Coronavirus measures work. Very few severe cases in Slovakia so far

Experts expect the peak in early July, but fewer infections than originally expected. Measures will need to last for more weeks, they say.

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Three patients at the intensive care units and none of the 336 patients infected with the novel coronavirus need artificial lung ventilation.

No death has been officially confirmed yet. This is the picture of the Covid-19 epidemic in Slovakia on the 24th day since the first patient was identified on March 6.

Thanks to the low number of infections and very low number of severely ill patients, Slovakia belongs among countries where the novel coronavirus epidemic is progressing at a very mild rate.

This stems from the comparison of Slovakia's data with three similar-sized countries - Czechia, Hungary, and Slovenia. Among these countries, only Hungary has fewer infections per one million inhabitants than Slovakia.

The mild progress of the epidemic is mainly due to the fact that Slovakia took stringent measures very early on, and that Slovakia's inhabitants are disciplined in adhering to the measures, experts say.

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Despite the positive progress, experts warn it would be too early to celebrate and if Slovakia wants to contain the epidemic without greater losses, it must continue respecting these strict, limiting measures.

The Health Ministry still reckons with a prognosis that projects the peak of the epidemic at the turn of June and July. Compared to their earlier prognoses, fewer people are expected to get infected.

Slovakia coronavirus measures are tough but effective

"If the epidemic continues for a longer time and there are fewer infections, the progress tends to be milder," the head of the Slovak Infectologists' Society Pavol Jarčuška explained.

This is in line with the model that the head of the Institute of Health Policy (IZP) running under the Health Ministry, Martin Smatana, presented on March 17.

The model that he presented at that time, being the effect of the measures that Slovakia launched in mid-March, resulted in the fact that the epidemic will last at least three months here, but there will be a lower number of infected and severely ill cases. The peak was expected on June 23.

"We took very strict measures very early on. Their effect is only showing now," said head of the Epidemiology Department at the Public Health Faculty of the Slovak Health University, Zuzana Krištúfková.

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One of the first and key measures was the ban on public events, which was applied as early as the fourth day since the first case was confirmed. In Slovenia, for instance, gatherings of fewer than 100 persons are still allowed.

Slovakia also took other measures very early on, compared with the aforementioned countries. On the seventh day, for instance, the country closed its borders, bars and pubs. Schools closed on the tenth day. Czechia, on the other hand, closed its borders after more than two weeks, on day 16.

"We have managed to prevent the outbreak of a sweeping epidemic like the one we see in Italy," explained Jarčuška.

The respected infectologist considers it key that the novel coronavirus infection did not penetrate social care homes, mainly pensioners' homes. People older than 65 are the most at-risk group. At 70 and older, as many as 43 percent of patients experience very serious to life-threatening course of the illness, according to the IZP prognosis.

"There have been appeals to the at-risk population from the very start," says Mária Avdičová, head of epidemiology at the Banska Bystrica Regional Public Health Office.

Thanks to the fact that seniors have been protected from the infection "we now have most infected people at a relatively good age", says infectologist Jarčuška.

The same thing stems from the Health Ministry statistics. The people who tested positive are mainly middle-aged and young. These groups usually experience mild symptoms.

"It is also positive that the virus has not penetrated marginalised groups of Roma communities," Jarčuška said. So far, there has been one suspicion in a community like this in Gelnica, but tests did not confirm the infection.

Slovakia might have also benefited from the fact that it is not as attractive to tourists as Austria and Czechia, said the head of the Virology Institute of the Slovak Academy of Sciences, Juraj Kopáček.

"This might be linked with the lower number of imported cases and, on the other hand, fewer inhabitants might have travelled abroad at the critical time," he added.

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The head of the infectologists' society, Jarčuška also sees behind the mild progress of the Covid-19 epidemic in Slovakia the fact that Slovakia's inhabitants are rather disciplined, and try to adhere to the restrictive measures in their daily lives.

Another key fact was that people started wearing protective masks en masse.

"The mask significantly lowers the amount of virus released into the environments and even if anyone gets infected, they get a lower dose [of the virus] which results in a milder course of the illness," Jarčuška explained.

Slovakia has not beat the coronavirus yet

Despite the positive development, all the experts the Sme daily spoke to warn about premature optimism.

It is too early to make any conclusions about the positive development of the Covid-19 illness in Slovakia, says Avdičová.

"For the measures to be really effective, we need to stick with them for another 14 days. At least. We really need to hold on," Krištúfková said.

"It matters what measures are taken in the near future, including the Easter holidays, and what the overall movement of the population will be," says Kopáček of the virology institute. "This might have a significant impact on the further spread or inhibition of the infection."

He says it is important to realise that "we have not reached the peak of the epidemic in Slovakia yet, so these favourable infection and mortality numbers are set to change".

Health Minister Marek Krajčí (OĽaNO) said on Monday that the updated prognosis sets the peak of the epidemic still on the 110th day from March 15, when the massive measures were taken. That means it should come in early July.

Yet, contrary to the first prognosis, the experts only expect 3 percent of Slovakia's population to be infected, as opposed to 10 percent in the previous prognosis from mid-March.

"At this point we will need to secure lung ventilation for 1,000 people. About 7,000 people will be hospitalised with rather severe symptoms of the illness," Krajčí told the press conference on March 30.

The head of the IZP said they would publish the updated prognosis regularly, but they have only done so two weeks after the first one was out. The health minister suggested one day before that it depended on the decision of PM Igor Matovič (OĽaNO).

What did Czechs, Hungarians and Slovenians do? The Czech Republic tested 200 people with negative results before their first case was confirmed. On March 1, their labs recorded the first three cases, all of them with a history of travel to Italy. At the end of January, the Czech government stopped issuing visa for Chinese citizens and subsequently cancelled all direct flights to and from China. On the 10th day, they closed schools, with the exception of kindergartens, and banned public events of more than 100 people. Two days later, the state limited the opening hours of pubs and restaurants, ordering them to close at 8 pm. Public events were only allowed if attended by 30 or fewer people. On the 15th day, the government ordered an all-out quarantine. Czechs can only leave home to go to work, to the doctor, to do shopping and take care of other essential needs. At that point there were 383 cases in the country. Hungary has focused on partial restrictions since the first case was diagnosed in the country. The first two cases were diagnosed in students from Iran, which is why the Orban government stopped granting visas to Iranian citizens. Five days later, it banned all flights from northern Italy, since the third confirmed case was a 69-year-old British citizen regularly travelling between Milan and the Hungarian city of Debrecen. After one week, Hungarians banned entry to the country for arrivals from China, South Korea, Italy, and Iran, with the exception of Hungarian citizens who had to go on compulsory quarantine. Like in the Czech Republic, Hungary only gradually restricted public events - seven days from the first case, it restricted attendance to 100 people if taking place indoors or 500 outdoors. Restaurants and cafes have not been closed in Hungary as of March 31, although they are not allowed to remain open longer than 3 pm. Slovenia's first case was a traveller from Morocco via Italy. Most of the initially recorded cases had some links to Italy, Slovenia's adjacent neighbour. Slovenia imposed a ban on public events of more than 500 people on the third day, and lowered the limit to 100 people two days later. Six days from the first case they banned flights from four risk countries - China, South Korea, Iran, and Italy. On the eighth day, Slovenia closed schools. On the tenth day, the new government took over and closed all bars and restaurants within 24 hours. Slovenia has not closed its borders completely, only crossings with Italy.

©Sme

31. Mar 2020 at 11:28 | Michal Katuška , Ján Krempaský