Indians struggled to register online for a mass vaccination drive set to begin next month as the country's toll from the coronavirus surged past 200,000 on Wednesday, worsened by shortages of hospital beds and medical oxygen.
The second wave of infections has seen at least 300,000 people test positive each day for the past week, overwhelming health facilities and crematoriums and fuelling an increasingly urgent response from allies overseas sending equipment.
The last 24 hours brought 360,960 new cases for the world's largest single-day total, taking India's tally of infections to nearly 18 million. It was also the deadliest day so far, with 3,293 fatalities carrying the toll to 201,187.
Experts believe the official tally vastly underestimates the actual toll in a nation of 1.35 billion, however.
"The situation is horrific, absolutely terrible, according to what I see. Everyone is afraid, every single person. People are afraid that if I am talking to a person, maybe I won't get to talk to them tomorrow or in the near future," New Delhi resident Manoj Garg said.
The World Health Organization said in its weekly epidemiological update that India accounted for 38% of the 5.7 million cases reported worldwide to it last week.
Early modelling showed that the B.1.617 variant of the virus detected in India had a higher growth rate than other variants in the country, suggesting increased transmissibility, it said.
The variants make for a perilous cocktail coursing through the world's second most populous country where people live in close proximity, often six to a room.
Search for vaccines
Experts said India's best hope to fight the pandemic was to vaccinate its vast population and on Wednesday it opened registrations for everyone above the age of 18 to be given jabs.
But the country, which is one of the world's biggest producers of vaccines, does not yet have the stocks for an estimated 600 million people becoming eligible, on top of ongoing effort to inoculate the elderly and people with other medical conditions.
People who tried to register said they failed.
"Tried registering and blocking a slot for vaccination," said Shourya Agarwal on Twitter. Failed multiple times."
Even those already eligible were struggling to find doses.
"They are telling us that injections are not available, as vaccines have not arrived," said Mumbai resident Pushpa Goswami at a vaccination centre. She said she registered three days ago.
The South Asia head of the International Federation of Red Cross and Red Crescent Societies, Udaya Regmi, said the world was entering a critical phase of the pandemic and needed to have vaccinations available for all adults as soon as possible.
"This is both an ethical and public health imperative," he added. "As variants keep spreading, this pandemic is far from over until the whole world is safe."
About 9% of India's population have received one dose since the campaign began in January with healthworkers and then the elderly.
Most of the shots are AstraZeneca made at the Serum Institute of India in the western city of Pune and a small proportion is Covaxin developed by local firm Bharat Biotech.
Meanwhile the search for life-saving treatment and dignity in death continued for those for whom any vaccination campaign will come too late.
Ambulances lined up for hours in the capital to take the bodies of Covid-19 victims to makeshift crematorium facilities in parks and parking lots, where bodies burned on rows of funeral pyres.
Hospitals in and around Delhi said oxygen remained scarce, despite commitments to step up supplies.
"We make hundreds of calls and send messages every day to get our daily quota of oxygen," Dr Devlina Chakravarty, of the Artemis hospital in the suburb of Gurgaon, wrote in the Times of India newspaper.
The Mayom Hospital nearby halted admissions unless patients brought oxygen cylinders or concentrators with them, its chief executive, Manish Prakash, told television channel NDTV.
Epidemiologist Bhramar Mukherjee said India must combine the immunisation drive with a widespread lockdown to slow the spread.
"At this point, lives are so much more important than livelihoods," the University of Michigan professor said on Twitter. "Provide assistance to the poor, but please lock down and vaccinate."
Delhi is under a lockdown until next week and the government of the western state of Maharashtra, home to financial capital, Mumbai, said it was considering extending its lockdown until mid-May.
Prime Minister Narendra Modi's government which imposed a severe lockdown on the country's 1.3 billion people when the pandemic struck last year has opposed such a measure because of the risk to an economic recovery that was under way before the second wave struck.
Credit rating agency S&P Global said India's second wave of infections could impede its economic recovery and expose other nations to further waves of outbreaks.
The Asia-Pacific region, in particular, was susceptible to contagion from the highly infectious variants in India, given the region's low ratios of vaccination, it added.