COVID-19 pandemic in the Czech Republic


The COVID-19 pandemic in the Czech Republic is part of the worldwide pandemic of coronavirus disease 2019 caused by severe acute respiratory syndrome coronavirus 2. The first three confirmed cases in the Czech Republic were reported on 1 March 2020. On 12 March, the government declared a state of emergency, for the first time in the country's modern history for the area of the entire country. On 16 March, the country closed its borders, forbade the entry of foreigners and issued a nationwide curfew. While originally planned until 24 March, the measures were later extended until 1 April and then again until the end of State of Emergency which was extended by the Chamber of Deputies until 30 April 2020 and then again until 17 May 2020.
Some measures undertaken by the Czech Republic differed in key aspects from other countries. A general curfew was in place between 16 March and 24 April, however it included generous exemptions. Apart from the usual essential shopping and going to/from work, it also included visiting relatives and unrestricted movement in parks and open countryside. A general closure of services and retail sale was in place from 14 March until 11 May, however all shops could conduct distance sales with delivery through makeshift takeaway windows and gradual opening of selected shops started in several waves from 24 March onwards. Fear, anger and hopelessness were the most frequent traumatic emotional responses in the general public during the first COVID-19 outbreak in the Czech Republic. The four most frequent categories of fear were determined: fear of the negative impact on household finances, fear of the negative impact on the household finances of significant others, fear of the unavailability of health care, and fear of an insufficient food supply. The government didn't order closure of manufacturing plants, but many did so voluntarily during the second half of March with Hyundai spearheading a gradual reopening from 14 April. The Czech Republic was the first European country to make the wearing of facemasks mandatory from 19 March onwards. COVID-19 testing was made widely available with drive through locations from 14 March, and from 27 March anyone with a fever, dry cough or shortness of breath was eligible for a free test. From 13 April onwards, COVID-19 testing capacity significantly surpassed demand. Contact tracing in the country also included voluntary disclosure of mobile phone position and debit card payments data for previous days and the quarantining of identified contacts. By 1 May 2020, altogether 257 COVID-19 related deaths were identified in the Czech Republic compared to 2,719 in similarly populous Sweden, which did not impose any lockdown.
The Czech Republic started gradual easing of measures from 7 April 2020 onwards with most restrictions being lifted by 11 May 2020.

Background

On 12 January 2020, the World Health Organization confirmed that a novel coronavirus was the cause of a respiratory illness in a cluster of people in Wuhan City, Hubei Province, China, which was reported to the WHO on 31 December 2019.
The case fatality ratio for COVID-19 has been much lower than SARS of 2003, but the transmission has been significantly greater, with a significant total death toll.

Timeline

28 January

As of 28 January 2020, suspected cases were tested with negative results.

Week 9 (24 February–1 March)

28 February –
As of 28 February 170 suspected cases were tested with negative results. 307 people were in home quarantine imposed by a regional health authority, 77 of them were in South Bohemian Region.
1 March –
The Minister of Health, Adam Vojtěch, reported that three cases of COVID-19 had been confirmed by the National Reference Laboratory. The three cases are treated at the Bulovka Hospital in Prague; one of the cases had been found in Ústí nad Labem, but was transported to the Bulovka Hospital. All cases were connected with northern Italy. One case was a man who returned from a conference in Udine, the second case was a woman studying in Milan and the third case was a man who returned from a skiing holiday in Auronzo di Cadore.

Week 10 (2–8 March)

2 March –
Another case was confirmed, a woman who was on skiing holiday in Auronzo di Cadore and was staying in the same hotel as the man from a previous case.
3 March –
Another case was reported, a woman from Ecuador studying in Milano, a friend of the U.S. tourist who tested positive several days prior. Government started taking active measures.
5 March –
Four new cases were identified a Czech and an Italian who returned from Italy by the end of February, third was related to case No. 3 and fourth was related to case No. 6.
6 March –
Obligatory 14 days quarantine for people returning from selected parts of Italy announced. As of 6 March 1,011 people were already in home quarantine imposed by regional health authority, 341 of them in Prague, 160 in South Bohemian Region and 63 in Central Bohemian Region. As of 6 March, some 16,500 Czechs were in Italy; spring break falls between early February and the middle of March 2020.

