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Metodologia de supraveghere a sindromului respirator acut cu noul coronavirus (COVID-19) – traducere în limba engleză

Methodology for the surveillance of the acute respiratory syndrome caused by the novel coronavirus (COVID-19)

 

The Romanian National Institute of Public Health

 Methodology for the surveillance of the acute respiratory syndrome caused by the novel coronavirus (COVID-19)

Updated on 23.07.2020 

  1. Name and classification of the disease 

The following ICD codes have been assigned for the acute respiratory syndrome caused by the novel coronavirus (COVID-19):

  • 1 – COVID-19, identified virus = valid for CONFIRMED cases
  • 2 – COVID-19, unidentified virus = valid for SUSPECT cases

 

The ICD-10 coding for COVID-19 based on the clinical picture has been communicated to the public health directorates in all counties and Bucharest.

Confirmed cases will be reported to the Register for Communicable Diseases (RUBT, Registrul Unic de Boli Transmisibile) and to CNSISP (The National Center for Statistics and Public Health) as an “unusual / unforeseen event”.

  1. Initial basis

 2019-nCoV (subsequently called SARS-CoV-2) is a new strain of coronavirus that has not been previously identified in humans. Outbreaks of infections caused by new coronaviruses in humans are always a matter of public health importance and a cause of concern.

The first cases in EU/EEA were confirmed in France. ECDC warned of a probable further worldwide spread.

Human-to-human transmission has been confirmed, but more data are needed to assess the scale of this transmission. EU/EEA countries should ensure that timely and rigorous measures are applied for the prevention and control of the infection when dealing with cases identified within the EU/EEA, in order to prevent future sustained human-to-human transmission in the community and healthcare settings.

 

Adapted from ECDC: www.ecdc.europa.eu/en/novel-coronavirus-china

 

In this context, it is imperative to implement in Romania the surveillance system for the human infection with the new coronavirus (2019-nCoV, subsequently called SARS-CoV-2).

 

III. Purpose: 

– To gain a better understanding of the epidemiological situation of the acute respiratory syndrome caused by the novel coronavirus (COVID-19) in Romania and recommend measures / interventions to prevent the occurrence of secondary cases or an epidemic in Romania

  1. Objective:

 – To establish the basic epidemiological parameters of the SARS-CoV-2 infection:

  • Characteristics of the case with respect to the individual, place, and time;
  • Basic clinical picture (signs and symptoms);
  • Pre-existing medical and physiological conditions;
  • Clinical course, outcome, and severity;
  • Exposures and travel history

The information collected from surveillance activities will also be used for the national risk assessment, as well as to guide response decisions.

  1. Case definitions for the acute respiratory syndrome caused by the novel coronavirus (COVID-19)

Suspect case

Any person with acute respiratory infection (sudden onset of at least one of the following symptoms): cough, fever, breathing difficulties (shortness of breath)

 

OR

 

Any person with pneumonia, bronchopneumonia +/- pleurisy

OR

Any person with a severe acute respiratory infection (SARI) (fever or a history of fever AND cough AND breathing difficulties (shortness of breath) AND requiring overnight hospitalisation)

Note:

 For children under the age of 16 years presenting gastrointestinal symptoms (vomiting, diarrhoea) that are not food-related, a SARS-CoV-2 infection may be suspected.

Definitions of community-transmitted COVID-19 and HCAI

 A COVID-19 case may have originated in the community or may be a case of healthcare-associated infection (HCAI), depending on:

– the number of days prior to the onset or laboratory confirmation of the infection, after the date of admission to a medical facility (hospital, dialysis centre) or a long-term residential care centre (day 1);

– evidence obtained from the epidemiological investigation with respect to its origin in the community or as a HCAI (whether the case relates to an outbreak site that has either one of the possible origins)

The following situations may occur:

  • Community-associated COVID-19 case

– symptoms are present at admission or the onset is within 48 hours after admission;

– onset during days 3 to 7 after admission and a strong suspicion of community-transmission (association with a community outbreak site);

  • Healthcare-associated COVID-19 case (HCAI)

– onset later than 48 hours after admission and a strong suspicion of transmission associated to healthcare);

– cases among the medical and auxiliary healthcare staff, if there is no strong evidence in support of community transmission;

Cases with onset within the first 14 days after discharge from a healthcare facility may be:

– HCAI, if the onset occurs within the first 48 hours after discharge;

– of uncertain origin, if the onset occurs 3 to 14 days after discharge and there is no strong evidence in support of either community origin or HCAI

Assignment to a certain category of transmission should be determined only after a careful assessment of each individual case.

Confirmed case

A person that has received laboratory confirmation of the SARS-CoV-2 infection, irrespective of the clinical signs and symptoms.

A close contact is defined as:

– A person who lives in the same household with a COVID-19 patient;

– A person who has had direct physical contact with a case of COVID-19 (e.g., handshake not followed by hand sanitisation);

– A person who has had unprotected direct contact with the infectious secretions of a COVID-19 case (e.g., while coughing, touching used handkerchiefs without wearing protective gloves);

– A person who has had face-to-face contact with a case of COVID-19 at a distance of less than 2 metres and for duration of at least 15 minutes;

– A person who has been in the same room (e.g., classroom, meeting room, hospital waiting room) with a case of COVID-19 for at least 15 minutes and at a distance of less than  2 meters;

– A healthcare professional or other person providing direct assistance to a COVID-19 patient or laboratory personnel handling samples collected from a COVID-19 patient without proper use of personal protection equipment*;

*Healthcare personnel who have observed the proper use of protection equipment as required by the type of assistance provided ARE NOT CONSIDERED A CLOSE CONTACT.

The epidemiological link may have occurred within a period of 14 days prior to the date of onset.

Death of a confirmed COVID-19 patient

A COVID-19 death is defined as the death of a confirmed COVID-19 patient, unless there is another clear cause of death that cannot be related to COVID disease (e.g., trauma, major acute bleeding, etc.) with no period of complete recovery between the illness and death.

A death due to COVID-19 cannot be attributed to another pre-existing condition (e.g., cancer, blood disorders) and COVID-19 should be reported as the cause of death independently of pre-existing medical conditions that are suspected of triggering a severe course of COVID-19.

COVID-19 must be specified on the death certificate as the cause of death for all individuals whose death was caused by COVID-19 or it is assumed that COVID-19 caused or contributed to their death.

It should also be mentioned that, pursuant to the Order of the Minister of Health no. 961/2020 issued to amend and supplement the Order of the Minister of Health no. 555/2020 on the approval of the Action Plan to prepare hospitals in the context of the COVID-19 epidemic, the List of hospitals that provide medical assistance to patients tested positive for the SARS-CoV-2 virus in phase I and in phase II, and the List of support hospitals for patients tested positive or suspected of SARS-CoV-2 virus, confirmed cases of COVID resulting in death for which the  findings of the RT-PCR dynamic profile in sputum / bronchial aspirate are negative (2 tests) may be considered as death due to SARS-CoV-2 infection if the clinician identifies signs and symptoms highly suggestive of this and the death is correlated with the clinical course determined by COVID. If it is necessary to clarify the cause of death, RT-PCR testing of lung tissue collected by a specialist of pathological anatomy / forensic medicine specialist is recommended, and necropsy is not required.

 

Criteria for performing SARS-CoV-2 testing

 

Prompt confirmation of a suspect case is necessary in order to ensure, in a fast and efficient manner, the epidemiological surveillance of contacts, implementation of prevention and control measures, and the collection of epidemiologically and clinically relevant information.

 

Guidelines for COVID-19 priority testing:

 

  1. Symptomatic persons, including medical and auxiliary healthcare personnel, according to the case definition;

 

  1. Symptomatic close contacts of confirmed cases;

 

  1. Asymptomatic patients within 48 hours prior to a transplant procedure and donors of organs, tissues, and of hematopoietic stem cells, prior to the procedure; recipients of transplants of organs, tissues, and of hematopoietic stem cells who are undergoing immunosuppressive therapy, prior to each hospitalisation during the post-transplant monitoring – 2 tests at a 24-hour interval;

 

  1. Medical teams collecting organs for transplant who travel between the transplant centre and the collection centres – once every 2 weeks;

 

  1. Asymptomatic patients with disease or drug-induced immunosuppression, within 48 hours prior to hospitalisation;

 

In this context, immunosuppression refers to: cytotoxic chemotherapy, extended-release biologics, cellular immunotherapy, and high doses of glucocorticoids, according to the guidelines provided by the Infectious Diseases Society of America (6.05.2020), accessed at https://www.idsociety.org/practice-guideline/covid-19-guideline-diagnostics/

 

  1. Asymptomatic cancer patients undergoing chemotherapy and/or radiotherapy:

 

– Asymptomatic cancer patients undergoing chemotherapy – within 48 hours prior to each cycle and prior each visit to the hospital for monitoring purposes;

– Asymptomatic cancer patients undergoing radiotherapy – before the first session and afterwards once every 14 days until the therapy regimen is completed;

 

 

  1. Asymptomatic cancer patients before surgery or invasive procedures, within 48 hours prior to the surgical intervention / procedure;

 

Note:

With regard to points 6. and 7., in case of children hospitalised with an adult, the accompanying adult shall also be tested.

