Suchergebnisse

Traditionally, India has focused on surveillance of communicable/infectious diseases such as small pox, polio, malaria etc., and the Integrated Disease Surveillance Programme (IDSP), with assistance from state governments, has played a key role in tracking and tracing these diseases. Sustainable progress has been achieved such as smallpox eradication in 1977, polio elimination in 2014 and reduction in the incidence of malaria. However, now the scope of tracking other diseases such as non-communicable diseases(NCDs) like diabetes, hypertension etc. and other emerging/ re-emerging diseases is being increased. Newer surveillance techniques such as participatory disease surveillance (PDS) have emerged. The surveillance system in India has so far evolved in conducting surveillance within the domains of human health, animal health, and the environment, but in silos. Public Health Surveillance is often viewed as a stand-alone activity, but in reality it cuts across all levels of care-primary, secondary and tertiary and many institutions are involved at different aspects. The ongoing COVID-19 pandemic has emphasized the need to build a robust, unified disease surveillance system in the country that cuts across all the relevant sectors to deal with the disease holistically. It is envisioned that public health surveillance in 2035 would be based on a Single Surveillance Information System that would collate information from various sources such as national programs like Integrated Disease Surveillance Program (IDSP), National AIDS Control Program (NACP) and National Tuberculosis Elimination Program (NTEP), hospitals and health centres, health insurance records, laboratories, pharmacies, plant and animal disease surveillance, environmental health surveillance, occupational health & injury surveillance etc. The creation of unified e-health records via use of unique health identity number (UHID), as recommended by the National Digital Health Bueprint, forms the foundation for the future of public health surveillance in India.

The burden of mental health problems is rising across the world. In South Asia region, the suicide rate is highest in India with one person dying every 40 seconds due to suicide with 16.5 suicides per 100,000 people. In 2017, around 200 million people were suffering from mental illness in India. The COVID-19 pandemic has even worsened the mental health situation in the country. People across all age groups suffered from anxiety and depression during COVID-19 lockdown. Some of the major factors that contribute to the burgeoning mental health burden are scarcity of mental health specialists particularly in rural areas,limited availability of mental health services,limited access to mental health services, stigma associated with mental illnesses and limited awareness and knowledge about mental health. The Central and state governments have taken various initiatives to deal with the mental health situation. These range from policy level initiatives like passing of Mental Health Act in 2017 to community level mental health programmes. The boom in internet access and telecommunications provide an apt opportunity for India to fill the large gap that exists in the provision of mental healthcare services.The central government has launched MANAS , a mobile application for improving mental wellbeing of citizens, Karnataka Government has launched e-Manas: Karnataka Mental Healthcare Management System and various pilot initiatives have also been taken by state governments in collaboration with private organizations. This is a concept paper based on secondary data from various national and international journals, government and private documents and websites. This paper presents an overview of mental health situation in the country and provides a detailed account of various digital platforms launched and pilot initiatives taken in India to tackle the rising burden of mental health problems. The paper also put forward some recommendations to improve the mental health situation in the country.

The Government of India has embarked on a path to achieve Universal Health Coverage for all the citizens of India as envisaged by the National Health Policy 2017. To achieve this, the National Health Policy 2017 recommends a paradigm shift from the health system existing in silos to a more comprehensive and a holistic healthcare system, based on the foundation of digital technologies. Digital health technologies are the most powerful tool towards the attainment of Universal Health Coverage. The National Health Policy 2017 recommends the creation of National electronic Health Authority (NeHA) or National Digital Health Authority (NDHA) as a regulatory body for the deployment of digital health interventions in the healthcare sector. The National electronic Health Authority (NeHA) will be the nodal authority to streamline all the efforts needed to develop integrated national health information architecture. The Government of India proposes to establish National electronic Health Authority (NeHA) as a statutory body through a Parliament act called "Digital lnformation Security in Healthcare, Act (DISHA)". The present paper is about the National electronic Health Authority. The document gives a detailed account of its purpose, mission, vision, objectives and functions. An act of parliament called "Digital lnformation Security in Healthcare, Act (DISHA)" under which the National eHealth Authority is proposed to be established is discussed. The role of state electronic Health Authorities is also discussed in brief. The document outlines key challenges for National eHealth Authority to achieve its objectives. This paper also presents a review of International experiences as a guide to establish National electronic Health Authority in India. A brief account of National Digital Health Mission is also given.

