Unofficial Translation
Press Conference on the current epidemiological situation 16/02/2021
Minister of Health Krajci
Good evening. Let me inform you about the current epidemiological situation in Slovak Republic and at the same time briefly inform you about the conclusions of the negotiations at the Pandemic Commission that took place today.
First, as usual let me show the comparison with our neighboring countries. The trend in case of Slovak Republic, and also Czech Republic, is slightly worsening. There is no dramatic increase in new cases, but the reproductive number in these two countries is unfortunately above number 1. The situation in the other three countries is relatively good, it is stabilized.
This is the same data expressed in numbers.
When it comes to mobility of population, this graph shows the mobility in terms of car transport on red line, walking on the grey-white line and the mass transportation on the blue line. The mobility is slightly increasing, which is expected due to opening of some schools, or possibility to travel to different districts for stay in nature, but it is certainly not increase to levels of months before lockdown.
When it comes to the weekly data, the 14-day incidence is relatively stabilized. The number of hospitalizations is unfortunately high, and it is increasing day by day. Also, the number of patients on lung ventilation is increasing. This rise is not dramatic, but gradual and not improving. The 7-day average of positively tested persons decreased slightly, the 7-day average of performed tests is 224071 when counting both PCR and antigen tests. The positivity rate of tests is stabilized – 20% for PCR tests and 1% for antigen tests. Unfortunately, the number of daily deaths increased slightly to 108. When it comes to vaccination, 311293 doses of vaccines were already used. The reproductive number has slightly increased compared to last week – it is somewhere between 1 and 1.1.
This is the graph showing the development of the number of the positive cases. The 7-day average of positive cases is 4793 when counting both PCR and antigen tests, and for PCR tests it is 1984.
The positivity of tests, as I mentioned is 20% for PCR tests and 1% for antigen tests.
When it comes to the situation in hospitals, we already see an effect of vaccination at the age division of hospitalized persons. The numbers of hospitalized people in the age category of 81-90 is gradually decreasing, as well as in category 71-80. In the first category it is decrease from 16% to 12% and in the second from 32% to 24%. We see, however, slight increase in the share of patients in the age category 51-60, from 13% to 18%. This can be caused by the British variant of virus in Slovakia and we can presume that its prevalence in the population will be higher and higher every day. The UVZ will do another screening of positive samples for this new variant, I suppose that the results could be known by Friday.
Here you can see the numbers of visits of patients by the emergency medical services, which is rising from week to week.
And here is the number of these emergency services visits by regions. In Kosice region we see increase, in Bratislava regions, after the weeks of increase, we see a stabilization. However, we see increase in Trnava and Trenčín regions. Nitra is improving every week. Presov started to increase, but there the number of patients is so far not so high, same in Banska Bystrica.
The best situation is so far in Northern Slovakia, in Zilina region.
The occupancy of hospital beds is showed on this slide. The blue color shows the used capacities and the pink color the reprofiled beds that are ready to be used for patients with this disease. Both numbers are increasing gradually, and the trend is negative. We only have 712 free beds with oxygen, and 52 free beds when patients with this disease can be ventilated.
The overall occupancy of the beds is 71% from 5900 reprofiled beds. There is around 85%
occupancy of beds for patients who need lung ventilation.
Here we can also see the effect of vaccination. Medical personnel is gradually returning to hospitals, 1543 people are currently unable to work. We are happy to see this positive trend.
As I mentioned already, the average daily number of deaths is 108. The Office for Medical Supervision has already confirmed 6063 deaths caused by Covid-19, 1266 deaths with Covid, and 36 cases are still considered as suspicions.
When it comes to vaccination, we already used more than 311000 doses, out of which 69000 doses were given to people as the second vaccination dose, thus completing the full vaccination process. In Bratislava region, more than 7.5% of population is already vaccinated, followed by Trencin region with 5.29%, Žilina with 5.26, Košice with 5.16, Prešov 5.22. As we announced, from 13 February we are vaccinating teachers and critical infrastructure.
Therefore 5 phases of the vaccination strategy are already opened, we still await another 6 phases to open in future. The next phase will be for people with serious health complication.
We will vaccinate those not older than 55 with AstraZeneca vaccine, and older with RNA vaccines.
We so far vaccinated 30% of all 74703 teachers. During the past weekend 22385 teachers were vaccinated and the vaccination process will continue.
And this is the data we are all waiting for. The average number of positive cases for last 7 days is 4793, thus we are still in the IV. level of warning. The number of hospitalizations is 3872, also translating into IV. level of warning. The reproductive number is between 1 and 1.1, which is at the III. level of warning, however as two conditions for nationwide criteria are met, our country is as whole in black phase.
When it comes to individual districts, unfortunately, we already have 19 black districts, 50 districts are dark red and the remaining 10 districts are red.
Here is the expected trend. If some district, such as Bratislava, has negative trend, it is expected that it can next week turn into worse level, in this case into black district; if it has stabilized trend, it should remain the same, and if it has the positive trend it might improve next week, if nothing changes. It is good that the red districts keep their stabilized situation, and district of Medzilaborce is even with positive trend, so it could be a district with the best epidemiological situation next week.
