ZAGREB, November 26, 2020 - Croatian Public Health Institute director Krunoslav Capak said on Thursday that the latest restrictions imposed to contain the coronavirus outbreak would be combined with the wide use of rapid antigen tests and that this was expected to result in a fall in new coronavirus cases over the next four weeks.

"Right now our epidemiological situation is concerning. Epidemiologists have made their suggestions about individual measures and their effectiveness. The most important thing is to reduce the intensity of social contacts and keep the mobility of people as low as possible," Capak said at the presentation of the latest package of measures.

Croatia's incidence rate among highest in Europe

Capak said he believed the latest measures, combined with rapid antigen tests and self-isolation, would help reverse the present trend over the next four weeks and ensure that the number of new infections started falling.

"Our incidence rate is currently among the highest in Europe, above 900 cases per 100,000 people over the last 14 days. We have the 13th highest mortality rate in the European Union. The number of hospitalisations and the number of people on ventilators are also rising, and we also have a large number of deaths," Capak said.

Asked why the number of new cases detected by rapid antigen tests was not included in daily statistics, he said that the World Health Organisation and the European Centre for Disease Control and Prevention did not recognise the antigen test but only the PCR test. He added that Slovakia had not reported the results of its massive antigen testing campaign to the WHO. 

"At this point, we are not including these figures. We are tracking them separately and will release them separately," Capak said.

No exemptions from measures

Capak said it was not possible for individual counties to be exempt from the latest restrictions because they were all colour-coded red.

"The incidence rate is so high that there is no need to consider any exemptions. In certain area the measures can only be tightened and not eased," he said.

Asked why the government had not at the same time presented a plan for easing the measures so that people could better organise their lives and work obligations, Capak said that Croatia had opted for a strategy of monitoring the epidemic on a daily basis.

"Some countries plan in advance the steps they will take when new cases reach a certain number, but Croatia is not among them. We are monitoring the situation on a daily basis, and we will discuss the easing of the measures in due course," Capak said.

ZAGREB, November 23, 2020 - Croatian Institute of Public Health (HZJZ) head Krunoslav Capak on Monday called for patience before the completion of trials of the coronavirus vaccine developed by the University of Oxford and AstraZeneca.

Earlier in the day, media outlets reported that the coronavirus vaccine developed by the University of Oxford stops 70% of people from developing Covid symptoms, according to a large-scale trial.

"This information is too serious. A few hours ago, reports said that the efficiency of the vaccine was estimated at 70%, and later AstraZeneca insisted on the rebuttal of that information, claiming that it could increase protection up to 90%," Capak told a news conference, adding that he would rahter wait for the completion of the vaccination trials.

KB Dubrava hospital has enough room and ventilators 

Assistant Health Minister Vera Katalinic Jankovic told the news conference that the situation in Zagreb's KB Dubrava hospital, which was converted into an institution for treating COVID-19 patients, was stable.

Currently, the hospital is providing for 420 patients and there is enough room in six intensive care units. There are enough ventilators, and we will procure new ones if necessary, the assistant minister said.

The head of the Zagreb-based Dr. Fran Mihaljevic hospital for infectious diseases, Alemka Markotic, said that currently 26 patients in that hospital were placed on ventilators.

"All over the world, there is a marked rise in the number of COVID patients, their clinical picture is graver than the situation in the spring, much more people have developed pneumonia. The situation is under control, but all are following the developments with concern," Markotic said.

Two to three winter months are ahead of us, it will be more and more difficult to keep the situation under control. We must be aware that all this will not be over in a few weeks' time. We are going to face an increasing pressure to care for patients who fall ill from the coronavirus infection, she said.

1,973 new coronavirus infections, 45 deaths in last 24 hours

Croatia has registered 1,973 new cases of the coronavirus infection over the past 24 hours, as well as 45 related deaths, the national COVID-19 crisis management team said today.

The number of active cases in Croatia stands at 19,275. There are 2,060 COVID patients in hospitals, including 235 on ventilators.

Since 25 February 2020, when Croatia registered its first case, a total of 105,691 people have contracted coronavirus, 1,398 of them have died, and 85,018 have recovered, including 2,638 in the last 24 hours.

