The COVID-19 pandemic has hit India harder in recent weeks with the country’s largest cities now looking to enforce harsher lockdown measures following a six-month high in infection rates.

Reuters reports that cases in the country have been surging for the past month as India becomes the third country with the highest number of infections, only following the U.S. and Brazil.

Half of the 89,129 cases reported by the national health ministry in the last day stem from Maharashtra, India’s wealthiest state, which has seen 47,827 infections. The state’s chief minister said that a lockdown will be imposed if cases continue to soar, warning that medical infrastructure won’t be able to handle the load.

The state of Karnataka has been hit with a new set of COVID-19 guidelines, including shuttering gyms and prohibiting religious functions. Movie theaters, bars, pubs, and restaurants can also only operate at limited capacity. Elsewhere, India’s capital, New Delhi, has seen its most cases this year, with 3,500 infections, though its chief minister decided against administering another lockdown at the moment.

Daily cases have risen from 15,000 in early March to 88,000 at the beginning of April. In total, India has seen 89,129 new infections and 714 deaths, the largest daily spike since Sept. 20 and most deaths since Oct. 21.

The Indian government has attempted to bolster its vaccination efforts, but the country’s program has remained sluggish even though India is home to the world’s largest vaccine producer.