The Information and Communications Technology (ICT) seem to diffuse in almost all the sectors. ICT has transformed the way the healthcare data is managed. The widespread usage of electronic devices like computers, tablets, mobile phones along with the availability of high speed internet have made possible the transition from paper based patient records to electronic records. Electronic Health Records (EHRs) are real time digital version of patient records. An Electronic Health Record (EHR) is a comprehensive report of an individual's overall health. Electronic Health Records (EHRs) help track patient's clinical progress, facilitate improved health care decisions and provide evidence based care. This is a concept paper based on secondary data from various national and international journals, government documents, government and private websites. This paper presents a review of Electronic Health Records (EHRs) and its use in India. The document gives details of initiatives taken by the government of India in relation to EHRs. Further, the paper discusses the potential benefits of Electronic Health Records (EHRs). International lessons from other countries like China, Bangladesh and Malaysia are also discussed. A brief account of Electronic Medical Record Adoption Model (EMRAM) and private initiatives is also given. Challenges in the way of adoption of Electronic Health Records (EHRs) in India are discussed in detail. Further, this paper presents an outline of roadmap for adoption of Electronic Health Records (EHRs) in India.

The Information and Communications Technology (ICT) has a huge potential of changing the landscape of service delivery across the globe. It acts as a catalyst for the speedy delivery of services. The Government of India is in the transition phase, moving from traditional paper mode to using Information and Communications Technology (ICT) in the governance process. The use of ICT in the governance process is called e-Governance. The Government of India has been increasingly focusing on the use of Information and Communications Technology (ICT) to overcome issues like red-tapism, lack of accountability and transparency in public services, lack of access to information, slow movement of files and other documents, ineffective delivery of public services etc. This is a concept paper based on secondary data collected from government websites and documents, various national and international Journals and private websites. The present paper discusses the concept of e-Governance, pillars of e-Governance, objectives of e-Governance, types of interaction in e-Governance, guiding principles for e-Governance and benefits of e-Governance. The paper presents a review of evolution of e-Governance in India. It gives a detailed account of e-Governance initiatives in India. The document lays specific emphasis on e-Governance initiatives in healthcare in India, both at the National and State level. Further, the key challenges related e-Governance in India are discussed. The paper also put forward some recommendations which may help in the implementation of e-Governance in the Indian context.

Over the last few decades, the Information and Communication Technology (ICT) has revolutionized the way the healthcare is delivered in India. ICT acts as a catalyst for speedy delivery of healthcare services. It is now possible to connect healthcare delivery in rural areas to the mainstream. ICT has made a valuable contribution to healthcare decision making. This is a concept paper based on secondary data collected from government documents and websites, various national and international Journals and private websites. The present paper discusses potential effects and application areas of ICT in health, existing and emerging ICT based platforms, e-Health policies and strategies and current challenges in ICT implementation specific to scenario in India. This document lays specific emphasis on the role of ICT in improving healthcare service delivery at India's sub-centre level. This paper also presents a review of evidence base from International studies related to how ICT interventions can improve health service quality and delivery. The use of the Information and Communication Technology (ICT) in Health is defined as e-Health. It encompasses broader concepts like m-Health, telemedicine, Health Information Systems, electronic health records and many more. Each of the ICT intervention has brought its own bundle of benefits to healthcare. Mobile Technology is being used for the purposes of data collection, health workforce training, early warning of unusual health related events and many more. With the advancement of Telemedicine and Tele-counselling, it is now possible to deliver health care services in rural and remote areas of the country. Health information systems have made possible the monitoring of health data in real time. Electronic health records (EHRs) have made it possible to digitize paper health records and has made healthcare delivery quick, coordinated, transparent and secure. (.)

