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A deadly second wave of coronavirus infections is ravaging India, leaving millions of people infected and straining the country’s already overburdened health system.

Officially, by the end of April, more than 17.9 million infections had been confirmed and more than 200,000 people had died, but experts said the real numbers were likely much higher. During the same period, India was responsible for more than half of the daily cases of Covid-19 worldwide, setting a record rate of more than 300,000 cases per day.

For the most recent numbers, The New York Times is tracking the latest case counts here.

Months ago, India appeared to be surviving the pandemic. After a severe first lockdown, the country has not seen an explosion of new cases and deaths comparable to other countries.

But after the first restrictions were lifted, many Indians stopped taking precautions. Large gatherings, including political rallies and religious holidays, resumed and attracted millions of people.

As of this spring, the country saw an exponential increase in cases and deaths.

In April, some vaccinated people, including 37 doctors at a hospital in New Delhi, contracted the virus, leaving many wondering whether a more contagious variant was causing the second wave.

Many in India already assume that the B.1.617 variant is responsible for the severity of the second wave. The variant is sometimes referred to as “the double mutant”, although the name is a misnomer as it has many more mutations than two. It earned the name because one version contains two genetic mutations found in other hard-to-control variants.

Researchers outside India say the limited data so far instead suggests that the variant called B.1.1.7, which has affected Britain and the United States, is more likely to be blamed.

So far, the evidence is inconclusive and researchers warn that other factors could explain the wickedness of the outbreak.

Overwhelmed by new cases, hospitals in India cannot keep up with the demand and patients in many cities have been left to die.

Clinics across the country have reported a severe shortage of hospital beds, drugs, protective equipment and oxygen.

The Indian government says it has enough liquid oxygen to meet medical needs and is rapidly increasing its supply. But production facilities are concentrated in eastern India, far from the worst outbreaks in Delhi and the western state of Maharashtra, and it can take days for supplies to get there by road.

Families of the sick fill social media with demands for oxygen as supplies run out in hospitals or because they try to provide care at home.

Some in Delhi say they have paid at least 10 times the usual price for oxygen, and media have reported that cylinders have been looted from hospitals.

India is one of the world’s leading vaccine manufacturers, but it has struggled to vaccinate its citizens.

Less than 10 percent of Indians received even a single dose. Now the country’s pain can be felt all over the world, especially in the poorest countries.

India had planned to ship millions of doses. But given its glaring immunization deficit, exports have essentially been shut down, leaving other countries with far fewer doses than expected.

Charities, volunteers and businesses in India and beyond are trying to help Covid victims and frontline workers across the country.

(Before donating money to an organization, make sure you feel comfortable. In the United States, sites like Guidestar and Charity Navigator assess nonprofits on their effectiveness and financial health.)

Here are some ways to help.

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