I will also show the trends in the individual three indicators. The 7-day average might seem to be decreasing in the last couple of days, however, we would need to get under the level of 4000.
When it comes to the development of hospitalizations, it is unfortunately still negative and has an increasing trend.
I will ask my colleagues to comment on the conclusions of the Pandemic Commission. We have discussed how the experts suggest continuing in this situation. The most important action we can take is to speed up the vaccination, however in this case we are limited by the delayed deliveries of vaccines, which are not coming in the promised numbers. We also discussed the possibility of buying the vaccination Sputnik and I will ask Professor Jarčuška to comment more on this.
Professor Jarčuška
Good evening. We, as experts, evaluated that the situation is not good, and despite of accepted measures it is not improving. We, who work in hospitals, see on daily basis the increase in number of patients, and the serious course of infection or even deaths can be already seen also in younger groups of population. Of course, the most effective solution is the vaccination. The vaccination depends on two factors – the capacity of vaccination centers, which already work very effectively, and the second is the delivery of vaccines, which cannot be influenced much. Currently there are three certified vaccines in the EU. The numbers of delivered doses are lower than originally declared and lower than we would need.
In such situation you need to look for the vaccine elsewhere. Of course, these should be vaccines with good parameters, such as the documented results and effectivity from some reliable study, good security profile, and this vaccine should already be practically used
somewhere. From the vaccines that are already on the market, the vaccine best meeting these parameters is the Sputnik vaccine. One EU country, Hungary, is already using this vaccine from 21 January. Every vaccine coming to market needs to have the inspection done, which, for the vaccine procured by the EU is done by the European Medicine Agency. This vaccine had very good results in study published in prestigious journal Lancet. There is expectation that this vaccine could be approved by the EMA. The whole EU is very disappointed with the deliveries of already registered vaccines, and so every country is trying to access vaccine from other sources. Given that the vaccine Sputnik is not part of the joint EU procurement, if we would have lack of vaccines, we need to have this vaccine contracted in some way.
Minister Krajci
I want to highlight again that the vaccination of our population is already being shown in the numbers of hospitalized in the vaccinated age categories, as well as in the numbers of medical personnel in work incapacity. Vaccination is definitely effective in fighting the virus, and that is also why it is creating different more aggressive variants, which makes coping with the situation much more difficult. It now suffices to have much shorter contact with positive person to spread the virus than before. That is why we need to continue to comply with the rules, it is very important at this moment. I will also ask the Chief Hygienist to comment on the situation and the activity of regional health offices.
Chief Hygienist Mikas
Ladies and gentlemen, you seen the data presented by the Minister – the epidemiological situation is still very serious. The public health offices continue in tracing of contacts of the positive cases. When I arrived at Pandemic Commission I received a question whether the self- tracing of contacts is helping, and yes the regional hygienist confirmed this is helping very much, so I want to ask people to continue to self-trace their contacts when they find they are positive.
Two weeks ago, we found the large prevalence of the British mutation in our population, specifically in 74% of the positive samples. Tomorrow we are starting the second round of this research, so we want to see the development in prevalence of this variant. We expect we could have results on Friday.
At the Pandemic Commission we have also discussed the possibility of sequencing of the samples. In cooperation with the Slovak Academy of Sciences, we will try to set some effective testing strategy for sequencing. The UVZ will start the sequencing method directly at its office too, in order to increase sequencing capacities in the Slovak Republic. The current recommendation is to do sequencing in 5-10% of samples, which is quite high number, but I hope we will manage to get closer to this level soon.
Thank you very much.
Minister Krajci
At the Pandemic Commission we have entrusted the Slovak Academy of Sciences to present a plan of sequencing of samples at 9 possible sequencing centers in Slovakia at the level of so far 5%. The Ministry of Health will be ready to help in developing of this strategy.
The Pandemic Commission has also accepted recommendation for the Government of SR to start negotiations with the Russian side due to serious epidemiological situation, and ensure the procurement of sufficient amount of Sputnik vaccines, also in connection with the lack of vaccines.
The Prime Minister is, at the same time, communicating with the European Commission, where we are also trying to ensure some extra vaccines to be able to vaccinate as early as possible.
Thank you, that is all.
Questions:
Q: If the negotiations with Russian side are started, how long could it be until we get the Sputnik vaccines, and they are fully authorized at our market?
MK: The Government meeting will be on Thursday morning to discuss this topic. If the Government approved the resolution, the SR will, probably through the Ministry of Health, initiate the steps to sign the contracts for procuring these vaccines.
Q: How many vaccines are we talking about?
MK: I cannot specify this at the moment, it will all depend on the possible delivery dates and other conditions.
Q: When it comes to authorization, how will we able to inspect these vaccines as SUKL claims it does not have sufficient capabilities to make the full inspection?
MK: The vaccine has two parameters – the first is the effectivity, which is sufficiently proved already, and the second is the assessment of the quality of production of the vaccine. We agreed with SUKL already that they will take all steps necessary for approving this vaccine. The director of SUKL prof. Batova will receive all necessary documents needed for such assessment and she will be also invited to see the production process in Russian Federation.