Artificial Intelligence (AI), also referred to as the new electricity, is the emerging focus area in India. AI refers to the ability of machines to perform cognitive tasks like thinking, perceiving, learning, problem solving and decision making. Most of the AI systems rely on historical large datasets for predicting future trends and outcomes at a pace which humans would not be able to match. The development of AI in India is in the initial stages and there is no regulatory body focused solely on AI. However, recently, Government of India has taken various initiatives related to AI such as establishment of Artificial Intelligence Task Force, formulation of NITI Aayog's National Strategy for Artificial Intelligence #AIFORALL, setting up of four Committees for AI under Ministry of Electronics and Information technology etc. Some of India's state governments have also taken few initiatives, such as establishment of Centre of Excellence for Data Science and Artificial Intelligence (CoE-DS&AI) by Karnataka, Safe and Ethical Artificial Intelligence Policy 2020 and Face Recognition Attendance System by Tamil Nadu, AI-Powered System for monitoring driving behaviour by West Bengal, AI System to fight agricultural risks by Maharashtra etc. As with any other technology, AI brings with it a span of opportunities and challenges. In healthcare, AI could be beneficial in mining medical records; designing treatment plans; forecasting health events; assisting repetitive jobs; doing online consultations; assisting in clinical decision making; medication management; drug creation; making healthier choices and decisions; and solving public health problems etc. AI could be very helpful in areas where there is scarcity of human resources, such as rural and remote areas. AI technology has been helpful in dealing with COVID-19 in India. It has helped in preliminary screening of COVID-19 cases, containment of coronavirus, contact tracing, enforcing quarantine and social distancing, tracking of suspects, tracking the pandemic, treatment and remote monitoring of COVID-19 patients, vaccine and drug development etc. The path for adoption of AI driven healthcare in India is filled with a lot of challenges. The unstructured data sets, interoperability issues, lack of open sets of medical data, inadequate analytics solutions which could work with big data, limited funds, inadequate infrastructure, lack of manpower skilled in AI, regulatory weaknesses, inadequate framework and issues related to data protection are some of the key challenges for AI-driven healthcare. It is recommended that government should support companies to invest in AI; encourage public private partnerships in the domain of AI and Health; enact and effectively enforce laws and legislation related to AI and Health; frame policies addressing issues related to confidentiality and privacy in the AI-driven healthcare; and establish a certification system for AI-based healthcare solutions. To adopt AI-based healthcare, it is important to train workforce in AI so that they can carefully handle sensitive health information, protect data against theft and use AI systems effectively. It is also crucial that healthcare decisions based on AI solutions should have a rationale and are explainable.

The second wave of COVID-19 caused havoc across India. It was twice as severe as the first one. More than 400,000 COVID-19 cases per day were being reported. The worst affected states were Maharashtra, Kerala, Karnataka, Tamil Nadu, Delhi and Andhra Pradesh. The spike in cases was largely assumed to be the result of leniency in COVID-19 appropriate behaviour, such as people were not wearing masks, resumption of economic activity, gathering in large numbers e.g. in marriages, political meetings, rallies, IPL matches, religious gatherings like Kumbh Mela etc. 67 percent of India's population above the age of six years has been exposed to COVID-19 according to a national serological survey conducted by ICMR, the findings of which were revealed on July 20, 2021. The survey was conducted during June and July across 70 districts of 21 states. These are the very same districts where three earlier rounds of sero surveys were conducted during May-June 2020; August-September 2020 and December-January 2020/21. On January 16th 2021, India launched the world's largest vaccination drive and as of July 15, more than 391,340,491 vaccine doses had been administered across the country. The vaccine has been administered in a phased manner with the initial focus being on priority groups like health workers, frontline workers like the police workforce, municipal workers, defence personnel etc., people above 60 years of age and those between 45-60 years with co-morbidities. From May 1, 2021, people between age group 18-45 were also eligible for vaccination. But, until a substantial proportion of the population is vaccinated, precautionary measures like wearing masks, sanitization, regular hand washing and physical distancing must remain the mainstay. Inter-departmental coordination has been the cornerstone in dealing with COVID-19 situation in India. Various departments such as Health, Tourism, Defence, Information and Communication Technology (ICT), Finance etc. took various initiatives in collaboration with other departments to deal with the pandemic. Challenges posed by COVID-19 also sparked a wave of innovations across sectors in India. A host of new interventions were implemented by various departments, such as health, agriculture, education, police, railways etc. This document is based on secondary data collected from government documents and websites, news reporting, media interviews, newspaper articles, various national and international journals and private websites. The present paper discusses current scenario of COVID-19 in India, COVID-19 vaccination drive, innovative approaches to address vaccine hesitancy in India, inter-departmental coordination and innovation across sectors in dealing with COVID-19 situation. We also put forward recommendations to deal with the surge in COVID-19 cases in future and to scale up innovations and undertake research studies to identify gaps and address challenges.

