Last checked at 
* New cases rise by over 300,000 for 12th consecutive day
* Ratio of positive cases to tests drops for 1st time since
Apr 15
* Peak in cases may come May 3 to 5, modelling shows
* Epidemiologist calls for stay at home order, medical
emergency
(Writes through)
By Adnan Abidi and Shilpa Jamkhandikar
NEW DELHI/MUMBAI, May 3 (Reuters) - India postponed exams
for trainee doctors and nurses on Monday, freeing them up to
fight the world's biggest surge in coronavirus infections, as
the health system crumbles under the weight of new cases and
hospitals run out of beds and oxygen.
The total number of infections so far rose to just short of
20 million, propelled by a 12th straight day of more than
300,000 new cases in a pandemic sparked by a virus first
identified in central China at the end of 2019.
Medical experts say actual numbers in India could be five to
10 times higher than those reported.
Hospitals have filled to capacity, supplies of medical
oxygen have run short, and morgues and crematoriums have been
overloaded with corpses. Patients are dying on hospital beds, in
ambulances and in carparks outside.
"Every time we have to struggle to get our quota of our
oxygen cylinders," said B.H. Narayan Rao, a district official in
the southern town of Chamarajanagar, where 24 COVID-19 patients
died, some from a suspected shortage of oxygen supplies.
"It's a day-to-day fight," added Rao, as he described the
hectic scramble for supplies.
In many cases, volunteer groups have come to the rescue.
Outside a temple in the capital, New Delhi, Sikh volunteers
were providing oxygen to patients lying on benches inside
makeshift tents, hooked up to a giant cylinder. Every 20 minutes
or so, a new patient came in.
"No one should die because of a lack of oxygen. It's a small
thing otherwise, but nowadays, it is the one thing every one
needs," Gurpreet Singh Rummy, who runs the service, told
Reuters.
Total infections since the start of the pandemic have
reached 19.93 million in India, swelled by 368,147 new cases
over the past 24 hours, while the death toll rose by 3,417 to
218,959, health ministry data showed. At least 3.4 million
people are currently being treated.
Offering a glimmer of hope, the health ministry said
positive cases relative to the number of tests fell on Monday
for the first time since at least April 15.
Modelling by a team of government advisers shows coronavirus
cases could peak by Wednesday this week, a few days earlier than
a previous estimate, since the virus has spread faster than
expected.
At least 11 states and regions have ordered curbs on
movement to stem infections, but Prime Minister Narendra Modi's
government, widely criticised for allowing the crisis to spin
out of control, is reluctant to announce a national lockdown,
concerned about the economic impact.
"In my opinion, only a national stay at home order and
declaring medical emergency will help to address the current
healthcare needs," Bhramar Mukherjee, an epidemiologist with the
University of Michigan, said on Twitter.
CRISIS TESTS MODI
As medical facilities near breaking point, the government
postponed an exam for doctors and nurses to allow some to join
the coronavirus battle alongside existing personnel, it said in
a statement.
In Pune, the second-largest city in the state of Maharashtra,
Dr. Mekund Penurkar returned to work just days after losing his
father to COVID-19. His mother and brother are in hospital with
the virus, but patients are waiting to see him.
"It is a very difficult situation," he said. "Because I have
been through such a situation myself, I can't leave other
patients to their fate."
Modi has been criticised for not moving sooner to limit the
spread and for letting millions of largely unmasked people
attend religious festivals and crowded political rallies in five
states during March and April.
In early March, a forum of government scientific advisers
warned officials of a new and more contagious variant of the
coronavirus taking hold, five of its members told Reuters.
Despite the warning, four of the scientists said the federal
government did not seek to impose major curbs.
With the next general election due in 2024, it remains to be
seen how the pandemic might affect him or his party. His Hindu
nationalist party was defeated on Sunday in a state poll in the
eastern state of West Bengal, although it won in the
neighbouring state of Assam.
Leaders of 13 opposition parties urged Modi in a letter on
Sunday to immediately launch free national vaccinations and to
prioritise oxygen supplies to hospitals and health centres.
Despite being the world's biggest producer of vaccines,
India does not have enough for itself. Just 9% of a population
of 1.35 billion has received a dose.
Daily shots have fallen sharply from an all-time high
reached early last month as domestic companies struggle to boost
supplies. Vaccination centres in Mumbai were
deserted after the state government said it did not have enough
supplies to administer second doses for adults above 45.
Only limited doses were available for those aged 18-44 and
no walk-ins were allowed.
India has struggled to increase capacity beyond 80 million
doses a month due to a lack of raw materials and a fire at the
Serum Institute, which makes the AstraZeneca vaccine.
Another manufacturer, Pfizer Inc, is in talks with
the government for "expedited approval" of its vaccine, Chief
Executive Albert Bourla said on LinkedIn, announcing a donation
of medicines worth more than $70 million.
Last month, India said its drugs regulator would hand down a
decision within three days on emergency-use applications for
foreign vaccines, including that of Pfizer.
International aid has poured in in response to the crisis.
Britain will send another 1,000 ventilators to India, the
government said on Sunday. Prime ministers Boris Johnson and
Modi are set to talk on Tuesday.
The Indian COVID-19 variant has now reached at least 17
countries including Britain, Iran and Switzerland, spurring
several nations to close their borders to travellers from India.
(Reporting by Tanvi Mehta and Anuron Kumar Mitra; Additional
reporting by Sachin Ravikumar in Bengaluru; Writing by Michael
Perry and Nick Macfie; Editing by Lincoln Feast, Clarence
Fernandez, Raju Gopalakrishnan and Hugh Lawson)