Week 11 (9–15 March)

9 March – Bulovka Hospital in Prague has announced that all but two tourists have been released to home quarantine.
10 March –
Positive cases were being identified in ever increasing number of regions.
11 March –
Schools closed.
12 March –
The Czech government has declared a state of emergency for 30 days and adopted a number of measures.
13 March –
Brno University Hospital was hacked, disrupting services.
15 March –
Shortly before midnight, Prime Minister Andrej Babiš announced approval of the nationwide quarantine.

Week 12 (16–22 March)

16 March –
Starting at midnight, an hour after the nationwide quarantine declaration was approved the previous day, nearly 11 million Czech residents were placed under quarantine. The Czech Republic became one of the first countries in the EU to completely close its borders. First three people were reported recovered.
18 March –
The Czech Republic became the first country in the EU to introduce mandatory face cover.
21 March –
Deliveries of protective gear purchased by Czech Government in China started: a heavy cargo plane Antonov An-124 provided through NATO Support and Procurement Agency brought 100 tons of masks, respirators and coronavirus tests from China, while a China Eastern plane brought seven million facemasks. This helped to alleviate the shortage of personal protective equipment in the Czech Republic. According to Security Information Service, the shortage happened after Chinese embassy conducted massive purchases of respirators available on Czech market during January and February and transferred them to China.
22 March –
First death reported: a 95-year-old man. While COVID-19 positive, at the time of death, the man was not at ICU and did not suffer from pneumonia that is a COVID-19 specific type of death. The man suffered from chronic heart issues and had also a pacemaker. The cause of death was formally established as a "complete exhaustion of organism".

Week 13 (23–29 March)

23 March –
The local health authority in the Moravian-Silesian Region announced that 80% of COVID-19 examinations that were conducted in the region in the previous days with use of fast-test kits that government procured and airlifted from China came out wrong when double-checked through standard testing.
It was later confirmed the cause was an incorrect use where the fast-test react to an immune response and are not suitable for new patient screenings.
24 March –
A second death was reported: a 45-year-old man died after six days in a hospital in Havířov. The patient was suffering from advanced cancer with metastases to multiple organs. The cause of death was established as multiple organ failure due to cancer but COVID-19 infection accelerated the patient's death.
A third death was reported: a 71-year-old woman died in Všeobecná fakultní nemocnice in Prague. The woman suffered from the chronic obstructive pulmonary disease as well as other illnesses, so it wasn't immediately clear that she may be COVID-19 positive. Only after being hospitalised the woman informed doctors that her relative recently returned from Italy and was then tested for COVID-19. The woman was connected to a ventilator but died three days after start of hospitalisation.
Apart from the Uber driver on ECMO, there were 19 other patients in hospitals in serious condition, all of them connected to ventilators.
25 March –
A fourth and fifth death was reported: The fourth victim of the disease is an 82-year-old from Prague with long-term chronic health problems. The fifth patient is an 88-year-old man from the Central Bohemian Region who was at home getting treatment and was suffering from a chronic disease.
A sixth patient died at Thomayer Hospital. The 75-year-old patient suffered from diabetes and Parkinson's disease and also had advanced heart problems. The patient had been in the hospital since January and got infected while in post-operative care. After this patient tested positive for COVID-19, the hospital tested all 29 other patients in the same ward on 22 March, all negative. The test was repeated again on 25 March, this time with positive outcomes for 13 patients. Several of the hospital's staff had become infected earlier, probably while taking care of the Uber driver who would later become the first remdesivir receiver in the country. This patient was originally admitted with simple pneumonia without initial indication of COVID-19. Two of the infected nurses were hospitalised at the local pulmonary ward at the time of the sixth patient's death.
The government was planning to evacuate Czechs from Australia and New Zealand by the end of the week. Hundreds of Czechs still remained abroad, mainly in Oceania and Southeast Asia.
An Antonov An-124 provided through the NATO Support and Procurement Agency arrived again with 24 tons of medical products purchased by the Czech government in China. The shipment included 52,600 protective suits, 70,900 protective glasses, 250,000 gloves, 1,160,000 respirators and eight million masks. Further government purchased personal protection equipment shipments were planned for delivery with use of planes by the companies Smartwings and China Eastern, which were contracted for nine flights per week for six weeks in advance.