 

  1. Asymptomatic patients undergoing haemodialysis – twice a month;

– Asymptomatic patients undergoing haemodialysis who have been in contact with a confirmed case, 2 tests every 6-7 days; throughout this period, these patients will receive haemodialysis separately from other patients;

 

  1. Symptomatic patients undergoing haemodialysis;

 

  1. Institutionalised asymptomatic individuals – twice a month;

 

  1. Personnel providing assistance in long-term residential care centres – twice a month;

 

  1. Asymptomatic pregnant women who are either quarantined / isolated at home or have been in close contact with a confirmed case – on day 14 if still asymptomatic;

 

  1. Asymptomatic medical and auxiliary healthcare personnel who have been in direct contact with a confirmed case, 6-7 days after the last contact with a potential infected patient**;

 

** During the period following contact with a potential infected patient and until the laboratory results are known, healthcare personnel will continue their activity in compliance with standard protection measures.

Positive cases among symptomatic or asymptomatic healthcare personnel will follow the required isolation procedures that apply to other infected individuals.

Changes in the epidemiological circumstances may lead to the revision of these recommendations.

 

Medical facilities may establish testing protocols for the medical personnel and/or patients using RT-PCR techniques, in addition to these recommendations, which can be carried out using their own resources, either in their own laboratories or in other laboratories.

 

The test reports showing positive results shall be reported immediately, scanned and included in the same e-mail message sent by the laboratory that has performed the test to the hospital that requested the test, to the public health directorate that has jurisdiction over the case, and to the National Institute of Public Health (INSP), and then necessary action will be taken to hospitalise / isolate the infected individuals.

In such cases, the medical facilities will conduct their own epidemiological investigation and will undertake measures to limit the infection; these actions fall under direct responsibility of the manager.

The report of the epidemiological investigation will be sent within 24 hours to the public health directorate in the county to which the case belongs.

 

Laboratory investigations

 

Samples must be collected according to Appendix 2 and sent to the laboratory, together with the Form accompanying specimens collected from a suspected COVID-19 case provided in Appendix 3.

Respiratory samples that have been collected shall be sent to the specialised centres that perform RT-PCR testing for the identification of SARS-CoV-2, specified in the Technical standards for the implementation of National Health Programme (PNS).

Laboratory personnel will comply strictly with the precautions required for the prevention of SARS-CoV-2 infection.

 

The method used for testing is the nucleic acid amplification testing (NAAT), which includes RT-PCR. Patients may be tested for other respiratory pathogens as well, but this should not delay the testing for SARS–CoV-2.

Due to the possibility of co-infections, patients who meet the case definition should be tested for SARS-CoV-2 regardless of the presence of another respiratory pathogen.

 

The minimum set of specimens recommended to be collected for diagnostic include:

– Upper respiratory specimens (nasopharyngeal and oro-pharyngeal swab or wash) –  it is recommended to use Dacron or polyester swabs, with plastic shafts, and to place both the nasopharyngeal and the pharyngeal swabs in the (same) vial containing the viral transport medium (VTM).

 

and/or

 

– Lower respiratory tract specimens: sputum (if expectorated) and/or endotracheal aspirate or bronchoalveolar lavage, collected from patients with severe acute respiratory infection.

 

In case of deceased patients suspected of COVID-19 autopsy lung specimens will be collected and sent to the laboratory for viral diagnosis. The collection of samples is not typically required for cases previously confirmed based on nasopharyngeal swabs or bronchotracheal aspirate, nor in cases with a negative result for SARS-CoV-2 based on these specimens.

Details regarding the collection of pathological specimens and laboratory tests can be found in Appendix 2.

 

  1. Type of surveillance: case-based, passive/active

 

VII. Population: all residents / people visiting Romania

 

VIII. Period: permanent

 

  1. Reporting data:

 

 

  • The minimum set of data to be reported immediately by telephone for a suspected case:

 – Case code, name, first name, Personal Identification Number (CNP), date of onset, symptoms (in correlation with the case definition), epidemiological link (contact with a confirmed case), occupation (e.g., healthcare personnel), date and place of hospitalisation, date and place of death;

 

  • In case of deaths recorded for confirmed cases of COVID-19: case code, Personal Identification Number (CNP), date of onset, symptoms (in correlation with the case definition), epidemiological link (contact with a confirmed case), occupation (e.g., healthcare personnel), date and place of hospitalisation, date and place of collection, date and place of confirmation (laboratory), date and place of death, pre-existing medical conditions;

 

  • In accordance with the Patient Monitoring Chart pertaining to a CONFIRMED case of COVID-19 (Appendix 1), therefore only for a confirmed case;

 

Data from the patient monitoring charts pertaining to confirmed cases are entered into the online application

 

See also X. Information circuit and informational feedback

 

  1. Information circuit and informational feedback

 

Peripheral level: hospitals

  • report to the Public Health Directorate (DSP) immediately, by telephone, the minimum set of data pertaining to the suspected case: name, first name, Personal Identification Number (CNP), date of onset, symptoms (in correlation with the case definition), epidemiological link (contact with a confirmed case), date of death;
  • report to DSP immediately, by telephone, the deaths recorded for confirmed COVID-19 cases;
  • collect and test / send biological specimens to the laboratory, together with the accompanying form that is provided in Appendix 3, which is a mandatory document;

 

Peripheral level: laboratories performing COVID-19 testing using RT-PCR:

 

  • report immediately the test reports with validated results, signed and sealed, scanned, by e-mail, in the same message sent to the DSP that has jurisdiction over the case (the DSP  in the county where the infection occurred) or which has requested preventive testing, according to the testing algorithm, to the hospital that requested the tests, or to the National Institute of Public Health – The National Centre for Communicable Diseases Surveillance and Control (INSP-CNSCBT);
  • report the tests performed for COVID-19 on a daily basis, between 8-9 a.m. for the previous day, on the platform of the Ministry of Health;
  • report the tests performed for COVID-19 on a daily basis, until 10 a.m. for the previous day, to INSP-CNSCBT, using the e-mail address raportare_covid@insp.gov.ro;

 

The number of positive cases will be notified in advance, by telephone, calling the mobile number 0744510640 or 0742031461 or the landline number 021 3179702.

 

The algorithm for reporting suspected COVID-19 cases is posted on CNSCBT website http://www.cnscbt.ro/index.php/informatii-pentru-personalul-medico-sanitar

 

As mentioned in the algorithm provided for testing, admission to hospital and discharge from hospital, all cases of pneumonia and all cases of SARI with no other aetiology (e.g., influenza) for ALL age categories and from ALL hospitals will be tested for COVID-19.

 

For all suspected/confirmed cases of COVID-19 identified as a result of sentinel surveillance for SARI, it shall also be required to fill in the Monitoring chart pertaining to a case of SARI (Severe Acute Respiratory Infection).

 

 

Peripheral level: family medicine practices, other medical practices

 

  • isolate and apply a mask on the nose and mouth of the suspect case;
  • call 112;report to DSP immediately, by telephone, the minimum set of data pertaining to the suspected case: name, first name, Personal Identification Number (CNP), date of onset, symptoms (in correlation with the case definition), epidemiological link (contact with a confirmed case),occupation (e.g., healthcare personnel);
  • refer the suspect case to the hospital, using an ambulance;
  • notify DSP immediately, by telephone the recorded deaths of suspect/confirmed cases of COVID-19;

 

 

Local level: County DSP / Bucharest DSP

 

  • report immediately on the STS platform any positive result;
  • enter the rest of the data required for a newly confirmed case into the STS platform within 24 hours;
  • initiate the epidemiological investigation for the CONFIRMED case within 24 hours;
  • enter the minimum set of data that is required for immediate reporting by telephone of a SUSPECT case into the electronic platform dedicated to the monitoring record;
  • complete and upload on the electronic platform dedicated to the monitoring record of the CONFIRMED case, within 7 days, the data contained in this chart (Appendix 1);
  • report to CNSCBT, immediately after detection, any outbreak site with at least 3 cases, including the measures that have been recommended / implemented;
  • immediately initiate the epidemiological investigation for the clusters;
  • report immediately, by telephone to CNSCBT, the deaths recorded for suspect/confirmed cases of COVID-19, and afterwards the updated monitoring chart including the information related to the death must be sent within 24 hours after death by fax/e-mail to CNSCBT and CRSP, with the specification “Update”;
  • initiate immediately the epidemiological investigation for the deceased case;
  • receive laboratory results from CNSCBT;

 

 

Regional level: CRSP (Regional Centre of Public Health)

 

  • takes action in the epidemiological investigations carried out with respect to clusters / outbreaks and provides technical assistance, upon request made by the DSP in its area of jurisdiction or following a request made by CNSCBT;
  • sends to CNSCBT and DSP, on a quarterly basis, the epidemiological analysis of the cases within its area of jurisdiction;

 

National level: CNSCBT

  • checks the entries made by DPS on the STS concerning the data and information pertaining to the confirmed cases and outbreak sites;
  • checks the minimum sets of data pertaining to SUSPECT cases and the information included in the monitoring charts pertaining to CONFIRMED cases (Appendix 1), uploaded on the online platform dedicated for these records;
  • sends to the Ministry of Health, every day at 12:00, the reports concerning the tests completed in the laboratories and the stocks of testing kits;
  • collects daily the validated, signed and sealed, scanned tests reports sent by laboratories;
  • conducts the epidemiological analysis of the national database and send the results to the Ministry of Health (MS) – DGAMSP (General Directorate for Medical Assistance and Public Health), CRSP, and DSP;
  • reports the confirmed cases in TESSy, case by case;
  • Provides to IHR department within INSP the information requested by WHO-IHR.

