India crossed 20 million reported cases of Covid-19 on Tuesday.

There were 357,229 new cases reported over a span of 24 hours, bringing the total to 20.28 million, according to health ministry data.

India’s first cases were detected in late January last year and the country’s total did not cross 10 million infections until December, according to Johns Hopkins University data. But the next 10 million cases were reported in the span of just under five months, mostly in April.

So far, at least 222,408 people have died from the disease, but that number is likely lower than the actual death toll. Media reports suggest crematoriums and burial grounds are overwhelmed with bodies of those who died from Covid-19.

Made with Flourish
“The pandemic has now entered the small towns and the villages, and we are now quite worried about how much of a devastation it will cause in those areas where the health systems are not well developed enough to provide support, when even some of the big metros are struggling with the case load on hospitals,” K. Srinath Reddy, president at the Public Health Foundation of India told CNBC’s “Capital Connection” on Monday.

Some states are going into lockdowns
During the first wave last year, India imposed a strict national lockdown between late-March and May, which derailed the country’s growth trajectory and left millions without a source of income.

While the central government appears reluctant to impose a second nationwide lockdown, several states have stepped up restrictions in recent weeks, including local lockdowns and curfews. That includes Maharashtra, which is India’s worst-hit state, Delhi, West Bengal, Uttar Pradesh, Rajasthan, Karnataka and others.

India’s health-care system has been overwhelmed by the sharp rise in cases as it faces a shortage of hospital beds, oxygen supply and medicines to treat patients.

Public Health Foundation’s Reddy told CNBC that India needs a two-pronged approach to fight the second wave. First, efforts to vaccinate more than 1.3 billion people must continue.

India faces at least near-term vaccine shortages and just over 2% of the population has received both doses. Starting in May, India is opening vaccinations to anyone age 18 and older.

Second, India needs a “very strong” containment strategy to reduce the spread.