The GOVERNANCE of the health system with regard to COVID-19 relates to pandemic response plans and the steering of the health system to ensure its continued functioning. It includes emergency response mechanisms, as well as how information is being communicated, and the regulation of health service provision to patients affected by the virus.
MEASURES INTRODUCED IN 2020
The National Emergency Management System (NEMS) was set up by the Government Emergency Ordinance no. 21/2004 to ensure and coordinate the human, material and financial resources for the prevention and management of emergencies. NEMS is organized by the central government and is composed of a network of ministries, central institutions and their deconcentrated bodies, and local authorities with different areas of competence.
The National Committee for Special Emergency Situations, led by the Minister of Internal Affairs, is the leading body within NEMS. The Committee is responsible for immediate action in the case of an emergency and to develop action plans to prevent, limit, and control any emergency, including public health threats.
In January 2020 the National Committee for Special Emergency Situations set up the Group for technical and scientific support of pandemics and initiated an action plan to fight the COVID-19 epidemic. Representatives of the Ministry of Internal Affairs/Department for Emergency Situations, the General Inspectorate for Emergency Situations, the Ministry of Health, the National Institute for Public Health, the National Centre for the Surveillance and Control of Communicable Diseases, and the Ministry of Defence are members of the group, all of whom have specific tasks to prevent and limit the COVID-19 epidemic. In February 2020, a Strategic Communication Group was established to communicate with the population and county institutions responsible for local outbreak prevention and control.
The National Centre for the Surveillance and Control of Communicable Diseases is responsible for the surveillance and international reporting to the WHO and EC/ECDC in regard to the COVID-19 epidemic in Romania.
The Government has progressively adopted legislation based on emerging needs. The first measures simplified national procurement legislation and strengthened the health system’s capacity to respond to the epidemic. The procurement of required goods for hospitals and laboratories is a continuous process at national, county, local, and hospital levels. Legislation to facilitate the licensing of medical devices has been simplified; while the local production of medical protection equipment, hygiene and disinfection products has been encouraged. The government has taken gradual measures during the State of Emergency (14 – 16 May ) that has continued during the State of Alert, to strengthen the capacity of the health and social protection systems, and to support the economy during the crisis (see Sections 4 and 6).
Although the central government oversees the epidemics as described above, county decisionmakers have the power to endorse local measures. Six counties have recently made mandatory covering the nose and mouth with medical or improvised masks outside homes.
In the second half of April, the president declared, through a series of public speeches and press conferences, that the national state of emergency will be lifted on May 15. Restrictions on public life will be gradually revoked. However, to date, no legislation was passed regarding an exit plan to ease or revoke restrictions.
On May 15, a 30-day State of Alert replaced the State of Emergency, through a Governmental Emergency Ordinance. The Parliament endorsed by law the State of Alert that entered into force on May 18, for the next 30 days. By law, the State of Alert cannot exceed 30 days. The State of Alert may be extended for another 30 days (maximum), by a governmental decision, at the recommendation of the Minister of Internal Affairs.
During the State of Alert, wearing a face mask is mandatory in all indoor public spaces, commercial spaces, working spaces and public transport. Exceptions include children under 5, people with medical conditions that affect their respiratory capacity, people working solitarily in an office. Hands disinfection and triage at the entrance are mandatory. Individuals with body temperature higher than 37.5 (measured twice) are not allowed to enter the building and are referred immediately to the family doctor (GP).
All public and private employers must evaluate the working spaces and working conditions and develop internal procedures to prevent the risk of COVID-19 infection among the employees.
The State of Alert was extended starting with June 17, for another 30 days. The restrictions continue to be gradually lifted. The Government has continued to enforce the State of Alert without interruption, for consecutive periods of 30 days (July 17- August 15; August 16-September 14; September 15-October 14). Due to the continuous increase in the number of people testing positively each day some restrictions remained in place while others were gradually lifted (see also Section 1.2. Physical distancing).
Schools (e.g. primary, higher education, etc.):
Kindergartens, schools, and universities remain closed; with distance learning continuing until the end of the school year on June 12. Students in the final year of middle or high school must return throughout the period of June 2 and June 12 to complete the national exams. A maximum of 10 children will be permitted within a classroom, with physical distancing restrictions being respected (Law 55/15.05.2020 on the State of Alert/Government Decision 394/18.05.2020).
During the summer holidays, the kindergarten and after schools will be reopened, provided that preventive measures are respected.
Schools reopened for the new scholar year on September 14, on a case-by-case basis. The decision belongs to the schools’ Councils, based on the cumulative incidence reported by the National Centre for the Surveillance and Control of Communicable Diseases (number of cases per 1,000 inhabitants in the last 14 days). There are three scenarios: regular in-class hours, a mix of in-class and online courses, and online classes only. Decisions on the selected scenario are updated weekly or whenever necessary. The Ministry of Education presents on its website real-time data regarding the number of schools following each scenario. As of September 24, 12,838 schools are providing face-to-face courses, 4,505 schools are in the hybrid model, and 313 schools provide only online teaching. Face masks, physical distancing, hands hygiene and other preventive measures are mandatory in classes.