Artificial Intelligence (AI), also referred to as the new electricity, is the emerging focus area in India. AI refers to the ability of machines to perform cognitive tasks like thinking, perceiving, learning, problem solving and decision making. Most of the AI systems rely on historical large datasets for predicting future trends and outcomes at a pace which humans would not be able to match. The development of AI in India is in the initial stages and there is no regulatory body focused solely on AI. However, recently, Government of India has taken various initiatives related to AI such as establishment of Artificial Intelligence Task Force, formulation of NITI Aayog's National Strategy for Artificial Intelligence #AIFORALL, setting up of four Committees for AI under Ministry of Electronics and Information technology etc. Some of India's state governments have also taken few initiatives, such as establishment of Centre of Excellence for Data Science and Artificial Intelligence (CoE-DS&AI) by Karnataka, Safe and Ethical Artificial Intelligence Policy 2020 and Face Recognition Attendance System by Tamil Nadu, AI-Powered System for monitoring driving behaviour by West Bengal, AI System to fight agricultural risks by Maharashtra etc. As with any other technology, AI brings with it a span of opportunities and challenges. In healthcare, AI could be beneficial in mining medical records; designing treatment plans; forecasting health events; assisting repetitive jobs; doing online consultations; assisting in clinical decision making; medication management; drug creation; making healthier choices and decisions; and solving public health problems etc. AI could be very helpful in areas where there is scarcity of human resources, such as rural and remote areas. AI technology has been helpful in dealing with COVID-19 in India. It has helped in preliminary screening of COVID-19 cases, containment of coronavirus, contact tracing, enforcing quarantine and social distancing, tracking of suspects, tracking the pandemic, treatment and remote monitoring of COVID-19 patients, vaccine and drug development etc. The path for adoption of AI driven healthcare in India is filled with a lot of challenges. The unstructured data sets, interoperability issues, lack of open sets of medical data, inadequate analytics solutions which could work with big data, limited funds, inadequate infrastructure, lack of manpower skilled in AI, regulatory weaknesses, inadequate framework and issues related to data protection are some of the key challenges for AI-driven healthcare. It is recommended that government should support companies to invest in AI; encourage public private partnerships in the domain of AI and Health; enact and effectively enforce laws and legislation related to AI and Health; frame policies addressing issues related to confidentiality and privacy in the AI-driven healthcare; and establish a certification system for AI-based healthcare solutions. To adopt AI-based healthcare, it is important to train workforce in AI so that they can carefully handle sensitive health information, protect data against theft and use AI systems effectively. It is also crucial that healthcare decisions based on AI solutions should have a rationale and are explainable.