 

 

The National Focal Point for RSI (2005):

Provides to CNSCBT information updated daily with regard to the number of cases and participates in the national risk assessment.

 

  1. Control measures

 

 

Are applied immediately after the identification of a suspect case of COVID-19, without waiting for the laboratory test results!

 

1) Conduct with respect to the case:

 

A case is deemed to be infectious 2 days prior to onset and for another 14 days after the onset.

The following actions are required:

  • isolation of the suspect and confirmed cases;
  • implementation of precautionary measures to avoid transmission by droplets, contact and, as the case may be, air-borne transmission, as well as universal precautions throughout the period of hospitalisation;
  • training of the personnel providing assistance to the suspect case / case confirmed by the hospital epidemiologist, conducted for each new shift by the coordinator of the previous team;
  • cohorting of the suspect cases and personnel that provides assistance to them;

 

2) Conduct with respect to close contacts:

 

The definition of a close contact has been provided in section V. Case definitions for the acute respiratory syndrome caused by the novel coronavirus (COVID-19).

The approach taken in this regard shall observe the provisions of the legislation in force.

 

3) Conduct with respect to clusters of at least 3 cases:

 

The epidemiologic investigation by DSP shall be initiated immediately after the cluster has been reported to DSP / identified by DSP and reported, by DSP, to CNSCBT.

The identification of a cluster requires a thorough epidemiological investigation carried out by DSP, possibly with the technical assistance of CRSP, if requested by DSP or CNSCBT.

The information about the cluster (DSP, location of the cluster – town/city, community / hospital, date of onset of the first case and of the most recent case in the cluster), alongside the recommended measures shall be sent to CNSCBT and CRSP, on the date of identification by DSP.

 

4) Conduct with respect to individuals arriving from international travel

In such cases, the approach shall be established by the legislation in force.

 

XII. Recommended epidemiological analysis

  • number of cases identified daily and weekly, broken down by age groups, sex, environments, and geographic area: county / CRSP jurisdiction / national;
  • number of cases identified daily and weekly, based on their classification as suspect / probable / confirmed cases;
  • the weekly fatality rate and the cumulative fatality rate (probable or confirmed cases);
  • the weekly mortality rate and the cumulative mortality rate (probable or confirmed cases);
  • the attack rate in case of epidemics

 

XIII. Assessment indicators of the surveillance system

 

– % of counties that report correctly (in a complete and timely manner) to CRSP and CNSCT;

– % of suspect / probable cases for which the epidemiologic investigation has been initiated immediately by the epidemiologist;

– % of suspect cases that have been confirmed;

– % of confirmed cases with known source of infection (first confirmed case identified)

 

 

Dr. Adriana Pistol

Dr.Odette Popovici

Dr.Teodora Vremeră

 

 

Appendix 1

Monitoring chart for a CONFIRMED case of COVID-19

 

DSP: ____________________ (county abbreviation)

DSP CODE: ­­­­­­­­­­­­­­­­­______________ (county abbreviation / case number / year – e.g. AB/01/2020)

Date of reporting by fax/e-mail to DSP by CNSCBT: _ _ /_ _ /_ _ _ _ (dd/mm/yyyy)

Detected at the entry point: □ NO                      □  YES             □ Unknown

If YES, specify the date:  _ _ /_ _ /_ _ _ _ (dd/mm/yyyy)

 

Section 1: General information about the patient

 

Name, first name:______________________ CNP: | _ | _ | _ | _ | _ | _ | _ | _ | _ | _ | _ | _ | _ |

Date of birth: _ _ /_ _ /_ _ _ _ (dd/mm/yyyy)   or age in years: _____________

If the age is < 1 year: ___________ months;

If the age is < 1 month: ___________days

Sex at birth: □ Male      □ Female

Place of diagnosis: Region (NUTS 2): RO____ County/NUTS 3: ____ / RO____

Legal home address: Region (NUTS 2): RO____ County/NUTS 3: ____ / RO____ City/town____

Was quarantined in: Region (NUTS 2): RO____ County/NUTS 3: ____ / RO____

City/town______________________

 

Section 2: Clinical information

Date of onset of symptoms: _ _ /_ _ /_ _ _ _ (dd/mm/yyyy)         □ Unknown

Asymptomatic person with a positive result (quarantined / contact of a confirmed case) □

Hospitalised: □ NO      □  YES       If YES, date of first admission: _ _ /_ _ /_ _ _ _ (dd/mm/yyyy)

Name of hospital: ___________________________

Date of current admission: _ _ /_ _ /_ _ _ _ (dd/mm/yyyy) Name of hospital: _________________

Admitted to ICU: □ NO            □ YES

Date of reporting to DSP: _ _ /_ _ /_ _ _ _ (dd/mm/yyyy)

Health status (please circle) at the moment of reporting: Cured/Not cured/Deceased/Unknown/Still under treatment

Date of death: _ _ /_ _ /_ _ _ _   (dd/mm/yyyy)

 

Patient’s declared symptoms (check all that apply):

□ History of fever (≥380 C)        □ Difficulty breathing   □ Pain (check all that apply)

                                                                                       ( ) Muscular  ( ) Chest

                                                                                       ( ) Abdominal  ( ) Joint

□ Chills

□ General weakness                  □ Diarrhoea

□ Cough                                   □ Nausea / vomiting

□ Sore throat                            □ Headache

□ Rhinorrhoea                          □ Irritability / confusion

□  Other, specify _________________________________________

 

Signs observed at admission (check all that apply):

□Measured fever ( ≥380 C) ____ degrees Celsius

□ Pharyngeal discharge             □ Coma                        □ Changes of chest X-ray

□ Conjunctival congestion        □ Dyspnea / Tachypnea

□ Convulsions              □ Modified lung auscultation

□  Other, specify_________________________________________

 

Ventilator support:

Has received only oxygen through respiratory                □

Has received invasive ventilation (intubated)                  □

ECMO (Extracorporeal membrane oxygenation)            □

Was not necessary                                                        □

Was not available                                                         □

 

Current and pre-existing physiological and medical conditions (check all that apply):

□ Pregnancy (trimester: __________)                            □ Post-childbirth (< 6 weeks)

□ Cardiovascular disease, including arterial hypertension  □ Immunodeficiency, including HIV/AIDS

□ Diabetes                                                                   □ Renal disease

□ Hepatic disease                                                         □ Chronic lung disease

□ Chronic neurological or neuromuscular disease           □ Cancer

□  Other, specify

 

Section 3: Exposure and information about travelling during the period of 14 days prior to the onset of symptoms

 

  • Occupation (check all that apply):

□ Student                                 □ Healthcare personnel

□ Working with animals            □ Laboratory personnel handling biological specimens

                                                                        □  Other, specify _________________

 

  • Has travelled during the period of 14 days prior to the onset of symptoms?

□ NO     □YES             □ Unknown

 

If YES, please specify the places of travel:

 

COUNTRY                 REGION                     CITY                           PERIOD

  1. ___________ ___________               ___________               ___________
  2. ___________ ___________               ___________               ___________
  3. ___________ ___________               ___________               ___________

 

Has travelled by airplane?                    □ NO      □  YES       If YES, flight no.:________ Seat_____

Airport of departure _____________     Airport of arrival _____________

Has travelled by coach / minibus?         □ NO      □  YES       If YES,  travel company: _____________

Place of departure _____________ Place of arrival _____________

 

  • Has visited healthcare facilities during the period of 14 days prior to the onset of symptoms?

□ NO      □  YES     □  Unknown

If YES, town/city _____________ Healthcare facility _____________

Period _____________

 

  • Has the patient been in close contact1 with a person with acute respiratory infection during the period of 14 days prior to the onset of symptoms?

