India crossed another grim milestone Monday with more than 300,000 people lost to the coronavirus, while a devastating surge of infections appeared to be easing in big cities but was swamping the poorer countryside.

The milestone, as recorded by India’s Health Ministry, comes as slowed vaccine deliveries have marred the country’s fight against the pandemic, forcing many to miss their shots, and a rare but fatal fungal infection affecting COVID-19 patients has worried doctors.

India’s death toll is the third-highest reported in the world after the U.S. and Brazil, accounting for 8.6% of the nearly 34.7 million coronavirus fatalities globally, though the true numbers are thought to be significantly greater.

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