Russia has become one of the world’s worst-hit countries by the pandemic, with the number of confirmed coronavirus cases second only to the United States.
(CN) — A prefect storm is lashing Russia: oil prices have crashed, the economy is in free fall and the coronavirus pandemic is harshly exposing years of government neglect as stressed medics reportedly jump out of windows and medical staff describe working excruciating hours without breaks to even relieve themselves because of a shortage of protective gear.
This crisis is putting Russian President Vladimir Putin’s authoritarian regime built around oil exports and government brutality to the test.
“It is the most serious challenge they have faced in the last 20 years,” Andrey Kortunov, the director general of the Moscow-based think tank Russian International Affairs Council, said in a telephone interview with Courthouse News. “It will be a bumpy road ahead.”
For weeks, Russia acted as if it was impervious to the coronavirus outbreak. After closing its long border with China at the end of January, it confidently said the virus wasn’t a threat.
Government media likened the virus to the flu. Putin ignored it. He was consumed with the stuff of great powers: Wars, weaponry, espionage, treaties, oil markets. On the home front, he was concerned with political intrigue, squashing dissent and cementing his power by changing the constitution to become, in effect, president for life.
All the while, the virus was circulating as thousands of rich Russians returned to Moscow from European ski getaways in the Alps and winter holidays, bringing with them the coronavirus. An estimated 1.2 million people arrived in Moscow before international flights were stopped in late March. People arriving from Western Europe weren’t being tested, though, and the virus spread undetected.
By the end of March, even Putin had to turn his attention to the inevitable truth: Russia was sick.
Since then, Russia has become one of the world’s worst-hit countries by the pandemic with more than 252,000 confirmed cases — the second-highest after the United States — and more than 2,300 official deaths. The disease is mostly concentrated in Moscow, Russia’s cosmopolitan capital with more than 12 million inhabitants.
“So many people thought it was a global joke, they thought it was all a joke. The government said it was just a flu, state TV said it was nothing to worry about,” said Anthony Louis, the editor of an online newspaper, the Moscow Tribune, in an interview. “It kind of hit home only when things started getting bad in Moscow. It was a complete mess until it was way too late.”
The stories from doctors and nurses in Russia are harrowing and a reflection of those heard in Italy, Spain, England and the United States, but with a harsh Russian twist. In Russia, despite many advances and growing wealth since the collapse of communism, the public health care system is creaky to say the least. About a third of medical facilities don’t even have running water. Others are depressing bare-bones operations where it is not uncommon to find cockroaches running on the floor. On top of that, medical workers labor for poor pay under opaque directives and state intimidation.
Since March, at least three medics have fallen from windows, reportedly brought to despair over working conditions. Two have died and a third was in critical condition. The paramedic in critical condition, 37-year-old Alexander Shulepov, filmed a video alleging he was forced to work at a hospital in Voronezh, some 280 miles south of Moscow, even though he had tested positive for Covid-19, the respiratory disease caused by the coronavirus. Police are investigating the incidents.
There is a big difference between hospitals in Moscow and those outside the capital.
In Moscow, the epicenter of Russia’s outbreak, the hospital system is described as modern and better equipped to handle the wave of coronavirus patients.
At a facility known as the Filatov hospital, about 1,300 of its 1,500 beds are taken up with patients, most suffering from Covid symptoms. The number of Covid patients has decreased by about 100 from mid-April when the outbreak exploded.
Doctors and nurses at the hospital, posting reports on social media, describe having enough protective gear and, though fatigued and overworked, present themselves as keeping up their spirits.
Still, even Moscow’s hospitals struggled to cope. Hundreds of medical students were called up to help and ambulances were running nonstop. At points, the emergency services were too overwhelmed to handle all the calls.
“The ambulance service at one point stopped picking up the phone,” Louis said. “No one could get an ambulance for any reason.”
The situation is much more bleak outside Moscow. The virus was taken to towns and cities in the ring around the capital by Muscovites as they fled the city’s lockdown for countryside dachas.
