India's total Covid-19 caseload surged past 25 million on Tuesday as a powerful cyclone complicated the health crisis in one of the states where the disease is spreading most quickly.

Covid-19 tests were administered to 200,000 people evacuated from coastal districts of the western state of Gujarat before the cyclone struck late on Monday and efforts were being made to try to limit any spread of infections.

“Masks have been arranged for people shifted to shelter homes,” said Sandip Sagale, a top official in Ahmedabad, the main city in Gujarat.

“Efforts are also made to maintain social distancing.”

India's total tally of coronavirus cases surged past the 25 million mark with 263,533 new infections over the past 24 hours, while deaths from Covid-19 rose by a record 4,329.

Only the United States has had more cases, or a worse single-day death toll, when it lost 5,444 people on Feb 12. But whereas the epidemic peaked months ago in the United States, there is no certainty that India's infections have.

Though the official count shows new infections subsiding, there are fears that the new, highly infectious B.1.617 variant, first found in India, is running out of control and many cases, particularly in rural areas, are going unreported due to lack of testing.

India's total caseload since the virus first struck over a year ago, stands at 25.2 million, while the death toll is at 278,719, according to health ministry data.

Prime Minister Narendra Modi's home state of Gujarat had suffered a 30 per cent increase in infections since May 2, while the total number of vaccinations administered in the state last week was just 1.1 million — half the total of a month earlier.

The storm complicated efforts to tackle the coronavirus in the state as vaccinations were suspended for two days, while hospitals awaited back-up generators to keep power running and additional oxygen supplies.

Gujarat Chief Minister Vijay Rupani said oxygen manufacturing and distribution were not disrupted. Out of the more than 1,400 hospitals designated for treating Covid-19, power failures were reported in 16, and restored in 12, while the remaining four moved to back-up generators.

'Struggling' vaccination drive

In neighbouring Maharashtra state, which was sideswiped by the cyclone on Monday, 1,000 coronavirus deaths were reported overnight — the worst toll nationwide. The infection rate in Maharashtra has soared 15pc in the last two weeks, government data showed.

The pace of vaccination in Maharashtra has fallen 30pc since peaking in early April, according to data from the government's Co-WIN portal.

Since April 1, 269 doctors have died of Covid-19, 78 of them in the mostly rural state of Bihar, according to data released by the Indian Medical Association.

“The surge has been very devastating,” Jayesh Lele, secretary general of the IMA, told Reuters.

In the northern state of Uttar Pradesh, home to more people than Brazil, rural areas have been severely hit, as healthcare systems have struggled to cope.

Incensed by scarce testing and tracing, a state court remarked on Monday the situation was turning to “God's mercy”, and hurtling towards a “third wave”.

“If this is the state of affairs of five districts, one can guess where we are leading people of this state to, i.e. (a) third wave of the pandemic,” the state's Allahabad High Court said.

Chandrakant Lahariya, a public policy and health systems expert, said in the Hindustan Times newspaper that India's vaccine policy urgently needed a reset.

“For six weeks now, India's vaccination drive has been struggling. How long must one wait before acknowledging that what was planned is not working? Part of the problem seems to be the fact that there is political decision-making in the areas that are purely technical. The political leadership should give a free hand to technical experts to decide and implement new strategies.”

US President Joe Biden announced on Monday that his administration would send at least 20m more Covid-19 vaccine doses abroad by the end of June. Biden has been under pressure to share vaccines to help contain worsening epidemics from India to Brazil, where new, more contagious coronavirus variants have become rampant.