Public Perception of the First Major SARS-Cov-2 Outbreak in the Suceava County, Romania

COVID-19 Vaccination in Romania and the Benefits of the National Electronic Registry of Vaccinations

BACKGROUND

Recording real-time data of vaccinations performed, vaccine stocks, and adverse events following immunization is a particularly useful activity in the effective development of any vaccination campaign or vaccination program, guiding the decisions of public health authorities. The aim of this paper is to present the benefits of the National Electronic Registry of Vaccinations in providing useful information for the optimization of healthcare vaccination policies, specifically related to COVID-19 vaccination.

METHODS

We performed a descriptive study using data available in the reports generated from the National Electronic Registry of Vaccinations regarding COVID-19 vaccinations performed between 27 December 2020 and 31 December 2021.

RESULTS

A total of 27,980,270 doses of the COVID-19 vaccine were distributed. Of these, 15,757,638 (56%) were administered in 4545 vaccination centers: 7,882,458 as the 1st dose (50%), 5,878,698 as the 2nd dose (37%), and 1,996,482 as the 3rd dose (13%). More than 25% of the total doses were administered to people over 65 years of age. A total of 41% of the population received at least one dose of the COVID-19 vaccine. A total of 4083 adverse events following immunization were reported.

CONCLUSIONS

The existence of a National Electronic Registry of Vaccinations containing accurate information on vaccinations performed in Romania offers the opportunity to obtain a clear picture of vaccination status that will significantly contribute to the optimization of vaccination strategies and programs.

Evaluation of Non-Pharmacological Measures Implemented in the Management of the COVID-19 Pandemic in Romania

The management of the COVID-19 pandemic in Romania has included the involvement of not only the medical system, but also that of the administrative and social services. All these organizations are working together to lower the impact on the health of the general population, to increase the health system’s response capabilities and even to diminish the negative effects upon the economy due to the epidemic’s length. Therefore, non-pharmacological measures (NPMs) imposed through restrictive measures (administrative, economic and individual) have influenced the evolution of morbidity and mortality. Even from the first months of the pandemic’s progression, researchers have shown the impact of the NPMs’ existence, as there were many studies on all NPMs in conjunction, as well as those targeting specific measures such as school closures. Our study started by establishing a temporal relationship between the non-pharmacological measures found in most countries (wearing a mask, washing hands and physical distancing, limiting economic activities, closing schools, limiting internal and international movement, banning public and private events in closed spaces) and the evolution of the pandemic in Romania. The degree of novelty brought by this study consists of extending the analysis to the pre-existing state of the health system and to the measures meant to increase the resilience of the population, as well as to the measures aimed at reducing the type of risk, and factors that can equally influence the evolution of the number of cases. The results of the statistical analysis show the important effects of certain NPMs (mask mandates, online schooling, decisions regarding imposing or lifting local restrictions) as well as the reduced impact of other measures (hand disinfection, social distancing or the restriction of public and private events). Hence, it can be concluded that during such pandemics, implementing quick, simple measures can prevent the spread of the disease and help fight the contagion in a better manner.

Modelers of students’ entrepreneurial intention during the COVID-19 pandemic and post-pandemic times: The role of entrepreneurial university environment

This paper examines the shaping factors, drivers, and impact credentials of students’ entrepreneurial intention during the COVID-19 pandemic. The proposed framework addresses the antecedents of entrepreneurial intention among students in Romania, focusing on three focal constructs, namely, risk-taking, proactiveness, and innovativeness, with a keen focus on the mediation effect of the entrepreneurial university environment. The study used self-reported data collected through an online questionnaire during November 2020–February 2021 from a sample of 1,411 students in western Romania. The methodology relies on two modern techniques of modeling cross-sectional data, namely, structural equation modeling (SEM) and Gaussian graphical models (GGMs). The main results highlight that the three constructs positively relate to students’ entrepreneurial intention in a comprehensive framework where the entrepreneurial university environment drives innovativeness. The paper brings forward, in an innovative way, that entrepreneurship education and training at the university level enhance students’ entrepreneurial intentions as it fosters the attainment of advanced knowledge and skills. The results are well associated with the start-up process as prerequisites for successful entrepreneurship engagement of youth in a globalized digital economy, particularly during this challenging pandemic outbreak, but also post-pandemic times. This research sheds new light on the essential role played by higher education institutions in providing advanced knowledge and necessary skills matched with the labor market needs, thus enhancing students’ innovativeness and their entrepreneurial intentions.