There are currently 40,083 people in self-isolation.

To date, 683,104 people have been tested for coronavirus, including 6,139 in the last 24 hours.

As Poslovni Dnevnik writes on the 12th of November, 2020, the director of the Croatian Institute for Public Health, Krunoslav Capak, recently commented for U mrezi prvog on when the first vaccinations against the new coronavirus in Croatia would begin. Four million and 600 thousand doses of vaccine are set to arrive in the country. The most optimistic forecast is that the first doses of the brand new will arrive in December.

"We've got the first draft plan, but we still don't know when the vaccines will come. Croatia is being provided with a vaccine from three suppliers, and we'll continue on with other suppliers. For now, we will have enough for more than 50 percent of the population. We don't know which will be the first vaccine to be registered, the most likely one will be the one from Oxford's Astra Zenica. When they'll be ready - we don't know yet, but according to what we heard from them yesterday, it should be soon. That moment is now approaching,'' Krunoslav Capak assured.

He added that once the side effects are known, further elements for the plan will be known in order to best handle the next hurdle in the battle against the novel coronavirus - SARS-CoV-2.

"Pfizer's vaccine could be the first in the world. We will start vaccinating early, we will be among the first in the world to do so,'' added Krunoslav Capak.

''Those who will administer the coronavirus vaccinations will be general practitioners, pediatricians and staff at public health institutes. Rapid vaccination teams may also be organised for special sections of the population. We will first vaccinate the most vulnerable groups, older people, and people with commodities. It's very important to include the strategically important population - healthcare workers, workers in nursing homes and possibly the police and the army. But we'll know more about that only when we know how many vaccines we're going to get,'' said the first man of the Croatian Institute of Public Health, adding that they don't even know how long the vaccine will be valid for, ie how much the vaccine will be worth, as some vaccines are valid for a mere six months.

The vaccine against the novel coronavirus will be voluntary and free for strategic and vulnerable groups of people.

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ZAGREB, November 9, 2020 - Croatia's chief epidemiologist Krunoslav Capak said on Monday the latest data on the rise of coronavirus cases in the country gave one hope that the incidence was stagnating.

In three weeks up to November 2, we had a 90% to 100% change in the weekly numbers of new cases, he told a press conference of the national COVID-19 response team. "In one week, our numbers increased 100%, whereas now we have a 4.2% increase. This gives us hope that the increase is stagnating and that the situation will improve."

Croatia 13th in Europe in terms of mortality

"We have a 14-day incidence of 750.4 per 100,000 inhabitants, which is a high incidence, ranking us 22nd out of 27 European countries. The mortality rate since the start of the epidemic is 184.5 per million inhabitants, which puts us in 13th place in the EU, in the middle of the ranking, which is good," said Capak.

"We hope the numbers will stop rising and that the curve will even out. The fact that the number is stagnating shouldn't encourage us not to adhere to the measures, because strictly adhering to the prescribed epidemiological measures is key for achieving stagnation," the head of the Croatian Institute of Public Health added.

In the past 24 hours Croatia registered 1,529 new coronavirus cases and 38 deaths. The number of active cases is 14,952, including 1,451 hospitalised patients, of whom 142 are on ventilators.

Since February 25, when the virus was first registered in Croatia, 68,776 persons have caught it, including 832 who have died, and 53,002 have recovered, including 2,227 in the past 24 hours. To date 564,686 people have been tested for the virus, including 5,670 in the past 24 hours.

Currently 28,122 persons are self-isolating.

Situation best in Istria County, worst in Varazdin and Medjimurje

Capak said the pandemic situation remained the best in Istria County, despite plenty of cases recently, while being worst in Varazdin and Medjimurje counties.

Croatia has not reached the PCR testing limit and most countries are starting to use high antigen tests, which are not totally accurate but take 10 minutes.

"Those tests are now being used only for symptomatic patients and we are annulling false negatives by sending all those with false negatives for PCR. There is no strategy which could endanger the detection of new cases," said Capak.

As for the high number of deaths, he said it was due to the higher numbers of new infections.

