Uttar Pradesh, which is predominantly rural, is the largest source state of internal migrant workers in India. The return of millions of labourers to their home villages from cities during lockdown is thought to be behind the spike in the number of cases.

While the Uttar Pradesh government is attempting to screen every household for symptoms by July 15 and says it is monitoring every returning migrant, the sheer number of returnees means many cases are being missed.

Residents will now only be able to access markets between Monday and Friday, as the state government hopes restricting non-essential travel on the weekend will slow the spread of coronavirus.

India’s public healthcare system is one of the most chronically underfunded in the world – annual spending is £12 per person – and hospital access is at its lowest in rural areas.

On average, there are only 0.2 public hospital beds per 1,000 people in rural India, with the World Health Organisation recommending a safe level of five beds to 1,000 citizens. 

In many states, the lack of hospital facilities means Covid-19 patients are already having to travel to multiple hospitals to find a bed, while a peak is still not predicted until November.

“Though India has been continually strengthening preparedness and response measures which include training health workers, readying hospitals, arranging and stocking-up medicines and essentials, we are aware of the varying capacities at the sub-national levels,” said Dr Poonam Khetrapal Singh, the WHO’s Regional Director for South-East Asia.

“Also, it’s not unusual in a country as big as India and its population size, that the measures taken may often not be uniformly sufficient across all areas.”

From today, a lockdown will also be re-implemented until further notice in many parts of the largest city in Indian-administered Kashmir, Srinagar.

Residents will only be permitted to leave their homes in an emergency, with shops and markets shut, after 78 Covid-19 deaths in the Kashmir Valley over the past 12 days. Health experts have warned hospitals in Srinagar would “crumble under pressure” if a lockdown wasn’t imposed to slow the spread of cases, with healthcare provision stunted after decades of conflict. 

So far the Indian Government has refused to consider a return to a nationwide lockdown after it previously caused economic devastation.

Between March 25 and June 1, Indians were unable to leave their homes unless they were purchasing groceries or medicines, leading to over 120 million people losing their jobs.

Instead, it is calling on state governments to identify local hotspots and set up containment zones until Covid-19 can be brought under control.

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