National testing program in Slovakia decreases national COVID-19 prevalence by 58% in one week
As COVID-19 cases started their third surge in the United States and in Europe, one country undertook a massive nationwide COVID-19 testing initiative that appears to have significantly impacted the prevalence of COVID-19 cases in that country. Slovakia, a small country of 4 million people and located in central Europe, organized two rounds of national COVID-19 testing in late 2020.
While the national testing strategy was implemented by Slovakian health officials in late 2020, research about the effectiveness of this testing strategy was published more recently (late March 2021). So far, the impact of Slovakia’s national testing program supports the efficacy of large-scale COVID-19 testing and serves as a potential model for other governments.
How Slovakia’s National Testing Program for COVID-19 Worked
The national testing strategy employed by Slovakia included at least two nation-level rounds of COVID-19 testing using antigen testing and pooled sample testing to accommodate the volume of tests required. Slovakia was able to achieve high compliance with this national testing program—3.6 million of its 4 million citizens participated.
Positive individuals were quarantined upon identification, and clusters of positive individuals were tested more frequently. Contact tracing was also used to help prevent the spread of infection. All quarantining, contact tracing, testing, and other COVID-19 prevention measures were completely voluntary during Slovakia’s testing program.
The results from this innovative program were significant. Within one week of beginning national testing, Slovakia realized a 58% decrease in COVID-19 prevalence. This decreased prevalence was statistically significant, even when adjusted for numerous other safety measures that were implemented in the same time frame.
National COVID-19 Testing in the US?
“Because we’re a small country, it’s much easier to execute ideas,” Martin Pavelka, an epidemiologist at Slovakia’s Ministry of Health, told Scientific American in a recent interview. “It was a massive campaign. In Slovakia, 40,000 army staff supported the whole intervention. We had 20,000 medical staff because it was a nasopharyngeal swab, so you have to be trained to administer it.”
“The mass testing was definitely useful in that it took tens of thousands of infected people out of circulation,” Pavol Jarcuska, President of the Slovak Society of Infectologists, said in a recent interview. “What needs to happen now is more testing, backed up by contact tracing.”
While a nationwide COVID-19 testing program can be implemented in a smaller country such as Slovakia, trying to develop a similar program in the United States would be much more difficult. “I don’t think the U.S. would be able to replicate this approach,” Pavelka says. “More than 300 million people—it’s just too much. But for smaller countries—I could see this working in Estonia, I could see it working in Portugal, I could see it working in Ireland.”
Considering Mass COVID-19 Testing for Local, Regional Outbreaks
Perhaps prohibitive nationwide in the US, a mass COVID-19 testing program in the US—modeled after the program implemented in Slovakia—could potentially be implemented in the event of future outbreaks at the state or county level. Clinical laboratories that are working with local governments could suggest similar initiatives during localized or regional COVID-19 outbreaks.
As some COVID-19 vaccines begin facing safety questions and emerging variants increase the risk of new outbreaks, the recent research on Slovakia’s national testing strategy provides a potential model for containing infectious disease outbreaks. Clinical laboratories can serve as a resource on implementing this type of model and provide this type of wide-scale testing if it becomes necessary.
—By Caleb Williams, Editor, STAT Intelligence Briefings
Scientific American: Slovakia Offers a Lesson in How Rapid Testing Can Fight COVID
The Lancet: COVID-19 testing in Slovakia