Logo Medical Science Monitor

Call: +1.631.470.9640
Mon - Fri 10:00 am - 02:00 pm EST

Contact Us

Logo Medical Science Monitor Logo Medical Science Monitor Logo Medical Science Monitor

30 March 2022: Clinical Research

COVID-19 Pandemic Was Associated with Lower Activity but Not Higher Perioperative Mortality in a Large Eastern European Center

Stefan Andrei 12ABCDEF , Sebastian Isac 23ABDE* , Diana Jelea 2ABCDEF* , Cristina Martac 2ABCDEF , Mihai-Gabriel Stefan 4DEF , Mihail Cotorogea-Simion 2BCD* , Cristina Georgiana S. Buzatu 2BDEFG , Daiana Ingustu 2BDE , Imam Abdulkareem 2BD , Catalin Vasilescu 56DEF , Daniela Filipescu 14DEF , Gabriela Droc 12ABCDEF

DOI: 10.12659/MSM.935809

Med Sci Monit 2022; 28:e935809

Supplementary Table 1 History of the epidemiology and legal framework of the pandemic in Romania.

National levelInstitutional level
Romania declares state of emergency
Emergency medicine, infectious disease and anesthesia and intensive care resident doctors are set to interrupt their current rotations, excepting the rotations in the aforementioned specialties and report to their guidance offices in order to plan their duty hours/shifts within the departments/units of their chosen specialty.Emergency medicine, infectious disease and anesthesia and intensive care resident doctors are set to interrupt their current rotations, excepting the rotations in the aforementioned specialties and report to their guidance offices in order to plan their duty hours/shifts within the departments/units of their chosen specialty.
Within FCI, a White Plan is in place, outlining the strategies in case of emergency situations. As stated in the White Plan, in the event of Code Red Emergency, not only the FCI Commandment of Crisis, but also the Crisis Unit of each department are set to be activated.In case of Code Red situations, all departments are required to elaborate a reaction plan that must include:
All nurses are prohibited from practicing outside working hours in private hospitals or in any medical facilities other than the one they are employed in.
All departments are required to assign a dedicated hospital room, equipped with PPE (personal protective equipment) that shall remain unoccupied. These isolation rooms are designated for admitted patients that present signs and symptoms of COVID-19 during their hospitalization.
Outlining general control measures to break chains of transmission of SARS-CoV-2 within the hospital:
New rules are proposed for granting leave and health social security benefits during the state of emergency
NHH: National Health Curative Programs comprises non-urgent diseases that nonetheless require further treatment and investigations (chemotherapy, radiation therapy, CRRT, treatment for chronic hepatitis recurrence after liver transplantation). Regarding these conditions, the attending physician decides upon the possibility of postponing the treatment/investigations for 14 days.
Organ Transplantation is considered an urgent surgical procedure, thus both the donor, as well as the recipient must be tested for COVID-19.
Ministry of Health and National Health Insurances House Order nr 539/437/2020 is issued, stipulating the prolongation of the regulation of the Ministry of Health and National Health Insurances House Order nr. 397/836/2018 regarding the approval of bundled services and the framework agreement that stipulates the conditions of granting medical care, medication and medical devices within the Social Security Health system for 2018–2019, the prorogation of certain terms and the implementation of health policies throughout the state of emergency.
Romanian Society of Anesthesia and Intensive Care Medicine announces an international humanitarian mission based in Italy, with teams comprising emergency medicine and anesthesia and intensive care medical doctors and certified nurse practitioners.
Emergency situations department issues a plan to organize and optimize intensive care units: assigning a coordinator responsible for COVID-19 matters, epidemiological assessment of ICU personnel, optimization of shifts schedule in both COVID and non-COVID areas, sufficient O2 supplies to meet O2 demands, minimizing the risk of contamination among healthcare professionals working in non-COVID areas.
A specific protocol is issued about the management of the deceased with confirmed SARS-CoV-2 infection.
Ministry of Health. Public Health District Authority Bucharest: a minimal set of data regarding the suspected COVID case must be immediately reported over the telephone to the public health district authority of Bucharest. Moreover, a surveillance form for COVID-19 confirmed cases must be completed and sent to the public health district authority of Bucharest. All deaths of suspected/probable/confirmed COVID-19 cases must be immediately reported over the telephone and a surveillance form must be transmitted by fax within 24 hours from death.
