India has eased its COVID-19 rules on testing, quarantine and hospital admissions in a bid to free up resources for its neediest people, a strategy hailed by experts even though it carries the risk of a heavy undercount of infections and deaths.
The moves will offer a breathing space for healthcare facilities, often overstretched in the nation of 1.4 billion, as they battle a 33-fold surge in infections over the past month from the highly contagious Omicron variant.
This week, federal authorities told states to drop mandatory testing for contacts of confirmed cases unless they were old or battling other conditions, while halving the isolation period to a week and advising hospital care only for the seriously ill.
"Contact-tracing has been the most resource-intensive activity since the pandemic began," said Sanjay K Rai, a professor of community medicine at the All-India Institute of Medical Sciences in New Delhi.
"That strategy did not work and wasted resources," he added, saying serological surveys had shown it had detected only a fraction of infections. "The new one will ensure optimum utilisation of what we have got."
India's tally of infections crossed 36 million on Thursday, with 247,417 new cases, although daily testing has stayed well below the capacity of more than 2 million.
Four Indian epidemiologists echoed Dr Rai's view, saying it was better to monitor the numbers of those in hospital, rather than infections, while targeting crowded spaces such as workplaces, dormitories and barracks with rapid testing.
They added that the guidelines on shorter isolation and hospital admissions were in line with global practice, as most Omicron sufferers recover quicker, although they spread the virus faster.
But some experts say the new rules could lull people into taking infections lightly until it is too late, especially in the rural areas home to two-thirds of the population, where few seek tests unless directed by authorities.
"This new strategy will affect data from rural India or certain states in a disproportionate way," said Bhramar Mukherjee, an epidemiology professor at the University of Michigan.
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