Speaking of scientist Ivan Djikic's estimate of 1,500 dead by the end of this month, Capak said he was surprised because he did not know if Djikic meant the total death toll or the monthly number. "I said I thought the number was exaggerated. If the number of infections continues to stagnate, the number of the dead will decrease too."

Speaking of a drug shortage for cancer patients, Health Minister Vili Beros said HRK 1.8 billion would be paid to wholesalers on Wednesday and that it should suffice for ensuring drugs for the gravest patients.

He condemned "the inhumane act of switching off power in KB Dubrava" hospital, which is being investigated by the police, saying the arrival of a new leadership was expected to improve the situation in the Zagreb hospital.

Interior Minister Davor Bozinovic said wearing masks was mandatory there where it was not possible to socially distance and that more and more people were behaving responsibly, wearing them both indoors and outdoors.

"You have countries which have imposed a curfew, a lockdown, and you see what is happening. The problem with those strict measures is that, at the moment, no one can say how long they will last. Besides all the epidemiological reasons and demands, we must take into account not only the economy, but also the sentiment in society, the nation's mental state. Where there is no other way, there are sanctions and they will be applied," he said.

ZAGREB, Nov 4, 2020 - Head of the Croatian Institute of Public Health Krunoslav Capak on Wednesday said that more stringent epidemiological measures, like a lockdown or a curfew that have been introduced in neighbouring countries, have proved to be ineffective and that the current measures in Croatia are good.

"We think that our measures are good. We appeal to citizens to adhere to them and if they do, we are certain that we will curb these numbers," Capak told reporters.

Despite doctors calling for more stringent measures, Capak claimed that the curfews and lockdowns that have been introduced in other EU countries are not bringing any results one week after they were introduced as the numbers in those countries are continuing to grow.

"We think that those measures are not effective," he underlined.

Six doctors' associations today called on the government to urgently introduce more stringent epidemiological measures, otherwise the health system could collapse, seeing that hospitals are already at the "breaking point."

Capak claimed that the problem of a possible lack of equipment or shortage of staff can be resolved with redistribution to those areas where they are more needed.

"We have a sufficient number of ventilators, there are more than 70,000 people working in the health system. I am certain that we will protect the health of our citizens," said Capak.

As Poslovni Dnevnik writes on the 31st of October, 2020, the director of the Croatian Institute of Public Health (HZJZ), Krunoslav Capak, said that rapid antigen tests would help speed up the coronavirus testing process and reach the population, but PCR tests remain the "gold" standard. He also explained just who can be considered coronavirus positive even without having been tested for the disease.

"These rapid antigen tests have reached a stage of development, we have researched them relatively well and we know what their flaws and positive sides are. They're relatively specific,'' Krunoslav Capak told Dnevnik Nova TV.

If someone is really coronavirus positive, he will certainly return a positive result on a PCR test, which is still the gold standard, and if someone is negative on an antigen test, we cannot be one hundred percent sure that he is indeed actually negative,'' Capak said.

“If there are symptoms, we'll check with a PCR test. We'll check the negative results,'' pointed out the director of HZJZ.

Priority is given to people who have symptoms of the new coronavirus, SARS-CoV-2.

Priority is given to people who have symptoms and will be tested with the use of rapid antigen tests. ''It will help us in the speed of testing and population coverage,” he said.

With the flu season rapidly approaching, Capak reiterated that it will be difficult to distinguish the flu virus from the new coronavirus because there will be a lot of respiratory symptoms typically present in both diseases.

"People who have symptoms and have been in contact with those who are infected and haven't been tested will be considered coronavirus positive. We're now going with joint tests and that will be a significant help in terms of diagnostics," he pointed out.

"People who have characteristic symptoms of the new coronavirus - fever, cough, shortness of breath and other symptoms - and have been in contact with someone who is infected, but haven't been, are considered coronavirus positive," explained Capak.