The second wave of COVID-19 caused havoc across India. It was twice as severe as the first one. More than 400,000 COVID-19 cases per day were being reported. The worst affected states were Maharashtra, Kerala, Karnataka, Tamil Nadu, Delhi and Andhra Pradesh. The spike in cases was largely assumed to be the result of leniency in COVID-19 appropriate behaviour, such as people were not wearing masks, resumption of economic activity, gathering in large numbers e.g. in marriages, political meetings, rallies, IPL matches, religious gatherings like Kumbh Mela etc. 67 percent of India's population above the age of six years has been exposed to COVID-19 according to a national serological survey conducted by ICMR, the findings of which were revealed on July 20, 2021. The survey was conducted during June and July across 70 districts of 21 states. These are the very same districts where three earlier rounds of sero surveys were conducted during May-June 2020; August-September 2020 and December-January 2020/21. On January 16th 2021, India launched the world's largest vaccination drive and as of July 15, more than 391,340,491 vaccine doses had been administered across the country. The vaccine has been administered in a phased manner with the initial focus being on priority groups like health workers, frontline workers like the police workforce, municipal workers, defence personnel etc., people above 60 years of age and those between 45-60 years with co-morbidities. From May 1, 2021, people between age group 18-45 were also eligible for vaccination. But, until a substantial proportion of the population is vaccinated, precautionary measures like wearing masks, sanitization, regular hand washing and physical distancing must remain the mainstay. Inter-departmental coordination has been the cornerstone in dealing with COVID-19 situation in India. Various departments such as Health, Tourism, Defence, Information and Communication Technology (ICT), Finance etc. took various initiatives in collaboration with other departments to deal with the pandemic. Challenges posed by COVID-19 also sparked a wave of innovations across sectors in India. A host of new interventions were implemented by various departments, such as health, agriculture, education, police, railways etc. This document is based on secondary data collected from government documents and websites, news reporting, media interviews, newspaper articles, various national and international journals and private websites. The present paper discusses current scenario of COVID-19 in India, COVID19 vaccination drive, innovative approaches to address vaccine hesitancy in India, interdepartmental coordination and innovation across sectors in dealing with COVID-19 situation. We also put forward recommendations to deal with the surge in COVID-19 cases in future and to scale up innovations and undertake research studies to identify gaps and address challenges. CSD Working Paper Series - COVID-19 in India: Disease Burden, Managing the second wave and Innovations

India is using Information and Communication Technologies (ICTs) to leapfrog economic development in key sectors: health, education, infrastructure, finance, agriculture, manufacturing, and perhaps most important, governance. In doing so, India is increasing Internet penetration by increasing Internet subscribers and digital literacy. These have acted as the key drivers for the Indian Government to envision digitalization in its various sectors including health care. The Government of India laid emphasis on digitalization in India's healthcare sector in its National Health Policy, 2017. The National Digital Health Blueprint, 2019 recognized the need to put together a National Digital Health Mission (NDHM) which can act as the foundation on which national digital health ecosystem can be built. On the nation's 74th Independence Day, the Government of India embarked on its journey to achieve Universal Health Coverage by launching the National Digital Health Mission. NDHM intends to create a holistic and comprehensive digital health ecosystem that will lay the foundation of a strong public digital infrastructure, digitally empower individuals, patients, doctors, health facilities, and help streamline the delivery of healthcare services and related information. However, it is important to emphasize that the success of NDHM is dependent on its adoption by the centre and states, by public and private entities and by individuals and decision makers. It is also crucial to analyse international experiences in order to learn from their achievements and mistakes.

