What Happened to Slovakia’s Coronavirus Success Story?

The country’s swift fall shows that managing a pandemic is a marathon, not a sprint.

By Dalibor Rohac, a resident scholar at the American Enterprise Institute.
Slovakian Prime Minister Igor Matovic and Health Minister Marek Krajci speak at Kosice International Airport.
Slovakian Prime Minister Igor Matovic and Health Minister Marek Krajci give a press statement at the international airport in Kosice, Slovakia, on March 1. PETER LAZAR/AFP via Getty Images

On March 1, Slovakian Prime Minister Igor Matovic went ahead with the purchase of 2 million doses of the Russian-made Sputnik V COVID-19 vaccine, following in the footsteps of nearby Hungary. The decision, which came after weeks of gradually worsening case numbers, sidelined the European Union’s vaccine approval process and ignored the protests of two smaller parties, leaving Matovic’s government hanging by a thread.

Recently, the Slovakian government has visibly struggled to bring the coronavirus under control. With a population of just 5.5 million people, the country now records more than 2,000 new cases and around 100 deaths every day. That translates into more coronavirus-related deaths per capita than in any other country except the neighboring Czech Republic—more than four times as many as in the United States and more than seven times as many as in Germany. Slovakian hospitals are overstretched, and local media report they are rationing ventilators to prioritize younger patients.

Ten months ago, Slovakia was a public health success story. It largely avoided the first wave of the pandemic with early and widespread masking, border closures, and a strict lockdown, seeing daily cases in the dozens even as the virus ravaged Western Europe. Slovakia’s top epidemiologist, Vladimir Krcmery, an avuncular figure akin to U.S. immunologist Anthony Fauci, predicted last May that the country might avoid a second wave altogether. Slovaks enjoyed an extended reprieve from the virus during late spring and summer of 2020: eating out, taking holidays abroad, and eschewing most protective measures.

It turns out that managing a pandemic is a marathon, not a sprint, just as Sweden’s controversial state epidemiologist Anders Tegnell quipped last year. While Tegnell’s laissez faire approach to the pandemic has come at a steep price in his own country, his reasoning held a kernel of truth. Draconian lockdowns and curfews are not indefinitely sustainable. Approaching the pandemic as a marathon certainly doesn’t preclude drastic measures to flatten the curve, but the time bought with those measures must be used to put long-lasting policy tools in place—particularly an effective regime of testing, tracing, and isolating new cases.

Against the background of international applause last spring, Slovakia largely missed that opportunity. Now suffering from lockdown fatigue, a lack of strong political leadership, and a severely limited vaccine rollout, its pandemic fortunes have reversed.

While other European countries are still struggling with the pandemic, Slovakia’s crumbling health care infrastructure stands apart.

While other European countries are still struggling with the pandemic, Slovakia’s crumbling health care infrastructure stands apart. Before the pandemic, the country suffered from elevated rates of preventable deaths, roughly twice the Western European average. Images from northern Italian hospitals overflowing with COVID-19 patients last March instilled a sense of urgency behind Slovakia’s initial measures. Both the political class and the general public understood that its hospitals would not withstand similar pressure.

Recent months have confirmed that suspicion. When new cases and hospitalizations peaked in January, around 20 percent of all patients hospitalized with COVID-19 in Slovakia died. In the United States, by comparison, the mortality rate has been below 5 percent since June 2020. Unfortunately, the numbers only seem to be getting worse. At Slovakia’s second-largest hospital, the Louis Pasteur University Hospital in Kosice, the mortality rate of COVID-19 patients in February was 30 percent, up from less than 24 percent the previous month.

Slovakia’s case numbers first started to climb in August 2020, first into the hundreds, then to more than 1,000 a day by the beginning of October 2020. The government half-heartedly tightened restrictions, closed restaurants, reintroduced mask mandates, and closed schools for students above the fifth grade. Desperate to avoid harsher measures, Matovic became obsessed with the idea of nationwide mass testing as a solution. The appeal was obvious: Instead of shutting down economic and social life again, why not just identify and isolate all positive cases?

