On Wednesday, India reported more coronavirus deaths in a single day than any other country during the pandemic, while infections spread through vast rural areas with underdeveloped health systems. The Health Ministry reported 4,529 deaths in the previous 24 hours, bringing India’s total confirmed fatalities to 283,248. It also reported 267,334 new infections as daily cases fell below 300,000 for the third day in a row. The figures are almost certainly an undercount.

According to data from Johns Hopkins University, the previous record for most daily deaths from the coronavirus was set on Jan. 12 in the United States, when 4,475 people died.

With over 25 million confirmed cases since the pandemic began, India is second only to the United States in terms of confirmed infections. According to experts, the rate of new infections in India, which has been steadily increasing, may be slowing. However, the number of deaths has continued to rise, and hospitals are still overcrowded. COVID-19 fatalities in India have increased sixfold in the last month.

While megacities like Mumbai and New Delhi have shown signs of improvement in recent days, there is concern that the virus is spreading through the vast countryside, where the majority of the population lives and health care and testing are limited.

The situation is particularly worisome in Uttar Pradesh, India’s most populous state with 200 million people, where a court on Monday declared that citizens were “at God’s mercy.” Despite a drop in new cases over the last week, the state still has over 136,000 confirmed active infections.

Government officials are rushing to contain the virus’s spread in the state’s villages. According to senior health official Amit Mohan Prasad, teams have reached nearly 90,000 villages and the virus has been detected in approximately 21,000 of them.

According to health experts, the true scope of the virus is difficult to assess, in part due to a lack of data, and the government response is too late. “The national story obscured what was going on in rural India, and it remains relatively invisible,” said Murad Banaji, a mathematician who models India’s cases.

People in many parts of Uttar Pradesh are dying of fever and shortness of breath even before being tested for coronavirus. Crematoriums have run out of wood, and hundreds of bodies have washed up on the Ganges River’s banks. “The villagers frequently disregard fever and body ache. The patient dies before the relatives realize what is happening,” said Raja Bhaiya of the nonprofit Vidya Dham Samiti, which works to raise awareness about the pandemic in the state’s Banda district.

According to Bhaiya, the “only testimony of death in the village is the cries of women and children, and these cries are becoming increasingly frequent.” India’s vaccination campaign is also faltering just as it is needed the most. Over the last six weeks, the number of daily administered doses has dropped by roughly half, from a high of 4 million per day on April 2 to around 2 million or less this week.

While India is the world’s largest producer of vaccines, it is struggling to keep up with the increase in infections. It will take at least two months for its two current vaccine producers to increase total monthly output from 70 million to 80 million doses. Many states claim they don’t have enough vaccine to go around.