Commuters
37,000 and 13,000 Czechs live in the Czech Republic and work in Germany and Austria respectively, large portion of that in healthcare. Cross-border workers were originally exempted from the complete travel ban. As Germany and Austria gradually became major centers of COVID-19 outbreak, the Government started tightening up rules for commuters. By 26 March, Czechs commuting to work in Austria and Germany were required to remain in those countries for at least 21 days. Upon return, they would be quarantined for 14 days. Czechs working in health, social services, and emergency services abroad were not subject to the new rules. The rules were eased from 14 April onwards.
Districts bordering Germany and Austria gradually became major centers of COVID-19 outbreak in the Czech Republic. Domažlice District reached the highest number of COVID-19 positive persons relative to population size in the country. According to Vice-prime Minister Czech government avoided closing the commuter loophole because German and Austrian healthcare system in areas close to the border is dependent on Czech commuters and also because government feared it could lead Slovakia to close access to Slovak commuters working in Czech healthcare.

26 March –
A Taiwanese student in her twenties, who recently returned to Taiwan from the Czech Republic tested positive for coronavirus. She left the Czech Republic after 8 months in the country on 19 March 2020, announced symptoms to Taiwanese authorities on 24 March and was diagnosed COVID-19 positive on 26 March 2020. 34 patients were in severe condition.
27 March –
Despite having been quarantined already for two weeks, at least six retirement homes were hit by the spread of the COVID-19 virus. Authorities noted also the rising number of COVID-19 positive healthcare workers. As the capacity for COVID-19 testing increased, authorities eased requirements for free testing. Anyone with a fever, dry cough or shortness of breath may be eligible for a free COVID-19 test.
29 March –
Five people died. Among the victims was a 45-year-old nurse from Thomayer Hospital, an elderly woman from a senior home in Michle and an elderly woman from a senior home in Břevnice. There were 227 patients in hospitals, 45 of them in severe condition.

Week 14 (30 March–5 April)

30 March –
In South Moravia, testing of the so-called "smart quarantine" was started: local travel history of infected persons were to be tracked using data from mobile phones and bank cards. 300 military personnel were deployed to reinforce local health authority for the purpose of tracing patients' contacts and collecting samples. If this approach is deemed successful by the authorities for diminishing the pandemic, the "smart quarantine" method is planned to replace the existing nationwide curfew policy. The city of Uherský Brod started thorough disinfection of all common areas of apartment buildings and public areas after a significant increase in COVID-19 infections. Health authority registered thirty new cases in the town.
31 March –
In a community of 72 people living in a retirement home in Litoměřice, 52 positive tests were confirmed.
Employees of the retirement home in Česká Kamenice decided to stay with their clients 24 hours a day until 15 April, to avoid the seniors getting COVID-19.
1 April –
One month ago the Czech Republic reported the first coronavirus case. A second senior from the Litoměřice retirement home died, as well as seniors from Prague and Moravia-Silesia. The Department of Infectious Diseases of the Central Military Hospital in Prague has treated COVID-19 patients with hydroxychloroquine. Eight of them have already been released for home quarantine. The evaluation of preliminary results of this therapy will be carried out in April. Chloroquine and hydroxychloroquine were originally used to treat malaria, but at present they also help patients with autoimmune diseases—rheumatoid arthritis or systemic lupus.
The World Health Organization considers these substances as one of the options to treat COVID-19.
Supreme Administrative Court ruled that Government decision to postpone the Senate district 32 by-election due to COVID-19 pandemic was illegal. According to the court, the Government lacked the authority to make such a decision, as that can only be done by an Act of Parliament. The by-election to fill a seat after Jaroslav Kubera, who died of heart attack, was originally planned on 27 March and would take place on 5 June.