The COVID-19 Pandemic in Romania: A Comparative Description with Its Border Countries

The COVID-19 pandemic continues to be a major public health problem in most countries of the world, especially in developing countries with an underfunded healthcare system. We aim to present a comparative profile of the epidemiological characteristics of the COVID-19 pandemic in Romania and neighboring countries, which have similar onset and a similar socio-cultural pattern. A descriptive comparative study was performed using COVID-19 data collected from various official websites regarding demography, morbidity, mortality, vaccination, and testing capacity. The countries included in the study were Romania, Bulgaria, Hungary, Republic of Moldova, Serbia, and Ukraine. The study period was from week 09/2020 to week 46/2021. Overall, these countries have reported 8,382,441 cases and 216,014 deaths (during the study period). The highest cumulative incidence rate of cases has been recorded in Serbia (17,801.5) and the highest mortality rate has been recorded in Bulgaria (391.0). Romania is in fourth place regarding the cumulative incidence rate of cases/100,000 inhabitants but in third place regarding the mortality due to COVID-19 (case–fatality rate of 3.1%). Although the World Health Organization and EU co-ordinate the COVID-19 response, each state makes its own decisions regarding SARS-CoV-2 mitigation measures, the epidemiological indicators directing us about the effectiveness of responses.

Challenges and Drawbacks of the EU Medical System Generated by the COVID-19 Pandemic in the Field of Health Systems' Digitalization

The COVID-19 pandemic and the digitalization of medical services present significant challenges for the medical sector of the European Union, with profound implications for health systems and the provision of high-performance public health services. The sustainability and resilience of health systems are based on the introduction of information and communication technology in health processes and services, eliminating the vulnerability that can have significant consequences for health, social cohesion, and economic progress. This research aims to assess the impact of digitalization on several dimensions of health, introducing specific implications of the COVID-19 pandemic. The research methodology consists of three procedures: cluster analysis performed through vector quantization, agglomerative clustering, and an analytical approach consisting of data mapping. The main results highlight the importance of effective national responses and provide recommendations, various priorities, and objectives to strengthen health systems at the European level. Finally, the results reveal the need to reduce the gaps between the EU member states and a new approach to policy, governance, investment, health spending, and the performing provision of digital services.

Social Cohesion and Community Resilience during the COVID-19 Pandemic in Northern Romania

The COVID-19 pandemic and the lock-down have highlighted the growing awareness of the need to involve the population in solving problems that directly affect the existence and trajectory of the life of the individual and civil society in the local, national, and regional context. The article aims both to analyze the reaction of formal and informal civil society in a context of major crisis and to analyze how the population perceives the involvement of civil society at the level of a county in Romania and its county seat city. The present sociological diagnosis used data that were collected through an online survey at the beginning of May 2020 among the population of Suceava County. It was sought to identify how the reaction of civil society was perceived and how it was mobilized, as well as how the mass media contributed to reducing the effects of the pandemic. After the elimination phase of non-compliant responses, the volume of the sample included a total of 1231 people. The results of the study indicate that this pandemic context, which manifested as a major crisis, also had positive effects in the sense of mobilizing latent but extensive energies at the local level, whose manifestation contributed to diminishing and limiting the effects of the sanitary crisis the county faced. The media, as a component of civil society, has managed to mobilize important segments of the population, both in quarantined localities and in other localities in Suceava County and Moldova. The COVID-19 crisis tested the social cohesion and resilience of communities and offered perhaps one of the most remarkable lessons of solidarity in the post-December period, both locally and nationally. Although the perception of Romanians on the role of civil society would rather be part of a culture of individualism, in extreme situations it was found that its activity has never been more important.

The Impact of COVID-19 on Behavior and Physical and Mental Health of Romanian College Students

Background and Objectives: The COVID-19 pandemic caused by SARS-CoV-2 significantly marked people’s lives with respect to their behavior, and their physical and mental health. Materials and Methods: This is a cross-sectional study that was conducted in 2021 for a period of 5 months. The study sample included 218 students from the College of Physical Education and Sports of the University of Suceava who filled in a questionnaire on mental, physical and behavioral symptoms caused by the COVID-19 pandemic, as well as the Anxiety Assessment Questionnaire (STAI). Results: The responses indicated increased anxiety, physical symptoms, altered behavior, and increased perception of social restrictions. Regression analyses indicated that the levels of anxiety during the COVID-19 outbreak were strongly correlated with cognitive, physical and behavioral symptoms of the students. These were influenced by the living arrangements, location (urban vs. rural), age group and study year. Conclusions: The results show that first-year students did not exhibit significant physical and cognitive symptoms despite reporting anxiety, probably due to their enthusiasm as beginners. The 3rd year students were prone to anxiety and reported cognitive symptoms, possibly due to the prospects of an uncertain future.

Post-Lockdown Effects on Students' Mental Health in Romania: Perceived Stress, Missing Daily Social Interactions, and Boredom Proneness

The rapid spread of COVID-19 worldwide was accompanied by intense fears, confusion, worries, anger, and stress threatening people's mental health. Unprecedented measures to slow down and prevent the transmission of COVID-19 have had various impacts on the population's health behaviour and mental health. The main purpose of the present study is to investigate the lockdown's effects on university students' mental health in Romania. Based on a cross-sectional design, the survey data were collected from a sample of 722 participants (247 males; M = 21.1 years; SD ± 1.73). A path analysis was performed to verify the hypothesised direct and indirect effects included in the multiple mediation model. The findings showed a positive association between stress and boredom proneness, missing daily social interactions, spending more time on phone conversations, and the increasing interest in following news about the pandemic. The path analysis revealed an excellent fit between the proposed multiple mediation model and the sample data. Boredom proneness and missing daily social interactions both affected stress, directly and indirectly, through more time spent on phone conversations. In addition, it was found that the increased interest in following news about the pandemic mediated the relationship between boredom proneness and perceived stress. In terms of gender differences, our findings revealed that female students experienced significantly higher stress levels than male students, perceived to a greater extent the lack of daily social interactions, and spent more time on phone conversations. Overall, the findings further extend the empirical evidence on university students' mental health in the context of the COVID-19 pandemic. Therefore, universities need to organise support programmes focused on developing university students' coping strategies to maintain their mental health even in adverse contexts.

Introduction and Characteristics of SARS-CoV-2 in North-East of Romania During the First COVID-19 Outbreak

Romania officially declared its first Severe Acute Respiratory Syndrome Coronavirus-2 (SARS-CoV-2) case on February 26, 2020. The first and largest coronavirus disease 2019 (COVID-19) outbreak in Romania was recorded in Suceava, North-East region of the country, and originated at the Suceava regional county hospital. Following sheltering-in-place measures, infection rates decreased, only to rise again after relaxation of measures. This study describes the spread of SARS-CoV-2 in Suceava and other parts of Romania and analyses the mutations and their association with clinical manifestation of the disease during the period of COVID-19 outbreak. Sixty-two samples were sequenced via high-throughput platform and screened for variants. For selected mutations, putative biological significance was assessed, and their effects on disease severity. Phylogenetic analysis was conducted on Romanian genomes (n = 112) and on sequences originating from Europe, United Kingdom, Africa, Asia, South, and North America (n = 876). The results indicated multiple introduction events for SARS-CoV-2 in Suceava, mainly from Italy, Spain, United Kingdom, and Russia although some sequences were also related to those from the Czechia, Belgium, and France. Most Suceava genomes contained mutations common to European lineages, such as A20268G, however, approximately 10% of samples were missing such mutations, indicating a possible different arrival route. While overall genome regions ORF1ab, S, and ORF7 were subject to most mutations, several recurring mutations such as A105V were identified, and these were mainly present in severe forms of the disease. Non-synonymous mutations, such as T987N (Thr987Asn in NSP3a domain), associated with changes in a protein responsible for decreasing viral tethering in human host were also present. Patients with diabetes and hypertension exhibited higher risk ratios (RR) of acquiring severe forms of the disease and these were mainly related to A105V mutation. This study identified the arrival routes of SARS-CoV-2 in Romania and revealed potential associations between the SARS-CoV-2 genomic organization circulating in the country and the clinical manifestation of COVID-19 disease.