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A health-care worker tests a sample at a COVID-19 testing site, in Trencin, Slovakia, on Oct. 31, 2020.RADOVAN STOKLASA/Reuters

Slovakia is gradually reopening its economy after declaring its mass-testing program, the first of its kind in Europe, a success.

The small central European country tested two-thirds of its 5.5 million people over two days, on Oct. 31 and Nov. 1, using rapid antigen kits, which are less accurate than PCR tests.

A week later, a second round of tests was done in the worst-hit regions and found a few new hot spots.

Officials say the two-stage testing program identified 57,500 new COVID-19 cases. All the people who tested positive were put into mandatory quarantine. Testing was not obligatory, but anyone who refused to take a test was required to isolate. Those who tested negative received a certificate allowing them to move about freely.

In a Facebook post Sunday, Health Minister Marek Krajci said mass testing “broke the curve … and directed it quite steeply down.” But he warned that Slovakia was nowhere near declaring victory. “If we don’t keep testing and get infections out of the population, the reproduction number will rise again and the curve will turn back to its original trajectory.”

Two days earlier, Mr. Krajci said the virus’s reproduction rate in Slovakia ranged from 0.7 to 0.9, meaning infected individuals were infecting fewer than one other person on average. A reproduction rate greater than 1.0 can trigger exponential increases in infections that, absent a vaccine, can only be controlled by lockdowns, strict mask use and physical distancing.

The lower infection rate has allowed Slovakia to flatten its pandemic curves. On Monday, the country opened theatres, cinemas and churches at half-capacity. Pools and fitness centres were allowed to open with a maximum of six visitors at any one time. The ice hockey and soccer leagues will also restart, without fans in their arenas.

But the re-openings were too slow for some Slovaks. On Tuesday, thousands of them took to the streets in Bratislava and other cities to protest the restrictions, shouting “Return our freedom!”

By Nov. 16, Slovakia had recorded 88,602 cases, with a rise of 1,326 on Monday. A total of 557 people have died, giving it one of the lowest death rates in Europe, equivalent to 102 per million people. The equivalent figure in Italy, where more than half the country is in lockdown, is 757. In the neighbouring Czech Republic, more than 6,400 COVID-19 fatalities have been reported.

Slovak Prime Minister Igor Matovic last week claimed that the infection rate plummeted in the regions that saw two rounds of testing. But Martin Samatana, the former head of Slovakia’s Institute of Health Policies, said on Facebook that “a large part of the impact must be the result of stricter restrictions and reduced mobility.”

The Slovak experiment has been closely watched by other European countries. A team from the British Prime Minister’s office went to Slovakia in late October to observe the testing and learn some lessons ahead of similar efforts in Liverpool, which began on Nov. 6. About 90,000 residents were tested in the first week.

Austrian Chancellor Sebastian Kurz told Bloomberg Friday that his government is studying the idea of Slovak-style mass testing and might launch a similar program next month.

The Slovak experiment was a formidable logistical challenge. It required 5,000 eight-person teams of military and civilian medics to perform the tests. Slovakia recruited Austrian and Hungarian medics to help. The antigen tests were made in South Korea and produce results within half an hour.

Lenka Regulyova, 35, a yoga instructor and businesswoman in the town of Nizna, in northern Slovakia, said her county was among the four where the teams performed pilot tests over the Oct. 24 weekend. Those tests produced a positive rate of just less than 4 per cent. “My mum and my brother tested positive, and I tested negative, so we had to divide our house into two parts so we could isolate,” she said. “They did not have any symptoms in the week before the testing.”

She said that, after the pilot testing, all the local hotels, pubs, fitness centres and churches were closed and restaurants were limited to takeout orders. “People weren’t too happy about the restrictions, but it was for the good of the country," she said. "I feel safe now.”

Pfizer has launched a pilot delivery program for its experimental COVID-19 vaccine in four U.S. states, as the U.S. drugmaker seeks to address distribution challenges facing its ultra-cold storage requirements.

Reuters

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