India is the second-worst affected country in the world by COVID-19 pandemic. Although the Government of India took various initiatives to curb the spread of corornavirus in the country which included a 3-week nation-wide lockdown to begin with (from March 25 to April 14) and which later was extended thrice up until May 31, 2020, increasing testing, setting up quarantine facilities, COVID-19 treatment facilities, contact tracing through Aarogya Setu application and many more, but these efforts fell short when it came to supressing the pandemic. Especially, because of lockdown, when the migrant workers were forced to leave cities and travel back to their homes in rural areas, the COVID-19 infection which predominantly affected the urban areas until then also reached rural areas of the country. Overtime, the proportion of COVID-19 cases in rural areas has risen. Rural districts in the states of Andhra Pradesh, Maharashtra, Karnataka, Uttar Pradesh and Assam witnessed a significant rise in COVID-19 cases. Many factors pose a big challenge for rural India in dealing with COVID-19. These include scarcity of medical staff, equipment and health facilities, social stigma, fear of ill-treatment at the health facility, fear of losing income on being quarantined etc. Post-COVID complications are also emerging as a new threat in dealing with the current crisis. Health and Wellness Centres (HWCs) under Ayushman Bharat and Accredited Social Health Activist (ASHA) workers can play a crucial role in dealing with COVID-19 in the rural areas. ASHAs are involved in conducting house-to-house visits, reporting symptomatic cases, carrying out contact tracing, maintaining documentation, monitoring the situation and creating awareness about COVID-19 in the community. But, ASHA workers are facing many challenges such as increased work load, lack of protective equipment and training, they are underpaid, stigmatization, caste discrimination, domestic violence etc. India needs to develop a strategy specific to rural settings to deal with the COVID-19 situation. We believe that at a time when the federal and state governments are dealing with the challenges emanating from the Covid-19 pandemic, this crisis should be seen as an opportunity to strengthen the public health system in India. This would entail, among other things: 1) a much higher level of public health spending; 2) comprehensive training, effective control and oversight and timely and adequate payments for the ASHAs; 3) an effective and efficient management structure for the health facilities at the village, block and district levels; and 4) commensurate physical infrastructure and human resources in the sub-centers and the Primary Health Centers with the growing needs of the regions.

India is the second-worst affected country in the world by COVID-19 pandemic. Although the Government of India took various initiatives to curb the spread of coronavirus in the country which included a 3-week nation-wide lockdown to begin with (from March 25 to April 14) and which later was extended thrice up until May 31, 2020, increasing testing, setting up quarantine facilities, COVID-19 treatment facilities, contact tracing through Aarogya Setu application and many more, but these efforts fell short when it came to suppressing the pandemic. Especially, because of lockdown, when the migrant workers were forced to leave cities and travel back to their homes in rural areas, the COVID-19 infection which predominantly affected the urban areas until then also reached rural areas of the country. Overtime, the proportion of COVID-19 cases in rural areas has risen. Rural districts in the states of Andhra Pradesh, Maharashtra, Karnataka, Uttar Pradesh and Assam witnessed a significant rise in COVID-19 cases. Many factors pose a big challenge for rural India in dealing with COVID-19. These include scarcity of medical staff, equipment and health facilities, social stigma, fear of ill-treatment at the health facility, fear of losing income on being quarantined etc. Post-COVID complications are also emerging as a new threat in dealing with the current crisis. Health and Wellness Centres (HWCs) under Ayushman Bharat and Accredited Social Health Activist (ASHA) workers can play a crucial role in dealing with COVID-19 in the rural areas. ASHAs are involved in conducting house-to-house visits, reporting symptomatic cases, carrying out contact tracing, maintaining documentation, monitoring the situation and creating awareness about COVID-19 in the community. But, ASHA workers are facing many challenges such as increased work load, lack of protective equipment and training, they are underpaid, stigmatization, caste discrimination, domestic violence etc. India needs to develop a strategy specific to rural settings to deal with the COVID-19 situation. We believe that at a time when the federal and state governments are dealing with the challenges emanating from the Covid-19 pandemic, this crisis should be seen as an opportunity to strengthen the public health system in India. This would entail, among other things: 1) a much higher level of public health spending; 2) comprehensive training, effective control and oversight and timely and adequate payments for the ASHAs; 3) an effective and efficient management structure for the health facilities at the village, block and district levels; and 4) commensurate physical infrastructure and human resources in the sub-centers and the Primary Health Centers with the growing needs of the regions.