Workers (e.g. essential workers, childcare workers, etc.):
State institutions and private companies conduct door checks to measure the temperature of those who go in. Entry is not allowed for workers with temperature over 37.5 (measured twice). Masks and hands hygiene are mandatory in enclosed spaces. During the entire State of Alert, ensuring continuity of activity is mandatory in residential centres for older people, children, and adults, with and without disabilities, as well as residential centres for other vulnerable groups.
Businesses (SMEs, restaurants, etc.):
Retail activities of products and services in shopping malls remain closed, except for (a) small shopping centres (under 15,000 sqm, with individual shops on the premises of less than 500 sqm each); (b) home delivery of electronic and household products; (c) retail centres with direct access from the street; (d) the agri-food stores, pharmacies, dental offices, lens medical service centres, dry cleaning services and beauty parlours. Indoor and outdoor restaurants and coffee-shops remain closed (Law 55/15.05.2020 on the State of Alert/Government Decision 394/18.05.2020).
Starting on June 1, outdoor restaurants opened for the public, with a maximum of four individuals per table, with tables two metres apart. Beaches are also opened, provided that sunbeds are two metres apart for individuals not belonging to the same family.
Starting with June 15, retail activities in shopping malls have reopened, but food-courts and cinemas remain shut. Reopening of outdoor pools and indoor fitness businesses also started on 15 June.
Following the increase in the number of new cases, some restrictions were introduced on August 1, including mandatory use of masks in crowded outdoor spaces during certain hours, and limited hours for outdoor restaurants and clubs.
Since 1 September, cinemas and indoor event venues are allowed to operate at a maximum of 50% of their capacity, in the counties where the SARS-CoV2 cumulative incidence is less than or equal to 1.5 per 1,000 inhabitants in the last 14 days.
Indoor restaurants and bars reopened on September 15. Indoor pools remain closed for the public (see also Section 1.2 Physical distancing).
Travel (local, cross-border, etc.):
Inter-city travel is not permitted without justified exceptions. Freedom of movement within cities is permitted without the requirement of an affidavit. Borders remain closed (Law 55/15.05.2020 on the State of Alert/Government Decision 394/18.05.2020). Restrictions of movement outside the residential / metropolitan area were lifted on 1 June. Also from 1 June, international railway and road transport of individuals is resumed through regular, special, and occasional services, in compliance with preventive measures instated during the State of Alert. Since 23 June, 22 EU/EEA countries have been considered as “green zone” countries and the mandatory 14 day at-home isolation was lifted for people returning from these countries.
During the entire State of Alert, borders remain closed. The commercial flights to and from countries that are not excepted from the quarantine requirements remain suspended (see also Section 1.2 Physical distancing).
Gatherings (events, informal gatherings, religious services, etc.):
Gatherings in indoor or outdoor spaces are not permitted during the State of Alert. Outdoor groups can accommodate a maximum of six people. Private indoor events cannot exceed eight people, who must comply with the physical distancing rules (1.5-2m). Since 15 June, indoor events can accommodate up to 20 individuals.
Since 17 July, the number of people taking part in outdoor recreational activities who are not members of the same family has been increased to ten people and to 50 people for private events in open spaces.
Since 1 September, up to 50 people are allowed in indoor private events and up to 100 in outdoor events. Training sessions and workshops allow 50 adults indoors and 100 outdoors, with physical distancing measures respected.
On 28 August, special physical distancing measures were put in place in preparation for the local and parliamentary elections on, respectively, September 27 and December 6, 2020: indoor meetings are limited to 50 people for two hours maximum; outdoor gatherings can accommodate up to 100 people and four square-meters per participant is mandatorily required; pedestrian groups can consist of up to six people walking together; and on the voting day, people must wear masks and organizers must ensure that a distance of at least 1-meter between every two people can be observed.
Religious services can accommodate a maximum of sixteen people. For the indoor service, the rules are to assure 4 square meters per person, with 2 meters distance between two individuals. For religious services hold outdoor, the rules ask for 1.5m physical distancing. Starting on June 1, outdoor concerts, public and private festivals, and other outdoor cultural events are allowed for up to 500 participants wearing face masks and observing the 2-metre physical distancing rule. Additionally, drive-in shows are permitted under specific health regulations, and only if attended by the members of the same family. Starting on June 1, outdoor sporting competitions without public attendance can be organized in compliance with detailed preventive measures. Contact sports competitions are not yet permitted.
https://gov.ro/ro/masuri (Decision of the Government no. 476/2020 on the extension of the State of Alert in Romania and the measures to prevent and combat the effects of the COVID-19 pandemic; Decision of the Government no. 553/2020 on the extension of the State of Alert in Romania and the measures to prevent and combat the effects of the COVID-19 pandemic; Decision of the Government no. 668/2020 on the extension of the State of Alert in Romania and the measures to prevent and combat the effects of the COVID-19 pandemic; Decision of the Government no. 782/2020 on the extension of the State of Alert in Romania and the measures to prevent and combat the effects of the COVID-19 pandemic)
Joint MoH-Ministry of Education Order no. 5487/1494/2020 approving the measures for organizing safety schools' activity, at https://www.edu.ro/sites/default/files/Ordin%20comun%20MS%20-%20MEC_septembrie_2020.pdf