India's daily Covid-19 cases hit 400,000 as vaccine efforts stumble

India's devastating Covid-19 surge accelerated further on Saturday, with more than 400,000 new cases recorded in 24 hours.

This came as the country opened its faltering vaccination programme to all adults.

Indian authorities lowered their guard in the early part of the year after infections fell, lifting restrictions on most activity and allowing mass religious and political gatherings to take place.

Less than two months after Health Minister Harsh Vardhan said India was in the "end game" of the pandemic and New Delhi sent millions of vaccines abroad, the surge has sent worried Indians rushing for the doses still in the country.

A crowd of around 100 people formed outside one Delhi hospital on Saturday as a staff member came out regularly to call out the numbers of people who had booked.

"There are so many people that are getting sick ... so we just wanted to be here as soon as possible," said one of those waiting, Aadya Mehta, 25.

Following the recent surge, exports of the AstraZeneca vaccine produced by India's Serum Institute and Bharat Biotech's homegrown Covaxin have been frozen to prioritise India's needs.

Until now, only frontline workers, such as medical staff, people over 45 and those with pre-existing health conditions had been given vaccines.

Even this more modest programme has stumbled, with some areas running out of shots and others throwing them away because of a lack of demand.

But the recent surge has seen many people anxious to get vaccinated.

"The queues here are colossal," said Jayanti Vasant, as he waited for hours at a busy vaccination centre in Mumbai this week. "The people are just fighting among themselves."

So far around 150 million shots have been administered – equating to 11.5 per cent of the population of 1.3 billion people. Two shots have been given to 25 million people.

On Saturday, the programme was expanded to all Indians over 18, around 600 million people, even though many states said they have insufficient stocks to do so.

Millions of younger people, terrified by the current situation and desperate to get inoculated, have registered on the government's digital platform.

But very few have been given appointments. Only half a dozen of India's 28 states have begun vaccinating people under 45, and in many cases only on a token scale.

Further confusion has been created by the Indian government's decision to ask states and private hospitals to order vaccine supplies on their own, creating a three-tier pricing system that requires them to pay more per dose than the central government.

This has led to squabbles between the central government, run by Prime Minister Narendra Modi's Bharatiya Janata Party, and states governed by opposition parties.

Anecdotal evidence suggests that some private clinics have been told they won't receive any doses for months.

"The whole thing looks like a confused elephant to me right now," said T Jacob John, a retired clinical virology professor at the Christian Medical College Vellore, in the south-eastern state of Tamil Nadu.

"Do you want to control the epidemic, save lives or both? If you want both, you'll require a huge amount of vaccines. And we don't have it," Mr John told AFP.

He and other experts say that given the shortages –  and its huge population – India should have a much more targeted policy, concentrating vaccinations in hotspots.

Gujarat, in the north-west, is among the few states to have said they would do this, with Chief Minister Vijay Rupani saying on Friday that vaccinations for over-18s would happen only in the 10 worst-hit districts.

Serum is making 60-70 million AstraZeneca doses a month, and is aiming for 100 million by July. Bharat is aiming to produce 10 million a month and targets 60-70 million.

Indian firms also have deals to produce other shots including Russia's Sputnik V – some doses of which were due to arrive soon – and Johnson & Johnson's single-dose vaccine, but it could be months until these are deployed.