The unfolding COVID-19 emergency in India not only points to the explosive speed with which SARS-CoV-2 can spread in populations if unchecked, but also to the gross misreading of the status of the pandemic when decisions to reopen the economy were made in March this year. In this modelling analysis, we isolate the population and policy-related factors underlying the current viral resurgence, and project the growth and magnitude of the health impact and demand for hospital care that may arise if immediate measures to contain the pandemic are not implemented. We indicate that only by re-introducing some measure of social mitigation alongside a swift ramping up of vaccinations will the country be able to contain and ultimately end the pandemic safely. Our results together with the scale of the virus resurgence reported in India also highlight the need for national decision-making that is driven primarily by scientific analysis and data.