There are reports of hospitals lacking protective equipment, not testing patients for Covid and skipping basic CT scans. In Russia, it is common for medical staff to work staggered 24-hour shifts and now these excruciating shifts are even more unbearable as workers are required to don full-body protective gear for the duration. With gear in short supply, medical workers have reported being told they cannot remove their suits even to relieve themselves.
“It’s third-world conditions outside Moscow,” Louis said.
In one hospital in southern Russia, medical staff walked out because of a lack of equipment such as face masks and protective gear. They were also upset because they were offered a $1 bonus for the dangerous conditions, Louis said. In March, Putin promised front-line medical workers about $1,000 in danger pay, but Russia has not lived up to that promise.
In Volgograd, a southern Russian city, medical staff at one hospital said they were putting pillowcases on their heads to protect themselves against infection due to a lack of proper gear, according to reports in Russian media.
Such dangerous working conditions have also been reported in Moscow. A surgeon at a southwest hospital said staff working eight-hour shifts were unable to take breaks and take off their protective gear, according to Public News Service, a Russian nonprofit news agency. That surgeon, Alexander Gadzyra, described being outfitted with full-body gear as being packed inside a plastic bag “from head to bottom” with a tight-fitting mask limiting breathing and, once taken off, leaving sores on his face.
“During this time, you can neither eat, nor drink, nor relieve your natural needs, nor remove this harness that is exhausting you,” Gadzyra said on social media.
Veronika Skvortsova, the head of the Federal Medical and Biological Agency, said about 40% of medical staff working in Covid wards are suffering from depression, anxiety and stress. Officials say at least 174 medical workers have died from Covid and about 21% of medical personnel have contracted it.
It’s still unclear how deadly Russia’s outbreak has been in part because of the way Russia counts Covid deaths. Unlike many other countries, Russian doctors list Covid as the cause of death only when other conditions cannot be blamed. But the infection is known to worsen underlying health problems and lead to heart attacks, organ failures and other fatal complications.
“They have been listing deaths as caused by heart failure, cancer, whatever else,” Louis said. “But it was corona that pushed them over the edge.”
Russia’s mortality rate from Covid is about 13 deaths per million people, much lower than the world average of 36 per million.
Foreign media, including the New York Times and the Financial Times, earlier this month reported that Moscow’s death toll was likely much higher than officially registered based on the number of overall deaths in April. The Russian government blasted the news reports as false and threatened to withdraw accreditation to journalists.
But the media reports were based on Moscow city government data showing deaths recorded in April exceeded the five-year average by more than 1,700. That is nearly 1,100 more deaths than Moscow’s official Covid toll for April. Still, even if Russia’s mortality rate is 70% higher than officially reported, its toll remains extremely low compared to other countries like the United Kingdom and Italy where more than 30,000 people have died.
Despite skepticism over Russia’s death count, Kortunov said it is impossible for the government to hide mass deaths.
“You cannot falsify huge numbers, thousands and thousands of deaths,” the think tank director said.
For that reason, he said Russia’s lower death rate means the country deserves credit for limiting the spread of the disease. He said the Russian government can argue its public health system is superior to those of rival countries in the West.
“We were lucky or maybe the government was efficient to limit the spread of the virus,” Kortunov said.
Louis, the Moscow Tribune editor, said it is possible fewer have died because Russia doesn’t have a network of nursing homes, which have become death traps in Western Europe and the U.S. Also, Russia’s elderly population is smaller than other countries because life expectancy in Russia is considerably lower.
“There aren’t that many old people — that is a factor,” Louis said.
It also remains unclear how widespread infection has been in Moscow and the rest of Russia. Moscow Mayor Sergey Sobyanin has estimated more than 300,000 people have contracted the virus in the capital. More than 130,000 infections have been diagnosed through testing, but many people never get tested because they have mild cases or are asymptomatic.
