Authorities in Slovakia say they hope a nationwide programme in which two-thirds of the country’s population were tested for Covid-19 in just two days last weekend will halve the number of cases of the virus in the country.
The Slovak testing programme has drawn interest from across Europe, as debates continue about whether or not blanket testing is the best way to fight coronavirus. A Downing Street team travelled to Slovakia last weekend to witness the testing, keen to draw lessons before a mass testing programme due to be launched in Liverpool this weekend.
Slovak officials said the team included two Downing Street advisers and two people responsible for arranging the UK’s large-scale testing programme in Liverpool.
“They are interested in our lessons and in the details and results,” said Slovakia’s deputy defence minister, Marian Majer, who added that Slovakia has offered to send a planning team to London to help with UK preparations if required.
A No 10 spokesperson declined to comment on the visit except to say that “we are constantly seeking to evolve our testing system in order to control the spread of the virus and bring the R rate down”.
In Slovakia, the army ran the logistics of the operation, which involved 5,000 eight-person teams working over the weekend, with a combination of military and civilian medics performing the tests. Army medics from Hungary and Austria also took part in the testing.
Tests were carried out on 3.6 million out of the country’s 5.4 million population, making it the largest country to carry out a nationwide testing programme so far. A little over 1% of those tested, 38,359 people, tested positive. Rapid antigen tests made in South Korea were used, which give results within half an hour. PCR tests are more accurate but costlier and take longer to process in labs.
People were told to come to their local testing point at a particular time, depending on the alphabetical order of their surnames, though Majer admitted it had not always worked, and there were bottleneck periods with long queues. Children under 10 were not obliged to be tested, and people over 65 and those with serious medical conditions were also not recommended to take the test.
Testing was not obligatory, but those who declined to take it were required to quarantine for two weeks, along with those who tested positive. Those who took the test and did not have the virus were given a certificate allowing freedom of movement. The second phase of testing will take place this weekend in 45 of Slovakia’s 79 counties where the infection rate was higher than 0.7%.
“We are expecting to cut in half the number of positive cases,” said Majer.
Slovakia, like many countries in central Europe, had much lower case numbers than neighbours further west during spring, but has reported increasing numbers in recent weeks.
While many countries are considering the potential benefits of mass testing, given that track and trace programmes in many places are be floundering, not everyone is enthusiastic about testing the whole nation.
Richard Kollar, a mathematician from Comenius University in Bratislava, said there were two reasons why it was a waste of resources to test the whole country.
“The first reason is logistics. China can test a city of 9 million by bringing doctors from other parts of China. But when you try to organise testing the whole country, it’s simply impossible to have enough qualified personnel to do it properly,” he said.
He added that mass testing was only suitable in areas with a high prevalence of coronavirus. While the test is believed to give false positives in only 0.4% of cases, when it is used in low prevalence areas this can skew the results. The test’s 0.4% false positive rate means that from the overall sample of 3.64 million in the Slovakia test, around 15,000 of the 38,000 positive cases are likely to be false. And there will have been many more people who do have the virus which the test did not detect.
Kollar said the plan to do targeted, repeated testing in Liverpool was a better idea, but positive results should be followed up with more accurate PCR tests. “Frequent, repeated testing in the biggest clusters is what the antigen tests are perfect for,” he said.