In Slovakia, the Prime Minister today speaks of a “lost fight”.
That of the massive screening of the population that the government had preferred to confinement to fight against the Covid-19 epidemic.
More than a month after having tested the vast majority of its 5.4 million inhabitants, the small central European country is suffering a sharp rise in contamination.
He is now considering another turn of the screw, with a curfew and travel restrictions.
The strategy of Slovakia, the first state of this size to organize national tests, has been widely observed.
Its neighbor, Austria, was inspired by it to launch a large-scale screening campaign in early December.
In France, the agglomerations of Le Havre and Charleville-Mézières began this Monday to massively test their inhabitants.
What lessons can be learned from the Slovak program?
What have been its effects on the spread of the coronavirus?
Ambitious project
A first wave of tests was carried out on the weekend of November 1, the second a week later.
In all, between 80 and 90% of Slovaks took part in the campaign.
The threat of a quarantine had been wielded to put down the refractories and employers could only accept their employees if they showed a negative test certificate.
"We have literally found an atomic weapon against the Covid-19", then rejoiced Prime Minister Igor Matovic, in the face of such participation.
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Its ambitious and costly bet - 100 million euros - mobilized more than 45,000 health professionals, the army and the police, deployed to carry out tests in around 5,000 screening centers.
It found that around 1% of those tested were positive for the coronavirus.
A decline that began before the screening campaign
The contaminations fell at first.
But this dropout is not to the credit of the screening campaign, believes Antoine Flahault, director of the Institute of Global Health at the University of Geneva.
The drop in new contaminations "had started just before the program started," notes the epidemiologist.
“Around October 27, Slovakia was at the end of the exponential phase of its epidemic, a bit like in France.
The number of new cases then fell until about November 20, before stagnating for several days, then increasing in early December.
“The curve goes up quite strongly with an R (
Editor's note: reproduction rate, or the number of people that an infected individual will infect on average
) of 1.15.
That's a lot, ”notes the public health professor.
In France, the R is 0.83, according to the latest data released by the health authorities on December 5.
No better than its neighbors
Did the screening campaign contribute to the decline in the first few days?
Perhaps, but nothing proves it.
Above all, it has not made it possible to maintain the reduction in cases deeply and over time, nor to stand out from neighboring countries.
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The Czech Republic, in the north-west of Slovakia, has also experienced a similar development without massively screening its population.
We find there "the same break in the curve of daily contaminations at the end of October, then a drop, as everywhere in Europe, before a recovery", notes the epidemiologist.
This rebound is particularly strong in Slovakia, where epidemic monitoring indicators have turned red.
"Threatening figures", "increase in hospitalized patients", "the number of contaminations and deaths is increasing", warns the Slovak press for several weeks.
Support measures not effective enough
A massive screening policy must indeed "be accompanied by measures to isolate cases or encourage them to do so, as well as to trace contacts downstream and upstream", recalls epidemiologist Carole Dufouil, research director at the 'Inserm.
Isolation of positive people would therefore not have been effective.
"There was probably a first impact because the positives were able to stay at home but if we don't help them to really isolate themselves, it only has a temporary effect and that's what we are currently seeing. ", Estimates in the JDD Eric Billy, researcher in immuno-oncology in Strasbourg who studied the Slovak situation.
"This campaign had a bit of the effect of a sword in the water," says Antoine Flahault.
The program was launched in Slovakia as the country had just passed the peak of its second epidemic wave.
Conversely, the screenings started on Monday in French cities are done "at low tide", which could be "more relevant", compares the epidemiologist.
And this would also make it possible to better trace and isolate the cases detected.
