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Press Conference on the current epidemiological situation 16 March 2021

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Unofficial Translation

Press Conference on the current epidemiological situation 16 March 2021

Minister of Finance Heger temporarily entrusted with the leadership of Ministry of Health Good evening ladies and gentlemen. Today´s Pandemic Commission brings positive news.

Pandemic situation in Slovakia has stabilized and I can even say it is slightly improving. I thus want to thank to all abiding the rules, as that is the only way out of pandemics.

Also, many of you are waiting for this news – due to improving pandemic situation there will not be any hard lockdown in sense of closing of whole economy. This is the most key information that I was happy to hear today at the Pandemic Commission. On the other hand, I also have to say that another important information is that it is not yet a time to relax any measures.

Another topic that was discussed today by the Pandemic Commission was whether to recommend to the government to prolong the state of emergency. The Commission has voted by great majority that it is necessary to prolong the state of emergency by another 40 days. I was interested in the reasons for this necessity and I was ensured that if the state of emergency was not extended, it would literally break down our whole system of pandemic protection. I am thus taking this strong mandate to the government meeting tomorrow, where I hope the extension will be approved by the government. Both experts and representatives of various sectors today agreed that it is really necessary.

These are the main messages I wanted to inform you about today, and I will take floor to state secretaries of the ministry to inform you about the current epidemiological situation and the vaccination processes. I can only express that it is in our best interest to continue smoothly with the vaccination and the government is doing everything it can to ensure sufficient amounts of vaccines. We are also taking necessary steps to make the vaccination more comfortable for people, and I hope the results of these actions will be visible in short period of time. Let’s thus be patient and lets respect the rules, it is meaningful.

State Secretary of the Ministry of Health Stachura

Good evening ladies and gentlemen, let me inform you about the epidemiological situation in Slovakia.

As Minister already mentioned, the results are positive on the whole country basis, however there are still places in Slovakia where they are facing problems and where the situation is still not under control. Therefore, I also want to ask you to continue to abide to rules.

Let’s first compare ourselves with the neighboring countries. As you can see the situation is not changing significantly, even though Slovakia is experiencing slight decrease in new cases.

Other countries, on the other hand, are seeing increase in the incidence per 100 000 inhabitants.

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Expressed in numbers, we see Slovakia is one of countries experiencing slight decrease, same as Czech Republic. On the other hand, Hungary, Poland and Austria see a gradual increase in new cases.

When it comes to the development in numbers of confirmed cases in Slovakia, the positivity culminates on around 4000 confirmed cases a day, when counting both PCR and antigen tests.

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When it comes to the percentual representation of positivity of these tests, for PCR tests it is around 20% positivity, and for antigen tests it is somewhere around 1%.

The positive news, already presented at previous press conference, is that we have managed to decrease the mobility of the population, which stays at the same improvement level.

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The numbers we regularly show are here. Oh, I see we have some problems here, so you cannot see the numbers properly, but let’s navigate through arrows at least. All of these indicators, with the exception of the reproduction number maybe, which stays the same, show a positive trend.

Now let’s discuss the situation in hospitals. The health emergency services report the decrease in number of visits they have to make to patients with Covid disease, which is also a very positive news and we expect that in short time this will also reflect in the burden on hospitals in the whole territory of SR. At the bottom graph you also see the absolute numbers, which were very high namely in Prešov region, Košice or Trenčín regions – these numbers are

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gradually decreasing, which is a very good trend. In Nitra region, the visits of emergency services to Covid patients are stabilized at very low and even decreasing.

Here are the visits of emergency health services presented on interactive map. You can see that even though the whole country numbers see a positive trend, we still have some localities in Slovakia where the situation is still very tense. We need to focus on these.

The positive trend that we recorded some time ago is still being confirmed – in hospitals there are, thanks to vaccination, still less and less positive nurses and doctors, which positively affects the provision of health care.

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This slide shows the availability of the beds in hospitals in SR. As we mentioned, the number of hospitalizations is slightly decreasing, however there is problem with ventilated beds for those in most critical condition requiring the artificial lung ventilation. We really do not have enough of these. You know we asked for the foreign help and we had to send some patients behind the borders of Slovakia, and we also received foreign health workers from Belgium, Denmark and Romania. Thanks to this we still manage to keep this situation stabilized, but there is really a lack of these beds, and my colleagues doctors need to struggle every day when needing to place a patient on ventilated bed.

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We also see these problems when we look at the trends of occupied beds with ventilation per 1 million of citizens.

Also, this graph showing the age distribution of patients received in hospitals is very important.

We see the effect of vaccination here – people older than 60, which presented even in February almost the half of all hospitalized patients, now present lower numbers. It is definitely caused by the fact that these people are now being actively vaccinated.

Deaths are still relatively high, which we are very sorry for. On average, around 70-90 people die per day due to this disease. The total number of deaths confirmed by the Office for Health supervision is currently 8669.

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I will now give floor to my colleague to comment on the process of vaccination.

State Secretary of the Ministry of Health Ježíková

Good evening. The numbers of vaccinated are growing and we are expanding the numbers of vaccination places.

I will start with the vaccine AstraZeneca, which is a very widely discussed topic right now and it was also discussed on the Pandemic Commission today. The SUKL also commented on this issue. The doubts about this vaccine started with the death of teacher in Austria, where the direct relation has not been so far confirmed, I even think it was already ruled out. However, some countries interrupted the administration of certain batches, such as Estonia or Austria.

This batch from Austria ABV5300 was delivered to 17 countries in the amount of 1 million doses, and some of these countries preventively interrupted the vaccination with this vaccine.

This batch was not delivered to Slovakia at all. Other countries, such as Norway or Denmark have also interrupted the vaccination with the vaccine, but it was, in all of these cases, just a preventive step, it was not taken in relation to any confirmed deaths or adverse effects. In the UK and EU, altogether around 17 million doses were administered. Out of these, 5 million used in the EU, as for EU we have better data than for UK, which is not an EU member anymore, 30 cases of thromboembolic events were reported and so far it was not demonstrated that these would be caused by the vaccination. This number, 30 cases, is not higher than the share of its occurrence in the normal population. It is very important that WHO or EMA still recommend vaccination with this vaccine and the causal link between the vaccination and thrombosis has not been demonstrated yet. The important conclusion – SUKL and the Council of Experts recommend to continue with the vaccination with AstraZeneca in Slovakia in accordance with the vaccination strategy.

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Altogether, 220863 people have received the second dose already, and 661129 doses were in total administered to people so far. You can see on graph that there is sharp increase in vaccination, due to larger deliveries of vaccines, and we are also expanding the vaccination sites. There is still high interest in vaccination, which we are very happy about. On the map you can see the percentages of vaccinated population in individual regions.

When it comes to vaccination capacities, in the upcoming days, for the vaccine Pfizer, 52000 appointments will be opened for the first dose this week. Actually, these capacities are already filled for this week. Also, 16000 appointments for the second dose will be opened. For social service facilities, around 6000 doses will be provided, this is our big priority. As for Moderna, we were stagnating for some time due to low deliveries, which were used only as the second dose. This is the case for this week as week. However, next week we will start to use it also for the first dose. The deliveries of Moderna should now be increasing on the monthly basis. For AstraZeneca, we opened 46000 appointments for this week. From 20-26 March we will open another 41000 appointments, and during the following week, another 25000 appointments.

Our weekly capacity of vaccination is getting close to 140000-150000. We are establishing large capacity vaccination centers in self-governing regions, at which we vaccination together with district cities and hospitals. I read a Czech article this week saying that PM Babiš expects that already 100 000 people could be getting vaccinated. We are vaccinating more, so the trend is very positive.

This is the graph showing the vaccination by mobile vaccination teams, which come directly to the facilities of social services, where already 56% clients already received at least first dose of vaccine. This is our priority and we need to work hard on vaccination in these centers.

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This is the table for expected deliveries, it is more or less the same table as we showed last week. For Pfizer we have already received 613080 doses and we expect to receive in total 196400 doses in whole March. In April we expect around 60000 doses a week. Moderna stays without change compared to last week – we still expect 45600 doses this month. There is a significant change in AstraZeneca deliveries – last week you seen that we expect 300000 deliveries of AstraZeneca this month, however we have been notified that only around 25000 doses will arrive this month. We will need to accommodate this fact in our large capacity vaccination centers, where we use AstraZeneca vaccine, due to its suitable storage conditions.

We will need to continue in responsible way in order to have enough vaccines for the re- vaccination with the second dose. The second dose administration of this vaccine was changed to 10 weeks in accordance with vaccine characteristics. We expect that within 10 weeks the vaccines will surely arrive. We also expect one more delivery of Sputnik until the end of March.

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We have not shown this table yet. It shows the vaccination centers. Currently these are divided according to the type of vaccine. We have 60 hospitals that vaccinate with Pfizer due to very strict storage conditions, then in 14 health care clinics we are vaccinating with Moderna, and 17 large capacities centers vaccinate with AstraZeneca. We are closely cooperating with self- governing regions on how to vaccinate in these large capacity vaccination centers, we provide them with manuals and communicate with them regularly. We also distribute vaccines to them. As for the self-governing regions we rely on them to ensure the right premises for these large capacity centers, in order to ensure suitable conditions for the vaccination. We have 17 of these, which is higher number than the number of self-governing regions, as they also establish them in some district cities, and this number should continue to increase. Currently the weekly capacity is 45000 but we are able to increase it to 70000, but we need vaccines for this. The critical infrastructure is being vaccinated in 5 places – in 3 hospitals and 2 clinics. We assign them with very limited amount of vaccines, and they are vaccinating in accordance with the system overseen by the Ministry of Interior. Then we also have internal vaccination, as some facilities are still vaccinating their own employees. We are waiting for opening of 5 other vaccination centers. So in total, you can see how many vaccination centers we have opened according to each type of vaccine. This network is very good, and it is still not working in full mode.

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This graph is very important. We have worked with the number of 10342 deaths. We wanted to show that the current prioritization for vaccination according to the age is closely connected to the age distribution of deaths in the population. The blue columns show the standard distribution of population in Slovakia. The red columns show the share of the age groups in the Covid deaths. Thus, 33% of deaths are in the age group 70-79, and so on. In overall, 90%

of all deaths are in the age group 60+. These are the most vulnerable groups and thus the prioritization is based on age. However, the new registration system will also work with the health conditions, so people will be able to mark the diseases, so they can be gradually prioritized also regardless of their age.

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Here we see good trends in the percentages of vaccinated. I already commented on 56% of vaccinated in the social service facilities. In the population of 80+, 33% people are vaccinated.

This percentage is pretty stabilized, so either there is no more interest in vaccinated in this age group, or we will have to work more hard in cooperation with general doctors or other entities to increase the share of vaccination in this age group. The share of vaccinated in the age group 70+ has increased to 30% and in category 60+ to 20%. In the second graph you can see that much more women are vaccinated than men. I do not know why this is the case.

The very last information is related to Sputnik vaccine. The vaccine was deliveries on 1 March and from this date we are working on laboratory control of the batches. In total, 3 batches were delivered to Slovakia, that means 3 different production processes. The controls are taking place under the supervision of SUKL by the Biomedicine center of Slovak Academy of Sciences. There are 13-15 methods, so these need to be taken in order to control whether the vaccine is safe. From last week, the sterility of the vaccine is being inspected, so far the results are good. We will wait until next Tuesday to have the complete results, as this test takes 2 week. We thus expect that during next week we will have statement from the SUKL on the safety of this vaccine. Currently, the inspectors of the SUKL are in Russia, where they are visiting the production sites of the batches that were delivered to SR.

Thank you very much.

State Secretary Stachura

Our society is already tired from negative news and maybe today will provide some optimism that with joint forces we can manage to succeed to overcome the negative forces in the pandemic. The indicators of the Covid Automat are the number of hospitalizations, the

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number of positive cases and the reproduction number. Taking into account all these three indicators, Slovakia is still as whole in black zone.

However, the more important information is that the current situation in regions, which for this week looks the following:

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will change into the map looking like this from next week:

The map is thus turning more red and there are fewer districts in black phase. Despite this I would like to emphasize again that we have not won and there are localities in Slovakia which record a very serious situation, namely the districts close to Czech border.

In the second level of warning, there are four districts – Kežmarok, Námestovo, Nové Zámky and Tvrdošín.

That is all from today´s presentation, thank you very much.

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Questions:

Q: How is it with the allegations that Slovakia gave up some Pfizer vaccines?

Jezikova: Very serious allegation saying that Slovakia was not interested in significant amount of Pfizer doses that could have been available to it that appeared in media are not true. I deny these allegations. Slovakia has contracted 5.8 million Pfizer vaccines, they come in pretty steady deliveries. This case is not connected anyhow with Sputnik vaccine either, as there were news that we reject Pfizer deliveries so we can vaccinate with Sputnik. This is not true at all. Contracting of vaccines works in a way that countries show their interest to the European Commission, which in turn negotiates certain package of vaccines with the pharmaceutical companies. In the first package it has negotiated 200 million of vaccines and each country was offered certain amount of vaccines based on its population size. Thus, Slovakia was offered 1.22% of this package, which 2.4 million of vaccines. All these vaccines were contracted by Slovakia and we receive regular deliveries. They are for 1.2 million people, as it is a 2 dose vaccine. Then there were further orders, the so-called bazaars, where EC negotiated further volumes of vaccines, and it again proceeded in the same way, thus based on population size offering these to member states. Thus it again offered as many doses as the share of population size of these countries and each country was to decide how many of these vaccines it will take also taking into consideration how many vaccines the country in question has already purchased. First such additional offer came at the beginning of January, and we have meanwhile contracted 3.6 million doses of AstraZeneca vaccine, 1 million of Moderna, 1.4 million of one-dose vaccine Johnson and Johnson and 1 million of Curevac. So in total we had over 10 million vaccines contracted, so you have to take these into account when deciding how many more to contract. At that time, nobody knew either how these deliveries will be coming. Gradually when we seen that the deliveries are not regular and the companies are not responsible and do not deliver as they promised, the debate over Sputnik vaccine started at the end of January. Therefore, this is not connected with Pfizer anyhow. There were 3 additional orders all in January. Within these additional orders, Slovakia has contracted additional 3.4 million Pfizer vaccines. That means that in total, for this year, we have contracted 5.8 million of Pfizer doses and we expect these doses to be delivered. However, we do not know how many vaccines will really come even in two weeks, the deliveries are still uncertain in all member countries. We are negotiating currently the earlier delivery of these vaccines already in second quarter.

(many repeating questions on this topic, the answer was repeated several times)

Q: How do you want to push for state emergency to be approved in Parliament as well as many deputies already said they will not support it?

Minister Heger: I listened to experts today and they all said that we need to extend the state of emergency. If we do not extend it, we cannot restrict the mobility. If we cannot restrict the mobility, the number of new cases will increase and situation in hospitals will worsen again. I believe that when we will present it tomorrow at the government, all ministers will understand the necessity of this step. All ministries also had their representatives today at the

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meeting so they should have relevant information. I do not think there will be problem with approving this extension at the Government. Then we will also try to persuade the deputies.

Q: The government was supposed to discuss last week also the state quarantine but it did not approve it. Will the discussion continue tomorrow?

MH: Yes, it was discussed today too, the different state bodies are preparing it, when more information will be known we will inform about it.

Q: How will the Easter holidays look?

MH: We wanted to show to people that the situation is improving, but it is not that good yet.

There are too many people in hospitals. I want to ask people not to think that Easter will look like Easter in 2019. Our situation is not that good. We presented that current data do not require stricter measures, but at the same time, they do not allow for any relaxation of measures yet.

Q: Does that mean that many measures suggested by experts which were not implemented yet will not be needed to be taken anymore?

MH: This was one of my first questions when I came to Ministry last week. I was informed that all measures from the round meeting in the competence of the Ministry of Health are already being prepared or being implemented. I let the ministry to prepare for me the progress of implementation for all of these measures and when it will be ready we will present it sometime in the upcoming days.

Q: When it comes to Johson vaccine, it was said that first doses of this vaccine should come in April. Can you confirm it?

SS Jezikova: The company already announced that it will have delays in deliveries. We have some delivery plans but we are in the end informed about the specific deliveries only a week or two before the delivery itself.

Q: Given the changes in deliveries of AstraZeneca vaccine, will the people who received the first dose receive the second on time?

SS Jezikova: Yes, we have enough of vaccines for the second dose.

Q: When it comes to patients transported to foreign hospitals, we have information that some of them died. The families of these patients so far do not have information whether their bodies will be transported to SR on state expenses.

SS Stachura: Yes unfortunately 2 patients died. Of course, the SR will ensure the transportation of the bodies to SR, and according to my information this has already happened.

Q: You mentioned that in the registration form people will be able to click on their diseases.

How will this work, will there be specific disease listed to choose from?

SS Jezikova: The registration form will work on the same basis as now – it will be still possible to click on the category, whether the person is a health worker for example, on age group and we also want to add the diagnoses. When it comes to the question to which disease will be

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included there in the list, we still want to discuss this with experts to really include those diagnoses only that are linked to worse course of Covid disease, and these people will be then, in accordance with their age, given priority.

Q: When will the registration form be launched?

SS Jezikova: In few hours. Currently the testing is taking places, so depending on how the testing will go.

Q: How will it be with foreigners living in SR and working in SR who are not Slovak or EU citizens, such as ambassadors, for example from the Chinese Embassy, or other foreign workers? Are they entitled to get vaccinated and what documents will they need?

SS Jezikova: Currently there are many unanswered questions namely regarding the vaccination of foreigners. We are currently preparing law that should be presented to the next government meeting, where we address some of these issues, because there are certain groups of citizens, such as Slovaks working outside SR, or non-payers of health insurance, and we will address some of these questions now and some other questions later, gradually. When it comes to the vaccination of embassies, there is a completely separate debate going on, as there is also a foreign politics dimension there, so these are all questions which still await to be solved.

Q: But is there an interest in vaccinating foreigners, also out of embassies, let’s say Ukrainian workers, who work in Slovakia only in certain seasons, for example?

SS Jezikova: If foreigners are to be vaccinated, the condition of longer stay in Slovakia should be met, therefore only the work relation in Slovakia might not be enough.

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