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With its 1.3 billion population and faced with the COVID-19 pandemic, India is at the junction of two crucial decisions, balancing healthcare and the economy. To prevent the community spread of the virus, the Indian Government imposed a nationwide lockdown. Though initially successful to some extent in containing the disease spread, the extended lockdown eventually leads to a spiraling out effect resulting in the slowdown of the economy, which, in turn, lead to widespread consequences affecting the lives of millions of people, mostly those at the base of the social pyramid. We investigated the implications of few government policies taken during this pandemic and their impact on society, thereby suggesting short-term crisis management with long-term solutions. Here, we present a comprehensive account of Indian policy in dealing with the COVID-19 crisis, balancing both economic and public health. We also explored a future contingency plan for risk mitigation along with few recommendations. This viewpoint will be useful for effective healthcare management and the economy in Asia's populous nation in the COVID-19 and prepare for a future crisis of this nature.

Ruby Dhar,1,* Babban Jee,2,* Subhradip Karmakar1 1Department of Biochemistry, All India Institute of Medical Sciences, New Delhi, India; 2Department of Health Research, Ministry of Health and Family Welfare, Government of India, New Delhi, India*These authors contributed equally to this workCorrespondence: Subhradip KarmakarAll India Institute of Medical Sciences, New Delhi, IndiaEmail subhradip.k@aiims.eduAbstract: With its 1.3 billion population and faced with the COVID-19 pandemic, India is at the junction of two crucial decisions, balancing healthcare and the economy. To prevent the community spread of the virus, the Indian Government imposed a nationwide lockdown. Though initially successful to some extent in containing the disease spread, the extended lockdown eventually leads to a spiraling out effect resulting in the slowdown of the economy, which, in turn, lead to widespread consequences affecting the lives of millions of people, mostly those at the base of the social pyramid. We investigated the implications of few government policies taken during this pandemic and their impact on society, thereby suggesting short-term crisis management with long-term solutions. Here, we present a comprehensive account of Indian policy in dealing with the COVID-19 crisis, balancing both economic and public health. We also explored a future contingency plan for risk mitigation along with few recommendations. This viewpoint will be useful for effective healthcare management and the economy in Asia's populous nation in the COVID-19 and prepare for a future crisis of this nature.Keywords: COVID-19, India, economic crisis, healthcare, vaccination, management

Ruby Dhar,1 Karthikeyan Pethusamy,1 Babban Jee,2 Subhradip Karmakar1 1All India Institute of Medical Sciences, New Delhi, India; 2Department of Health Research, Ministry of Health and Family Welfare Government of India, New Delhi, 110001, IndiaCorrespondence: Subhradip Karmakar Email subhradip.k@aiims.eduAbstract: With about 0.4– 0.5 million COVID cases diagnosed every single day in a row over the past three weeks back in May 2021, India was at the epicenter of the global viral rampage. The catastrophe of this crisis was unprecedented, pushing the health care system to its breaking point. Although significant progress has been made in identifying these highly transmissible variants, what is somewhat lacking is the competence to exploit this information for risk mitigation and effective disease management through an integrated nationwide coordinated approach. With a positivity rate of 15– 20% (April–May 2021) and the healthcare system pushed to its limit, accompanied by increased mortality, the situation was rather grim then. Though the central command scrambled all its resources and logistics to streamline the supply chain, the efforts were insufficient in response to the ongoing crisis due to a disproportionate rise in the case. We examined the current scenario emerging from this 2nd COVID wave and identified the possible lacunae. We also suggested few recommendations that may be adopted to avoid similar failures in the future.Keywords: COVID-19, pandemic, India, healthcare, economy, vaccine