From time to time, until the crisis has passed, the HEPL blog series authors will be given the opportunity to provide short updates on their country/region’s continuing response to this worldwide catastrophe and their further reflections on those responses. Each update will be labelled accordingly with the original response at the bottom of each post.

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HEPL blog series: Country Responses to the Covid19 Pandemic

The Czech Republic’s Response to the Coronavirus Pandemic – Update (May 2020)

Olga Löblová
Department of Sociology, University of Cambridge
ol264@cam.ac.uk

The Czech Republic implemented an early lockdown and required the use of facemasks in public on March 12-16. By mid-April, its R was <1 and the government announced a plan to relax lockdown measures, which it repeatedly, chaotically brought forward. The government has been heavily criticised for its lack of transparency and evidence for decision-making.

Lifting the lockdown

On April 17, the government announced a first plan of the lockdown relaxation timeline. It respected a 14-day distance between easing stages to allow for evaluation. First to open were small shops under 200 sqm; among the last would theatres and galleries on June 8.

At Easter (10-13 April), DYI, home improvement, and garden centres opened and were visited by masses, which was later described as a “spontaneous lockdown relaxation” and an experiment to evaluate before further easing.

On April 20, university students in their final year were allowed to enter university (max 5 people per group). Farmers’ markets, car dealerships, artisan shops, and outdoor training spaces for professionals opened; weddings were allowed (max 10 people).

On April 23, a Prague court ruled that its measures were unlawful and gave the government four days for rectification (see below). Later that day, the Minister of Health lifted the ban on freedom of movement, including on travel abroad (the latter announced in a response to a reporter’s question). Public assembly of 10 people maximum was allowed.

According to the new plan, all shops under 2,500 sqm (except in shopping malls) opened on April 27; universities (max 5 people), libraries, driving schools, and fitness centres (without changing rooms and showers) opened. Subsequent stages of this plan were brought forward further on April 30. The current exit plan schedule is as follows:

May 11:

• pupils in final year of elementary schools, all high school and university students may go to school (max 15 students per class)
• events below 100 people allowed with physical distancing
• shopping malls and shops above 2,500 sqm open
• terraces of cafes and restaurants & castles open (outdoor only)
• hairdressers, massages, museums, etc. open

May 25:

• primary schools open (max 15 pupils); attendance not mandatory
• hotels, restaurants, tattoo parlours and other businesses open (“subject to satisfactory epidemiological situation”)

Facemasks stay mandatory in public until at least June 15.

From May 1^st cross-border workers must present a negative test once a month (originally required every 2 weeks).

Population prevalence study

On April 23, a multi-site population study of COVID-19 antibody prevalence, with samples from 26,549 individuals (self-selected and sociological cohorts) was reported. It found a prevalence of 4-5% in the worst hit towns. 51% of people with antibodies had no symptoms.

“Smart quarantine”

“Smart quarantine”, a variation on test & trace, launched on May 1. Contact tracing is supported by an app (“eRouska” = eMask) and a collaboration with banks and mobile phone operators (see previous blog). About 500 contact tracers have been trained, including from the army. Testing capacities are currently reported at around 12,000 tests/day maximum.

Contestation

On April 23, a Prague court ruled that the limits to fundamental rights imposed by the lockdown and shop closure measures were too great for the measures to be issued single-handedly by the Minister of Health as decrees based on the Public Health Protection Act. Instead, the court insisted they be re-issued by the government based on the Crisis Act, subject to parliamentary scrutiny. In fact, the measures had been initially issued under the Crisis Act but some days later, the government cancelled the original decrees and replaced them with identical measures under the Public Health Protection Act. Crucially, under the Crisis Act fines are capped lower and the government is potentially liable for damages.

The Constitutional Court refused to hear two cases on grounds of standing and additional procedural grounds; it is expected to hear more cases.

Support for the government has been high and political and civil society opposition has focused mostly on selected parameters of the lockdown measures (e.g. cross-border workers), the management of economic measures, and the government’s lack of transparency.

On April 28, Parliament did not approve an extension of the state of emergency for another 30 days but only until May 17.

Analysing the exit plan

The swift, comprehensive lockdown imposed in March succeeded in containing the infection, with R=0.7 and 251 deaths (23 per million inhabitants) by May 4. The acute care system had spare capacity. Relaxing containment measures was therefore in principle warranted; however, it is unclear what evidence the government has been using to inform its exit plan.

The government publishes selected aggregate epidemiological data but has refused to release more detailed data, analyses or names of its experts, even to the Parliament. It repeatedly reversed its previous reasoning (e.g. on opening borders) and justified expediting the easing solely by low transmission rates.

This opacity plays into the popular hypothesis that lifting the lockdown is motivated by the government’s fear of a wave of compensation claims. Nevertheless, the relatively low number of coronavirus cases and deaths means protests against accelerated easing have been rare.

The Czech Republic’s Response to the Coronavirus Pandemic – Original post (April 2020)

Olga Löblová
Department of Sociology, University of Cambridge

The response of the Czech government stands out by its early adoption of a country-wide lockdown in addition to two measures that went against contemporaneous WHO recommendations: border closures and mandatory use of face masks by the general population. The government has published little formal evidence for these measures, following an implicit precautionary principle. The reaction of the Czech population has been supportive.

Testing
By the time the first three cases of coronavirus were confirmed on 1 March 2020, the Czech Republic had carried out 211 tests. As of April 5, there were 4,475 confirmed cases, 80,304 tests, and 62 deaths.

Testing was first indicated for symptomatic individuals who have been in close contact with a confirmed a COVID-19 case or travelled to a high-risk area; by March 5 the high-risk criterion was dropped. Anecdotal reports suggest access to testing has been difficult, partially due to overburdened triage hotlines.

