Klaus Iohannis Report: Not even a quarter of hospitals report nosocomial infections in a pandemic | News, News Romania | Freedom

“I also saw that DSP reported zero and I did not understand what they did. I called the INSP and they told me that the DSPs did not give the data, they said zero. And I said:” And do you stop here? Why don’t you ask the hospitals? That’s why I sent people to hospitals. ”

Nelu Tătaru, Minister of Health:

• After eight months of pandemic, Minister Nelu Tătaru is surprised that hospitals and DSPs have forgotten about the surveillance system for infections associated with the medical act. According to the minister: “There were cases in which, to the deaths of COVID, the analyzes of other nosocomial infections were not carried out”

On Wednesday, October 21, in the second conference of the same week organized by the president, Libertatea again asked about the number of nosocomial infections in patients hospitalized for COVID-19. This was after the Ministry of Health officially said that the DSPs reported zero nosocomial infections. We publish the response of the Ministry of Health for the newspaper in facsimile, at the end of this article.

80 hospitals out of 374 enter information into the system, voluntarily

Half of this information comes from the computer platform of the National Authority for Health Quality Management. Here, hospitals voluntarily enter data on adverse events associated with healthcare, a category that also includes nosocomial infections (in fact, half of the reported adverse events are nosocomial infections).

Precisely because the report here is done on a voluntary basis, the platform usually radiographs a small number of all nosocomial infections that affect hospitalized patients in Romania.

“In Romania there are 374 public hospitals and 290 private, and in the ANMCS platform only about 80 hospitals”, says Minister Nelu Tătaru, “reported, in the eight months of the pandemic, cases of nosocomial infection”. This despite the fact that nosocomial infections are a reality in any hospital, at any time, even in the cleanest institutions in the medical world.

What does the data show?

How representative are the ANMCS reports? On the ANMCS platform, 211 cases of infection by the new coronavirus transmitted in medical units were reported, while the INSP has more than 4,500 of these cases, centralizing the data in DSP sources.

However, to date, this is the only official document that counts some of the nosocomial infections in COVID-19 hospitals and COVID support hospitals, which is why we detail the information in the report given to Liberty by President Iohannis.

Between March 1 and September 30, 2020, so in seven months of pandemic, the ANMCS platform reported:

• 1,356 infections associated with the medical act
• 274 of them took place in COVID hospitals
• 557 nosocomial infections in COVID support hospitals
• and the rest, 525, in non-COVID hospitals.

ANMCS DOCUMENT – Note on reported infections:

These hospitals have not always exclusively treated COVID patients, so we cannot say that all of these nosocomial infections have been detected in COVID-19 patients. But we can say with certainty that Romanian hospitals have reported hundreds of infections in COVID-19 patients.

ANMCS is a public institution operating under the government and coordination of the Prime Minister.

Who is responsible?

In Romania, the surveillance system for infections associated with the law is run by the Ministry of Health, through the National Institute of Public Health.

The INSP collects information from the regional public health centers, where the data from the DSPs arrive, which in turn receive from the hospitals.

During the pandemic, this system did not work at all, which motivated the response that Libertatea received this Monday from the Ministry of Health and the National Institute of Public Health:

“We inform you that, so far, the Public Health Directorates have not reported, in the surveillance, prevention and limitation of infections associated with health care in health facilities, no case of death from Covid-19 and no case of infection associated with health care in patients diagnosed with Covid-19 ”.

Life or death information missing from Iohannis report

Despite the information provided by the ANMCS, neither the President’s institution nor the Ministry of Health can answer the following questions today:

• How many of those killed by COVID-19 in Romania had taken the infection from the hospital, being already hospitalized for something else?
• How many of the COVID-19 patients in Romania received nosocomial infections with other viruses or bacteria during hospitalization?

How does Nelu Tătaru explain that the ministry he directs does not have up-to-date data on nosocomial infections?

The newspaper discussed with the Minister of Health how the surveillance system for infections associated with the medical act has been neglected, although these are one of the most important public health problems in recent years in Romania.

– Minister, why is there not an updated situation of nosocomial infections?
– I also saw that DSP reported zero and I did not understand what they did. I called the INSP and they told me that the DSPs did not give the data, they said zero. And I said, “And you stop here? Why don’t you ask the hospitals? That’s why I sent people to the hospitals.

“And what did they discover?”
– I started two days ago. Some hospitals had not reported infections in January, Harghita, for example. Others, Sibiu, for example, were up to date, with 309 infections reported since the beginning of the year.

– How long will the report take, when will people have the reality?
– You realize that there are 374 public hospitals and 290 private. I started with the publics.

Honestly, I can’t give you a deadline. For now, we have seen what Libertatea wrote, we have sent President Klaus Iohannis what data exists, those of outbreaks and those voluntarily reported by some 80 hospitals. And we will collect the data, hospital by hospital.

Nelu Tătaru:

– When you say COVID outbreak, do you mean people who took the coronavirus in hospitals?
– Yes. Whether they are patients or employees.

– What you gave the president can’t make that difference, can it?
– No, You can not. But we will, we will know how many patients have been infected with COVID in the hospital, how many members of the medical staff, but only after we take him to the hospital. But it takes time.

“Honestly, what won’t we have?”
– We do not know how many hospitals have actually made the situation of nosocomial infections during this period …

– Okay, they were very busy, but it is vital that they know them themselves, the law requires them!
– That’s right, but they weren’t used to it either. This is the truth. There were cases in which, in the case of deaths from COVID, analyzes for other nosocomial infections were not performed.

Where were the outbreaks in the medical system? County hospitals and psychiatric hospitals are more likely to reach COVID-19 outbreaks

Of the 1,356 infections associated with the medical act, reported on the ANMCS platform, 211 were SARS CoV-2 infections:

• -39 cases in COVID hospitals
• -110 in non-COVID hospitals
• -62 cases in COVID support hospitals.

DOCUMENT Ministry of Health – Outbreaks in medical units:

In other words, the risk of contracting the new coronavirus from the hospital seems, according to the ANCMS data, so high, regardless of whether the hospital is dedicated to COVID or not.

The report sent to the newspaper’s readers by President Iohannis also includes a centralization of the COVID-19 outbreaks in the medical system. This time the source of information is the National Institute of Public Health.

Counties such as Iasi, Bucharest-Ilfov, Brasov, and Prahova top the counties that reported the most nosocomial COVID-19 cases. In Iasi alone, there were 470 cases of COVID-19 in health system outbreaks. At the opposite pole is Vrancea, which reported a single outbreak with 5 cases in a medical unit.

87 outbreaks occurred in county hospitals and resulted in 856 COVID-19 cases. Additionally, 20 outbreaks in psychiatric hospitals (36 in total) resulted in 603 cases of COVID-19. A total of 23 dialysis centers became outbreaks of COVID-19, leading to 244 new cases of COVID-19.

The list of outbreaks in medical institutions also includes

• 8 outbreaks in ambulance services, with 49 cases
• 3 outbreaks in institutes, with 38 cases
• 3 outbreaks in recovery centers, with 32 cases
• 2 outbreaks in pediatric hospitals
• a maternity ward
• an oncology center.

Response of the Ministry of Health to Freedom: