An increased incidence of both acute respiratory diseases and hospitalisations can be expected to follow, especially during the "flu season" period (October to April), when people are increasingly affected by respiratory diseases, including COVID-19. We therefore bring information and recommendations to the Office of Public Health of the Slovak Republic.

What can we expect in the coming months?
The incidence of COVID-19 and the emergence of SARS-CoV-2 mutations are expected to occur. SARS-CoV-2 virus has not disappeared by abolishing area measures, continues to circulate virtually worldwide and continues to cause COVID-19 disease in humans. There is no exception to Slovakia, for example the continuous presence of SARS-CoV-2 virus in the treated wastewater in Slovakia. We are currently seeing a slight increase in SARS-CoV-2 in all regions.
The following period is expected to increase the incidence of both acute respiratory diseases and hospitalisations, especially during the period called flu season (October to April), when people are increasingly affected by respiratory diseases, including COVID-19. On 5 May 2023, the World Health Organisation (WHO) lifted the state of threat to public health of international importance in relation to COVID-19, signalling first and foremost the withdrawal from the emergency crisis regime, not the end of the pandemic.
Are you planning to re-introduce sweeping measures?
There is currently no reflection on the introduction of sweeping measures. In the prevention of COVID-19 diseases, we currently prefer a responsible and proactive approach by citizens to protect their own health (prevention against disease is recalled in the text below).
Most countries have abolished public health and social measures, and despite the continued circulation of SARS-CoV-2, there has been a significant reduction in hospitalisations, ICU stays and mortality in all age groups. Several factors are involved, including an increase in population immunity against infection, vaccination, early diagnosis and availability of COVID-19 treatment. Global immunity at population level has increased significantly, with an increase significantly affecting the use of vaccines and immunity after COVID-19 or a combination of both (so-called hybrid immunity).
What about targeted school closures?

The educational process can be interrupted provided that the disease is high, i.e. if more than 20 percent of pupils are absent from the total number of children. However, this can be applied regardless of whether it is CVID-19, influenza or other acute respiratory diseases. The teaching is interrupted by the head of the school on the basis of a recommendation from the competent regional public health authority. During the flu season, we often find that for a higher number of sick pupils, kindergartens, elementary schools or secondary schools close for the time needed.
What about banning hospital visits?
In view of the increased morbidity of acute respiratory diseases and influenza and its similar diseases, health establishments themselves may prohibit visits to the relevant clinics and departments of the establishment and, where appropriate, may consult the competent regional public health authority on the epidemiological situation in the region.
What variant of SARS-CoV-2 virus currently prevails in Slovakia?
According to the results of the sequencing of positive samples, the large majority of the subvariants are micron XBB and XBB.1.5 in Slovakia, which do not cause serious deterioration of the epidemiological situation.
Subvariants EG.5 (unofficially called Eris) and BA.2.86 (unofficially called Pirola) are not laboratory confirmed in Slovakia. However, EG.5 can already be found on our territory and this cannot be excluded even for BA.2.86.
The micron variant, which is extremely variable, still dominates the European population, causing it to have a number of sub-lines. One of these numerous sub-lines is XBB.1.5 with a specific mutation. For example, subvariant EG.5 has this particular mutation that puts it in this subline.
In patient samples XBB.1.5 has not yet been confirmed with a specific mutation that would advise it under sub-variant EG.5.
In waste water samples, which is a mixture of biological material from a large number of people, we caught XBB.1.5 with a specific mutation. From a laboratory point of view, it has not yet been possible to identify by available methods whether this is specifically a subvariant EG.5.
What about the sequencing of positive samples to SARS-CoV-2 now?
Sequences are performed in laboratories Office of Public Health of the Slovak Republic in Bratislava, regional public health authorities in Banská Bystrica, Košice and Trencin and in the UK Bratislava Science Park. Bioinformatic analysis of extensive sequencing data of all SARS-CoV-2 samples is complete in the Science Park of Comenius University. The results of the managed data on SARS-CoV-2 variants and subvariants are recorded in the International Genomic Databases GISAID (Global Initiative on Sharing All Influenza Data) and ENA (European Nucleotide Archive) and are also reported to the European TENSy system managed by the ECDC.
Naturally, due to the lower incidence of acute respiratory disease, fewer positive samples were sent to SARS-CoV-2 during the summer. About 20 percent of the total positive samples (PCR, LAMP, POCT) have been sequenced in the last four months. This number ranks SR at 6th place within the EU in number of sequenced samples.
In the autumn we expect more positive samples for SARS-CoV-2.
How is waste water collection currently carried out to monitor SARS-CoV-2?
Currently, every odd calendar week from 16 wastewater treatment plants (WWTPs) is carried out within Slovakia. These CHOVs were selected to be followed in each region by 2 COV with the highest population. When processing results, the current number of copies of SARS-CoV-2 virus RNA is compared to the previous week. The number of viral RNA copies is a quantitative indication of the amount of SARS-CoV-2 virus in the waste water. Depending on the evolution of the epidemiological situation, we are prepared to increase the sampling of waste water.
Last vaccination against Covid-19 last year, will it protect me now in the fall?
The formation of protective levels of antibodies (whether after vaccination or after the disease has passed) and its persistence in the body is individual. It depends on a number of factors, such as age, associated diseases, the immune system status of the vaccinated person, etc. The interval between booster doses or between disease progression and vaccination is generally given for at least four months. We recommend a booster dose at about the same time as influenza vaccination (October, November).
Increasing protection against severe COVID-19 disease after a booster dose is most appropriate for people with a higher risk of serious disease, i.e. older adults and people with health risk factors.
When do you recommend wearing a respirator?
We recommend that visitors in hospitals, waiting rooms, and ambulances be covered in their airways. There are vulnerable groups of people, such as people with acute or chronic diseases, immunocompromised people, pregnant women or elderly people.
Covering the airways with the respirator is also recommended:

How else can you protect yourself?

What should I do in case of illness?
If you are ill, do not go to work, school, or other groups and other public areas. COVID-19 is an infectious disease, consider your own health and the health of vulnerable population groups.
If it is not possible to stay home, for example because you need to go for medication, take care to wear the respirator properly (fully covered nose and mouth). Careful hand hygiene (washing with soap and hot water, using hand disinfectants based on alcohol) should still be considered.
Do not meet people who do not live with you in one household, especially if they are high-risk groups (seniors, chronically ill, immunocompromised, pregnant women, young children and babies).
In case of illness, if possible, limit contact with your loved ones who live in one household. For example, stay as close as possible in a separate room, wear a respirator when in contact with other people, do not use common items (towels, cutlery, plates, glasses, etc.). Regularly ventilate and disinfect the touch surfaces, e.g. handles, switches, sanitary facilities - toilet, sink and sink levers etc.
Is it mandatory to isolate the sick and quarantine of his close contacts?
Mandatory isolation of the person positive to COVID-19 was abolished by Decree No. 2/2023 of the Slovak Public Health Office, which entered into force on 20.3. 2023.
As with other acute respiratory diseases, adults and children with COVID-19 are in the care of their treating physicians who determine their treatment. The disease currently does not require compulsory isolation of positive persons and quarantine of close contacts.
However, the doctor's instructions should be followed very carefully, that is, to be treated at home in peace and to take into account your health. It is important to cure the disease and not to cross it. This does not prolong the duration of the disease and prevent further spread of the disease to others, including vulnerable groups.