Slovakia is the first country to attempt COVID-19 testing on a national scale. While not uncontested, this could be a potent strategy for staving off further economic and social calamity
As COVID-19 cases surge across Europe, a new mass screening strategy being implemented in Slovakia could prove instructive in providing a continent-wide blueprint for curtailing community transmission, averting loss of life, and reopening shuttered businesses and schools.
Responding to an uptick in cases, the Slovak government has initiated a national testing scheme, requiring its adult population, aged 10-65, to be either tested twice for COVID-19 over two consecutive weekends, free of charge, or complete a 10-day period of home quarantine.
Initial results are promising
Put together in only the span of a week, the mass screening, which makes use of rapid antigen tests that produce results within 30 minutes, was piloted this past weekend in northern regions of the country most impacted by the coronavirus. Initial results appear promising.
The trial run saw lines of residents waiting to be swabbed snaking around school buildings, swimming pools, daycare centres, movie theatres, and mobile testing sites. Over 90 per cent of the approximately 155,000 people in the pilot area required to participate completed the first round of testing, with 3.97 per cent of tests coming back positive.
Testing is now set to expand nationally over the next two weekends.
Slovakia received widespread plaudits for its early decisive action in March, including a lockdown and a national mask mandate, which warded off the first coronavirus wave. Yet, cases have recently soared, spurring Prime Minister Igor Matovič to devise a bold and unconventional approach to the problem at hand.
The spike in cases across Europe has put contact tracing programmes under severe strain and hospital systems on the brink of collapse. The Czech Republic and Poland, facing among the highest per capita rates of infection in Europe, have opened makeshift field hospitals. Caps on public gatherings, the shuttering of social establishments, evening curfews, mask mandates, and school closures, meanwhile, are back across the continent.
Against this backdrop, the value of Slovakia’s testing scheme lies in identifying both asymptomatic, up to 40 per cent of those infected, and symptomatic cases. Detection will ensure that so-called ‘silent spreaders’ do not unbeknownst transmit the virus, including to those in high-risk groups.
While Slovakia is the first country to attempt testing on a national scale, similar screening programmes have been successfully implemented across a range of sectors in different countries.
The return of professional sports leagues, like the Bundesliga in Germany and the NBA and MLB in the United States, has been made possible through frequent and rapid testing of athletes. Similarly, through twice-weekly testing of students, some universities have been able to maintain in-person instruction and on-campus social activities without major COVID-19 outbreaks.
Not without pitfalls
Large-scale testing, meanwhile, has been adopted as a strategy in China with health authorities recently carrying out mandatory testing of all residents in the city of Qingdao after coronavirus cases were detected.
Though not without pitfalls – the Slovak government has struggled to recruit enough health professionals to carry out testing – what is perhaps most remarkable is that the Slovak testing regime has been put in place within an extremely short time window.
The country has put its military in charge of managing the logistics of the operation, alleviating an already over-burdened healthcare bureaucracy, and transformed election polling places, mostly schools, into testing sites giving predictability and order to the process.
The testing also comes at an attractive price point. While many institutions have discovered that tests that can be cost-prohibitive at more than 100 euros each, the 13 million antigen tests ordered by the Slovak government come in at only 4 euros per test. As noted by Slovak Prime Minister Igor Matovic, this expense pales in comparison to the potential damage inflicted on economies by COVID-19-induced lockdowns.
The approach has not been without pitfalls though. Hastily organised – even President Zuzana Čaputová was not initially privy to the plan – the Slovak government has struggled to recruit enough health professionals to carry out testing under the extremely short time window.
Some critics argue that the Slovak government’s use of antigen tests, rather than more accurate molecular tests like PCR, could result in numerous false negatives. The government, nonetheless, expects 80 per cent of infectious cases and 30 per cent of overall cases to be identified.
In Iowa, Cornell College similarly employs antigen tests and has yet to experience an outbreak, potentially illustrative of the promise of the approach.
Failure to identify every case through testing need not be a problem. Bringing down coronavirus cases is enough to mitigate the human and economic toll and enable schools and businesses to reopen. Because cases will rise again if left unchecked though, any such scheme should be supplemented with mask mandates, continued vigilance in social distancing, and the organisation of multiple rounds of testing.
Repurposed testing sites
While Slovakia is a distinctly small country, there is no reason national or local testing cannot be replicated elsewhere with similar strategies. The armed forces have already been mobilised in numerous European countries to carry out logistics in support of pandemic responses. And like in Slovakia, many of the same locations that serve as polling places could also be repurposed as testing sites.
With many European countries setting new records of cases and reimposing restrictions, adoption of national testing programmes could indeed prove a potent strategy for staving off further economic and social calamity until a vaccine becomes widely available.