Czech aid to other countries
  • China: On 17 February, a plane with 4,5 tons of personal protection equipment donated by Czech Government left from Vienna to China. The plane was also loaded with Hungarian, Slovak and Austrian PPE donations to China.
  • China: On 1 March, a plane with 5 tons of PPE left from Prague to China. This time the load was donated by a multitude of parties, including President's Office, Olomouc Region, Karlovy Vary Region, South Moravian Region, Vysočina Region, the town of Třebíč and Škoda Auto. The donation was too large to fit into a single plane and thus there were further flights planned. Those however did not take place, as China declined to accept the aid.
  • Italy: Czech Government donated 110,000 FFP2 respirators to Italy on 23 March. This donation took place after Czech authorities confiscated 680,000 respirators from a fraudster, who was stockpiling them in a warehouse in Lovosice. According to media, 110,000 of the confiscated respirators were originally sent from China as a donation to the 300,000 strong Chinese minority that lives in Northern Italy.
  • Italy, Spain: 10,000 protective suits were donated to Italy and Spain each on 26 March.
  • Slovenia: One million face masks and 200.000 FFP2 respirators were donated to Slovenia on 1 April 2020.
  • France: Czech Republic offered treatment of French COVID-19 patients in serious condition. First six patients were to be airlifted from France on 6 April and placed at University Hospital in Brno. On the day of the planned airlift, however, France declined the help, stating that it is now able to better deal with the pandemic on its own.
  • North Macedonia: Czech Republic donated 1 million facemasks on 12 April 2020.
Foreign aid to the Czech Republic
  • Taiwan: Taiwan donated 25 lung ventilators to hospitals in the Czech Republic at the beginning of April 2020.
  • Japan: Japan donated experimental drug Avigan for treatment of 20 patients with option to sell packages for further 80 patients on 9 April 2020.

2 April –
One victim died at the General University Hospital in Prague ; another victim was a 79-year-old patient hospitalised at the Hradec Králové University Hospital. The government decided to extend the border control by 20 days. Border checks with Germany and Austria will last until midnight Friday, 24 April.
3 April –
A public controversy has arisen around shipments of personal protective equipment that the Czech Government purchased and airlifted from China. On 31 March, Mayor of Prague Zdeněk Hřib publicly praised Government of Taiwan for donating ICU ventilators to the Czech Republic, while pointing out that all of the equipment from China was purchased, none was donated. Representatives of China's business interest in the Czech Republic countered by claiming that China donated personal protective equipment that was to be handed over to Czech hospitals on 1 April. According to the media, Czech authorities received a promise of donation of PPE, however none have reached the country by 3 April 2020.
4 April – There were 29 infected police officers in the Czech Republic, 343 more were in preventative quarantine.

Week 15 (6–12 April)

6 April – Government eased a number of restrictive measures, e.g. by opening outside sporting grounds, movement in parks and nature without facemasks and opening of more shops and services.
7 April – Government sought extension of the State of Emergency for 30 days, i.e. until 12 May 2020. Chamber of Deputies of Parliament granted extension until 30 April 2020.
12 April – Government announced that it was preparing a plan for gradual lifting of remaining restrictions. Government aimed at reaching maximum of 400 newly infected people a day in order to prevent overburdening the healthcare system. Instead of general restrictions, the intended maximum number should be reached through contact tracing of positive cases.

Week 16 (13–19 April)

13 April – Number of COVID-19 tests sank from 8,000 a day to mere 3,200 a day during Easter weekend which included also Friday and Monday as state holiday. According to health authority, testing capacity during Easter weekend significantly surpassed demand for testing from potential patients. Health authority expected the demand to rise again in the following week.
14 April – A month-long complete border closure ended. A large number of Czech Romanis started returning from particularly hit United Kingdom, where many lived for over 15 years, leading to fear of possible increase of COVID-19 infection.
Hyundai factory in Nošovice, which makes 1,500 cars a day including Kona Electric, restarted production after three weeks pause. Ten days later, Government exempted Korean Hyundai "specialists and key workers" needed for ramp up of electric vehicle production from cross-border and quarantine restrictions. Manufacturing plants were unaffected by Government restrictions, however many had decided to close voluntarily.
The Czech government outlines a five-step plan for re-opening shops, restaurants and other businesses. Each subsequent step will be triggered as planned only if the previous step has not resulted in a total of 400 new COVID-19 patients per day.
The aforementioned timeline was not kept as government significantly accelerated lifting of restrictions in the following weeks, with most being lifted by 11 May.