 

If YES, where did the contact take place (check all that apply):

 □ Medical facility      □  Family     □  Workplace           □  Unknown

 □ Other, specify _______________________________________

 

  • Has the patient had contact with a probable or confirmed case during the period of 4 days prior to the onset of symptoms? □ NO         □  YES             □ Unknown

If YES, please specify the case codes for all probable or confirmed cases:

Case code 1: ____________ Case code 2: _________ Case code 3: ___________

If YES, where did the contact take place? (check all that apply):

□ Healthcare facilities   □ Family          □ Workplace    □ Unknown

□Other, specify

If YES, place / city / country of exposure: ___________________________

 

  • Has the patient visited, during the period of 14 days prior to the onset of symptoms, any live animal fair / market? □ NO               □  YES             □ Unknown

If YES, place / city / country of exposure: ___________________________

 

Section 4: Laboratory information

 

Name of the laboratory that has performed the testing: ________________________

Type of respiratory specimen(s) (please indicate all of them): ___________________________ ______________________________________________________________________

Please specify the test that was used: _________________________________________

Has sequencing been performed?           □ NO   □  YES             □ Unknown

Date of confirmation (validation of the test) in the laboratory: _ _ /_ _ /_ _ _ _     (dd/mm/yyyy)

Result of influenza virus detection (RT-PCR): □ AH1-positive  □ AH2-positive□ A positive □ B Positive

□ Unknown      □ Untested

 

Section 5: Case classification                                     

 

Case classification:                  □ Suspected     □ Confirmed    □ Ruled out

 

Section 6: Identified contacts

 

TOTAL number of identified contacts: ___________, of which

No. of contacts in the family: _________

No. of contacts in the workplace / school: ______

No. of contacts from other settings: _________, specifically _____________________

 

 

Signature and stamp of the attending physician / hospital epidemiologist _____________________

 

Signature and stamp of the DSP epidemiologist _______________________

 

 

1 Person who lives in the same household with a COVID-19 patient;

– A person who has had direct physical contact with a case of COVID-19 (e.g., handshake not followed by hand sanitisation);

– A person who has had unprotected direct contact with the secretions of an infectious case of COVID-19 (e.g., while coughing, touching used handkerchiefs without wearing protective gloves);

– A person who has had direct face-to-face contact with a case of COVID-19 at a distance of less than 2 metres and for duration of at least 15 minutes;

– A person who has been in the same room (e.g., a classroom, meeting room, hospital waiting room) with a case of COVID-19 for at least 15 minutes and at a distance of less than  2 m;

– A healthcare professional or other person providing direct assistance to a COVID-19 patient or laboratory personnel handling samples collected from a COVID-19 patient without proper use of personal protection equipment*;

 

*Healthcare personnel who have observed the proper use of protection equipment as required by the type of assistance provided ARE NOT CONSIDERED A CLOSE CONTACT.

 

The epidemiological link may have occurred within a period of 14 days prior to the date of onset.

 

 

 

Appendix 2

 

 

COLLECTION, TRANSPORT, AND INVESTIGATION OF BIOLOGICAL SPECIMENS FOR THE DIAGNOSIS OF INFECTION WITH SARS-CoV-2

 

Respiratory specimens (Table 1) shall be collected from patients meeting the criteria for the case definition and from all individuals in the categories mentioned “Guidelines for COVID-19 priority testing”, as follows:

– Nasopharyngeal or oropharyngeal swab or wash from patients with mild or moderate clinical forms and from asymptomatic individuals;

– Sputum and/or endotracheal aspirate or bronchoalveolar lavage from patients with severe clinical forms, as applicable;

– Additionally: blood samples, stool samples, autopsy material.

 

It is recommended to collect a sufficient amount a specimens so as to allow multiple tests.

 

According to ECDC, in case of suspicion of infection with the novel coronavirus in hospitalised patients, it is recommended to collect samples repeatedly, every 2-4 days, until two consecutive negative results are obtained at least 24 hours apart (https://www.ecdc.europa.eu/en/european-surveillance-human-infection-novel-coronavirus-2019-ncov ).

 

Table      I. Recommendations for the collection of samples from symptomatic patients and asymptomatic contacts

 

Type of specimen

Collection instrument

Transportation

Preservation

Nasopharyngeal oropharyngeal swab

Dacron or polyester swab*

2-8°C

 

≤5 days: 2-8°C

> 5 days: -70°C

Bronchoalveolar lavage

Sterile container*

 

2-8°C

 

≤2 days: 2-8°C

> 2 days: -70°C

Endotracheal aspirate, nasopharyngeal or nasal aspirate or wash

Sterile container*

 

2-8°C

 

≤2 days: 2-8°C

> 2 days: -70°C

Sputum

Sterile container

 

2-8°C

 

≤ 2 days: 2-8°C

> 2 days: -70°C

Tissue samples obtained by biopsy or necropsy (including lung tissue)

 

Sterile container with saline solution or viral transport medium (VTM)

 

2-8°C

 

≤ 24 hours: 2-8°C

> 24 hours: -70°C

Stool

Stool container

2-8°C

 

≤ 5 days: 2-8°C

> 5 days: -70°C

Whole blood

Blood collection tube

2-8°C

 

≤ 5 days: 2-8°C

> 5 days: -70°C

Urine

Urine collection container

2-8°C

 

≤ 5 days: 2-8°C

> 5 days: -70°C

 

 

 

* The samples for viral detection shall be transported using a viral transport medium (VTM) containing antifungal and antibiotic supplements. Repeated freezing and thawing of specimens shall be avoided. If VTM is not available saline solution may be used instead, but in this case specimen stability at 2-8°C may be different from what is indicated in the table.

 

Biosafety measures during the handling of specimens

The medical personnel responsible for the collection and transport of specimens shall follow the recommendations provided in the Guideline Infection prevention and control during health care when novel coronavirus (nCoV) infection is suspected (https://www.who.int/publications-detail/infection-prevention-and-control-during- health-care-when-novel-coronavirus-(ncov)-infection-is-suspected).

All specimens shall be regarded potentially infectious. Additional precautions shall be undertaken during the collection of samples by means that pose a risk of aerosolisation (e.g., bronchoscopy, aspirate).

Specimens that can be transported fast to the laboratory may be kept at 2-8°C. Otherwise, it is recommended to use a viral transport medium, and the samples may be frozen (at minus 20°C or, ideally, at minus 70°C) and transported carbon ice. Avoid repeated freezing/thawing cycles.

Guidelines for the prevention and control of infections shall be strictly observed, as well as national and international regulations concerning the transportation of infectious materials. The personnel transporting the samples must receive proper training on the correct handling of specimens, as well as decontamination procedures. Involved personnel will observe proper use of the personal protection equipment (PPE). The use of pneumatic systems for the transportation of specimens shall be avoided. The samples shall be labelled properly, and the laboratory will be given prior notice. In the request for analysis, full identification details will be provided, together with the date and time of collection, type of specimen, tests requested, clinical symptoms, relevant case history information (vaccinations, antibiotic treatments, epidemiological information, risk factors).

Specimens collected for molecular diagnosis will be handled in compliance with the same biosafety provisions as those that apply for the molecular testing for influenza (BSL2). However, the isolation of the virus requires a higher level of biosafety (at least BSL3). Involved personnel will observe proper use of the personal protection equipment (PPE).

The following shall be observed:

– national guidelines regarding laboratory biosafety

– the recommendations provided in WHO Laboratory Biosafety Manual – Third Edition

(https://www.who.int/csr/resources/publications/biosafety/WHO_CDS_CSR_LYO_ 2004_11/en/)

– WHO Laboratory biosafety guidance related to coronavirus disease 2019 (COVID-19)

https://apps.who.int/iris/bitstream/handle/10665/331138/WHO-WPE- GIH-2020.1-eng.pdf

– WHO Infection prevention and control during health care when novel coronavirus (nCoV) infection is suspected, interim guidance, January 2020

 

The transport of specimen to another laboratory must observe the national guidelines, as well as WHO recommendations – Guidance on regulations for the transport of infectious substances 2019–2020

( https://www.who.int/ihr/publications/WHO-WHE-CPI-2019.20/en/ ) and

WHO interim guidance for laboratory biosafety related to 2019-nCoV.

 

Samples are regarded as inadequate in the following circumstances:

– swabs sent without a viral transport medium;

– specimen is sent in improper containers (damaged, cracked tube, open cover);

– failure to observe the requirements for transport or preservation (duration, temperature);

– missing label on the samples to be tested;

– missing request for testing;

– the request for testing is not properly filled in, with patient information either missing, incomplete, erroneous, or illegible.

 

Laboratory diagnosis of SARS-CoV-2 infection:

 

  1. Nucleic acid amplification testing (NAAT)

 

The diagnosis of the infection with SARS-CoV-2 is based on the detection of specific viral RNA sequences based on testing the amplification of nucleic acids, such as Real Time RT-PCR, and confirmation by sequencing whenever it is necessary. The viral gene targets include: N, E, S, and RdRP genes. The extraction of nucleic acids must be performed in a laboratory biosafety hood at level BSL-2. Thermal treatment of samples prior to the extraction of nucleic acids is not recommended.

 

The confirmation of cases in areas where the virus was not previously known to be in circulation:

– a positive result for at least two gene targets, of which at least one target is specific to SARS-CoV-2, using a validated test

or

– a positive result for beta-coronaviruses followed by SARS-CoV-2 sequencing (partial or WGS – the target sequence must be bigger or different than the one identified through the genic amplification  test)

 

In case of inconsistent findings, the following steps are recommended:

– collection of a new sample;

– sequencing of the virus from the original sample or the amplicon generated from a genic amplification testing other than the one used initially.

 

Any unusual result should be confirmed by an international reference laboratory.

Also, it is recommended to send the first 5 positive samples and the first 10 negative samples (tested in a laboratory in countries where the virus was not previously known to be in circulation) to one of WHO’s reference laboratories https://www.who.int/emergencies/diseases/novel-coronavirus-2019/technical-guidance/laboratory-guidance

 

 

Confirmation of cases in areas where the virus is known to be in circulation

 

In areas where the virus is widely spread, a simplified diagnosis algorithm can be used, in which the screening by Real Time RT-PCR of a single discriminatory target is sufficient.

Each Real Time RT-PCR testing must include internal control, positive control, and negative control. It is recommended that laboratories which perform SARS-CoV-2 testing take part in an external quality control scheme when it becomes available. Also, the quality of reagents must be checked upon reception, in order to confirm the absence of contamination.

It is recommended that laboratories with limited experience collaborate with more experienced laboratories for the confirmation of initial results and improvement of their own performance.

