A wave of coronavirus infections is spreading beyond India to its neighbours, creating an opening for China to make inroads into a region New Delhi considers its backyard by providing vaccines and medical assistance.

Cases in Nepal have risen to more than 3,000 a day from fewer than 100 in March, as alarm mounts about strains first identified in India and the UK. The percentage of positive tests, an indication that virus spread is accelerating, has jumped to 25 per cent, higher than in India.

Bangladesh is also battling a surge in cases, although its daily infections have fallen from a peak this month to about 3,500. Cases are rising in Pakistan and Sri Lanka, too.

As recently as last month, India, the world’s largest producer of vaccines, was poised to consolidate its position as a regional powerhouse by supplying jabs to its neighbours.

But its second Covid-19 wave has been so brutal that India has stopped almost all vaccine exports and is relying on overseas medical assistance. India reported another world record of 360,000 infections in a single day on Wednesday, and became the fourth country to surpass 200,000 total deaths. Experts believe the toll is far higher.

China has moved swiftly to fill the void as anxiety grows in countries that were dependent on Indian-made shots.

After a videoconference between Chinese and regional foreign ministers — excluding India — on Tuesday, Bangladesh said it had asked China to supply it with vaccines as soon as possible. Nepal said that Beijing had offered medical equipment and materials.

Analysts said the chaos in India had given China an advantage in a long-simmering competition for regional influence that has intensified during the pandemic.

“It’s a boxing match with so many rounds,” Constantino Xavier, a senior fellow at the Centre for Social and Economic Progress, a New Delhi think-tank. “Now India is on the defensive, and China is punching harder, making the best out of India’s domestic preoccupations.”

Authorities in India have introduced a string of local lockdowns, most recently in tech hub Bangalore, as they struggled to cope with the deluge of cases and acute shortages of oxygen.

The US, UK, EU and other allies have sent oxygen, vaccine materials and other life-saving medical supplies.

Before the second wave struck, India exported about 20m doses of vaccines to its immediate neighbours. Some of those doses were donated while others were purchased through commercial contracts, including enough for tiny Bhutan to inoculate almost all of its adult population.

During a visit to Bangladesh last month, Narendra Modi, India’s prime minister, donated 1.2m doses of the Oxford/AstraZeneca jab.

But India’s eastern neighbour has since joined the countries closing their borders over fears that the latest outbreak could exacerbate domestic caseloads.

“The interruption of critical vaccine supplies may have fuelled concerns among the neighbours about depending on India,” Xavier said.

Nepal, which shares a long border with India, is particularly susceptible to transmission from its neighbour.

Even Gyanendra Shah, the country’s former king, has not been spared. He tested positive after returning from a trip to the Kumbh Mela, a Hindu festival in India attended by millions on the banks of the Ganges River.

His wife, Nepal’s former queen Komal Shah, has also been infected. The couple are said to be in stable condition.

In Pakistan, China has already taken a leading role in supplying millions of vaccines. A senior government official said up to 2m more jabs were expected to arrive on Thursday.

India’s bitter rival is reporting more than 5,000 cases a day and has deployed the army to enforce safeguards against the spread of Covid-19.

“If our situation becomes the same as in India, then we will have to close down cities,” Imran Khan, Pakistan’s prime minister, said last week. “We can’t do that because as we have seen already, the poor suffer the most when lockdowns are imposed.”