Slovakia plans to test entire population for Covid-19:But president calls for rethink

Slovakia has begun an ambitious project to test everyone over the age of 10 for Covid-19, but the president has said she thinks the idea is “unfeasible”.

The operation to test four million people is to last over two weekends.

Infections have soared in Slovakia and officials argue the only alternative would be a total lockdown.

President Zuzana Caputova called for a rethink of the plan after armed forces chiefs said there were not enough trained health workers to carry it out.

So far only 70% of the 20,000 staff needed to administer the nasal swab tests have been recruited, according to the defence minister.

Some 45,000 medical workers, army and police are being deployed to carry out the tests in the EU member state of 5.4 million people, collecting swabs at around 5,000 testing points.

“The world will be watching,” Prime Minister Igor Matovic said earlier this week, adding that the measure would save “hundreds of lives”.

Antigen tests give quick results — sometimes within minutes — but are not seen as being as reliable as the PCR test for which nasal swabs have to be sent to a lab for analysis.

Participation in the testing is not mandatory but anyone who is not able to produce a negative test certificate if stopped by police could get a heavy fine.

Anyone who tests positive has to go immediately into quarantine for 10 days.

“This will be our road to freedom,” Matovic said, hinting that virus restrictions could be eased once testing is complete or reinforced if the programme is not carried out in full.

Slovakia would be the first country of its size to undergo nationwide testing, although mass testing has taken place in entire Chinese cities.

Smaller European states such as Luxembourg and Monaco have also announced mass testing programmes.

Government ‘threatening people’

Like other countries, Slovakia has seen a sharp rise in covid-19 cases although it is below the EU average.

On Friday it reported a record of 3,363 new daily infections, bringing the total to 55,091. The death toll currently stands at 212.

The government is hoping to complete the nationwide testing over two days and carry out another round of mass tests next weekend.

But it has struggled to find medical workers to staff all the testing sites and has been forced to offer cash bonuses for doctors.

During pilot testing in four high-risk regions last weekend, people had to queue for up to two hours in some cases.

The Slovak Association of General Practitioners has criticised the government’s plan, saying it is ill-prepared.

The association said that the “mass concentration of millions of people” at testing sites “is at odds with the recommendations of infectious disease experts to reduce public contacts and mobility as much as possible”.

Many ordinary people — like Radovan Babincak, an unemployed man living in the capital Bratislava — want to stay away.

“The government and the prime minister are threatening people,” the 40-year-old told AFP.

Anton Dubovsky, a 67-year-old petrol station operator, said he and his son would not go.

“I am not convinced this testing is a good idea at all,” he said.

There’s no alternative’

From dawn on Saturday, soldiers and medics were due to fan out across the country, from the vast Petrzalka housing estates of Bratislava, to tiny hamlets in the shadows of the Tatra Mountains, to the mostly Hungarian-speaking towns dotted along the Danube plain.

Long queues and some delays were reported at testing centres as Prime Minister Igor Matovic urged people to take part.

“The eyes of Europe and the world are upon us,” he said.

The plan is to test almost four-fifths of the population, using rapid antigen testing that has an estimated 30% false negative rate. Results will be delivered in a sealed envelope within 30 minutes.

“It’s the army’s biggest logistical operation since the country became independent,” said Defence Minister Jaro Nad.

“In terms of the pandemic we’re in a worse situation than the Czech Republic, but we’re two or three weeks behind,” he told me. He said he had been put in charge of the national operation after a pilot project in four counties in northern Slovakia had been judged a success.

The neighboring Czech Republic, with twice the population, recorded 13,051 new infections on Thursday, bringing its total to 310,068. Some 2,862 people have died, and the mortality rate in the past two weeks is the highest in the EU.

Slovakia’s numbers are far lower but government modelling predicts a catastrophic overload of hospitals by mid-November if nothing is done.

“There’s no alternative – it’s either mass testing or harsh lockdown,” Mr Nad told the BBC.

Why antigen tests?

The standard diagnostic tool for Covid is PCR tests (polymerase chain reaction), which detect the presence of the virus’s RNA – its genetic material. PCR tests are fairly sensitive, offering perhaps 90% accuracy, but they are slower and more expensive.

Antigen tests detect the presence of coronavirus proteins. While they are quicker, they are also less accurate, producing high false negatives – around 30%, depending on the type of test used.

However, the defence minister said that in the current situation they were by far the best option.

“It’s actually a fantastic number – if you take into account that you’re identifying 70% of sick or infected people across the country,” said Mr Nad.

“You then send them home so they don’t come into contact with other people and spread the infection further.”

“There’s no better alternative if you want to find thousands and thousands of people who are currently infected but don’t know it.”

Each test result, handed out in a sealed envelope, will contain a leaflet explaining what to do next if positive – go home, self-isolate and call your doctor.

“Most of them will be healthy after 10 days. Some of them will probably end up in hospital. But they’d end up in hospital anyway,” Mr Nad told the BBC.

However, the operation is now the source of intense criticism at the highest levels.

While testing is voluntary, those who refuse must self-isolate for 10 days. Breaking that quarantine will be punished with a hefty fine.

A negative test result, however, will serve as a “free pass” from a curfew due to be introduced from Monday.

‘Idea born out of despair’

President Caputova called the curfew measures “divisive”, saying that such categorisation of citizens was “the last thing we need at the moment”.

And the sheer scale of the operation has aroused some scepticism.

“Two days before they’re due to start and they don’t have enough people for the testing. It looks impossible,” said Matus Kostolny, editor-in-chief of the daily Dennik N.

Others were more understanding.

“Yes, it’s an idea born out of despair. But no-one in Europe seems to have a solution of how to flatten the curve of new infections during this second wave,” said Pavol Strba, foreign news editor at online daily

If it works, other countries might soon follow suit.

The defence minister told the BBC that the Slovak government had received a call from an adviser to UK Prime Minister Boris Johnson, asking them to share information both from the pilot project and the two weekends.

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