Q: We see that the numbers of deaths are increasing and we also know we have that first place in the ranking of the deaths per week per the number of inhabitants. How do you explain this, only the British mutation or something else could have caused it?
MK: I see mainly the British mutation as the cause, as it led to faster spread of the disease among the most vulnerable groups, also in hospitals. I would like to calm the public – only 23%
of persons hospitalized in our hospitals end up dying and 49% of people at the artificial lung ventilation. These are comparable data with the other European Union countries. Our health
care is thus not bad. The problem is that many people do not respect the measures, which causes the higher spread of the infection.
Q: When it comes to Sputnik vaccine, you want to purchase it and have it as reserve, or you want to directly start using it?
MK: We need to start the procurement process and the registration process, so if we need more vaccines, we will have it at our disposal, so we can use it when we will be absolutely sure it is safe.
Q: Will we wait for the approval by the European Medicines Agency or will we start using it before?
Prof. Jarcuska: We will first need data on the production process, if all standards are being kept, and then if by that time the EMA has still not approved the registration, we might not wait for such approval and start using it even earlier if all conditions are met.
Q: Today the President had meeting with several experts who suggested to her that the Covid Automat should be re-assessed, namely when it comes to test requirements. Are you open to any further changes?
MK: These are the same experts, who were invited at Council of Experts previously to assess the Covid Automat plan, so if they changed their opinion compared to 10 days ago, we are open to communication. If any such recommendation is formed, I can call the Pandemic Commission and we can re-evaluate the current Covid Automat even every single week.
Q: Should the mandatory testing stay or not?
MK: We are considering also this alternative, how to make it easier for people and at the same time effectively identify positive persons. We have several options prepared, we will inform about these later.
Q: We previously seen some data on when people got infected the most often. Are you collecting such data at the moment too and is it possible to assess how many people could have got infected when waiting for antigen testing?
CH: We cannot rule this out 100%, but we do everything possible that this does not happen.
We will communicate with providers of MOMs to comply with all rules to prevent any possible infections.
Q: Today there were also discussions about the possible political responsibility for the current bad situation and the possible actions. What do you think about this?
MK: I think the biggest mistake was made when the lockdown was not effectively used before Christmas already. The huge presence of British variant in Slovakia is caused by the high migration between our two countries, as lot of our inhabitants work in UK and come back to Slovakia. The situation is bad, but we have to the maximum together, in order to cope with it.
We could vaccinate much more, but we need more vaccines.
Q: Can you explain what is changing from next week based on the current map of districts?
MK: The whole country stays in black regime, thus not much is changing. I want to ask people to continue to leave their house only in needed cases specified in the resolution. Nothing is changing about this. What is changing however, is that the number of black districts has increased, and in these it will not be possible to leave these for stay in nature in different district, of course the exception is traveling to different district for work. The 7-day test will be also needed for commuting to work, which cannot be done from home. The children will not go to schools in these districts either. The schools in dark red districts are being opened based on the recommendation of regional public health office.
Q: You mentioned that the number of available beds with ventilation is limited. Do you take any steps for the possible scenarios when these get occupied? Are you re-training any medical personnel for operating these devices?
MK: I will, at tomorrow Government, present a proposal for activating the civil protection mechanism, which means we would turn to European Commission to help us with the numbers of medical personnel. We have 9 extra lung ventilations here in child hospital in Bratislava, where, we will also ventilate if we receive any help with personnel from the EU.
When it comes to other ventilators, we have 65 more left at our disposal. Of course, we have much more beds with ventilation available, but there the white health care (not Covid departments) is being provided. There are thus some hidden capacities. In total, we are able to operate around 1000 beds with ventilation, together with the trained personnel.
Q: Crematoria are complaining about the problems with capacities for storing dead bodies.
The Ministry of Interior informed us you will also discuss this issue today at the meeting.
MK: We had representative of the Ministry of Interior at the meeting today, but he did not raise this issue. I cannot react to this at this moment, we would need more information to be able to help.
Q: Do not you think there should be some political responsibility for the late lockdown, which was not pushed for in December?
MK: I brought the proposal and all data to Government in December, but they outvoted me.
Q: Do not you think the government is thus responsible for all those deaths just because it was afraid to take measures before Christmas?
MK: We tried to find the consensus in Government. Unfortunately, the individual ministers were not willing to take stricter measures at that time, thus the milder lockdown that was accepted was taken.
Q: The Confederation of bishops is asking the government to re-evaluate the possible opening of church services. What do you think about it?
MK: At this moment any relaxation is dangerous and threatens further spread of virus. The churches are included in Covid Automat, we just need to fulfill the conditions to open them.
Q: Health organization estimates that the antibodies can function for several months, more than the three months. Are you considering re-evaluating the condition for counting as having overcome the disease in extending the duration of this period?
Prof. Jarčuška: It is very individual, some people can have the immunity for 8 months, some shorter. I think the three months are ideal length at this moment.
