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