How Slovakia Flattened the Curve

• Health
• Pandemics
• Europe

The European country that has recorded the lowest number of deaths per capita from the coronavirus is neither restriction-easing Germany nor lockdown-averse Sweden but Slovakia—the Central European country of just 5.4 million people. As of May 6, Slovakia had confirmed 1,429 cases and 25 deaths from COVID-19. If New York City had the same per capita mortality rate from the virus, it would have 40 victims rather than 19,000.

How has Slovakia successfully contained the coronavirus so far? First, let’s dispel the misconceptions. Slovakia hasn’t fared well against the coronavirus because of its isolation. On the contrary, it is very interconnected. Hundreds of thousands of Slovaks work elsewhere in Europe—as daily commuters, seasonal workers, or long-term migrants. For example, more than 20,000 Slovaks commute daily as caregivers for older adults in neighboring Austria, which had a major outbreak. Slovakia’s young people are also more likely to study abroad than those in any other European Union country. According to mobile phone data, about 50,000 Slovaks traveled to coronavirus-stricken northern Italy during the second half of February and early March, but Slovakia didn’t experience its own significant outbreak after they returned.

The European country that has recorded the lowest number of deaths per capita from the coronavirus is neither restriction-easing Germany nor lockdown-averse Sweden but Slovakia—the Central European country of just 5.4 million people. As of May 6, Slovakia had confirmed 1,429 cases and 25 deaths from COVID-19. If New York City had the same per capita mortality rate from the virus, it would have 40 victims rather than 19,000.

How has Slovakia successfully contained the coronavirus so far? First, let’s dispel the misconceptions. Slovakia hasn’t fared well against the coronavirus because of its isolation. On the contrary, it is very interconnected. Hundreds of thousands of Slovaks work elsewhere in Europe—as daily commuters, seasonal workers, or long-term migrants. For example, more than 20,000 Slovaks commute daily as caregivers for older adults in neighboring Austria, which had a major outbreak. Slovakia’s young people are also more likely to study abroad than those in any other European Union country. According to mobile phone data, about 50,000 Slovaks traveled to coronavirus-stricken northern Italy during the second half of February and early March, but Slovakia didn’t experience its own significant outbreak after they returned.

Nor can Slovakia’s low mortality rate be credited to the quality of its public institutions. Though it is an EU member, Slovakia did not score highly in the 2019 Global Health Security Index, which assesses countries’ capacity to respond to pandemics or similar threats. It ranked 70th in its ability to detect a health security threat and 105th in its ability to respond to such a challenge. By comparison, Germany ranked 10th for detection and 28th for response.

Over the last six weeks, the public has observed what this means in practice. At the beginning of the pandemic, the Slovak public health authorities had limited stocks of personal protective equipment and diagnostic test kits. They also had only a few teams ready to implement testing and contact tracing, though the teams were composed of seasoned civil servants working for the Slovak version of the U.S. Centers for Disease Control and Prevention.

[Mapping the Coronavirus Outbreak: Get daily updates on the pandemic.]

Even now, Slovakia has no mobile tracking app or intelligent quarantine system in place. Among other successful countries, Taiwan had such a system ready even before the pandemic began, and the Czech Republic—initially caught unprepared—put one in place at the end of March. Still, outbreaks appear to be limited primarily to three groups: poor members of the Romani minority living in rural slums, likely spread by individuals returning from the United Kingdom; older adults living in care facilities; and returning migrants and their families. The authorities’ response came quickly—but only after the outbreaks emerged.

Then why isn’t Slovakia overrun by the coronavirus? Experts that I spoke to credit three main factors. The most important was the government’s quick decision to institute a national lockdown effective March 16, 10 days after the country confirmed its first coronavirus case. The lockdown included the closure of all schools, restaurants, bars, and shops except for grocery stores, pharmacies, and banks—as well as a ban on all public events and gatherings. The country also secluded itself by closing all airports and implementing mandatory quarantine for citizens returning from abroad. But unlike in some other countries, physical movement of individuals remained largely unrestricted.

The lockdown measures have only worked because of the second factor: an immediate and universal compliance by the Slovak population. People did what they were told, even though Slovakia is generally plagued by low levels of trust in politicians and the government, according to the European Values Study. Slovaks acted voluntarily without the need for large-scale coercive enforcement. The response by the country’s political elites surely contributed to this compliance. Though Slovakia saw partisan conflict over who was responsible for the lack of preparation, there was no disagreement about the seriousness of the threat or the need for the lockdown itself—unlike in the United States, where federal and state authorities have clashed.

This is where the third factor comes in. More than the functioning of public institutions, experts credit the media as crucial to Slovakia’s success. The universal use of face masks—instituted early despite the dismissive attitude of the World Health Organization—has become a symbol of Slovakia’s response to the coronavirus. A pivotal moment came on March 13, when the anchor of the country’s most popular television program, Zlatica Puskarova, hosted incoming Prime Minister Igor Matovic and his health minister. Puskarova began by asking the government officials why they didn’t lead by example, handing them two face masks. They complied immediately, and from the next day the whole country started making and wearing face protection. Since then, no Slovak politician, news reporter, or celebrity would be seen in public without a mask.

The coronavirus crisis has also increased readership of the more serious media outlets. Fringe and conspiracy sites focused on health issues, usually very popular in Slovakia, ignored the virus altogether for several weeks. This allowed the mainstream media to dominate public discourse. Even when criticizing specific government actions—such as a mismanaged travel ban during the Easter holiday—the mainstream media was careful not to denigrate the need to strictly observe the lockdown.

Slovakia’s TV stations, newspapers, and news websites are a diverse but fragmented bunch operating in a small market. They lack the financial clout or resources of outlets in larger countries. Despite that, many outlets have been able to attract committed and bright reporters motivated by the public interest. The media has played an outsized role in the coronavirus crisis: not just by holding the government accountable but also by quickly disseminating new social norms.

The Slovak government began easing its lockdown measures on April 22, and since the number of new daily infections has remained in the single digits, the authorities opened most shops, restaurants, and hotels on May 6. The situation is far from normal—schools remain closed, and restaurants and bars can only serve patrons outdoors—but Slovaks have celebrated their ability to finally get a haircut by posting selfies of their new coiffures on social media.

While early and decisive action by governments is crucial in fighting the coronavirus, the case of Slovakia shows that media and civil society can compensate for the weakness of public health institutions by forging a consensus to observe the necessary social norms.