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As Poslovni Dnevnik writes on the 31st of October, 2020, Prime Minister Andrej Plenkovic has stated that we're now entering the most difficult phase of the fight against the coronavirus pandemic, but added that the growth in the number of infected people in Croatia is slower than it is over in Western Europe. He still believes that we can avoid further tightening of measures, including a damaging lockdown. The director of HZJZ, Krunoslav Capak, was a guest on RTL Danas (Today) recently. Asked what other measures could be introduced in the fight against coronavirus, he said that they presented the measures that came into force on Tuesday.

"We're just getting started with the measures. We're not going to introduce any new ones for a few days now because we need to see the results of these ones first,'' he replied, adding that HZJZ still has ''a whole range of measures'' in their arsenal.

''The additional limitation of the number of people who are permitted to gather together, the additional limitation of working hours, the additional limitation of the number of people who can participate in sporting competitions, training and so on. So... a whole host of other measures exist. I'm not announcing them and it doesn't mean that they'll come into force,'' the HZJZ director said.

Lockdown?

Capak said that the reason for the state of the financial and economic situation in the country is "absolutely not" the only reason why the National Civil Protection Headquarters isn't yet going for a new lockdown. "It's just one of the elements. Epidemiologists need to ban things and close things down because it reduces contact, and it's the most effective way to combat contracting this new infection,'' he said, adding that there are a number of ''social, psychological, financial and all other aspects'' that the government must address and take care of.

''The government that must take care of that. That isn't our job as epidemiologists, it's the job of  those who make the decisions, it's them who must take care of it,'' he said, adding that Croatia doesn't have as much growth as other, neighbouring countries and European Union countries.

"We've got the Scandinavians who are traditionally good, but most of these Central and Western European countries have seen huge growth. Our growth isn't so massive and we think our measures are good and balanced, and that these measures that we've adopted are good and that they're going to have an effect,'' the HZJZ director said.

When asked if he expects Croatia to go reach more than 3,000 newly infected people a day, he said that he thinks it's realistic "that the number will reach 3,000 in the next few days". "But after that, at least in my opinion, it won't really grow more,'' he noted.

''During the summer, we had 30 to 35 percent asymptomatic people. Today we think we have a little less of them, about 25 to 13 percent. We currently have 14,000 active cases and 987 people hospitalised, that’s about 7 percent. 7 to 10 percent is realistic in that there are more severe cases that require hospitalisation. We have 71 on respirators, which is 0.5 percent of the total active cases in Croatia,'' he said.

He revealed that Croatia can cope with even over the current amount of 10,000 people tested in a day. "We still have about 20 to 25 percent of the space because in some counties the numbers are lower and they test less," he said, adding that here in Zagreb, we're "on the verge of not being able to cope anymore."

"Because Zagreb now has huge numbers," the HZJZ director said, the praising people who work day and night to process coronavirus test samples.

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October 20, 2020 - In an interview on Monday evening, Krunoslav Capak announced measures that could be introduced next in Croatia if citizens do not adhere to the measures already in place.

The director of the Croatian Institute of Public Health and a member of the National Civil Protection Headquarter Krunoslav Capak, spoke about a plan for the worst-case scenario and what would happen if there were not enough doctors and nurses to replace the infected health workers.

In an interview with Dnevnik Nova TV, Capak said:

"Although we do not expect such a scenario and we hope that it will never happen, we are preparing for it. We have more than 1,100 intensive care physicians who can work on ventilators and intensive care for COVID patients and flu patients.

However, we are also preparing for the scenario that other colleagues who are close to the profession will be educated and can learn the basics of intensive care relatively quickly. This also happened during the Homeland War," Capak explained. He added that young doctors were taking emergency courses at the time.

"The Ministry of Health, in cooperation with hospitals, will prepare such courses, but we hope that this will not happen," he said.

When asked how many newly infected patients Croatian hospitals can handle before the worst-case scenario, Capak said that we are "far from completely filling the health care system."

He also revealed that he is not considering the introduction of a curfew.

"We have not talked about it so far, nor do we plan to introduce it," said the Croatian Institute of Public Health director.

He says he does not think a new lockdown is needed, but it is necessary "for people to stick to the measures".

"There are a number of other possibilities. Further shortening of working hours, reducing the number of gatherings, even in families," he said and pointed out that it seems to him that Croatia is among the most liberal countries in Europe.

