. It took less than three weeks for cases to then double to one million.

Researchers at the Massachusetts Institute of Technology (MIT) predicted in a paper last week that India will have the highest daily new coronavirus cases in the world by February 2021, and that it will overtake the US and Brazil in terms of absolute cases by the end of that year.