Czech Republic and Low COVID-19 Mortality in the Heart of Europe: Possible Explanations

Jiri Benes, M.D., PhD; Alexander M. Celko, M.D., PhD; Petr Widimsky, MD., DrSc., FESC., FACC


Eur Heart J. 2020;41(40):3876-3879. 

In This Article

Lockdown Timing

We believe that the single most important factor was the early decision to close schools, public events, and even state borders. The Third Faculty of Medicine was the first institution in the country that cancelled a public event. Facing the onset of COVID-19 hospital admissions in Prague (after the return of thousands of Prague families from skiing in Northern Italy), we decided to cancel our annual medical students' ball (1200 expected attendees) on 5 March. This was followed 5 days later by the decision of the Czech government to close schools and public events with >50 attendees.

This lockdown was ordered 13 days before the first COVID-19 death in the country, and its timing was most probably (along with the border closure) crucial for the subsequent low rates of COVID-19 in the country. The importance of lockdown timing is supported by data from other countries that closed schools (along with other 'lockdown measures') before the first COVID-19 death in the given country: Hungary, Norway, Finland, Slovakia, Denmark, and Portugal. Also, Greece closed schools just the day after the first death. In contrast, lockdown in countries suffering most from COVID-19 was done much later—more than 6 weeks after the first proven case (Italy, Spain, the UK, Belgium, and France); see Table 3.