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Tests are delayed. Medical oxygen is scarce. Hospitals are understaffed and overflowing. Intensive care units are full. Nearly all ventilators are in use, and the dead are piling up at crematoriums and graveyards. India recorded more than 250,000 new infections and 1,700 deaths in the past 24 hours alone, and the U.K. announced a travel ban on most visitors from the country this week. Overall, India has reported more than 15 million cases and 180,000 deaths – and experts say the numbers are likely undercounts. (Ghosal and Mehrotra, 4/20)

The Swedish Health Agency on Tuesday recommended that people under 65 years old who received the first shot of the AstraZeneca coronavirus vaccine should get a different vaccine for the second shot. There are no definitive studies regarding immune responses when initial and follow-up vaccine doses are different. The agency said that when results on mixing different doses are released they will evaluate whether the recommendation should be changed. (Gonzalez, 4/20)

When Ghana received 50,000 COVID-19 vaccine doses from India last month, it hit a frustrating roadblock: it had not trained enough staff to distribute them. The country was still rolling out shots received in late February from the global vaccine-sharing scheme COVAX, and didn't have the capacity to expand that operation, according to the head of Ghana's immunisation programme. (Mcallister, 4/21)

Mexican President Andrés Manuel López Obrador finally got a coronavirus vaccine Tuesday, after waffling on receiving the shot. Mexico is in a race to get its population vaccinated as case numbers have begun to rise again and the country’s estimated total death toll from COVID-19 surpassed 336,000. On Tuesday, Mexico expanded efforts to vaccinate teachers to five more states. (Marquez, 4/20)

New Zealand announced Wednesday it will consolidate its fragmented health care system into a national service similar to the one revered by many in Britain. New Zealand’s government-run system is currently divided into 20 district health boards, each with their own budget. Some describe the system as a “postcode lottery” of different treatment depending on where people live. (Perry, 4/21)

Doctors and medical ethicists in the UK are calling for terminally ill patients to have the option of using general anesthesia prior to their death as a way to relieve suffering. People with terminal illnesses like advanced cancer are often given treatments only meant to ease their pain and improve their quality of life before they die, in what doctors call palliative care. These can include potent painkillers and prolonged sedation. But in a new paper published Wednesday in the journal Anaesthesia, researchers at the University of Oxford say that general anesthesia—drugs used to send a person into full unconsciousness—should be made available to patients who want it. (Cara, 4/20)