Week 17 (20–26 April)

22 April 2020 – Prime Minister Andrej Babiš announced that the Government will not request the Chamber of Deputies of the Parliament to extend the State of Emergency beyond 30 April. Meanwhile, Minister of Interior announced that he will seek further discussion of the topic, claiming that State of Emergency is crucial for Government's ability to fast procure and distribute personal protection equipment outside of standard lawful procurement process.
23 April 2020 – The Municipal Court in Prague invalidated some of the restrictions adopted in order to battle the COVID-19 spread. In particular, the court invalidated Ministry of Health Protection Measures that introduced curfew, banned hospital visits and banned selected retail sale and services. The court held that such wide restrictions of basic rights may be adopted only under the Crisis Act by the Government as whole and not under Protection of Public Health Act by the Ministry of Health alone. Both the curfew and retail sale ban were originally adopted by Government Resolutions on 14 and 15 March respectively, however then they were replaced by Ministry of Health Protection Measures from 24 March onwards. The court invalidated these measures from 27 April onwards, giving the Government three days to remedy the situation. The Ministry of Health may lodge an appeal to the Supreme Administrative Court. On the day of court's decision, there were suits against 17 other measures still pending.
While Ministry of Health Protection Measures may be adopted indefinitely, Government Measures under Crisis Act may be adopted only for period of State of Emergency. Government may declare State of Emergency for period of 30 days, any prolongation requires assent of the Chamber of Deputies.
24 April 2020 – In line with the decision of the Municipal Court of Prague, the Government announced that it would seek Chamber of Deputies' consent to extend the State of Emergency until 25 May. At the same time the Government announced a faster roadmap for the lifting of restrictions.

Week 18 (27 April–3 May)

28 April – The Government sought an extension of the State of Emergency until 25 May 2020. The Chamber of Deputies of Parliament granted an extension until 17 May 2020.

Week 19 (4 May–10 May)

6 May – The Ministry of Health presented the outcome of the COVID-19 prevalence study conducted over the previous weeks. Out of 26,549 people tested for the presence of anti-bodies, the countrywide testing identified only 107 people with antibodies who were previously undetected. This showed a high success rate of contact tracing and quarantine measures and a very low rate of virus presence in the general population.

Week 20 (11 May–17 May)

State of Emergency ended on 17 May. Extraordinary measures either ended or were extended beyond the State of Emergency with lesser restrictions. According to Ministry of Health, the main aim going forward was to achieve three main objectives:
A court ordered pre-trial detention of a first person charged with spreading of COVID-19. A 32-years old woman was arrested for movement at a public space without a facemask, although she had been personally ordered to remain in quarantine. Despite quarantine order, the woman used a taxi and visited a shopping mall. The woman was jailed at a hospital ward of Brno prison. If convicted, she may be sentenced to up to 8 years imprisonment.

Week 21 (18 May–25 May)

A new major COVID-19 hotspot emerged in the city of Karviná. Over 150 workers became infected at a black coal mine where miners work in tight shafts as deep as 1,000 meters underground. Authorities expected the number to significantly rise further as the workers' family members were likely to become positive later. Among those infected were also many foreign workers from Poland, where coal mines became hotspots in previous weeks. Health authority planned to conduct testing of all 2,400 workers within three days. Czech Army deployed six medical teams to assist local authority in collection of samples and contact tracing. As of 22 May, up to 40% of infected miners had no symptoms with many others reporting tiredness as the only symptom. Meanwhile, a school was temporarily closed down in nearby city of Havířov after a child of one of the miners tested positive. Apart from the coal mining hotspot, authorities deemed situation in the rest of the country as stable, except for Prague where they identified several small clusters with community spread.

Week 23 (1 June–8 June): Further lifting of restrictions, opening of borders.