 

  1. Whole genome sequencing provides useful information for understanding the origin of the virus and the way in which it spreads. It is recommended that identified sequences be reported to WHO and the scientific community and made public on platforms such as GISAID, in compliance with WHO Draft code of conduct for handling of Genetic Sequence data related to outbreaks (https://www.who.int/blueprint/what/norms-standards/GSDDraftCodeConduct_forpublicconsultation-v1.pdf?ua=1)

The sequences of the virus can be used for>

– confirmation of diagnosis in certain cases;

– monitoring of the occurrence of mutations that may impair the performance of diagnosis tests (due to the regular sequencing of samples collected from clinical cases);

– epidemiological studies.

 

Interpretation of results:

The possibility of an infection with SARS-CoV-2 is not ruled out by a one or multiple negative results, in particular in case of samples collected from the upper respiratory tract. A false-negative result may be due to:

– inadequate collection of samples, resulting in a reduced quantity of pathologic product

(it is recommended to include a human DNA target in the PCR testing);

– sample collected too early or too late in the course of the infection;

– inadequate handling and transportation of the sample;

– mutations of the virus;

– the presence of PCR inhibitors.

The identification of another pathogen does not rule out an infection with the novel coronavirus, and the role of co-infection in the pathology is not fully known.

In order to certify the clearing of the virus, it is recommended to repeat the sampling until two consecutive negative results are obtained by genic amplification reactions. All test results (positive or negative) must be notified immediately to the national authorities.

 

Source: https://apps.who.int/iris/bitstream/handle/10665/331329/WHO-COVID-19-laboratory-2020.4-eng.pdf?sequence=1&isAllowed=y

 

 

 

 

 

 

 

 

 

 

 

Appendix 3

 

Form accompanying the samples collected from a SUSPECT / CONFIRMED case of COVID-19 or other categories of individuals

 

Hospital / DSP __________________________

 

To, Laboratory __________________________

 

Case code: | _ | _ | _ | _ | _ | _ | _ | _ | _ (county abbreviation / case no./ year – e.g., AB/01/2020)

 

Sample no. __________________________

 

The case code will be kept for future samples collected form the same person.

 

Other categories of individuals: _____________________________

(e.g., cancer patient, resident in a long-term care facility etc.)

 

Name, first name: _____________________________

 

CNP: | _ | _ | _ | _ | _ | _ | _ | _ | _ | _ | _ | _ | _ |

 

Age: (completed years): _________  months (for children under the age of 1 year) ______

                                                        days (for infants under the age of 1 month) _____                 

Mobile phone no. _____________________________

 

Healthcare personnel □

_____________________________

 

Date of onset of the disease: _ _ / _ _ / _ _ _ _

 

Type of specimen:

nasal wash or aspirate □   nasal exudate  □    pharyngeal exudate  □

nasopharyngeal exudate □            sputum □          tracheobronchial aspirate □

bronchoalveolar lavage product  □    necroptic lung material

 

Date of specimen(s) collection:

  • nasal wash or aspirate _ _ / _ _ / _ _ _ _
  • nasal exudate / pharyngeal exudate _ _ / _ _ / _ _ _ _
  • nasopharyngeal exudate _ _ / _ _ / _ _ _ _
  • sputum _ _ / _ _ / _ _ _ _
  • tracheobronchial aspirate _ _ / _ _ / _ _ _ _
  • bronchoalveolar lavage product _ _ / _ _ / _ _ _ _
  • other type of specimen, specify ____________ _ _ / _ _ / _ _ _ _
  • necroptic lung material _ _ / _ _ / _ _ _ _

 

Type of investigation requested: Detection of SARS-CoV-2 by RT-PCR

Date when the sample was sent to the laboratory: _ _ / _ _ / _ _ _ _

Referring physician: _________________________

(signature and stamp)

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HOTĂRÂRE pentru modificarea și completarea anexelor nr. 2 și 3 la Hotărârea Guvernului nr. 553/2020

În textul de mai jos aveți tradusă în limba engleză Hotărârea pentru modificarea și completarea anexelor nr. 2 și 3 la Hotărârea Guvernului nr. 553/2020.

                   Romanian Government hereby adopts this decision.

Art. 1 – Annexes No. 2 and 3 to Government Decision No. 553/2020 on the extension of the state of alert on the Romanian territory as of 17 July 2020, as well as the establishment of the measures to be applied throughout such period to prevent and combat the effects of the COVID-19 pandemic, published in the Official Gazette of Romania, Part I, No. 627 of 16 July 2020 shall be amended and supplemented as follows:


1. Annex No. 2, after Article 11 shall include a new Article, Art. 12, with the following content:


“Art. 12 – (1) In the application of Art. 5 para. (2) letter d) of Law no. 55/2020 on some measures to prevent and combat the effects of COVID-19 pandemic, as further amended, wearing a protective mask, so as to cover the nose and mouth is mandatory for all persons who have reached the age of 5, present in public open places, such as markets, fairs, waiting areas (bus stations, platforms and the like), sea fronts, areas where public celebrations or pilgrimages take place, outer part of tourist attractions, in certain time intervals, established by the decision of the County Committee / Bucharest Municipal Committee for Emergency Situations. The areas and time intervals shall be determined upon the proposal of the Public Health Division, by taking into account the probability of the simultaneous presence of a large number of people in those areas and within those time intervals, where there are difficulties in ensuring the physical distance necessary for health protection established under the law.

(2) The directors / owners of open public places established under para. (1) shall display in a visible place information regarding the obligation to wear a protective mask in those places, upon the request of the County Committee / Bucharest Municipal Committee for Emergency Situations.”

2. Article 2 of Annex No. 2 shall be amended and read as follows:
“Art. 2 – Compliance with the measures set forth in Art. 1 – 12 shall be monitored by the Ministry of Health and the Ministry of Internal Affairs.”

3. Annex No. 3, after item 3 in Article 5 shall include three new items, items 4 – 6, with the following content:

“4. The economic operators carrying out their activity in the areas referred to in item 3, such as terraces, clubs, bars and the like are required to comply with the opening hours and the restrictions established by the decision of the National Committee for Emergency Situations, upon the proposal of the Technical and Scientific Support Working Group for the management of highly contagious diseases on the Romanian territory or of a County Committee / Bucharest Municipal Committee for Emergency Situations.
5. The measures set forth in item 4 shall be established for the administrative and territorial units where there is an intense community spread of the virus and/or an increasing number of persons infected with the SARS-COV-2 virus.
6. The economic operators carrying out their activity in the areas referred to in item 3 are required to take measures to limit the number of customers to the number of seats and any activities involving physical interaction between the customers.”

4. Annex No. 3, after item 4 in Article 8 shall include a new item, item 41, with the following content:
“4.1. The economic operators carrying out gambling activities are required to comply with the opening hours and the restrictions established by the decision of the National Committee for Emergency Situations, upon the proposal of the Technical and Scientific Support Working Group for the management of highly contagious diseases on the Romanian territory or of a County Committee / Bucharest Municipal Committee for Emergency Situations. The measures shall be established for the administrative and territorial units where there is an intense community spread of the virus and/or an increasing number of persons infected with the SARS-COV-2 virus.”

5. Paragraph (15) of Article 10 in Annex No. 3 shall be amended and read as follows:
“(15) The measures set forth in Art. 8 item 4 shall be applied by the Ministry for Economy, Energy and Business Environment and the Ministry of Health. Compliance with the measures set forth in Art. 8 items 4 and 41 shall be monitored by the Ministry of Labour and Social Protection and the Ministry of Internal Affairs.”
Art. 2 – The measures set forth in Article 1 shall become effective upon the publication with the Official Gazette of Romania, Part I.

PRIME MINISTER

LUDOVIC ORBAN

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Hotărârea nr. 37 din 28.07.2020 a Comitetului Național pentru Situații de Urgență – traducere în limba engleză

În textul de mai jos aveți tradusă în limba engleza, hotărârea nr. 37 din 28.07.2020 a CNSU privind constatarea pandemiei de COVID-19 și stabilirea unor măsuri necesar a fi aplicate pentru protecția populației.

ROMANIA

ROMANIAN GOVERNMENT

NATIONAL COMMITTEE FOR EMERGENCY SITUATIONS

DECISION no. 37 dated 28.07.2020

on establishing measures to limit the spread of SARS-CoV-2 infections within spaces/ activities with a high risk of infection

         Being given the proposals from Decision no. 23 dated 24.07.2020, of the Group of technical-scientific support regarding the management of highly contagious diseases on the Romanian territory,

          taking into account the analysis of the risk factors regarding the management of the emergency situation generated by the SARS-CoV-2 virus on the Romanian territory on the date of 28.07.2020, performed at level of the National Centre for Intervention Coordination and Management,

        considering the daily exponential growth of the number of infected persons, mainly in certain areas or localities, that determined a permanent pressure on the capacity of management of administrative-territorial units and the sanitary system,

        in accordance with the provisions of art. 4 para. (1) letter c) and art. 81 of GEO no. 21/2004, on the National System for the Management of Emergency Situations, with the subsequent amendments and completions,

        pursuant to the provisions of art. 5 para. (2) letter (d), para. (3) letter (f) and art. 71 of Law no. 55/2020 on certain measures for the prevention and fight against the effects of COVID-19 pandemic, of art. 20 letter I) of Government Emergency Ordinance no. 21/2004 on the National System for the Management of Emergency Situations, approved with amendments and completions by Law no. 15/2005, with the subsequent amendments and completions, and art. 2 and 4 of Government Decision no. 94/2014 on the organisation, operation and members of the National Committee for Special Emergency Situations,

 

the National Committee for Emergency Situations adopts the present

DECISION:

Art. 1 (1) It is proposed the establishment of the obligation for people present in open public spaces to wear a protective mask, in certain time intervals communicated through a decision of the county committee/ the committee of the municipality of Bucharest for emergency situations, endorsed by the Public Health Directorate.

