Spike in COVID-19 cases in Mizoram, which prompted the Central government to rush a team of experts, has sounded the alarm bell ringing against yawning gaps in disaster management in the state. It has also exposed poor health infrastructure in the state that needs immediate attention. A single-day rise of 1681 positive cases on Tuesday pushed the active caseload to over 16,000 in the Northeastern state with a 10.97 lakh population. The single-day positivity rate stood at 18% when the daily positivity rate for the country stood at 1.34% (less than 3% for 37 consecutive days). The country's active caseload declined to 2,46,687- the lowest in 203 days. The Aizawl district accounts for the highest active caseload close to 10,000. The district accounting for nearly 40% of the state's population explains the district also accounting for nearly 62% of the active caseload in the state bordering Myanmar and Bangladesh. Over 300 children being among the new positive cases is a matter of grave concern for parents as well as the state health authorities. The arrival of the Central team has triggered hope for improvement in the situation but testing remaining quite low could pose hurdles in getting the desired results. While the Ministry of Health and Family Welfare has been asking all the states to intensify testing, tracking, and treating to prevent a spike in cases, Mizoram has only one hospital notified as COVID care centre and one government laboratory for RT-PCR testing. As the capacity of the lone RT-PCR testing centre is limited many infected patients have remained undetected and such infected patients mingling with others in public places spread the infection. The expert team is learnt to have suggested to the state health authorities to strengthen COVID-19 care facilities in the entire state by putting in place a dedicated wing in all district hospitals. Another Central team visited the state last month when daily and weekly positive cases continued to rise. It is surprising that the state failed to learn lessons from the two waves of pandemics and still having only the Zoram Medical College Hospital in Aizawl with 341 beds including 34 in the Intensive Care Unit as the lone COVID hospital for the entire state with nine district hospitals. The State government's plan to run a 10-day campaign to sensitise people on COVID-19 appropriate behaviour of wearing a facemask and using hand sanitiser/handwashing is a timely measure. Ensuring that the awareness drive continues even after the official campaign period is over is critical to achieving the desired result. Apart from strengthening the COVID care facilities, the state improvising its health system is important to build resilience against such disaster management. The State Health and Family Welfare Department have received a 32 million US dollar support from the World Bank to implement the 'Mizoram Health Systems Strengthening Project' (MHSSP). The project has four major components which include the creation of an enabling environment for reforms at state, district, and sub-division levels, enhance the performance of the department and its subsidiaries, and improve the efficiency of the public health administration. Besides, the project will support improvements in clinical and non-clinical services and the availability of medicines and diagnostics. At the referral level, it will support the strengthening of neonatal and pediatric intensive care units. Capital investments will improve infrastructure and fill key equipment gaps, and include retrofitting to ensure water supply, sanitation, and electrical power states a World Bank document on the project. Another key component of the project is to enhance the quality of health services and developing a comprehensive quality assurance system, improving biomedical waste management enhancing human resource management are critical sub-components. In addition, a mechanism for the provision of immediate response to health crises or emergencies will be put in place. The project, however, will not finance the construction of large hospitals or healthcare facilities that may require the Health Department to explore alternative resources available with the State government to set up more healthcare facilities for better access of the people. The project, if implemented in the right earnest, will bring about a change in the health system but that will not happen immediately and take a few years. The prevailing COVID situation in the state demands that the state should mobilise all resources available to set up one COVID care centre in each district hospital and take a cue from Assam and other neighbouring states in setting up an adequate number of temporary covid care and isolation centres to augment treatment capacity and set up more RT-PCR laboratories with assistance from the Central government to increase the testing capacity. Unless testing is ramped up, the state cannot hope to check the infection as relaxation in COVID restrictions has become a necessity to put the economic activities back on the rails. The prevailing situation calls for special measures by the Mizoram government.