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Slovakia’s mass coronavirus testing finds 57,500 new cases
High participation in landmark screening programme identifies previously unknown hotspots

Slovakia used antigen tests, which deliver results in as little as 15 minutes but are less accurate than the standard PCR tests © Zuzana Gogova/Getty
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James Shotter in Warsaw NOVEMBER 10 2020
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An attempt to test almost the entire population of Slovakia for coronavirus identified 57,500 new infections, according to official figures from the landmark programme that has been closely watched by other countries.

The central European country tested 3.6m people — two-thirds of its population — on 31 October and 1 November using rapid antigen tests, before testing a further 2m people in the worst-hit regions — some for the second time — last weekend.

Despite long queues at some screening centres during the first weekend, fears that a lack of staff would stymie the project were unfounded. Participation was high with 80-90 per cent of eligible people taking part in the first weekend of testing and some previously unknown hotspots, such as in the district of Puchov, were identified.

In total, during the two weekends and a trial run in two badly hit regions a week earlier, 57,462 people tested positive, and were sent into quarantine along with their families, according to official figures. The country’s standard polymerase chain reaction, or PCR, testing has separately found 77,123 cases since the start of the pandemic.

Slovakia is the first EU nation to test its entire population so quickly, and the experiment was watched by health officials across the continent desperate to contain the second wave of the pandemic. The UK sent four officials to Slovakia to observe, and last weekend began a similar mass screening programme using antigen tests in the city of Liverpool.


People queue for a test in Bratislava on October 31 © Vladimir Simicek/AFP/Getty

British Army soldiers staff a coronavirus testing centre in Liverpool, north-west England, on Tuesday © Oli Scarff/AFP/Getty
Igor Matovic, Slovakia’s prime minister, said on Monday that the infection rate in regions that were tested in both rounds of screening dropped from 1.47 per cent in the first weekend to 0.62 per cent in the second. This, he said, meant that antigen testing was a very effective tool for fighting the pandemic.

“[When] I came up with the idea of mass testing . . . all sorts of opinions emerged, that this was complete stupidity and would only make the situation worse,” he said in a statement on Sunday.

“The results? Above all expectations. After [the second round] we can say that mass testing reduces the number of infectious people from week to week by 55 per cent! Which is amazing.”

Other experts were more cautious. Rather than PCR tests which are considered the gold standard for spotting coronavirus, Slovakia used antigen tests, which deliver results in as little as 15 minutes but are less accurate.

“We don’t know how many of those who tested negative are really negative,” said Professor Vladimir Krcmery, an expert on tropical and infectious diseases, who helped carry out the testing. “[Antigen tests] are not as sensitive as the PCR test, but you do catch the most infectious people.”

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Experts also cautioned that the drop in relative levels of infection across the two rounds of testing could not be attributed only to the impact of the testing itself.

“It is clear that the 55 per cent reduction in prevalence cannot be attributed only to mass testing,” said Martin Smatana, former head of Slovakia’s Institute of Health Policies. “A large part of the impact must be the result of stricter restrictions and reduced mobility,” he wrote on Facebook.

Prof Krcmery said bigger countries intent on testing their entire population should stagger screening over a longer period. But he said Slovakia’s experience showed that for small countries, rapid mass testing in conjunction with other tools such as quarantines and social distancing, could prove useful for fighting the pandemic.

“I would be very happy if we went back to the situation [in the summer] where we only had sporadic cases. But it would also be a partial success if this exercise means that we get a plateau [in case numbers],” he said.

“A plateau would serve as a bridge between now and the time that a vaccine arrives. But you have to build this bridge. You can’t just wait for cases to go down.”

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