As India Loosens Its Strict Lockdown, Coronavirus Deaths Jump Sharply

But in the last few days, the government has loosened up the rules, drawing people into the streets. And now the dangerous contagion appears to be spreading more aggressively.

The doubling rate of infections — the amount of time it takes for the number of coronavirus cases to double — has dropped from around 12 days to 9.5. The daily death rate has shot up from a few dozen in mid-April to more than 100 now.

This is still a long way from the devastating toll that the United States and several European countries have been enduring. The total number of reported infections in India is around 50,000, giving it a much lower per capita case rate than many other countries.

But a tour of Delhi shows how much has changed just this week.

The streets of working-class neighborhoods that last week were deserted are thronged with people. Bicycle rickshaws dart in and out of traffic. Pedestrians flow down the sides of the road. Most wear masks, as required, but many wear them off their chins with their noses and sometimes even their mouths exposed.

At liquor stores, which reopened Monday for the first time in six weeks — the government was desperate for liquor tax revenue — there is nothing close to social distancing. Instead, there is utter chaos.

Police officers try to beat back the crowds with long sticks, but it’s no use. The crowds just keep growing, with lines at stores sometimes stretching nearly a mile. At one shop in Delhi on Tuesday, hundreds of men converged to buy whiskey, pushing and shoving to get closer to the front, crumpled bills in their fingers, wild looks in their eyes. Many packed so close to each other that they rested their hands on the sweaty backs of people in front of them.

As the heat rises — it hit 104 degrees in New Delhi a few days ago — people who live in cramped quarters, sometimes eight to a room, are finding it unbearable to stay indoors as the government has ordered. So they spill outside. They mingle in the streets. They gather.

“There’s no police around, nobody is enforcing the lockdown, people are out everywhere,” said an exasperated Delhi shopkeeper who goes by one name, Mehtab.

The virus’s hot spots are India’s crowded urban areas, especially New Delhi, the political capital, and Mumbai, the business capital. About a third of all reported infections are from these two cities, each home to around 20 million people.

In Mumbai, the police officers enforcing the lockdown seem exhausted, and withdraw from neighborhoods at night.

“Every night when the police leave, the people get out as if there is a party,” said Rakhi Jadhav, a local representative in eastern Mumbai.

Dharavi, one of Mumbai’s biggest slums, where a million or so people are squeezed into less than one square mile of shacks and narrow alleyways, is emerging as a serious concern. At least 600 residents there have been infected and it’s nearly impossible to socially distance. People live face to face and share communal toilets, often dozens of people using just one.

Across the city, people are watching Dharavi closely. Officials are beginning to worry they might not have the resources they need to prevent a much wider outbreak.

“Testing labs, beds, facilities — they are all being overburdened with asymptomatic and mildly infected patients,” said Pradip Awate, an epidemiologist and chief surveillance officer in Maharashtra state, home to Mumbai.

Many Indians obeyed the rules, wary of catching the virus and not trusting India’s beleaguered health care system to save them.

Many out-of-work laborers are still marooned in India’s cities with no source of income and no way to feed their families except for meals provided by charities or the government.

With the pressure building, the central government and many states loosened up the lockdown rules this week, allowing small wedding ceremonies to resume, buses to operate and many businesses to open, including salons, pet shops and electrical stores.

So now Indians are wondering if the easing of the lockdown has led to the surge in reported infections or if this is the right time, with cases already rising, to allow people to interact more easily. The increase in reported infections could also be from an increase in the number of tests, from about 20,000 in late March to more than a million today. India has reported just one positive case for every 25 tests, compared with one infection for every six tests in the United States.

Still, Dr. S.D. Gupta, a public health expert and a member of the government’s Covid-19 task force, said testing would need to ramp up significantly to capture the full scope of India’s coronavirus outbreak.

Dr. Gupta said it was difficult to say whether India was in the midst of experiencing a dangerous upward trajectory of new cases. But he warned that the country’s growth curve of new infections had still not peaked. With so many asymptomatic patients unaware of their status, he said, officials needed to remain especially vigilant as more restrictions were eased in the coming weeks.

“What we are seeing is the tip of the iceberg,” he said. “Unless we do testing, we will never know how many cases we have. That’s a problem.”

Suhasini Raj and Hari Kumar contributed reporting.

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