The Visegrad countries (Czechia, Hungary, Poland, Slovakia) were lauded for their early successes in containing the pandemic, but the COVID-19 crisis laid bare some underlying health systems issues. The second wave hit the Visegrad countries much more severely. A common challenge has been the connection between scientific expertise, decision making and public health capacity. There is a need to understand how capacity on all sides can be strengthened and linkages improved. How can Visegrad countries address capacity challenges and make better use of scientific expertise to deal with the pandemic?