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Cablegate: Romania: Preparations for an H1n1 Pandemic

VZCZCXRO2598
PP RUEHIK
DE RUEHBM #0673 2790430
ZNR UUUUU ZZH
P 060430Z OCT 09
FM AMEMBASSY BUCHAREST
TO RUEHC/SECSTATE WASHDC PRIORITY 9944
INFO RUEHZL/EUROPEAN POLITICAL COLLECTIVE PRIORITY
RUEAUSA/DEPT OF HHS WASHINGTON DC PRIORITY
RUEHPH/CDC ATLANTA GA PRIORITY

UNCLAS BUCHAREST 000673

SENSITIVE

STATE FOR EUR/CE ASCHEIBE, OES/IHB DWINN

SIPDIS

E.O. 12958: N/A
TAGS: ECON EINV TBIO PGOV SOCI AMED RO
SUBJECT: ROMANIA: PREPARATIONS FOR AN H1N1 PANDEMIC

Sensitive but Unclassified; not for Internet distribution.

1. (SBU) Summary: The start of the school year and continued
steady uptick in AH1N1 cases has pushed the Government of Romania
(GOR) to advance its planning for a potential flu pandemic. AH1N1's
relatively low mortality rate to date has lessened the urgency of
the planning, but the Ministry of Health (MOH) and the General
Inspectorate for Emergency Situations (Romanian acronym IGSU), part
of the Ministry of Interior, have established a response plan and
tripwires for managing a pandemic. So far, there have been 330
confirmed AH1N1 infections in Romania, with this number projected to
grow. The MOH expects a domestically manufactured vaccine to become
available in December and will try to limit spread of the virus
until a vaccine can be widely distributed. End Summary.

2. (SBU) Since the domestic vaccine is still several months away,
the MOH strategy to limit transmission of the virus includes
hospitalization of all infected individuals and treatment with
antiviral drugs. As a further precaution, schools will be shut down
entirely for seven days if it is confirmed that three or more pupils
are infected. Each school must form a special committee, including
teachers and medical staff, tasked with identifying possible AH1N1
infections. To date, all 330 confirmed AH1N1 cases have been
hospitalized and treated with oseltamivir, and no schools have been
shut completely. The MOH has sufficient antiviral medications on
hand to cover three to four percent of the population and hopes to
increase this to ten percent over the next several months.

3. (SBU) Deploying an effective vaccine is a priority. However,
with the current budget crisis severely restricting funding, the MOH
has turned to the Cantacuzino National Infectious Disease Research
Institute instead of a commercial supplier to manufacture the
vaccine at-cost for the domestic market. Cantacuzino has the
capacity to make up to one million doses per month and plans to have
five million doses available when the vaccine receives final
approval for administration to adults (projected for December) and
children (likely February 2010). Vaccines will be free of charge
for recipients, with priority given to medical and emergency
services personnel, with pregnant women, children, and those with
compromised immune systems next in line.

4. (SBU) Given the substantial time lag before enough doses are
distributed nationally to have a significant impact on disease
transmission, MOH and IGSU have a pandemic plan in case interim
control strategies fail. At the national level, an emergency group
led by the Minister of Interior will coordinate interagency
responses once a "Level 5" pandemic is declared (i.e. virus spread
is uncontrolled, with significant impact on normal routines). Prior
to this declaration, the MOH will manage AH1N1 as a public health
issue, seeking assistance from IGSU in coordinating any non-medical
measures, such as those involving the police and fire services. The
national emergency coordination group retains authority over the
full range of national emergency services, to include assistance
from the military.

5. (SBU) IGSU and MOH have already requested that major private
sector employers develop contingency plans. IGSU and MOH have
surveyed a sample of these plans and report that most employers are
taking this task seriously. All employers must develop a workplace
continuity plan to maintain essential services, even at
significantly reduced staffing levels. MOH is recommending that
every institution have a flu monitoring "point person" and notes
that larger employers usually have a nurse or other medical
personnel already on staff.

6. (SBU) Comment. Romania's plans to combat a flu pandemic appear
to be well-developed. MOH, to its credit, has been proactive in
trying to anticipate and sort out interagency issues and mechanisms
in advance. At the same time, while Romanian institutions often
produce very detailed strategies and action plans, the ability to
implement them in a true crisis situation is always an open
question. GOR interagency coordination is spotty even under the
best of circumstances. Of additional concern are the very real
resource constraints that hospitals and doctors operate under in
Romania. For a population of over 22 million people, there are only
500 ventilators in the entire country, 215 of which are in Bucharest
alone. Personnel trained to use this equipment, and hospital beds
generally, are in short supply. If infections surge, individuals
would not be able to rely on emergency medical services. A flu
pandemic with a moderate to high fatality rate would overwhelm the
public health system. For this reason, MOH is working to deploy a
vaccine as quickly as possible. End Comment.

GITENSTEIN

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