India’s count of active Covid-19 patients surged overnight by over 125,000 to cross 2.15 million on Wednesday, double the peak during the first wave last September, portending additional strain on healthcare resources struggling with shortages of beds, oxygen and critical care staff.

Health authorities on Wednesday detected 295,041 new Covid-19 cases and recorded 2,023 deaths, the highest so far, but experts predict the daily casualty count is likely to increase in the coming days, given the lag between new cases and deaths.

Maharashtra accounts for the highest number of active cases with over 680,000 patients, followed by Uttar Pradesh (over 223,000), Karnataka (159,000) Chhattisgarth (125,000), and Kerala (118,000).

In the hardest hit cities, doctors reported patients struggling for intensive care unit beds and some hospital administrators with only hours of medical oxygen left awaited fresh supplies, amid growing concerns about inter-state supply disruptions.

At Delhi’s St Stephen’s Hospital, a senior hospital administrator reported on Wednesday afternoon that the hospital had only two hours of oxygen left and fresh supply ordered had been blocked at Faridabad near the Delhi-Haryana border by the authorities in the neighbouring state.

“It is devastating to hear this — we have oxygen that we expect will last until 11am tomorrow (Thursday),” a medical administrator in another Delhi hospital told The Telegraph. Both hospitals on Wednesday evening had all their available ICU beds for Covid-19 patients occupied.

Union health secretary Rajesh Bhushan said the Centre was aware of these concerns and has directed Haryana and all states to allow unhindered passage of medical oxygen. The health ministry said it has also increased the oxygen quota to the hardest hit states such as Delhi, Haryana, Madhya Pradesh, Maharashtra, Punjab, Uttarakhand and Uttar Pradesh.

Even healthcare workers are scrambling for hospital beds. “The biggest crisis is getting a bed,” said Raymond Savio, a critical care medicine specialist in Chennai. “There’s always someone in our own circle of friends and family for whom we find it difficult to accommodate in hospital.”

In Tamil Nadu, the seven-day average of daily new cases has climbed to over 9,400, from the earlier highest count of about 6,400 last year. “The numbers of daily new cases have crossed earlier peaks in almost all states,” said a senior government epidemiologist.

A doctor in Madhya Pradesh said Bhopal and Indore are both running short of ICU beds. “The number of isolation beds appear adequate for now — but people who need oxygen or critical care are unable to get ICU beds,” said Shankul Dwivedi.

The health ministry has said the case fatality rate — the proportion of deaths among lab-confirmed patients has — fell from 1.4 per cent in January to 1.3 per cent in March to 1.2 per cent in mid-April. But doctors say the absolute numbers of deaths are expected to rise in the coming days and weeks, given the continued rise in cases.