Tracking the pandemic footprint in Bucharest, Romania: A forensic and Impact Chain analysis from the PARATUS Project

Placing a few years between ourselves and the COVID-19 pandemic offers no shield or resilience against future pandemics and medical crises. Pushing healthcare facilities worldwide to their limits and disrupting the delivery of preventive and curative services. While it has provided scientists and stakeholders across various sectors with valuable insights, there are still reflections that remain to be fully understood. Despite a growing body of literature on pandemic lessons, a significant research gap emerges in understanding the unfolding of the COVID-19 pandemic as a long-lasting hazard through the lens of Disaster Risk Reduction.

This research work aims to investigate the impacts of the COVID-19 pandemic on the hospital network in the capital of Romania during 2020-2022, employing a multi-method approach that integrates the Impact Chain model and forensic analysis. Up to date, no forensic investigations have been conducted on COVID-19, which sets the present one at the forefront of pandemic-related research.

The Impact Chain integrates the COVID-19 pandemic as an epidemiological hazard, its various impacts, the contributing vulnerabilities, exposed elements, and adaptation options, as well as the connections established among them. The model was implemented following the guidelines formulated within the Paratus Project. It draws from scientific papers, official reports, statistical datasets, legislative documents, WHO official websites, and news reports, as well as from expert knowledge and the insights of medical personnel at the forefront of the fight against COVID-19 in Bucharest. The Impact Chain is used as a support tool for the forensic analysis that integrates elements from the Post-Event Review Capability (PERC) and the Detecting Disaster Root Causes (DDRC) frameworks.

This multi-method approach facilitated a detailed view of the pandemic impacts, the various types (i.e., financial, institutional, physical, and socio-cultural) vulnerabilities that contributed to them, and the mitigation measures implemented to address them. The impacts of the COVID-19 pandemic cover a broad spectrum, extending over both short and long periods, and are closely linked with the strain that the overwhelming number of COVID-19 patients placed on healthcare facilities. Most of the identified vulnerabilities stem from the ”chronic” underfunding of the medical system in Romania, as well as from the institutional vulnerability represented by the low performance of this system. In terms of mitigation efforts, the identified adaptation options tend to address impacts rather than vulnerabilities.

The systematic understanding of the key elements of pandemic risk provided by the structured model of Impact Chains, complemented by the detailed narrative put forward by the forensic analysis, offers a comprehensive and fresh understanding of the pandemic disaster and its effects on the medical facilities in Bucharest. Future research should extend the scope of the analysis beyond the hospital network, to include the local community.