State Secretary, head of Emergency situations Department issues the following Order: All functional mechanical ventilators produced by Dräger company from all public hospitals in Romania will be at the Emergency Situations Department’ disposal. All these mechanical ventilators shall be reconditioned in a centralized manner and then introduced in daily activity.
Starting with 13.04.2020 all patients admitted to Fundeni Clinical Institute will be tested for SARS-CoV-2
Scheduling for SARS-CoV-2 testing of medical personnel based on level of exposure.
Reorganizing of Fundeni Clinical Institute to provide care for suspected COVID-19 patients. Assigning dedicated areas in both Building A and Building B for suspected COVID-19 patients, defining internal routes and flows for suspected/confirmed patients in both hospital buildings.
Internal routes for suspected COVID-19 patients in Building A of Fundeni Clinical Institute: first floor will be entirely marked as red zone; second floor: A1, A2 and B sections are considered red zone. Upon finalization of fit-out work in Building B, all patients will be admitted in the red zone of Building A.
Ministry of Health announces the list of approved medical institutions for providing care during the COVID-19 pandemic along with recommendations of transporting and transferring suspected patients in accordance with patient’s pathology and hospital specifications: Grigore Alexandrescu Emergency Clinical Hospital for Children, Medical Centre Policlinico di Monza, Filantropia Clinical Hospital, Nicola Malaxa Clinical Hospital, Carol Davila Military Hospital ROL2.
Assigning a code for COVID 19 disease: diagnosis code that shall be used 64-other unclassified viral diseases.
The validity of the documents issued by public authorities that are set to expire during the state of emergency is extended.
Romania declares State of Alert.
Adopting measures to organize the activity in non-COVID medical units during the state of alert period.
Changes are made to the operating procedure regarding the newly admitted patients: Building A: ICU III (first floor) will become green zone as well as section C of the first floor. ICU red zone: section A2 (second floor), patient room 255. Other internal routes and circuits remain valid until 1 of June 2020.
ICU III will have two remunerated doctors on duty. Red zone is attended by the second line on duty who may be contacted on the ICU III dedicated telephone.
Public Health District Authority of Bucharest proceeds to the annulment of the order stipulating that “all medical personnel is prohibited from working during the COVID-19 pandemic in any other medical facility than the one they are employed in”.
ICU consultations throughout COVID-19 pandemic: limitation of medical consultations for terminally ill patients who are beyond medical rescue; these cases shall be undertaken by the attending doctor/head chief, thus ensuring a better management of the scarce medical and human resources in ICU.
Epidemiological investigations carried out in clinical wards require in case of COVID outbreaks the following measures to be adopted: Minimizing admissions for a period of at least 5 to 7 days, transferring COVID patients to dedicated hospitals, non COVID emergencies shall be redirected to other wards in FCI or other agreed-upon hospitals, all personnel must be tested.
Identifying all medical personnel available for relocation of COVID taskforce to Victor Gomoiu Clinical Hospital of Children, Grigore Alexandrescu Emergency Clinical Hospital for Children and Filantropia Clinical Hospital.
Identifying all medical personnel available for relocation to Sf. Ioan Emergency Clinical Hospital is requested.Revising the working schedule of medical personnel to construct a reasonable shift system, ensuring that shifts are overlapping by at least 1 hour.
FCI is included on the list of dedicated medical facilities for treating COVID 19 patients by Order 555/2020.
Authorization of ICU COVID 19 modular healthcare structure-4 beds and 25 beds in A2 section – Neurology ward for confirmed COVID-19 patients.
Taking into consideration the assigning of FCI as a dedicated COVID medical facility by Order 555/2020, it is brought to attention the establishment of the COVID structure: section A2, second floor-Neurology.

Your Privacy

We use cookies to ensure the functionality of our website, to personalize content and advertising, to provide social media features, and to analyze our traffic. If you allow us to do so, we also inform our social media, advertising and analysis partners about your use of our website, You can decise for yourself which categories you you want to deny or allow. Please note that based on your settings not all functionalities of the site are available. View our privacy policy.

Medical Science Monitor eISSN: 1643-3750
Medical Science Monitor eISSN: 1643-3750