India’s ever-spreading virus outbreak surpassed 4 million cases.

Reach of virus extends to every part of nation

NEW DEHLI — India’s coronavirus caseload surpassed 4 million on Saturday, deepening misery in the country’s hinterlands, where surges have crippled the underfunded health care system.

Initially the virus ravaged India’s sprawling and densely populated cities. It since has stretched to almost every state, spreading through villages and small towns.

With a population of nearly 1.4 billion, India’s massive caseload isn’t surprising experts. The country’s delayed response to the virus forced the government to implement a strict lockdown in late March. For more than two months, the economy remained shuttered, buying time for health workers to prepare for the worst.

But with the cost of the restrictions also rising, authorities saw no choice but to reopen businesses and everyday activities.

Most of India’s cases are in western Maharashtra state and the four southern states of Tamil Nadu, Andhra Pradesh, Telangana and Karnataka. But new surges are popping up elsewhere.

The 86,432 cases added in the past 24 hours pushed India’s total to 4,023,179. Brazil has confirmed 4,091,801 infections, and the U.S. has had 6,200,186 cases, according to Johns Hopkins University.

India’s Health Ministry on Saturday reported 1,089 deaths for a total of 69,561.

Even as testing in India has increased to over a million a day, a reliance on screening for antigens or viral proteins is creating more problems. The tests are cheaper and yield faster results but aren’t as accurate. The danger is that the tests might falsely clear many who are infected.

In Uttar Pradesh, India’s most populous state, the situation is already grim. With a total 253,175 cases and 3,762 deaths, the heartland state is staring at an inevitable surge with a shortage of hospital beds and other health infrastructure.

Sujata Prakash, a nurse in the state capital, Lucknow, recently tested positive for the coronavirus. But the hospital ward where she worked refused her admission because there was no empty bed. She waited for over 24 hours outside the surgical ward before she was allotted one.

“The government can shower flower petals on the hospitals in the name of corona warriors, but can’t the administration provide a bed when the same warrior needs one?” said Prakash’s husband, Vivek Kumar.

In rural Maharashtra, the worst-affected state with 863,062 cases and 25,964 deaths, doctors said measures like wearing masks and washing hands had largely been abandoned.

“There is a behavioral fatigue now setting in,” said Dr. S.P. Kalantri, the director of a hospital in the village of Sevagram.

He said that the past few weeks had driven home the point that the virus had moved from India’s cities to its villages.

“The worst is yet to come,” Kalantri said. “There is no light at the end of the tunnel.”

Manish Swarup The Associated Press A health worker takes a nasal swab sample to test for COVID-19 as a policeman stands guard Saturday in New Delhi.