(2)The spaces and the time frames are established taking into consideration the probable increase in the number of persons present at the same time in the said spaces and time frames, generated by the performance of individual or group activities.

(3)They are excepted from the measure provided for by para. (1) the following categories of persons:

a) the persons who perform intense physical activities and/ or in soliciting conditions of work, such as high temperatures or high humidity;

b) children under the age of 5 years old.

Art. 2 (1) It is proposed the ban on the sale and consumption of food products and alcoholic and non-alcoholic beverages in spaces specially designed for this purpose, arranged outside of the buildings where they are performed the activities of preparation, sale and consumption of food products and alcoholic and non-alcoholic beverages, in the time frame 2300 – 0600.

(2)Besides the time frame set out in para. (1), the economic operators who carry out these activities, have the obligation to take measures to limit the number of clients to the number of seats, as well as any activities that imply the physical interaction between the clients, including dancing.

Art. 3 It is proposed the ban on the activities involving public carried out by the economic operators from the gambling field, in the time frame 2300 – 0600.

Art. 4 It is proposed the amendments of the exception from the rules of physical distancing existing at level of administered and non-administered beaches, in the meaning that the distance of less than 2 meters between people/ sunbeds is allowed solely for spouses and children accompanied by adults (parents, grand-parents).

Art.5 The present decision is communicated to all of the components of the National System for the Management of Emergency Situations, to be enforced by their managers through orders and administrative acts.

PRESIDENT OF THE NATIONAL COMMITTEE FOR EMERGENCY SITUATIONS,

PRIME MINISTER

LUDOVIC ORBAN

 

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Hotărârea nr. 36 din 21.07.2020 a CNSU – tradusă în limba engleză

În textul de mai jos aveți tradusă în limba engleza, hotărârea nr. 36 din 21.07.2020 a CNSU privind constatarea pandemiei de COVID-19 și stabilirea unor măsuri necesar a fi aplicate pentru protecția populației.

R O M A N I A

THE GOVERNMENT OF ROMANIA

NATIONAL COMMITTEE FOR EMERGENCY SITUATIONS

 

DECISION no. 36 of 21.07.2020

on the ascertainment of the COVID-19 pandemic and the establishment of measures necessary to be applied for the protection of the population

 

Considering the declaration of the COVID-19 pandemic worldwide by the World Health Organization on 11.03.2020,

taking into account the proposals expressed by Decision no. 22 of 20.07.2020, of the Technical-Scientific Support Group on the management of highly contagious diseases in Romania,

in accordance with Art. 4 paragraph (1) letter c) and art. 81 of GEO. no. 21/2004 on the National Emergency Management System, with subsequent amendments and completions,

pursuant to the provisions of art. 4 and art. 11 paragraph (1) of Law no. 136/2020 establishing measures in the field of public health in situations of epidemiological and biological risk, of art. 20 letter l) of the Government Emergency Ordinance no. 21/2004 on the National Emergency Management System, approved with amendments and completions by Law no. 15/2005, with the subsequent amendments and completions, and of art. 2 and art. 4 of the Government Decision no. 94/2014 on the organization, functioning and constituents of the National Committee for Special Emergency Situations,

 

The National Committee for Emergency Situations adopts this

 DECISION:

Art.1 The COVID-19 pandemic declared by the World Health Organization on 11.03.2020 is certified.

Art.2 (1) Starting with the date of the present decision, the quarantine measure is established for the persons arriving in Romania from the countries/areas of high epidemiological risk established on the basis of the criterion provided in paragraph 2.

  • The criterion on the basis of which the countries/areas of high epidemiological risk are established is represented by the cumulative incidence rate of new cases of disease in the last 14 days per 100,000 inhabitants, which must be higher than the one recorded in Romania, in a similar period.
  • Based on the criterion provided in paragraph (1), the National Institute of Public Health draws up the list of countries/areas for which the quarantine measure is established for the persons arriving in Romania from them.
  • The list provided in paragraph (3) is updated/reviewed weekly, every Monday, by the National Institute of Public Health and is published on the website insp.gov.ro.

Art.3 The following categories of persons who do not show symptoms associated with COVID-19 are exempted from the measure established according to art. 2, in compliance with the legal provisions in force regarding the use of individual protective materials against COVID-19:

a) the persons who come to Romania from the areas/countries on the list drawn up according to the provisions of art. 2, paragraph (3) but who, before arriving in Romania, have spent a consecutive period of at least 14 days in one or more areas/countries for which this measure is not established;

b) drivers of freight vehicles with a maximum authorized capacity of more than 2.4 tons;

c) drivers of motor vehicles for the transport of persons with more than 9 seats, including the driver’s seat;

d) the drivers provided in letter b) and letter c) who move in the interest of pursuing their profession from their state of residence into another Member State of the European Union or from another state of the European Union into their state of residence, regardless of whether the movement is made by individual means or on their own account;

e) members of the European Parliament, parliamentarians and staff belonging to international institutions and the national system of defense, public order and national security, as well as representatives of Romania in international bodies and organizations to which the Romanian state is a party;

f) aircraft pilots and flight crew;

g) locomotive drivers and railway staff;

h) Romanian maritime and river navigating personnel repatriated by any means of transport, presenting to the competent authorities the “Certificate for International Transport Workers”, a model of which is published in the Official Journal of the European Union, series C, no. 96 I of March 24th, 2020;

i) sea and river navigating personnel carrying out the exchange of crew on board ships located in Romanian ports, regardless of the flag they fly, if at the entry into the country, as well as at the embarkation/disembarkation from the ship, they present to the competent authorities the “Certificate for International Transport Workers”, a model of which is published in the Official Journal of the European Union, series C, no. 96 I of March 24th, 2020;

j)  navigating personnel disembarking from inland waterway vessels, flying the Romanian flag in a Romanian port, provided that the employers provide the Certificate for International Transport Workers and personal protective equipment against COVID-19, during the travel time from the ship to the location where this personnel can be contacted between voyages;

k) cross-border workers entering Romania from Hungary, Bulgaria, Serbia, Ukraine or the Republic of Moldova, as well as Romanian citizens employed by economic operators from the mentioned countries, who upon entering the country prove the contractual relations with the respective economic operators;

l) employees of the Romanian economic operators who perform works, according to the concluded contracts, outside the Romanian territory, upon their return to the country, if they prove the contractual relations with the beneficiary outside the national territory;

m) the representatives of the foreign companies that have subsidiaries/branches/representations or agencies on the national territory, if at the entrance on the Romanian territory they prove the contractual relations with the economic entities located on the national territory;

n) persons entering Romania for activities of use, installation, commissioning, maintenance, service of equipment and technology in the medical, scientific, economic, defense, public order and national security, transport fields, as well as persons carrying out professional activities specific in the mentioned fields, if they prove the contractual/collaboration relations with the beneficiary/beneficiaries on the Romanian territory, as well as the inspectors of the international bodies;

o) members of diplomatic missions, consular offices and other diplomatic missions accredited in Bucharest, holders of diplomatic passports, staff assimilated to diplomatic staff, as well as members of the Romanian Diplomatic and Consular Corps and holders of diplomatic and service passports, as well as members of their families;

p) employees of the national system of defense, public order and national security who return to Romania from missions carried out abroad;

q) pupils, students, Romanian citizens or citizens with domicile or residence outside Romania, who have to take entrance exams or final exams to complete their studies, who start their studies in educational units/institutions on the territory of the country or travel for activities related to the completion/organization of the beginning of their studies;

r) members of international sports delegations participating in sports competitions organized in Romania, in accordance with the law.

Art.4 The measure of quarantine of persons who have come into direct contact with infected persons is established, which is ordered for each individual person by decision of the Public Health Directorate competent in each area.

Art.5 (1) For special situations involving participation in family events related to birth, marriage or death, travel for medical interventions/treatments in cases that cannot be postponed (e.g. oncological diseases, chronic renal failure – in hemodialysis program), change of identity documents, leaving the country, etc., the temporary suspension of the quarantine measure provided in art. 2 and art. 4 may be analyzed, based on supporting documents.

(2)The analysis of the situations provided in paragraph (1) is carried out at the level of the county centers for coordination and management of the intervention and, the cases considered as justified, may be subject to the temporary suspension of the quarantine measure, by individual decision, issued by the Public Health Directorate.

(3)The suspension decision shall mandatorily mention the time period for which it applies and the measures to prevent the spread of the new SARS-CoV-2 coronavirus.

Art.6 It is proposed to complete the Government Decision no. 553/2020 on the extension of the alert status on the Romanian territory starting with 17.07.2020, as well as the establishment of measures to be applied during it to prevent and combat the effects of the COVID-19 pandemic, with measures regarding the possibility of establishing isolation and quarantine on persons or zonal quarantine.

