Policy responses for Serbia - HSRM


Policy responses for Serbia

1.5 Testing

On 4 May, the government announced a national seroepidemiological study on how many people in the country have developed antibodies to COVID-19. The study will be done on a sample of 7,000 households, or a total of 17,000 people, according to a methodology developed by the Faculty of Medicine in Belgrade. The main objectives of the research are to determine the cumulative incidence of COVID-19 in relation to age and sex in the Serbian population, based on seropositivity, to determine the percentage of asymptomatic disease forms or subclinical infections, and to sequence and monitor the molecular epidemiology of SARS-CoV virus circulating in the population of Serbia. Also, this research will determine the risk factors for infection by comparing the exposure of infected and uninfected persons, study behavioural changes and assess the level of perception of population risk.

On May 19, the Crisis Response Team for the Suppression of Infectious Disease COVID-19 decided that PCR testing for coronavirus will be available also upon personal request of Serbian citizens and foreign citizens, and it will have the same price of 6,000 RSD (around EUR 51)  in all healthcare institutions. Testing at the personal request will be free for students and minors.

The Prime Minister announced on 25 May the introduction of fast coronavirus antibody tests that will be available upon personal request. It was announced that the price of the test would range between RSD 1,000 and RSD 1,200 (8-10 EUR).

In early July, the number of laboratories able to perform COVID-19 PCR tests in the northern region of Vojvodina increased from 2 to 8 because additional PCR machines have been procured. In addition to the Clinical Center of Vojvodina and the Institute for Public Health of Vojvodina, citizens can also be tested in IPHs in Sombor, Pancevo, Subotica, Kikinda, Sremska Mitorvica and Zrenjanin.

On July 20, a new service has been introduced on the e-Government portal where citizens can opt for receiving, either through an email or an SMS, information on whether their coronavirus test is ready.

On July 30, a new laboratory for the coronavirus testing “Fire Eye”, with a daily capacity of 1,000 samples, opened in Nis, southern Serbia. The Serbian Government invested around €3.5 million in this laboratory and €500,000 were donated by the Chinese company Zijin. The laboratory was constructed in a record time, in just three months.

On July 30, the government has formed a new working group for needs assessment in terms of public microbiological laboratories conducting SAR-CoV-2 testing. The working group will focus on determining needs in terms of staffing, available space, working conditions and required equipment. The Ministry of Health has confirmed that 27 private laboratories have commenced serological testing. According to the Ministry of Health, the 7 private labs that applied for PCR testing are still awaiting license and are expected to start as of August 15. Their capacities are checked for criteria and standards to be in line with WHO recommendations.

Following an increase in requests for PCR testing for travel purposes upon personal request, the Ministry of Health has increased the number of state-owned laboratories that perform tests and has extended their working hours. The number of laboratories in Belgrade where citizens can perform PCR test on their personal request has been increased to 6. The Ministry of Health announced that citizens will receive the test results for tests done on their personal request within 48 hours.

As of October 2, electronic scheduling of appointments for PCR testing on personal request has been enabled on the eGovernment portal. Citizens, foreign citizens with an approved residence in Serbia, as well as foreign citizens without an approved residence (tourists), can easily and quickly schedule an appointment in one of the 25 laboratories in 22 cities and municipalities in Serbia. In order to use the eRequest service for PCR testing on personal request, it is not necessary for citizens to register on the eGovernment portal.

According to the current algorithm, an infectologist at the designated clinic for infectious diseases or a general hospital, together with the locally in-charge epidemiologist, decides if the person fulfills the criteria for a suspected case and, if so, testing is being done. At the same time, they are deciding on whether hospitalization is required or if the patient can be sent to home-isolation or be released.

In accordance with WHO recommendations, before the beginning of the outbreak, the Institute of Virology, Sera and Vaccines "Torlak" was the only designated National Reference Laboratory for the confirmation of COVID-19. Also in accordance with WHO recommendations, only the RT PCR technique was approved and recognized as the method for laboratory diagnostics. The capacity of the “Torlak” Institute was 350 tests per day. As of 27 March 2020, “Torlak”s capacity was increased and an additional 5 laboratories are designated to perform the testing, using the same (RT PCR) method, which increased testing capacity to up to 2,500 tests per day. As of April 15, testing capacity increased to more than 3,000 RT PCR tests per day.  It is planned to involve some more laboratories which are capable to perform RT PCR testing, aiming to increase the testing capacity to up to 7,000 tests per day. In addition, for the purpose of rapid screening, it is planned to use rapid serological tests, intending to confirm all positive cases using the RT PCR method. Currently, it takes 2 hours to one day to obtain testing results. Rapid serological tests are expected to dramatically shorten this time.

The government announced that much wider testing will be available shortly, where all contacts of confirmed cases or persons with recent international travel history will be tested.  Samples are being collected in infectology departments of designated hospitals, at patients’ homes and at the facilities for the temporary observation of those who arrive in the country. Currently 6 institutions are performing real time PCR for testing COVID19 (the Institute of Virology, Sera and Vaccines "Torlak", Institute of Public Health Nis, National Reference Laboratory for Food Safety in Belgrade, Veterinary Specialist Institutes in Kraljevo, Nis and Sabac). TOn 20 April, a new laboratory with a capacity of 2,000 coronavirus tests per day was opened at the Clinic of the Clinical Centre of Serbia. It is the first of two laboratories established in cooperation with the Chinese company BGI. Another one will be opened in Nis soon and with this expansion, national capacity for COVID-19 test will double to 6,000–7,000 tests per day (https://www.srbija.gov.rs/vest/en/154559/capacity-of-new-laboratory-2000-coronavirus-tests-a-day.php).