India’s confirmed coronavirus total has passed seven million as health experts warn of mask and distancing fatigue setting in.

The Health Ministry registered another 74,383 infections in the past 24 hours, and India is expected to become the pandemic’s worst-hit country in coming weeks, surpassing the US, where more than 7.7 million infections have been reported.

The ministry also reported 918 additional deaths, taking total to 108,334.

The number of people who have died has remained relatively low in south and south-east Asia — from India to Vietnam and Taiwan — compared with European countries and the US, said Dr Randeep Guleria, a government health expert.

“We have been able to keep the curve rise slow, but I do agree that we have not been able to get it to move aggressively down. That’s related to our population density, diversity of our country and socioeconomic challenges in our country,” said Dr Guleria, referring to India’s population of nearly 1.4 billion.

HEALTH Coronavirus
(PA Graphics)

Some experts say India’s death toll may not be reliable because of poor reporting and health infrastructure and inadequate testing.

India aims to provide vaccines to 250 million people by next July, health minister Harsh Vardhan said last week. He said the government was planning to receive 450 million to 500 million vaccine doses and would ensure “equitable access”.

India saw a steep rise in cases in July and added more than two million in August and another three million in September, but it is seeing a slower pace of spread since mid-September, when daily infections touched a record of 97,894.

It is averaging more than 70,000 cases daily so far this month. India has a high recovery rate of 85% with active cases below a million, according to the Health Ministry.

Health officials have warned about the potential for the virus to spread during the upcoming religious festival season, which is marked by huge gatherings in temples and shopping districts.

A crucial factor will be people wearing masks and maintaining a safe distance.

Used rapid test kits in New Delhi
Used rapid test kits in New Delhi (Altaf Qadri/AP)

Dr SP Kalantri, a hospital director in the village of Sevagram in India’s worst-hit western Maharashtra state, said people in his village had stopped wearing masks, maintaining distance or washing their hands regularly.

India’s health resources are poorly divided across the country. Nearly 600 million Indians live in rural areas, and with the virus hitting India’s vast hinterlands, experts worry that hospitals could be overwhelmed.

“If we are able to have good behaviour in terms of physical distancing and masks, maybe by early next year we should be able to come to a new normal. Covid-19 will not finish but it will be under reasonable control with travel and other things becoming much more easier and people relatively safer,” said Dr Guleria.

Retired virologist Dr T Jacob John said there was an increasing tendency among Indians not to wear masks or maintain distancing.

Social media has compounded the problem by propagating misinformation and fake cures. “And the result of this is that people have gotten fed up and have started making their own conclusions,” Dr John said.

India is testing more than a million samples per day, exceeding the World Health Organisation’s benchmark of 140 tests per million people, but many of these are antigen tests, which look for virus proteins and are faster but less accurate than RT-PCR, which confirm the coronavirus by its genetic code.

With the economy contracting by a record 23.9% in the April-June quarter, leaving millions jobless, the Indian government is continuing to relax lockdown restrictions that were imposed in late March. The government in May announced a 266 billion dollar (£204 billion) stimulus package, but consumer demand and manufacturing are yet to recover.

A large number of offices, shops, businesses, stores, bars and restaurants have reopened. Restricted domestic and international evacuation flights are being operated along with train services.

Meanwhile, Iran has announced its highest single-day death toll at 251.

Health Ministry spokesperson Sima Sadat Lari said this pushes the total confirmed death toll to 28,544, making it the hardest-hit country in the region.

A further 3,822 new cases were confirmed over the past 24-hour period, raising total nationwide recorded cases to 500,075. Nearly 4,509 patients are in critical condition.