Covid-19: Cases rise in Russia as health workers pay the price for PPE shortage

Russia is now the country with the second largest number of covid-19 cases, after reporting more than 10 000 for a tenth consecutive day on 13 May. Russia has 242 271 cases, behind only the US which has 1.39 million cases.

The milestone comes as the central government ended the official “month without working” that started on 28 March. But President Vladimir Putin, who has kept an unusually low profile during the crisis, told local governments that the decision to lift restrictions or not was ultimately theirs.

Moscow, which accounts for more than half the country’s cases, will continue under lockdown, said its mayor, Sergey Sobyanin. Several other regions will also keep restrictions in place.

Speaking by video from his dacha outside Moscow, Putin said that the worst still lay ahead and that the protection of health workers was paramount, adding, “Right now, every single one of them counts.”

Initially bullish about Russia’s prospects in the pandemic, Putin has sounded a more realistic note since the start of May, when news images of ambulances lined up outside Moscow hospitals alerted many Russians to the gravity of the situation.

“We have a lot of problems, and we don’t have much to brag about, nor reason to, and we certainly can’t relax,” Putin told regional governors in a meeting last week, in comments published by the Kremlin.

On 13 May, Putin’s spokesman and close associate Dmitri Peskov was hospitalised with covid-19. He joins the prime minister, Mikhail Mishustin, and about 70 000 other Russians currently in hospital with the disease.

Russia was not slow in rolling out testing, but its process was plagued by false negatives. This, and an initial lack of urgency in government warnings, have contributed to unusually rapid spread which continued despite an official lockdown.

The pandemic comes after eight years of cuts to Russia’s health system, billed by the government as “optimisation” but consisting mostly of closures and staff reductions. Moscow called medical students as young as 21 to the front lines a month ago. The system was already strained, with cases a small fraction of what they are now.

On 12 May, the day Putin announced the easing of restrictions, a fire in a St Petersburg hospital killed six ventilated patients. Like a Moscow hospital fire three days earlier that killed one patient, it appeared to have started in an Aventa-M ventilator, of which Russia has built thousands in the past two months.

Aventa-M ventilators have been taken offline while an investigation proceeds. Several hundred were bought from Russia by the Trump administration last month, but these were never deployed in US hospitals as they used the wrong voltage.

Of most immediate concern to Russian doctors is the shortage of personal protective equipment (PPE). The government has cracked down on doctors posting on social media, under a new law that criminalises “fake news” about the virus, but reports of shortages continue to emerge. A report posted by a doctor at Moscow’s Botkinskaya Hospital, since deleted, said that 36 doctors there were sick with covid-19 because of a lack of PPE.

On 13 May, Governor Alexander Beglov of St Petersburg said that 1500 health workers there were infected, which would account for nearly a fifth of reported cases in the city. A memorial created online by anonymous doctors records the names of 174 Russian health workers who have died in the pandemic.1

The strain faced by Russian doctors was highlighted by the cases of three who fell from windows in the past three weeks. One of them, Alexander Shulepov, survived but is in a critical condition. He had previously posted a video in which he complained of being forced to continue to work in Voronezh after testing positive for covid-19. He fell from a window in the hospital where he was being treated.

Elena Nepomnyashchaya, head doctor of a hospital in Krasnoyarsk, Siberia, reportedly fell out of a window during a video meeting with provincial authorities who ordered her to open a new covid-19 ward, for which she felt the hospital was unprepared.

Russia has reported far fewer deaths per case than most countries, raising suspicions that many who succumb to covid-19 are listed under other causes of death. Moscow reported 658 covid-19 deaths in April, but the city’s overall mortality data showed 1855 more deaths than in April last year.2