Art.7 This decision is communicated to all components of the National Emergency Management System, for implementation by administrative orders and acts of their managers.

PRESIDENT OF THE NATIONAL EMERGENCY COMMITTEE

PRIME MINISTER

 

LUDOVIC ORBAN

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Traducere certificată de teste Covid 19

Trimite-ne testul, noi îl vom traduce și autoriza, în cel mai scurt timp.

Putem să ne auzim la telefon 0722223010 sau pe email la info@babylonconsult.ro .

Gama lingvistică pe care o acoperă Babylon Consult numără peste 30 de limbi, inclusiv combinații dintre acestea:

Limbi de largă circulaţie:

Engleză, Franceză, Germană, Italiană, Spaniolă, Rusă;

Alte limbi străine:

Albaneză, Arabă, Bulgară, Cehă, Chineză, Croată, Daneză, Ebraică, Finlandeză, Greacă, Georgiană, Japoneză, Latină, Macedoneană, Maghiară, Norvegiană, Olandeză, Persană, Polonă, Portugheză, Sârbă, Slovacă, Suedeză, Turcă, Ucraineană, Vietnameză.

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9SOS pentru iOS și Android

Aplicația de mobil 9sos este modalitatea prin care fiecare utilizator își declară starea de sănătate pe proprie răspundere și se automonitorizează.

Serviciul 9SOS a fost înființat în 20 martie 2020 de către mai mulți membrii Romanian Business Leaders împreună cu As. Open Knowledge și e oferit spre utilizare Statului Român prin Ministerul Sănătății, Directia de Sănătate Publică Brașov.

Pe lângă metoda de contact telefonic prin Call Center și CRM Medical, am dezvoltat aplicația 9SOS pentru iOS și Android care permite auto-monitorizarea simptomelor și facilitează accesul în spații publice.

Aplicația este localizată în limba Română, Engleză și Maghiară.

DACĂ apar simptome, acestea pot fi evaluate în scurt timp și detaliile pot fi transmise către, medicul dvs. de familie, DSP sau spital in momentul evaluării / anchetei epidemiologice.

Mai mult, veți fi contactat și notificat dacă ați fost într-o zonă unde s-a descoperit un focar Covid-19.

Conform legii, atunci când intrați în spații publice vă sunt preluate anumite date de contact cum ar fi nume, prenume, număr de telefon, email.

Dacă folosiți aplicația 9SOS, persoana care permite accesul în incintă vă scanează codul QR și sunt preluate doar câteva informații sumare Prenume, Inițială Nume, nivel risc declarat, data si ora de acces, protejându-vă datele cu caracter personal.

Mai mult, puteți și dumneavoastră să vă scanați prietenii, construind o listă de contacte directe.

Dacă sunt evenimente epidemiologice, Direcția de Sănătate Publică va putea să facă ancheta epidemiologică mai ușor și veți fi alertat(ă) în cazul în care ați putea fi la risc datorită contactelor directe cu persoane suspecte sau confirmate pozitiv Covid-19.

https://www.9sos.ro/administrativ/donatii/

https://www.9sos.ro/voluntariat/cum-pot-fi-voluntar-9sos/

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Avantajele interpretării simultane online

 

Zoom a devenit o parte importantă a vieții noastre în timpul blocajului global. Familiile, prietenii, profesorii, școlile, agențiile guvernamentale și corporațiile private folosesc Zoom zilnic.

Pentru noi, firmele de traduceri, Zoom oferă o altă mare posibilitate:

– serviciile de traducere simultană la distanță.

Dacă aveți un cont Zoom plătit (cont minim Pro, plus un pachet webinar), puteți adăuga traducerea simultană la întâlnirile dvs.

Setările avansate ale Zoom pot fi complicate și dacă nu aveți timp să urmați toți pașii, trebuie doar să anunțați echipa Babylon Consult pentru a solicita asistență profesională.

Biroul nostru vă oferă unii dintre cei mai buni interpreți de conferință din țară.

Avantajele sunt evidente:

– toată lumea folosește Zoom.

– traducere simultană disponibilă în confortul casei sau al biroului.

– acest serviciu este ideal atunci când nu este posibil să aveți un interpret la fața locului / în persoană, dar doriți totuși să aveți o conexiune vizuală cu interpretul.

Cerințe cheie:

– internet în bandă largă – minimum 5 mega biți pe secundă.

– un computer foarte bun – i7 sau MacBook Pro.

– microfon de cască cu calitate ridicată, de conferință, care anulează zgomotul.

– plan de rezervă (un al doilea computer, o a doua conexiune la internet și o a doua cască).

Zoom este în prezent una dintre puținele aplicații care permit traducerea simultană.

Există și alte aplicații care pot fi folosite pentru a beneficia de traducere simultană.

În această perioadă traducătorii noștri au lucrat și pe aplicația Google Meet și se țin la curent cu noile tehnologii.

Interpretarea simultană la distanță nu este un substitut pentru interpretarea la fața locului, întrucât videoconferința nu este o adevărată alternativă a unui eveniment profesionist, organizat în hoteluri sau locuri de conferință.

Speranța noastră este să depășim aceste momente dificile cât mai repede și să revenim  la circumstanțe normale.

Până atunci, Babylon Consult rămâne angajată să ajute la eliminarea barierelor lingvistice, prin utilizarea tehnologiilor disponibile.

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Secrete în învățarea unei limbi străine de la 5 experți lingviști internaționali

 

Să înveți o limbă străină, ca orice altă aptitudine, a fost deja predată de experți lingviști din întreaga lume. Prin imitarea cuiva care a reușit, putem învăța din greșelile acestuia și putem obține ce ne dorim mai repede.

Mai jos ai câteva dintre cele mai bine păstrate secrete în ale învățării unei limbi străine de la 5 experți lingviști internaționali.

1. Nu căuta fiecare cuvânt. 

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„Vor fi momente când vei simți nevoia să știi semnificația unui cuvânt anume. Este în regulă, dar dacă te vei opri să cauți semnificația fiecărui cuvânt, nu vei ajunge nicăieri. În schimb, caută numai cuvintele care par să apară mai des decât altele – ele vor fi cheia întelegerii unui text.” – Olly Richards, iwillteachyoualanguage.com

2. Portă-te ca un copil.

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“Ideea că în copilărie suntem în mod inerent mai buni la a învăța decât adulții se dovedește a fi un mit.

Studiile din ultima vreme nu găsesc o legătura directă dintre vârstă și capacitatea de a învăța.

Cheia învățării rapide ca un copil este o anumită atitudine copilărească: de exemplu, lipsa inhibițiilor, o dorință de a te juca și de a accepta greșelile”- Matthew Youlden, fluent în 9 limbi

3. Învață 625 cuvinte de bază: folosind poze, nu traduceri. 

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 „Pentru început sugerez să incepi cu cele mai comune cuvinte, pentru a-ți optimiza timpul.

Aceasta este regula 80/20 în acțiune; de ce să înveți “nepoată” la început când vei avea nevoie de “mamă” de opt ori mai des?” – Gabriel Wyner, autorul Fluent Forever

4. Permite tehnologiei să te ajute. 

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“Dmitrochenkova a avut o idee grozavă: “Un lucru amuzant ca resetarea limbii de pe telefonul tău te poate ajuta să înveți noi cuvinte imediat”.

La fel și schimbarea limbii browser-ului tău. Sau poți căuta alte oportunități de învățare online.

Traducatorul olandez Els De Keyser recomandă Anki pentru memorarea vocabularului”-– Krystian Aparta, TED.com

5. Conversație, Conversație, Conversație.

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“Dacă există un “secret” sau un “hack” în a învăța o limbă nouă, este acesta: ore peste ore de conversații incomode și intense cu oameni mai buni decăt tine în acea limbă.

O oră de conversație este la fel de bună ca 5 ore într-o clasă și 10 ore cu un curs de limbă străină de unul singur.” – Mark Manson, autorul Models: Attract Women Through Honesty

 

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Declarație stare de alertă

DECLARAȚIE PE PROPRIE RĂSPUNDERE

DECLARATION ON OWN RESPONSIBILITY

DÉCLARATION SOUS SERMENT

Nume, prenume:

_________________

Data nașterii:

_________________

Adresa locuinței:

________________

Se va completa adresa locuinței în care persoana locuiește în fapt, indiferent dacă este identică sau nu cu cea menționată în actul de identitate.

Locul/locurile deplasării:

________________________________________

Se vor menționa locurile în care persoana se deplasează, în ordinea în care aceasta intenționează să-și desfășoare traseul.