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October 13, 2020 - As of Monday, legal entities in Croatia could also receive fines if they do not comply with the National Headquarters' decisions. A look at how much violating measures in Croatia could cost companies.

Index.hr reports that Krunoslav Capak says that we have had recommendations so far, but as of Monday, these are decisions that are subject to inspection.

"Chief State Inspector Mikulić also took part in adopting measures and is familiar with the control. Tomorrow (Tuesday), we will decide where the inspectorate will have a big role because it will carry out controls. Now there is a possibility of fining if the inspector finds anything, and it could range from 20-70 thousand kuna for a legal entity," Capak told Nova TV.

As of Monday, wearing masks is mandatory indoors, except in gyms.

"Gyms are not on the list," Capak said, noting that they are in communication with representatives of the fitness industry, but have not yet discussed the possibility of wearing masks in gyms.

"It's not possible to wear a mask during practice, but it could be during your stay on the premises. We haven't talked about it yet," he said.

As for the working hours of catering facilities in Zagreb, Capak says that the National Headquarters has not yet received a proposal from the Zagreb Headquarters, but they talked to the caterers and "tomorrow a decision will be made by the National Headquarters which will be valid in all counties." We should expect this today.

"It's crowded, a lot of people are riding buses, we asked local headquarters to prepare more frequent bus lines and limit the number of people, and if necessary, the National Headquarters will prescribe measures," Capak said of the upcoming All Saints' Day and added that there should be fewer kiosks with flowers and candles in front of the cemetery because crowds form around them as well. 

At the end of the year, the first coronavirus vaccine could be on the market. The Oxford vaccine could be approved very soon, and Croatia is already ready for storage and distribution because it has pre-registered for the vaccine and the European Commission.

"We have prepared storage and operation of the distribution center, the first tranche would be from 200 to 400 thousand doses," said the director, noting that the flu vaccine is already in Croatia. Vaccination is expected to begin at the end of the week.

"The first tranche is in Croatia and is being distributed, and vaccination is expected at the end of the week," he said, adding that the first tranche provided 250,000 doses for vulnerable groups.

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As Poslovni Dnevnik writes on the 26th of September, 2020, the director of the Croatian Institute of Public Health (HZJZ), Krunoslav Capak, explained what awaits us in the coming months. He also commented on the case of an individual in a care home in Split who contracted the new coronavirus twice.

"We've put it so that whoever has proof that they got over coronavirus and was tested for it, if they come into contact with a sick person in the next three months, they won't have to self-isolate because we have evidence that they will not become sick with the disease in those three months." Capak told RTL.

When asked if it is possible that 400,000 people in Croatia have been in contact with the virus, Krunoslav Capak answered:

"No one knows the number of people who came in contact with the virus. Not even countries which have conducted much broader serological research than we have know that. We conducted this serological test on 1150 people and got the result of 2.5 percent of those carrying antibodies. If we were to copy the situation that existed when we conducted the examination then today, when we have a little more than 15,000 patients, then that number would be around 400,000.''

Krunoslav Capak said that the number of new cases is declining and that this can be seen through a larger number of tests. Although epidemiologists fear colder weather because people will spend much more time indoors, the winter holidays should look significantly different than the Easter ones.

“During Easter we had a quarantine, a lockdown. The motto was to stay at home, practically all economic and social activities were closed except for the most necessary ones. Such a situation will certainly not happen again, we now know more about the virus and we're focusing on the most effective measures to bring in. So I think Christmas will be much more relaxed than Easter was, but we'll have to stick to the measures,'' Krunoslav Capak said.

Epidemiological measures are still the only defence against the new coronavirus, and that could all finally end in the spring with the arrival of the much anticipated vaccine.

"We can't expect a large amount of vaccinations before spring. For me, that's most likely the end of the coronavirus story, and it means the vaccination of the general population. I hope that we'll be able to achieve that in the spring. In my opinion, we can't acquire collective immunity before the end of spring next year, and the good news is that the vaccine could be here by then,'' Krunoslav Capak believes.

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