Unofficial Translation
Press Conference after Council of Experts
Head of IZA Matej Mišík
Good afternoon. I will start with Covid Automat for next week. The number of districts in black phase has increased, next week there will be 10 black districts. It should also be said that 10 districts are in lower phase than they would be based on the incidence thanks to the vaccination share of the population over 50. Specifically Prešov and Žilina districts would be in black phase already if it was not for the high vaccination share in this age group.
Here is the map for next week.
As for the key indicators, we see that the rise in both the new positive cases and hospitalizations is continuing. During the last two days, there were more than 3000 positively tested by PCR tests a day. Almost 800 patients came to hospitals last week and we have in total almost 1000 patients hospitalized at the moment, with 125 requiring lung ventilation.
If we look at the age specifics of the incidence of new cases, last week we seen that new cases were mostly made of high school students and their parents.
This week, the incidence in these age groups has further increased, and we see that the incidence is growing also in close age groups closely interacting with these persons. These are younger children, 5-9 year old, but also younger parents.
I also want to say something about hospitalization of patients for September, as we looked at these data. Although we currently see almost 1000 patients with Covid in hospitals, in beginning of September this number was at approximately 70 patients and throughout the month it increased to 452 patients. The number of ventilated patients increased from 4 to 56 patients.
The situation with hospitalized patients varied across regions. Here is the distribution of districts from which the hospitalized patients come from. In whole Slovakia, approximately 1200 patients were hospitalized throughout September, which is 215 per 1 million inhabitants. Some districts, such as Snina, Bardejov or Čadca contributed to this number significantly more than other districts. This map also correlates with the map of division of districts according to Covid Automat.
From 1200 patients who required hospitalization in the past month, the average time spent in the hospital was 8 days. We can very clearly see the benefit of vaccination when looking at the hospitalizations. The simple nominal number of vaccinated persons in hospital does not provide a clear overview of the situation, it is necessary to look at the size of population from which these people come. Even more significant effect of vaccination can be seen when looking at patients who required the lung ventilation, in total 167 patients. The average time of stay at artificial lung ventilation was 13.5 days. In age group 70-79 we can see that the effect of vaccination is tenfold in sense of decreasing the risk of ventilation. In younger age groups, we practically seen no vaccinated patients requiring this type of treatment.
As for age structure of patients, given that we have much higher vaccination rate in older age groups, currently the younger age groups are more represented among the hospitalized patients. Persons up to 20 years old make up for almost 4% of hospitalizations, while before this was around 1%. It can be also observed at the average age of the patients, which is for the first time during pandemic below 60. This is explained by the fact that older age groups have higher vaccination share.
That is all from me, thank you.
Member of Council of Experts, expert at the Ministry of Health, Elena Prokopová
I will inform about few technical issues which should be repeated or made more clear. I would like to repeat, for example, the information about quarantine, isolation, or testing, as we still receive several questions related to these topics. People need a test for mass event or when crossing the border, for example. For vaccinated people it applies that they only need the confirmation of registering to ehranica, they do not have to get tested when crossing the border. Children up to 12 follow the regime of their parents. If vaccinated parents go to certain event, test is also not needed for their children up to 12, same applies to regime when crossing the border. If these are children from 12, they already follow their own regime, as these children can already be vaccinated. We remind that the quarantine still lasts 10 days from the last contact with the positive person or from the clinical symptoms. There is exception when testing after 5 days and having negative PCR test and no symptoms. As for people living in the same household, there are also some doubts coming from people. I will tell an example, if we have a positive child at home, who tested positive either based on contact or symptoms, the other members of household stay in quarantine for five days before testing. This is because the child can infect the other members of household during those 5 days, so we cannot test these people living in the same household immidiately, as they can still be negative after 2 or 3 days but get infected later, and that is why they receive the invitation for test only after 5 days. Those who are vaccinated of course do not have to get quarantined. They should follow the epidemiological preventive measures and they can also get tested 5 days after the contact, but mainly when they observe some clinical symtoms of the disease. These are the basic rules which are most often questioned.
Member of Council of Experts, expert at the Ministry of Health Alena Košťálová
We also have some information regarding the third dose of vaccination. We have 23000 people registered for the third dose, and more than 6400 already vaccinated people.
