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As Hyderabad opened up on Monday, crowds surfaced outside railway stations, and some temples even began selling the famed Tirupati laddus through regular counters. But the mood was one of nervousness.

For at least a month now, Hyderabad has been the only major Indian city where the daily testing capacity for suspected covid-19 cases has remained almost static (in Tamil Nadu and Andhra Pradesh, the capacity rose two-three times between April and May).

Doctors have critiqued the official policy of low testing; the high court has intervened. But nothing has effectively changed. And as India unlocks, Hyderabad will be the only major city to attempt a reopening without a massive ramp-up in daily tests, which can potentially catch disease clusters at an early enough stage.

“Everyone is anxious. Maybe (covid) cases will blaze through the city now," said Amir Ullah Khan, a development economist and public health expert. “Given the history (during two months of lockdown), I don’t think testing will become prolific suddenly."

The city seems to be adopting some form of an approach towards herd immunity, said Ram Karan, a former joint resident editor of The Times of India, Hyderabad. “It’s just that no one wants to openly admit it." The rise in daily cases (which might include many mild cases) is being seen as a source of unnecessary panic, Karan said. “We are unique in the overall country in how quickly we abandoned the idea of testing."

But while that strategy may have worked somewhat when the city was under substantial or total lockdown, opening up will result in a massive increase in interpersonal interactions. “If you don’t have a lockdown, then massive testing is key," said Sujatha Rao, a former health secretary with the government of India. “I personally feel the city has opened a little too fast. It should have been more gradual and cautious. In 60 days, the city ought to have had adequate testing kits."

“This is the strategy that every major economy that has opened up—from South Korea to Sweden—has used effectively. If the state doesn’t do testing, and there is no lockdown, then cases will obviously rise," Rao said.

Essentially, under a blanket name like “strategic testing", one can’t just pick and choose what to do, she said. “The (current) testing strategy is so non-transparent and changes every day," Rao added.

Neither the state government nor the municipal corporation of Hyderabad have publicly responded to the criticism yet.

One unintended fallout has been a rethink of the city’s containment plan. Since only primary contacts of known covid-19 cases are tested, the containment boundaries have also started to consistently get narrower, so that only primary contacts are placed under quarantine. “In many cases, the containment zone has become just one unit of dwelling. It’s one house," said Anant Maringanti, director of Hyderabad Urban Lab, a multidisciplinary urban research centre.

“Barely a month ago, there were entire lanes where people, on their own, made barricades. All of that has changed now. The question is: Do these narrow containment regions account for the fact that in some parts of the city, interaction levels between separate housing units is very high?"

“We (Hyderabad) are doing something very unusual and we can only hope we are right," Maringanti added.

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