Motivul deplasării în afara localității / zonei metropolitane:

interes profesional, inclusiv între locuință/gospodărie și locul/locurile de desfășurare a activității profesionale și înapoi;

în scop umanitar sau de voluntariat;

realizarea de activități agricole;

pentru comercializarea de produse agroalimentare de către producătorii agricoli;

îngrijirea sau administrarea unei proprietăți din altă localitate; eliberarea de documente necesare pentru obținerea unor drepturi;

participarea la programe sau proceduri în centrele de tratament;

asistență medicală care nu poate fi amânată și nici realizată de la distanță;

activități recreativ-sportive individuale desfășurate în aer liber (ciclism, drumeție, alergare, canotaj, alpinism, vânătoare, pescuit și altele) cu participarea a cel mult 3 persoane;

participarea la evenimente familiale, cu un număr limitat de persoane și respectarea regulilor de distanțare socială;

pentru achiziția, service-ul, efectuarea ITP sau alte operațiuni de întreținere a vehiculelor, activități care nu pot fi efectuate în localitatea de domiciliu;

alte motive justificate (precum: îngrijirea/însoțirea copiilor/membrilor de familie; îngrijirea unei rude/afin sau persoană aflată în întreținere; asistența persoanelor vârstnice, bolnave sau cu dizabilități; deces al unui membru de familie).

 Data

 …………………………….

Semnătura

…………………………………

Surname, name: ____________________

Date of birth:

____________________

Home address: ___________________

To be filled in the address of the place where the declarant lives, irrespective whether it is the same or not with the address from the identity card.

Place/ places where the declarant travels to:

________________________________________

To be mentioned the places where the declarant travels to, according to the itinerary of the declarant.

Reasons for travelling out of the locality/ metropolitan area:

professional interest, including between the home address/ household and the place/ places where the professional activity is carried out and back;

humanitarian or volunteering purposes;

to perform agricultural activities;

the trade of agricultural products by agricultural producers;

the maintenance or the administration of a property from a different locality; the issuance of the necessary documents to obtain some rights;

to participate in programmes or procedures carried out in treatment centres;

medical assistance that cannot be postponed or performed remotely;

individual recreational and physical activities outdoors (cycling, hiking, running, rowing, rock climbing, hunting, fishing and others) in groups of maximum 3 persons;

to take part in family events, with a limited number of persons and in compliance with the social distancing rules;

for the purchase, service, periodical technical inspection or other maintenance operations of vehicles, activities that cannot be performed in the home locality;

other justified reasons (such as: to provide care/ attend children/ family members; to provide care to a relative/ in-law or a dependent person; to provide assistance to an elder, sick or disabled person; in case of death of a family member). 

Date

…………………………..

Signature …………………………………

Nom, prénom :

___________________

Date de naissance:

____________________

Adresse personnelle :

____________________

À compléter avec l’adresse personnelle ou le/la déclarant/e habite effectivement, n’importe pas si cette adresse est la même ou non, avec l’adresse mentionnée sur la carte d’identité.

Lieu/lieux où le/la déclarant/e voyage :

________________________________________

À mentionner les lieux ou le/la déclarant/e voyage, dans l’ordre de son itinéraire.

La raison du voyage hors de la localité/ zone métropolitaine :

pour un intérêt professionnel, y compris entre le logement/ foyer et le lieu/ les lieux où l’activité professionnelle est déroulée et retour ;

à des fins humanitaires ou de volontariat ;

pour dérouler des travaux agricoles ;

pour la vente de produits agroalimentaires par les producteurs agricoles ;

pour l’entretien ou l’administration d’une propriété qui se trouve dans une autre localité ; la délivrance des documents nécessaires pour obtenir certains droits ;

pour participer aux programmes ou aux procédures déroulées dans les centres de traitement ;

pour l’assistance médicale qui ne peut pas être différée, ou effectuée à distance ;

pour des activités récréatives et sportives individuelles en air libre (cyclisme, marche, course, canoë, escalade, chasse, pêche et autres) en groupes de maximum 3 personnes ;

pour participer aux évènements de famille, avec un numéro limite de personnes, et en conformité avec les règles de distance sociale ;

pour l’achat, le service, l’inspection technique périodique ou autres opérations de maintenance des véhicules, activités qui ne peuvent pas être déroulées dans la localité ou le déclarant/la déclarante habite ;

autres raisons justifiées (telles que : pour fournir des soins/ accompagner les enfants/ membres de famille ; pour fournir des soins à un membre de famille/ belle-famille ou à une personne dépendante ; pour fournir de l’assistance aux personnes âgées, malades ou invalides ; en cas de décès d’un membre de la famille).

Date   

………………………….

Signature

…………………………………

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Angajatul dumneavoastră vă poate efectua traducerile?

Există câteva motive întemeiate pentru a opta ca angajații dumneavoastră să vă gestioneze traducerile.

Angajații din firmă înțeleg jargonul firmei și termenii folosiți în industrie, sunt accesibili, deci îi puteți pune să facă traduceri. Înainte de a face această alegere, există câteva elemente suplimentare pe care să le aveți în vedere.

1 – Scăderea productivității

Comparativ cu lucrările făcute în mod obișnuit, angajatul propriu are nevoie de timp suplimentar pentru a oferi o traducere de calitate, una care surprinde pe deplin semnificația unui mesaj și pentru a stiliza comunicarea.

Angajații care petrec timpul traducând, au mai puțin timp la dispoziție pentru a-l dedica responsabilităților lor principale, cu valoare adăugată.

2 – Calificarea traducătorului/verificatorului

În cazul în care angajatul nu este un bun cunoscător al limbii respective, nu are formare în ceea ce privește gramatica și stilul, calitatea traducerii dvs. va fi compromisă și veți cheltui mai mulți bani fie prin pierderea unor contracte sau corectarea documentelor “traduse”. Vă asumați riscul unor greșeli, atât în semnificația cât și în limbajul mesajului?

Un astfel de exemplu este un angajat care a verificat unul din documentele traduse de către un profesionist, și a înlocuit cuvinte cu unele care erau pur și simplu greșite. Atunci când traducătorul nostru nativ, doctor în domeniu, a citit modificările verificatorului intern, a fost capabil să explice de ce acestea erau greșite și să ofere dovezi pentru folosirea termenilor inițiali.

3 – Adaptarea culturală

Traducătorul trebuie să înțeleagă pe deplin ambele culturi și limbaje, pentru a realiza o traducere corectă, adaptată cultural și adecvată domeniului. Când ceva nu corespunde, acesta înțelege motivul și transmite clientului soluții de corecție.

4 – Clarificarea cuvintelor cu sens dublu

Dacă angajații dumneavoastră nu sunt traducători profesioniști, nu vor ști cum sau când să solicite clarificări.

De exemplu, când citesc ceva ce ar putea avea sens dublu, este posibil să nu vă întrebe sensul preferat. Alegând pur și simplu o semnificație, documentul ar putea transmite un mesaj denaturat și incorect.

5 – Controlul calității

Este important să aveți întotdeauna o persoană suplimentară care să verifice traducerile.

Dacă traducerea este realizată de către angajați interni, cine o va verifica?

Traducerea e bine să fie efectuată de către un traducător profesionist, iar apoi aceasta să fie verificată tehnic de către angajații dumneavoastră, pentru a surprinde orice elemente specifice ale societății sau orice termeni specifici industriei.

Acest lucru se poate face relativ repede, cu o întrerupere minimă a responsabilităților esențiale.

6 – Controlul versiunii

Dacă un angajat efectuează traducerile și are documentul original pe calculatorul său, ce se întâmplă dacă altcineva îl editează și păstrează această versiune pe calculatorul său?

Este bine să aveți o procedură și un proces de stocare centralizată în care toate versiunile finale să fie păstrate, pentru a fi ușor de accesat și verificat de către traducătorul profesionist atunci când se fac modificări.

7 – Specializarea

Așa cum nu o să solicitați vreodată unui redactor tehnic să vă scrie materialul de marketing, trebuie să vă gândiți și la cine vă efectuează traducerile.

Nu ați vrea ca un tehnician auto să vă traducă broșura de marketing pentru un echipament dentar, deoarece s-ar putea să nu utilizeze tonul corect, ar putea omite mesajul comercial pe care doriți să-l transmiteți sau sa traducă mecanic necunoscând domeniul.

Fiind o agenție profesionistă de traducere, ne gândim bine la momentul alegerii persoanei care să efectueze o traducere, domeniile în care a mai tradus, specializarile academice și satisfacția clienților anteriori.

Dacă alegeți pur și simplu un angajat pentru această sarcină deoarece “știe” limba, este posibil să vă confruntați cu niște probleme financiare, juridice sau de imagine.

Alegerea persoanei care să efectueze traducerea

Țineți cont întotdeauna de randamentul investițiilor atunci când alegeți traducătorul.

Iată câțiva factori care vă vor ajuta să luați o decizie în cunoștință de cauză:

1. Cât de esențiale sunt documentele traduse pentru câștigurile dumneavoastră?
2. Dacă documentul tradus va fi utilizat în scop comercial, sau dacă este ceva care vă poate afecta brand-ul, cel mai bine este să angajați un traducător profesionist care vă înțelege nevoile și știe cum să ofere cele mai bune și mai rentabile rezultate.
3. Eventualele responsabilități.
4. Orice documente legale, precum contractele, acordurile sau comunicatele  pot atrage posibile răspunderi și pot duce la un caz juridic.
5. Traducătorii care sunt experți în domeniul juridic vă pot ajuta să abordați orice situații precum alegerea limbii care este cel mai probabil să aibă întâietate dacă există întrebări cu privire la traducere.
6. Valoarea acurateței.
7. Traducătorii cu pregătire profesională vă pot asigura punctuația, gramatica și alegerea corectă a cuvintelor, astfel încât brand-ul dvs. să fie bine reprezentat pe piață.
8. Responsabilitate pentru controlul versiunii.