Most restrictions have been lifted. Borders were reopened and events of up to 500 people allowed.

Statistics

Current active cases and hospitalisation


*Active cases – hospital and home quarantine

**Current severe conditions including UPV/ECMO –
UPV: Artificial lung ventilation
ECMO: Extracorporeal membrane oxygenation
Active cases


New confirmed cases per day


* Laboratory-proven COVID-19 disease as reported by regional hygiene stations and laboratories

New confirmed recovered and deaths per day


New confirmed cases versus new recovered and deaths per day






Updated: 2020/06/22 09:00


Sources:
COVID-19 by Ministry of Health.

Epidemic curve

Flattening the curve

The main priority of affected nations currently is to move to a slower doubling time of new cases, to ensure less crowded hospitals and therefore a lower case fatality rate.
Governments of different countries take different approaches to flatten the epidemic curve. Beside travel bans and isolation of complete communities, citizens are also often requested to stay at home and keep social distance.
Research indicates that measures must be applied rigorously and immediately to be effective. Also, the national community's commitment to supporting/tolerating the restrictions and following the advice of health authorities plays an important role in the success of flattening the epidemic curve and limiting the spread of the virus.
For example, in South Korea mass testing efforts were successful. The South Korean national testing capacity reached 15,000 tests per day. Compared to population size, the Czech Republic reached the same rate of testing on 23 March 2020. The Ministry of Interior in South Korea also rolled out a smartphone app that can track the quarantined and collect data on symptoms, so scientists are able to see more epidemiological data.

Curve comparison

Comparing cumulative numbers of confirmed cases in selected countries, including the Czech Republic, shows the different curves of the epidemic in different countries. The chart shows the number of known cases and the pace at which the number increases on a logarithmic scale. The actual number of people infected may be and likely is, significantly higher, as only cases where the virus was confirmed by laboratory testing are shown. Many cases may only have an asymptomatic or mildly symptomatic course of the disease and never seek treatment. In yet others, the infection may still be in the incubation period, when it is asymptomatic and may not yet be detectable even by testing.
COVID-19 Epidemic curve selected countries


COVID-19 Epidemic curve selected countries per 1M pop.


Czech restriction actions:/ Day0: Schools closed / Day2: State of Emergency: close of sport facilities&close restaurants&bars at 8pm, border control, travel restrictions, ban 30+events /Day3: Criminalize spreading virus on purpose/Day4: Complete closure all shops restaurants&bars ex:food shops, petrol, pharmacies/Day5: Nationwide quarantine ex: shopping, employment need/ Day6: Borders closed&closure municipalities in Olomouc region/ Day8: Mandatory nose&mouth cover/ Day9: Special 7–9 shop-opening hours for seniors/ Day10: Changed special 8–10 shop-opening hours for seniors.
Czech eased restriction actions:/Day20: Lifted closure municipalities in Olomouc region/ Day27: Ease movement rule in parks&nature without facemask and opening some outside sporting grounds/ Day35: Eased conditions of entry to the territory of the Czech Republic/Day40: reopening farmers markets&small stores

Basic reproduction number

In epidemiology, the basic reproduction number of infection can be thought of as the expected number of cases directly generated by one case in a population where all individuals are susceptible to infection. The definition describes the state where no other individuals are infected or immunised.
The higher the R ratio number, the faster the disease spreads. If R is less than one, the reproduction within the population decreases.
Development of R ratio in the Czech Republic


Development of new cases ratio in the Czech Republic


During the second half of March 2020 the progress of the pandemic in the Czech Republic showed a decrease in the R0 ratio from the value above 2.0 down to the value 1.5 or below. The day-to-day ratio of the total number of cases decreased in a similar way, falling below 10 percent at the end of March.
On 1 April, the Director of the Institute of Health Information and Statistics announced that the R0 number ranged from 0.87 to 1.33 with the most likely value of 1.1.

Case details

Detailed information was reported regarding most of the first 99 cases, up to 12 March 2020:

Policies to fight the contagion

Interpersonal solidarity

The COVID-19 pandemic in the Czech Republic has created a wave of solidarity in a variety of areas, including: