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Assessment of COVID-19 Waste Flows During the Emergency State in Romania and Related Public Health and Environmental Concerns.

ABSTRACT: This paper provides a rapid assessment method of potentially infectious waste flow related to the coronavirus disease (COVID-19) pandemic in Romania focusing on the emergency state (from 16 March to 14 May 2020) where a national lockdown was in force with restrictive and social distancing measures concerning population mobility and economic activities. Medical and municipal waste management systems are critical services in combating the virus spread in the community. This assessment is useful due to poor available data of medical waste flow in environmental reports and it covers COVID-19 patients, quarantined, and self-isolated persons as the main potential infectious waste sources. The proposed model estimates that COVID-19 related waste flow is 4312 t at the national level from 25 February to 15 June of which 2633 t in the emergency state period. This assessment is correlated with deficiencies of medical and municipal waste management systems in Romania before the COVID-19 pandemic as stress factors of public health and environment. This study points out the main challenges of waste operators and reveals some best practices during this pandemic crisis. Based on the results and discussion section, several recommendations are proposed to COVID-19 waste-related issues and points out the crucial role of the reliable medical and municipal waste database in managing such biologic hazards at national and EU levels. Monitoring of COVID-19 waste flow through such models are important for decision-makers, particularly in low and middle-income countries which are facing waste management deficiencies and gaps in waste statistics, to reduce other contamination risks or related environmental threats.

SUBMITTER: Mihai FC

PROVIDER: S-EPMC7432111 | biostudies-literature | 2020 Jul

REPOSITORIES: biostudies-literature

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Assessment of COVID-19 Waste Flows During the Emergency State in Romania and Related Public Health and Environmental Concerns.

Mihai Florin-Constantin FC

International journal of environmental research and public health 20200728 15

This paper provides a rapid assessment method of potentially infectious waste flow related to the coronavirus disease (COVID-19) pandemic in Romania focusing on the emergency state (from 16 March to 14 May 2020) where a national lockdown was in force with restrictive and social distancing measures concerning population mobility and economic activities. Medical and municipal waste management systems are critical services in combating the virus spread in the community. This assessment is useful du ...[more]

PMID: 32731593

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Project description:BACKGROUND:The Government of Romania commissioned international technical assistance to help unpacking the causes of arrears in selected public hospitals. Emphases were placed on the governance-related determinants of the hospital performance in the context of the Romanian health system. METHODS:The assessment was structured around a public hospital governance framework examining 4 dimensions: institutional arrangements, financing arrangements, accountability arrangements and correspondence between responsibility and decision-making capacity. The framework was operationalized using a 2-pronged approach: (i) a policy review of broader health system governance arrangements influencing hospital performance; and (ii) a series of 10 casestudies of public hospitals experiencing financial hardship. Data were collected during 2016-2017 through key informant interviews with central authorities and hospital management teams, exhaustive semi-structured questionnaires filled in by hospitals, as well as the review of documentary sources where feasible. RESULTS:Overall, the governance landscape of Romanian public hospitals includes a large number of seemingly modern legislative provisions and management instruments. Over the past 30 years substantial efforts have been made to put in place standardised hospital classification, hospital governance structures, management and service purchasing contracts with key performance indicators, modern reimbursement mechanisms based on diagnosis-related groups (DRGs), and regulatory requirements for accountability, including internal and external audit. Nevertheless, their application appears to have been challenging for a range of reasons, pointing to the misalignment between the responsibility and decisionmaking capacity given to hospitals in a questionably conducive context. Incoherent policy design, outdated and often disjointed regulatory frameworks, and cumbersome administrative procedures limit managerial autonomy and obstruct efficiency gains. In a context of chronic insufficient funding, misaligned incentives, and overly rigid service procurement processes, hospitals seem to struggle to adjust service baskets to the population's health needs or to overcoming financial hardship. External challenges, combined with the limited strategic, operational, and financial management capacity within hospitals, make it difficult to exhibit good financial and general performance. CONCLUSION:Existing governance arrangements for Romanian public hospitals appear conducive to poor financial performance. The suggested framework for hospital governance assessment has proved a powerful tool for identifying system and hospital-specific challenges contributing to sub-optimal hospital performance.

Project description:BackgroundRural health professionals stand at the forefront of community response to climate change, but few studies have assessed their perceptions of the threat. Further, no previous study has compared the opinions of environmental to public health professionals or extensively analyzed the factors related to these experts' climate beliefs, risk perceptions, and issue prioritization.MethodsIn conjunction with the Montana Climate Assessment's 2021 Special Report on Climate Change and Human Health, the 479 members of the Montana Public Health Association and Montana Environmental Health Association were surveyed during September-October 2019, with 39% completing the survey. We summarized descriptive data about their perceptions of local climate-related changes and their beliefs that global warming is happening, is mostly human-caused, is a risk to human health, and that their offices and others should take action. We also evaluated which sociodemographic and risk perception factors related to these climate beliefs, risk perceptions, and workplace issue prioritization.ResultsHealth professionals in Montana, a politically conservative state, demonstrated high levels of awareness that global warming is happening, human-caused, and a threat to human health, well above reported rates of public concern. Eighty-eight percent said that global warming is occurring and 69% that it is mostly anthropogenic. Sixty-nine percent said that their own health was already affected by climate, and 86% said they were already seeing at least one climate change-related event in their communities. Seventy-two percent said that their departments should be preparing to deal with climate change's health effects, but just 30% said that it is currently happening. We found no statistically significant differences between Montana environmental health and public health professionals in regression models predicting climate beliefs, risk perception, and prioritization. As in studies of the public, political ideology and the observation of local climate-related changes were the strongest factors.ConclusionsMontana environmental and public health officials said that departmental action was needed on climate change, indicating the readiness of rural health professionals to take action. Further studies of health professionals in rural regions are warranted.

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Assessment of COVID-19 Waste Flows During the Emergency State in Romania and Related Public Health and Environmental Concerns.

Publications

Assessment of COVID-19 Waste Flows During the Emergency State in Romania and Related Public Health and Environmental Concerns.

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