With a second wave of coronavirus infections sweeping through Europe, one of the continent’s smallest countries is attempting a big response: Slovakia will try to test every adult over the next two weeks.
The government on Friday began its mass testing campaign in the north of the country, which has been hit hard by the new coronavirus. Thousands of people began lining up at schools, town halls and indoor swimming pools that have been converted into testing centers by the military.
The government has banned residents in the north from leaving their homes for almost any reason—unless they are on their way to get tested or can present a negative result.
Officials said they would ask every resident older than 10 in the country of 5.5 million to get tested twice before Nov. 8. Those who refuse to get a test will be asked to stay at home for 10 days, or face fines of up to about 1,600 euros, equivalent to $1,891. Those over 65 are exempt from participating in the program but are invited to take part. Officials said testing centers would be open nationwide by the end of next week.
Testing an entire population quickly when an outbreak is detected worked for the Chinese coastal city of Qingdao this month: Authorities tested more than seven million people after 12 cases were reported near the city’s port.
Slovakia is the first Western country to attempt a similar feat. Many epidemiologists and medical scientists at European universities have praised mass testing as a solution that, while imperfect, could allow governments to isolate small groups of exposed people rather than impose nationwide lockdowns.
“That’s the way forward, there’s no doubt about it,” said Luke O’Neill, professor of biochemistry in the School of Biochemistry and Immunology at Trinity College Dublin. “That’s a good case study. If that one works it will be informative for the rest of the world.”
Elsewhere in Europe, leaders have tried to avoid plunging their already distressed economies into another round of draconian restrictions. Instead, governments have enlisted teams of contact tracers to look at those who have contracted Covid-19, the disease caused by the coronavirus, and work backward to identify who else may have been exposed. The goal is to quarantine individuals—not entire countries.
But those efforts to track Covid-19 on a case-by-case basis have struggled to keep pace with a fast-moving virus that often spreads from individuals who aren’t yet sick.
Hospital staff worked on Thursday with a Covid-19 patient in the Czech Republic, which has Europe’s highest hospitalization rate.
Petr David Josek/Associated Press
Contact tracing in France and Belgium has been overwhelmed as both countries experience a drastic rise in infections. Slovakia’s neighbor, the Czech Republic, is now suffering the continent’s highest rate of hospitalizations, according to the European Centre for Disease Prevention and Control. Around 1% of the country currently has a Covid-19 infection.
All of those countries and many of their neighbors have had to impose restrictions this fall on businesses and on the social life of their citizens.
Slovakia’s case count has doubled in the past two weeks, forcing the country to impose similar restrictions. The mass testing plan is the best way to keep those restrictions mild and brief, Prime Minister Igor Matovic told reporters on Thursday. “Trust me, this is the only way to avoid a total lockdown and the inevitable economic damage linked to it,” he said. The government has bought millions of tests to prepare for the campaign.
There are limits to what a mass testing program can accomplish and some of those problems were visible Friday as testing began.
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The makeshift test sites were without staff or sufficient paperwork, and had to delay opening until late in the morning or afternoon, as people mingled nearby. The government has struggled to swiftly recruit the thousands of health care workers and medical students who are needed to conduct the tests.
At testing centers, staff complained of having to buy their own disinfectant. It wasn’t clear how the government would check whether people circulating in the streets had been tested.
“I have some unanswered questions as to how people will be protected from getting infected while waiting to be tested,” Peter Pellegrini, a former prime minister and member of the opposition, told reporters. “I think it is a project that hasn’t been well prepared.”
The tests aren’t the higher-quality PCR diagnostic tests that were used in Qingdao, which detect the presence of viral genetic material. Instead, the government is using less accurate antigen tests that look for specific spike proteins on the virus’s surface. Some epidemiologists worried that the relatively high rate of false negatives will lead to infected people carrying on with their social life.
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“They will think they are OK and they will spread the infection further,” said Alexandra Brazinova, epidemiologist at the Faculty of Medicine in Bratislava’s Comenius University. “We worry this will decrease the public’s trust in testing altogether.”
The government said there were few other options left. One hospital on Friday said its Covid-19 ward was full, while others complained of staff shortages. The country’s Federation of Employers’ Associations, an important business lobby, said it supported the mass testing as an unorthodox alternative to a protracted lockdown.
“I think it’s brilliant,” said Devi Sridhar, professor of global public health at the University of Edinburgh. “Yes it’s not perfect, but we’ve been debating too much. It’s not like you have to catch every case….You just have to catch the bulk of cases.”
Mass testing has become a major part of how the Chinese government plans to eradicate coronavirus and keep the economy on track. WSJ’s Chao Deng explains how the tourist city of Qingdao wants to test 9 million residents after a cluster of new cases. Photo: Agence France-Presse/Getty Images
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