An impressive mobilization of medical staff and volunteers executed the mass tests with an extraordinary degree of compliance over two weekends, beginning on Oct. 31, 2020. The situation temporarily improved, halving the number of daily cases, but the mass testing monomania backfired when it came to isolation. Although trips beyond the home and other activities required proof of a negative test, enforcement was scant in practice. The border regime remained loose, allowing new cases to slip in undetected. Most importantly, negative test results provided a false sense of security, resulting in more indoor socialization and higher mobility within Slovakia.

Case numbers and hospitalizations soon rose again, and Matovic pushed his reluctant coalition partners for yet more tests. Only when daily cases rose to more than 3,000 at the end of 2020 did the government announce a stricter lockdown. Case numbers fell but were increasing once again by February, likely due to lockdown fatigue, widespread flouting of the rules, and the spread of new strains. The supply of EU-provided vaccines is so far too limited to have a significant effect on cases, and the government now lacks the will to tighten restrictions further, anticipating they will likely be ignored.

Indeed, absence of political leadership is part of the problem. Slovakia’s health minister, Marek Krajci, resigned last week under pressure. “What should we do?” he asked in February. “If somebody came and told us what to do, they’d be very popular.” Before parliamentary elections in February 2020, few predicted that Matovic would end up leading an emerging center-right coalition. He built his political career around anti-corruption activism directed at the ruling Direction-Social Democracy party. Organized primarily around Matovic’s mercurial personality, his own party never developed a coherent platform, its appeal limited to disillusioned voters across the political spectrum.

Like former U.S. President Donald Trump, Matovic has relied on frequent displays of bombastic, impromptu protests and publicity stunts to dominate the news cycle. This form of half-politics, half-entertainment worked marvelously as a campaign strategy. But as a mode of governing during a crisis, the prime minister’s approach falls flat. His Facebook profile serves the same purpose as Trump’s defunct Twitter account: connecting the unfiltered Matovic with his base and enabling him to take jabs at the urban intelligentsia as well as his junior coalition partners.

Matovic’s urge to remain the center of attention while refusing to take ownership of any difficult policy choice does not exactly inspire the public trust needed to navigate the pandemic. In a coalition of four political parties, the prime minister invariably blames Slovakia’s failure to defeat the coronavirus on others. Unpopular lockdown decisions are outsourced to ad hoc committees of experts, shielding him from political responsibility.

At its current daily vaccination rate, it would take Slovakia more than a year to administer just one dose to its entire population.

Slovakia’s slow vaccine rollout, owing largely to the EU’s mishandling, hasn’t helped the situation. So far, Slovakia has only administered 633,000 doses of the Pfizer, Moderna, and AstraZeneca vaccines. In countries with high distribution rates, vaccines have already had a measurable effect in slowing the spread of the coronavirus, distinct from the effect of their lockdowns. At its current daily vaccination rate, it would take Slovakia more than a year to administer just one dose to its entire population.

So it wasn’t just Matovic’s penchant for grand gestures but also the seriousness of its health crisis that led the government to purchase 2 million doses of Sputnik V, which has not been approved for use in the EU. If delivered in their entirety, promptly, and effectively, those vaccines can make a meaningful difference.

But the optics of Slovakia’s prime minister standing in front of a military plane loaded with Russian vaccines were the straw that broke the back for his coalition partners, who were—until now—patient with Matovic’s antics. Defeating the coronavirus requires laser-sharp focus, particularly on speeding up the vaccine rollout. Instead, Slovakia’s parties have spent the last two weeks negotiating among themselves, leading to the departure of the health minister and the defections of several members of Parliament.

Worryingly for Slovakia, the prolonged period of uncertainty suggests that both its coronavirus crisis and political outlook will get worse before they get better. The vaccine purchase alone isn’t likely to turn Slovakia, with its staunchly liberal president and Atlanticist foreign minister, into a Russian vassal state anytime soon. But the controversy is good news for those who want to see countries on the EU’s eastern periphery divided and weakened.

Dalibor Rohac is a resident scholar at the American Enterprise Institute, where he studies European political and economic trends. He is also a research associate at the Wilfried Martens Centre for European Studies in Brussels and a fellow at Anglo-American University in Prague. Twitter: @DaliborRohac