Initially, public health authorities intended to conduct coronavirus testing exclusively in five public laboratories (the Health Minister publicly shamed a private laboratory that provided direct-to-consumer testing) and asked private laboratories to refrain from testing. This approach was later relaxed and by April the official Ministry of Health list counted 66 specimen collection points and 77 laboratories, about half of which were privately owned. By April, testing rate was about 6,000 tests per day.

Border closures
Early government response to the emerging coronavirus focused on targeting travel-related risks, predominantly from China and later Italy. Symbolically, an early press conference on COVID-19 took place at Prague airport on 26 January, 2020. On February 3, the government cancelled all incoming flights from China (effective from 9 February) and, on February 26, advised anyone travelling from the Northern Italian regions of Emilia Romagna, Lombardia, Piemonte and Veneto to self-monitor.

Following the confirmation of the first three positive coronavirus cases on March 1^st, the government cancelled flights from Northern Italy and South Korea, though ground travel was still possible. A two-week self-quarantine was mandated for all residents (later also tourists) arriving from Italy on March 7.

On March 12, the government declared a state of emergency and banned the entry of foreigners arriving from, as well as travel of Czech citizens to, high risk zones (including Austria, Germany, and the UK). On Friday March 13, all Czech citizens and foreigners arriving from these risk zones were to self-quarantine. From Monday 16 March, Czech citizens/residents were banned from leaving the country and no foreigners without residence permit were allowed entry (notable exceptions included cross-border work, especially with Germany and Austria).

Lockdown
The Czech Republic implemented a country-wide lockdown on March 16; at this point there were 383 confirmed COVID-19 cases and zero deaths. The lockdown followed a succession of increasingly strict physical distancing measures, starting with body temperature checks at the borders. On March 10, the government closed down primary, secondary and tertiary schools and universities (though not kindergartens), and banned all gatherings of more than 100 people (later decreased to 30 and eventually two people, with exceptions).

On March 16, the government limited freedom of movement except for: travel to and from work, medical care, necessary travel to family members, shopping for basic necessities, and individual walks in parks and nature. All shops except for drugstores, pharmacies, gas stations, grocery shops, and other essential services, were closed down.

On March 18, the government mandated the use of “respiratory protective devices” outside of one’s home; given the shortage of facemasks and respirators, the decree clarified that scarves or other cloth were acceptable, and within hours the Czech population responded by sewing DIY cloth masks.

The government also announced dedicated morning shopping hours for over 65 year olds.

Pilots of “smart quarantine” using mobile operators and bank data have been launched in early April. Mobile operators and banks are required to provide geolocation data to the Ministry of Health for the purpose of smart quarantine, with the user’s consent.

Measures to increase treatment capacity
In early March, the Ministry of Health banned exports of hand disinfectants and FFP3 masks (and their sale to the public). On March 17 export of all medicines was banned, this was later relaxed to selected medicines only.

Hospital and social care visits were banned, later including the presence of fathers during birth, followed by a ministerial ordinance on March 17 to limit and postpone all planned inpatient surgeries. All acute inpatient providers are required to allocate bed and staff capacity to COVID-19 patients as of March 19.

The government banned all healthcare professionals from taking leave and imposed work duty on medicine and selected other students. Shortages of protective equipment have been reported by some providers; procurement is coordinated by health and interior ministries.

Governance considerations
On 12 March 2020, the Czech government declared a state of emergency for 30 days. Its legality has been challenged (several court hearings are currently pending) and further prolongation is to be debated by Parliament. Many of the COVID-19 policies take the form of “extraordinary measures” published by the Ministry of Health, others are government ordinances (which has consequences for damages claims).

A Central Crisis Team was created four days after the declaration of state of emergency and was headed by a deputy minister of health and epidemiologist, Roman Prymula, as opposed to the traditional leadership by the Interior Minister. Later, Prymula was replaced with the Interior Minister and tasked with heading a special COVID-19 team.

Analysing the Czech response to COVID-19
Government measures have been very well accepted by the population: in April, 76% of respondents in one poll see them as “adequate” (and 16% as too lenient), even as economic consequences of the lockdown began to hit. 72% report staying at home except for necessary trips and 92% wearing a facemask (80% agree that access to public space without masks should be banned). Trust in the Prime Minister lags behind the leaders of the two crisis teams but the popularity of the senior ruling party (ANO) increased to 34.5% (up 5% from the 2017 election). Mid-March, trust that government measures would improve the pandemic outcomes was also high.

30 years after the Velvet Revolution, such high support for measures drastically limiting human rights is surprising. Fear of the disease may be a partial explanation: 60% of respondents in one survey are afraid of contracting coronavirus. Another explanation could be the long-term increasing voter preferences for authoritarian politics.

The Czech government has been notably lax in presenting scientific evidence to support individual measures. This is especially intriguing with the two measures that were not recommended by the WHO at the time of their implementation: border closures and mandatory facemasks (note that the WHO has since debated its advice on masks and the US CDC has recommended the use of homemade cloth masks). Explanatory reports (similar to impact assessments) are not required for extraordinary measures or government ordinances passed during the state of emergency, and the government has, as a rule, not provided scientific evidence (e.g. modelling) to support its decisions on official websites or during press conferences, where it chiefly referred to measures taken by other countries (e.g. lockdowns) and common sense (e.g. shopping hours for seniors).

Lack of evidence and disregard for constitutional legislative procedures have been cited as grounds in a legal challenge of the government’s measures and opposition parties have expressed hesitance to prolong the state of emergency for another month. Czech civil society has taken pride in the country’s inventiveness in sewing facemasks, but have criticized some of the individual measures (e.g. the ban of fathers’ presence during birth).

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