Currently mostly the group of immuno-compromised persons is being vaccinated with the third dose after 4 weeks since the second dose, but we also started with vaccinating the risk groups who need booster dose administered after 6 months from the second dose. Here belong for example the health workers or clients and staff of social service facilities for seniors.
We came accross few problems too, and we are looking for quick solutions. We were notified of some people receiving the invitation although they do perceive themselves as belonging to the group of immuno-compromised people or on the other hand, people who are immuno-compromised not receiving any invitation. We advise people to contact their general doctor or specialist, because this is really a group which is hard to identify precisely, therefore some problems are expected. However, it is very important that these people with worsened immunity get vaccinated as soon as possible.
At the same time, we recieved questions on vaccination with third dose of those people who were fully vaccinated and already overcome the Covid disease. It applies what we communicated before and these people do not need the third dose, as overcoming the disease has worked as a booster of immunity already. However, we observed the interest of such people to get vaccinated, and thus we have decided that we will allow such vaccination with third dose also to people who overcame the disease and are fully vaccinated, although it might not be completely necessary. Of course it might be very meaningful to receive the third dose in cases where there was only mild or symtomsless course of disease and if more than 12 months have passed since overcoming Covid. This applies to both immuno-compromised people and people with normal immunity.
At the same time, I would last to inform you that from Monday, we are launching the next phase of people eligible for third dose, so it will possible to register for third dose for people 55+, people 18+ with other diseases, and persons in higher risk of contracting the Covid disease. We ask people to use the registration system, as for the vaccination centers it is easier to organize the vaccination if they know how many people to expect. The capacities of vaccination centers will be gradually increased according to the interest. It also applies that as soon as around 80% of the interested people from this group gets vaccinated, we will open the registration for all interested people from the general population.
Member of Council of Experts, expert at the Ministry of Health, Elena Prokopová
Now we would also like to present the conclusions from the Council of Experts. One of the topics we discussed today were the measures for the upcoming Dušičky holidays. The recommendations for government and people are that we do not think that it is necessary to change the rules of Covid Automat or to adapt any new restrictive measures. We decided to rely on responsibility of people in Slovakia. We advise people to reconsider visiting graveyards and family members and we also do not recommend visiting districts which are in burgundy and black colour. If necessary to visit these districts, we advise visiting graveyards outside the most busy weekend, and if visiting crowded places, to have their airways covered also in exterior and avoid large groups. We also recommend avoiding crowded places where people meet and also reconsider visiting their family members who
might be older and thus most vulnerable. To people living in larger cities, we advise to visit nature instead of big shopping malls.
Member of Council of Experts, expert at the Ministry of Health Alena Košťálová
Another topic discussed today was the possible relaxation of rules for vaccinated people in black districts. At the Council we suggest measures to not restrict people, but to protect the healthcare system and health of citizens. The vaccination is the most powerful tool to keep the pandemics under control. The Covid Automat takes into account the vaccination share in given districts when adopting the rules, and we thus believe that it currently offers predictive and efficient measures. We of course perceive that vaccinated people in black districts feel penalized in a way that although vaccinated they cannot enjoy the freedom they expected. The situation in these districts is serious and there is large community spread and consequent faster filling of hospitals. Therefore, taking into account these factors, we have decided to so far not change the Covid Automat in sense of relaxing the measures, also in regards to the coming holidays and higher mobility of people. We are open to discuss this topic again after the holidays, also taking into account the dynamics of the epidemiological situation. We would like to ask people to get vaccinated not only to protect themselves but also to contribute to the efforts to easen the measures in their district.
Thank you.
Questions:
Q: Do you expect any major worsening of the situation after Dušičky holidays?
Mrs. Prokopová: We hope people will be responsible and this will not happen, although the current trends suggest that there will be some increase in the numbers. In some districts we have 1 positive person per 200 people, so the chance you will meet such person is very high.
So we intensively ask for people to be responsible.
Q: What factors will influence whether you will decide to easen the measures for vaccinated after the holidays?
