India’s crematoriums and burial grounds are being overwhelmed by the new surge of infections, depleting the supply of life-saving oxygen cylinders to critical levels.
The disaster has seen patients left to die, even as they wait in line to see doctors.
For the fourth consecutive day, India on Sunday set a global daily record for new Covid-19 infections, spurred by a variant that has emerged in the country.
On Sunday, the UK and Germany joined the US in pledging to send medical aid, including oxygen concentrators and ventilators, to support buckling health services.
The 349,691 confirmed cases over the past 24 hours took India’s total to more than 16.9 million, second only to the US.
The Health Ministry reported another 2,767 deaths in the past 24 hours, taking India’s Covid-19 toll to 192,311.
Experts say the real toll could be much higher, as suspected cases are not included and many deaths from the infection are being attributed to underlying conditions.
The crisis unfolding in India is most evident in its graveyards and crematoriums, and in heartbreaking images of gasping patients dying on their way to hospitals because of the lack of emergency oxygen.
Burial grounds in the capital New Delhi are running out of space and glowing funeral pyres light up the night sky in other badly hit cities.
At New Delhi's Bhadbhada Vishram Ghat crematorium, workers said they cremated the remains of more than 110 people on Saturday, even though government figures for the entire city of 1.8 million put the total number of virus deaths at 10.
“The virus is swallowing our city’s people like a monster,” said Mamtesh Sharma, an official at the site.
This number of bodies has forced the crematorium to stop individual ceremonies and rituals that Hindus believe release the soul from the cycle of rebirth.
“We are just burning bodies as they arrive,” Mr Sharma said. “It is as if we are in the middle of a war.”
Mohammad Shameem, head grave digger at New Delhi’s largest Muslim cemetery, where 1,000 people have been buried during the pandemic, said: “I fear we will run out of space very soon."
The situation is equally grim at hospitals, where desperate people are dying in queues, sometimes on the roads outside.
Health officials are urgently trying to expand intensive care units and stock up on dwindling supplies of oxygen.
Hospitals and patients are struggling to procure scarce medical equipment that is being sold at a high mark-up price.
The crisis is in contrast to government claims made on Saturday by Solicitor General Tushar Mehta that “nobody in the country was left without oxygen".
The breakdown is a stark failure for a country whose prime minister in January declared victory over Covid-19, and which boasted of being the “world’s pharmacy” – a global producer of vaccines and a model for other developing nations.
Caught off-guard by the latest surge, the federal government has asked industrialists to increase the production of oxygen and life-saving drugs that are also in short supply.
But health experts say India had a year to prepare for the inevitable and failed to.
Dr Krutika Kuppalli, assistant professor of medicine in the division of infectious diseases at the Medical University of South Carolina in the US, said the Indian government should have used the last year, when the virus was more under control, to plan for a surge.
It should have “stockpiled medication and developed public-private partnerships to help with manufacturing essential resources in the event of a situation like this”, Dr Kuppalli said.
Modi under fire
Prime Minister Narendra Modi is under increasing criticism for allowing Hindu festivals and attending huge election rallies that experts suspect accelerated the spread of infections.
With the death toll mounting, Mr Modi’s Hindu nationalist government is trying to quell critical voices.
On Sunday, he urged all citizens to be vaccinated and exercise caution, saying a "storm" of infections had shaken the country.
"We were confident, our spirits were up after successfully tackling the first wave, but this storm has shaken the nation," Mr Modi said in a radio address.
Arvind Kejriwal, the Chief Minister of New Delhi, extended by a week lockdown that was due to end on Monday, to try and stem the transmission of the virus.
"A lockdown was the last weapon we had to deal with the coronavirus but with cases rising so quickly we had to use this weapon," Mr Kejriwal said.
The Ministry of Ports, Shipping and Waterways said it directed all major ports to give the highest priority in berthing to ships with consignments of medical-grade oxygen, oxygen tanks and bottles, portable oxygen generators and oxygen concentrators.
White House National Security Adviser Jake Sullivan on Sunday said the US was “deeply concerned” by the severe Covid-19 surge in India.
“We are working around the clock to deploy more supplies and support to our friends and partners in India as they bravely battle this pandemic,” Mr Sullivan tweeted.
Help and support also appeared to arrive from arch-rival Pakistan, with politicians, journalists and citizens in the neighbouring country expressing support for people in India.
Pakistan’s Foreign Affairs Ministry said it had offered to provide relief support including ventilators, oxygen supply kits, digital X-ray machines, personal protection equipment and related items.
It said authorities of both countries can work out strategies for a quick delivery of the items and explore possible ways of further co-operation to mitigate the challenges posed by the pandemic.
Prime Minister Imran Khan in a tweet prayed for the “speedy recovery of the Indian people affected by the virus”.