Russia's remote regions struggle to cope with burgeoning Covid cases

Months after the Kremlin said it had the coronavirus pandemic under control, record numbers of Russians are falling ill and dying of the disease every day, pushing the country’s health services to the breaking point while Vladimir Putin has ruled out a new nationwide lockdown.

The official daily tally of new cases rose above 18,000 for the first time on Friday, when 355 deaths were also reported.Critics say the death toll indicated by tallies of excess deaths could be far higher. The increases have mirrored those in European countries such as France and Spain, but the brunt of the outbreak has been borne by far-flung regions that rarely make the evening news.

As opposed to the spring outbreak, when Moscow, St Petersburg and the Caucasus region were worst affected, the new rise has been driven by the disease’s spread across the the Urals, Siberia and the border with Kazakhstan, where colder weather has already driven many people indoors.

The images coming from Russia’s regions have been grisly. In the cities of Barnaul and Novokuznetsk, bleak videos have surfaced showing the bodies of coronavirus victims clogging hospital corridors. “There are bodies everywhere,” an anonymous videographer said in one clip.


Regional officials later confirmed the images. They said they didn’t have enough pathologists to carry out autopsies, so the bodies remained on trolleys and the floors of a hospital basement that serves as a makeshift morgue.

Ambulance drivers in Omsk have complained of hospitals turning them away, forcing them to protest with sirens blaring in front of a regional health ministry building. Doctors in Kurgan said the health system had collapsed and called on the government to send military medics. “There are no places in the hospitals, there are not enough medical personnel,” they wrote in an open letter.

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A shortage of oxygen in a hospital in southern Rostov-on-Don led to the deaths of as many as 13 patients in a single day, sparking an official inquiry. “The patients were panicking, trying to get oxygen from anywhere … they were like fish pulled out of the water,” Artur Toporov, an anaesthesiologist who was on call during the incident, told Novaya Gazeta. “We spoke to them. We could not do anything else for them.” Authorities have not confirmed how many people died, but a criminal investigation has been launched into five deaths.

Health workers bring a body to a hospital morgue in the city of Barnaul

Health workers bring a body to a hospital morgue in the city of Barnaul. Photograph: Tolk Channel/Reuters

Even Russia’s political class has been hit. A fifth of the MPs in the 450-seat Duma have fallen ill with the disease and 18 of the heads of country’s 85 regions have also been infected. The mayor of Ufa, a city of more than a million and capital of the Bashkortostan region, died of the disease on Wednesday, 35 days after testing positive.

Medics in several cities reached by the Guardian complained of poor preparation for the new rise in cases and an “unrealistic” workload for doctors. “People are acting like they are invincible, like they were already victorious, nobody is taking basic precautions,” said Maria, a paediatrician from Chelyabinsk, where infections increased sharply in September. “Conditions are just as bad as they were in spring, nothing has changed.”

A hospital doctor in the hard-hit Altai region described pressure to discharge patients because of a lack of beds. Russia’s deputy prime minister, Tatiana Golikova, told Putin on Wednesday that 16 regions were in a critical situation with more than 90% of hospital beds occupied. Five of them were at more than 95% of capacity.


Experts are hesitant to call it a second wave. They say that in most regions the first wave never truly receded. The data in recent weeks, however, has been extremely alarming.

“It’s much worse than in the first months,” said Alexey Raksha, an independent demographer who previously worked for the government statistics agency Rosstat. He cited rising official tallies, past data on excess deaths and experimental data collated by colleagues that shows an increasing number of internet searches for coronavirus symptoms. “I’m expecting huge excess mortality in October and unprecedented in November,” he said.

Excess mortality refers to the number of people who die in a given period above a past average, and it is an alternative way to estimate the toll taken by the coronavirus. Reuters reported last month that excess mortality in Russia from May to July was more than triple the official number of coronavirus deaths, leaving tens of thousands of deaths unexplained.

Raksha criticised tallies published on the government’s StopCoronavirus website, saying they should be “multiplied by four to get a much clearer picture”. The country’s current death toll is 27,656, but an estimate based on a proportion of excess mortality since April would put it between 120,000 and 130,000, he said.

Russian agencies have taken steps to block leaks. The health ministry has barred employees, including many doctors, from speaking to the media without coordinating with its press office. Data on deaths from the regions can take months to reach the public.

Many civil registration offices had stopped reporting data on deaths,” Raksha said, citing instances in ten regions, particularly those hard-hit by the virus. “We need something better. The official statistics are not up to it.”

The Russian government has defended its conservative methodologies, including the requirement that coronavirus diagnoses be confirmed by an autopsy. The lack of qualified pathologists to perform them is part of the official reason for the buildup of bodies in regional hospitals. Officials say a lack of morgue space and families’ slowness to retrieve bodies are also factors.

Russia has, however, resisted declaring a new coronavirus lockdown. “We’re not planning sweeping restrictive measures, the initiation of a so-called nationwide lockdown, which would lead to practically a complete shutdown of the economy and business operations,” Putin said at an investment conference on Thursday.

Sergei Sobyanin, the influential mayor of Moscow, said: “I very much hope that none of the severe measures being applied in Europe, in France, Germany and other countries, will be applied here.”



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