Mrs. Košťálová: The most important will be the epidemiological situation at that moment and we will surely take into account the numbers of the patients with the most serious course in hospitals. This is the key factor. The trend of the patients in hospitals cannot be rising for us to consider relaxing the measures. Also, we would be more willing to relax the measures if we knew that they are being properly followed, which we all know is not always the case. At this time with approaching holidays, we decided not to change the rules also in order to not further support the mobility of people, which is anyway expected.
Q: I want to ask about the hospitalized children, you said that their numbers in hospitals increased form 1 to 4%. Are these children with some other diseases or also healthy children?
Mrs. Prokopová: I cannot talk about exact statistics but we also see it in general doctors´
offices, when children show more symptoms and problems during the infection than during the first or second wave. In most cases when there are pneumonias and high fevers, as we have little experience on how the disease will develop in these children, they are usually hospitalized immediately.
Q: You also recently cancelled the obligation to wear masks in schools. Did it have any negative effect on the rise of cases?
Mrs. Prokopová: If we looked only at numbers of positive cases before and after cancelling the obligation to wear masks in the classrooms, we would see as increase in numbers, however it does not mean the increase was caused by this measure, but it can also be explained by the overall worsening of the epidemiological situation. There is no much difference between children sitting in masks during classes and then putting them off during breaks when eating and drinking and playing, and not wearing them during classes – the risk to get infected is the same.
Q: So you are not considering bringing this obligation back?
Mrs. Prokopová: Not at the moment.
Q: Do you think it might be de-motivating for people to get vaccinated if they have to follow the strict rules in black districts too even after vaccination?
Mrs. Košťálová: It could be seen from the other side as well – it might be very motivating for people to get vaccinated if it can move their district into better colour with less strict rules.
The classic example is Bratislava where we have much better situation. Also the benefit of protecting one´s health should be sufficient.
Mrs. Prokopová: We also think that there are currently enough of benefits for vaccinated people even in worse districts. They do not have to go into quarantine after contact with positive person and thus do not need to restrict their work, lose their wage, they still have access to basic shops and services. It is true that mainly the operators of establishments suffer in these black districts and we are very sorry about this, but the risk is very high.
Q: When you mentioned the topic of possible changes to Covid Automat after the holidays, is there also possibility of looking at people who overcame the disease as same as people who are fully vaccinated?
Mrs. Košťálová: This topic was discussed today too, but we so far have not reached a conclusion. We will return to it later. We follow the measures abroad and the latest scientific information.
Q: Will you consider restricting railways transport somehow during the holidays, as trains will most likely be crowded?
Mrs. Prokopová: We strongly recommend the individual transport. Restricting the schedules of transport is not meaningful as it would fill the trains even more.
Q: Are you considering changing the algorythm for sending the invitation messages for the third dose as some people are receiving it even without immunity problems? Should these people still come for the vaccination or what should they do?
Mrs. Košťálová: We recommend people who are not sure to discuss this with their general doctor. I do not think it is useful to change the algorythm now as we are opening the vaccination for further groups already.
Q: Do you recommend to people who overcame the disease and are fully vaccinated to still go for the third dose?
Mrs. Košťálová: If they are more than 12 months after the disease or had symptomsless course then yes, otherwise not really.
Q: Will people with contraindications to vaccination, those who cannot get vaccinated for health reasons, have the tests for free?
Mrs. Prokopová: We discussed such option, but it is very hard to identify people with real contra-indications to vaccination. If we look at package leaflet we see that there are in fact very few cases in which there is contra-indication to the vaccines. We recognize rather a temporary contra-indication when somebody has accute disease at the moment so the vaccine should be administered later. In this case we considered reimbursing the tests, and such option is being negotiated by the Ministry and the health insurance companies at the moment.
Q: We were contacted by a person who received first dose of AstraZeneca but did not go for the second dose and now it is not being given anymore. At the vaccination center they refused to give him Pfizer. Can the vaccines be combined this way?
Mrs. Košťálová: A clear conclusion is that the vaccines are possible to be combined. In this case I recommend visiting different vaccination center.
Q: You were expecting that the interest in vaccination will increase with the third wave however we see this did not happen. Why do you think this is?
Mr. Mišík: We really expected the rise in interest as observed abroad. We hope the number of vaccinated people will increase also based on vaccination campaign and the communication with mayors. We se that the vaccination really protects against the serious course of disease and hospitalization so this should be primary motivation.