Policy responses for Slovenia - HSRM


Policy responses for Slovenia

1.5 Testing

The case criteria for possible cases, requiring testing has changed throughout the course of the epidemic. At the containment phase, symptomatic persons showing symptoms and/or signs of Covid-19 were tested. The first few cases were all imported from travelling abroad.
Since 16 March 2020 there was a new definition of case, published on the webpages of the Ministry of Health and NIJZ (https://www.nijz.si/sites/www.nijz.si/files/uploaded/definicija_za_prijavo_in_spremljanje_novega_koronavirusa_16_3_2020_usklajeno_poslano_beovic_.pdf ). This definition made a change in the previous policy. There are now three categories of persons to be tested for Covid-19:
1. Persons with symptoms of Covid-19 and in need for hospitalisation; retesting is required for persons with a more severe course of the disease, two negative tests in 24 hours interval are required for discharge
2. Health care professionals, employed in health care and social care institutions, who are suspected of having Covid-19, regardless of the need for hospitalisation; retesting is compulsory
3. Persons residing in nursing homes with signs and/or symptoms of infection with Covid-19; retesting is not necessary, 14 days after the initial symptoms the person is considered non-infectious.
Testing is carried out prior to admission, if the patient needs to wait for the result, he/she is isolated in the meantime. Swab taking is carried out at the hospitals, at entry points or at the nursing home by a mobile team.
There are two possible outcomes from testing:
1. Likely case: a person who was in contact with a known case and has symptoms of a respiratory tract infection and also a person whose test gave an unclear result; if an unclear result is returned to a health professional, testing needs to be repeated immediately. Likely cases are not notifiable.
2. Confirmed case: a person who tested positive for Covid-19 by a certified laboratory test. Confirmed cases are notifiable immediately by phone to the regional epidemiologist at the regional unit of NIJZ.
COVID-19 laboratory testing capacity has grown as required. Slovenia has performed a comparatively high number of tests as it stands at almost 30,000 performed. Tests are conducted at the following laboratories:
1. The Institute of Microbiology of the Medical Faculty of Ljubljana
2. The National Laboratory for Health, Environment and Food with its locations in Maribor, Ljubljana, Celje, Kranj, Koper and Novo mesto
3. The University Clinic for Pulmonary Diseases and Allergy at Golnik
Given the strategy of testing described above and the fact that the majority of cases are linked to clusters occurring in health and social care institutions, it is likely that more testing will be done among health professionals at all locations and to residents at nursing homes.
Private testing for COVID-19 is currently not allowed in Slovenia.
The number of tests, positive cases, hospitalised, admitted to ICUs and deceased had to be reported daily by 9.00 before being published at 14.00 the same day. Since 16 March this has changed so data are collected until midnight and then reported for the day before.
As of 29 April, existing policies mostly follow the previously adopted strategy. The main change was a more aggressive policy of testing among health professionals and among residents and employees in nursing homes.

On 20 April 2020 the Institute of Microbiology and Immunology, together with the Faculty of Computer Sciences and Informatics and the Faculty of Social Sciences from the University of Ljubljana, with the assistance of the Statistical Office of the Republic of Slovenia and the University medical Centre in Ljubljana started a project, where 3000 persons were selected across 300 statistical units to represent the population of Slovenia. The principal investigator is Prof Mario Poljak from the Institute of Microbiology. Overall, 3000 people were invited. A total of 1368 persons consented to their participation and were swabbed for COVID-19 and had blood samples taken to check for antibodies. A targeted history (respiratory symptoms, fever etc.) with respect to COVID-19 was also taken. Results presented in the first week of May showed that out of the 1368 participants, 41 had antibodies against SARS-CoV2 and only two of these had swabs testing positive – one known previously and the other diagnosed through the study. The estimate of the prevalence of infection was set between 2.1 and 4.2% of the population.
The persons included will be retested in 6 months and if in the meantime they show symptoms of COVID-19 they would be fast-tracked for diagnostics.