A healthcare worker checks the temperature of a man at a slum in Mumbai. Photo: Himanshu Bhatt/NurPhoto

India has taken the lead in new Covid-19 cases as the virus spreads to smaller towns and villages.

Almost half its total of 3.38 million cases came in August and the country is fast narrowing the gap with Brazil’s 3.76 million. The United States remains the worst affected with 6.05 million cases.

On Thursday, India added a record 76,826 cases, the second day running with more than 75,000. It accounts for 28% of daily new cases worldwide and 13.7% of the global total of 24.6 million cases.

The new challenge has emerged from smaller towns and villages, which typically face a lack of hospital facilities, especially specialized medical personnel with qualifications and the ability to contain the virus. The initial infection was spread by migrant workers from cities. Now, it’s the lack of general hygiene, awareness and social discipline.

Adding to the spread is relaxation of lockdowns in several states and cities, mask fatigue, especially among the youth and the ignorant. Absence of hand hygiene, caution in touching anything exposed to the public, and absence of social distancing is hastening the spread of the virus.

The start of the festival season is also making the task of law enforcers tougher. Administrators and politicians prefer to remain as low-key as possible dealing with sensitive issues such as religion and festivals.

Some of the biggest Hindu festivals began in August, starting at the beginning of the month. Coincidentally, lockdown relaxations took place mainly after July. Lockdowns from March through mid-July were quite severe.

The 10-day Ganesh festival in western India is the biggest after Diwali and attracts hundreds of thousands of people arranging flowers, decorations, idols, or being part of the crowd taking the idol for immersion. Large crowds are seen at congested bazaars even though the government has drastically curtailed celebrations.

Sensing an imminent threat of cases flaring up, states such as West Bengal have extended the lockdown, while many others are not relaxing their restrictions. This is so in Maharashtra, which leads the nationwide tally with 733,000 cases and 23,444 deaths, or about two-fifth of the national toll.

Maharashtra, which has as its capital the country’s main commercial city of Mumbai, is likely to extend the lockdown restrictions, which are up for review this weekend. Mumbai’s suburban railways, which carry about six million commuters daily, are likely to remain shut as is the municipal bus system.

Undeterred, the Indian government keeps highlighting the positive side.

Nationally, 76% or 2.6 million people have recovered out of the 3.38 million infected. About 22% are still sick and only 0.26% of them are critically ill.

India has increased the number of house-to-house surveys following the motto of “test, track and treat”. In all, India has conducted 40 million tests, close to the highest in the world, and a level similar to the United States. It has increased the number of daily tests to more than 900,000.

After the initial shortage of medical facilities, all state governments ramped up their infrastructure. The country now has 1,723 dedicated Covid hospitals, 3,883 dedicated health centers, 11,689 care centers, 15.9 million isolation beds, 2.2 million oxygen supported beds and 57,380 ICU beds for the severely affected.

Avoiding the mistakes of European countries and the US, India kept its elderly locked up in safety and ensured a low fatality rate.

There was an unexpected positive between April and July, the phase of the serious lockdown. The Times of India citing a survey reported that serious crimes against women halved.