Masks made Czech Republic the envy of Europe. Now they’ve blown it

Inside the intensive care unit at Prague’s Na Bulovce Hospital some patients are hooked up to ventilators through tracheostomy tubes, others are lying face down, to help them breathe. The doctors and nurses don head-to-toe hazmat suits; as coronavirus cases surge in the Czech Republic, the country can’t afford to have health workers sidelined by the virus.

There are currently more new Covid-19 cases per million people recorded in the Czech Republic than in any other major country in the world. On Friday, more than 11,100 new cases were reported in a single day, a new record. In the first 17 days of October, more people have died of the virus in the Czech Republic than during the previous eight months of the epidemic combined.

A healthcare worker puts on personal protective equipment in an intensive care unit at Thomayer hospital in Prague in the Czech Republic on Wednesday.

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The Czech Medical Chamber and the health minister have called on Czech doctors living abroad to return home to help fight the virus. Medical students and people with medical training have also been encouraged to come forward. More than 1,000 qualified nurses who’ve left the profession have offered to come back to help.

For now, the Na Bulovce hospital has enough beds for everyone. But it’s preparing for the worst.

“We have other back-up beds prepared in other departments in case the capacity exceeds our current possibilities,” said Dr. Hana Rohacova, the head doctor at the hospital’s infection disease clinic. This weekend, the government began setting up a temporary field hospital in Prague. Czech Health Minister Dr. Roman Prymula told CNN he expects the extra beds will be needed as soon as the end of this month.

It’s a stunning development. Less than two months ago, the Czech Prime Minister Andrej Babis boasted his country was among the “best in Covid.”

Healthcare workers tend to Covid-19 patients at the intensive care unit at Thomayer Hospital in Prague on October 14, 2020.

While the Czech Republic is technically experiencing the second wave of the epidemic, the first one this spring looks like an insignificant blip on the radar in comparison to the current state. The Czech Republic was once one of the most successful countries in Europe at controlling the spread of the virus. Babis’ populist centrist government moved quickly to close the borders and implement a nationwide lockdown. Many other countries did the same, but what set the Czechs apart was the requirement to wear face masks by everyone, everywhere outside of the home.

Czech data scientist Petr Ludwig was among those pushing for that mask mandate back in mid-March, months before western health authorities or even the World Health Organization was recommending them.

Ludwig had just flown from New York to Prague, and says he was the only person on his flight with a face covering. When he arrived home, he dug through the scientific evidence supporting face coverings and made a YouTube video explaining why he was convinced masks were the answer. The Czech-language video attracted more than 600,000 views, in a country of only 10 million.An English version of the video has been viewed more than 5.7 million times.

Days later, Babis announced the mask mandate.

“We didn’t convince the government, we convinced public by [social media] influencers and then government followed because our government is slightly populist. So they followed the opinion of the public,” Ludwig told CNN.

Tomas Volny and his partner Barbora Duskova sew face masks in their apartment in Prague on March 17, 2020.

Medical masks were in short supply at the time, which was one of the reasons why the WHO didn’t recommend their use. Faced with the shortage, thousands of Czechs dusted off their sewing machines and became part of a wartime-like effort to make and distribute masks where they were needed. One group of volunteers created an interactive map of need which resulted in more than 600,000 masks, made mostly by individual volunteers, to be handed out around the country.

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The Prime Minister was converted – he even tweeted some advice to US President Donald Trump on March 29, “Try tackling virus the Czech way. Wearing a simple cloth mask, decreases the spread of the virus by 80% … God bless America!”

Most Czechs obeyed the mask rule. The measure wasn’t particularly popular with the masses, but it was wildly effective in controlling the spread of the virus. And it made the country an outlier. “Some people from the WHO, for example, told us that this is nonsense. Many other countries around Czech Republic told us that wearing masks is nonsense. But the Czech people were doing well,” said microbiologist Dr. Omar Sery, who was also one of the early advocates for face masks.

The Czech Republic’s first wave of infection peaked in late March at 408 cases in one day. The highest single-day death toll was just 18, in April. On June 30, the Czech Republic recorded no new Covid-19 deaths. That same day, an outdoor street party in Prague celebrated the end of the pandemic. Masks were not part of the dress code. Theaters reopened, indoor dining returned, people were allowed to travel abroad. Even Babis, the Prime Minister, went to Greece for a vacation.

In almost every way, the country had regained the normalcy that people in across Europe were craving. It wouldn’t last long.

“We didn’t see dead people, we didn’t see people with coronavirus in hospitals – the Czech people thought that this is nonsense and we don’t need to wear masks,” said Dr. Sery.

People dine at a communal table stretching across the Charles Bridge in Prague after coronavirus restrictions were eased on June 30, 2020.

When the government lifted the strict mask mandate over the summer, most people left theirs at home. The virus was slowly starting to make a comeback. Even the health minister conceded his country’s victory lap was premature.

“That’s true, because we had many experts – and those were not the epidemiologists and virologists – but they were arguing that, okay, the disease is there, but it’s very mild,” said Dr. Prymula, who has been on the job now for less than a month. “So they tried to push politicians just to skip out of strict countermeasures.”

In August, with case-counts rising and schools set to reopen, Rastislav Madar, a top epidemiologist and the coordinator of the government’s coronavirus restrictions advisory group, called for the government to re-instate the strict mask mandate that was in force in the spring. But when the then-Health Minister Adam Vojtech announced masks would again become compulsory in most indoor spaces, Babis said no. A day later, Vojtech walked back many of the new rules. Madar resigned a few days later.

With an early October Czech Senate election approaching, Ludwig thinks Babis’ decision was a populist political calculation.

Protesters attend a rally demanding the resignation of Czech Prime Minister Andrej Babis on June 23, 2019 in Prague. - Huge crowds flooded central Prague demanding Prime Minister Andrej Babis to step down over allegations of graft in a protest that organisers and local media claim drew around 250,000 people, which would make it the largest since the fall of communism in 1989. (Photo by Michal Cizek / AFP) (Photo credit should read MICHAL CIZEK/AFP/Getty Images)

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“During the first wave, [the government] was convinced that people wanted masks, so they pushed masks. Now, they are convinced that people don’t want to wear masks. So they are against [the mask mandate],” he said. “After the election, they started to push some harder rules again, but it was too late because we already had an exponential growth.”

Those measures have forced schools, restaurants and pubs to close down. Masks are required in indoor public spaces and on public transport including its outdoor stops and stations, but the same strict mask mandate that seemed so effective in the spring has not been re-instated.

“In Czech Republic, everybody hates wearing a mask, really. This is not Taiwan, this is not China where they are wearing a mask every day,” said Sery.

Prymula denies the decision was political. He says there are ongoing discussions about potentially expanding the mandate to require masks outdoors too. “But as it’s not only wearing mask, it’s an issue of other countermeasures, and particularly social contact, because some people still keep social contacts, even in private settings. This is the reason why the situation is still not under control,” he said.

Li-Lian Ahlskog Hou contributed to this report from Berlin.