India is using Information and Communication Technologies (ICTs) to leapfrog economic development in key sectors: health, education, infrastructure, finance, agriculture, manufacturing, and perhaps most important, governance. In doing so, India is increasing Internet penetration by increasing Internet subscribers and digital literacy. These have acted as the key drivers for the Indian Government to envision digitalization in its various sectors including health care. The Government of India laid emphasis on digitalization in India's healthcare sector in its National Health Policy, 2017. The National Digital Health Blueprint, 2019 recognized the need to put together a National Digital Health Mission (NDHM) which can act as the foundation on which national digital health ecosystem can be built. On the nation's 74th Independence Day, the Government of India embarked on its journey to achieve Universal Health Coverage by launching the National Digital Health Mission. NDHM intends to create a holistic and comprehensive digital health ecosystem that will lay the foundation of a strong public digital infrastructure, digitally empower individuals, patients, doctors, health facilities, and help streamline the delivery of healthcare services and related information. However, it is important to emphasize that the success of NDHM is dependent on its adoption by the centre and states, by public and private entities and by individuals and decision makers. It is also crucial to analyse international experiences in order to learn from their achievements and mistakes.

COVID-19 has not left any part of the world untouched and India is one of the worst affected countries in the world. The cases in India are rising steadily with each passing day. As of August 10th 2020, India has over 2.3 million (the second million coming in exactly three weeks since the country hit a million infections on July 16, with 42 percent of the new cases coming from Andhra Pradesh, Karnataka, Uttar Pradesh, West Bengal and Bihar) confirmed COVID-19 cases and 46,188 reported deaths. The worst affected states of India include Maharashtra, Tamil Nadu, Andhra Pradesh, Karnataka, Delhi and Uttar Pradesh. Another growing concern is that interior parts of the country are emerging as new hotspots. Four states in eastern India, namely, Odisha, Bihar, Assam and West Bengal are increasingly reporting positive cases. The two main reasons being reported for this surge in cases in rural areas are the returning migrants from major cities who did not undergo screening or were asymptomatic and the poor healthcare infrastructure in the rural settings. Out of a total of 739 districts in India, 13 districts (across 8 states and a union territory) account for 1 in seven Covid-19 deaths. The 13 districts are: Kamrup Metro in Assam, Patna in Bihar, Ranchi in Jharkhand; Alappuzha and Thiruvananthapuram in Kerala, Ganjam in Odisha, Lucknow in UP; North 24 Paraganas, Hooghly, Howrah, Kolkata and Maldah in West Bengal, and Delhi. These districts account for nearly 9 percent of India's active cases and about 14 percent of COVID-19 deaths. Over the spring and summer, the COVID-19 situation in India has really deteriorated and could get much worse on the current trajectory with around 60,000 cases being reported per day and around 900 daily deaths. Lockdown and travel bans due to COVID-19 have impacted almost every sector including tourism, hospitality, and education. To deal with the coronavirus crisis, the central government has undertaken various initiatives like monetary relief package under Pradhan Mantri Garib Kalyan Yojana, Uttar Pradesh Rojgar Abhiyaan, Atma Nirbhar Abhiyaan etc. The state governments have also undertaken various initiatives like Operation SHIELD, 5T Plan, Mission Fateh, Snehar Paras etc. We describe these briefly. Some regions in India have successfully contained COVID-19 like the state of Kerala, the district of Bhilwara in Rajasthan and the slums of Dharavi in Mumbai. In order for a strategy of containment and recovery to succeed, it is vital to keep using public health measures to suppress the epidemic, that is to drive R < 1. Besides the infection rate, it is vital to closely monitor the positivity rate and the case fatality ratio (death rate) and rely not so much on the recovery rate which is what seems to be happening currently. Eventually, in all likelihood, as the pandemic subsides, close to 97 plus percent cases are likely to recover implying a 2 or 3 percent death rate. India needs a epidemic control strategy to be developed and put in place to control and contain the spread of the infection in the country, something that is not being done currently. Due to COVID-19, while most countries are facing the twin crises of public health and the consequent economic downturn, India has an additional challenge to deal with, namely a massive migrant workers crisis. While it is hard to say what long-term impact this home migration might have, but some trends were quite clear so we made a few recommendations to the government in May that we list along with some lessons for India to learn from elsewhere. On the economic front, a deep and prolonged economic slowdown is inevitable.