There is speculation that Covid was present in Moscow much earlier than first believed, perhaps brought by large numbers of Chinese tourists who visit the city. Chinese do not need visas to travel to Russia. Before the outbreak, there were daily flights between Moscow and Chinese cities, including Wuhan, where the virus is believed to have emerged.
There is growing evidence the virus was traveling around the world well before Dec. 31, when China told the World Health Organization it had found a cluster of atypical pneumonia cases in Wuhan, soon found to be caused by the new coronavirus.
In France, doctors found a patient with no link to China infected with the virus in December. Italian doctors are investigating whether the virus was circulating in November and December.
Louis said Moscow was struck with lots of ill people in December and January with symptoms similar to Covid. He too got seriously sick with what he believes was Covid in January and ended up in a hospital, he said.
“It struck down the whole city, so many people were coughing, they had a high fever,” he said. “But they weren’t looking for coronavirus.”
He said doctors “knew it was a different bug” but were not allowed to classify the cases they were encountering as related to coronavirus.
“Doctors were not allowed to write corona [on diagnoses] so they came up with a term to diagnosis this as an atypical pneumonia,” Louis said.
Kortunov agreed the virus may have been in Russia much sooner than officially reported.
“If you take last year, there were large numbers of Chinese and definitely they could have brought the virus earlier than the official statistics reflect,” he said. “Especially if there were cases of ‘corona lite’ I can imagine some people got the infection before they even started recording the statistics.”
It wasn’t until March 26 before Russia recorded its first official Covid death.
The health crisis, though, is not necessarily Russia’s biggest calamity. Instead, that might be the economic blow hitting the country both from a precipitous drop in oil prices – in large part due to Putin’s own actions by getting into a price war with Saudi Arabia – and a looming global slowdown. In addition, Russia is suffering from international sanctions over its annexation of Crimea.
“In relative terms, the collapse of the oil prices is much more serious for the consequences of the economy than the pandemic,” Kortunov said.
During his 20 years in power, Putin has failed to make Russia less dependent on oil and gas revenues and helped other activities flourish, he said.
“I don’t think there is danger of an immediate collapse of the Russian economy,” he said. “They have accumulated a lot of reserves and they do not want to spend these reserves.”
While Russia’s economy may not implode in the short term, Kortunov said the multiple crises engulfing Russia are forcing the country to re-assess “the basic foundations of the economy.”
“This is the real problem,” he said. “It requires a lot of changes, but I just wonder if the leadership that has been in charge for 20 years will consider to implement the changes that are needed.”
He said Russia needs to diversify its economy and help small and intermediate enterprises take off.
“They need to do something to unleash this innovative potential that is suppressed right now,” Kortunov said.
Russia’s private sector is suffering the most from the economic effects of the lockdown. Unlike other countries, Russia has offered little help to private businesses such as restaurants and hairdressers and set up no economic stimulus package.
“There’s nothing for the small businesses, only for the big corporations of state importance like power companies,” Louis said. “All those in the service sector are supposed to survive on their own. You just live off your savings, borrow from friends.”
He said the government has aggravated the crisis for the self-employed by not supporting long-term relief by canceling payments for rents, mortgages, utilities and late fees.
Putin avoided using the term lockdown and instead declared a nationwide nonworking holiday at the end of March, which ended this week. During that period, Russia’s ranks of public employees and pensioners continued receiving their paychecks but private businesses were expected to fend for themselves. Conveniently for Putin, much of his support comes from those relying on public funds while the private sector tends to not support him.
It’s people like Nana Shakhbazyan, a 47-year-old Armenian-born self-employed interior designer and luxury brands events planner in Moscow, who are in the lurch. Unlike many places in Russia, Moscow remains in a lockdown until the end of May, leaving her and many of her friends and business associates stuck at home and unable to work.
“Everyone is terrified that they will go bankrupt,” Shakhbazyan said in a telephone interview.
She said spooked suppliers are asking for upfront payments, events have been canceled, rents and bills stack up and uncertainty clouds the future. Putin promised to give private businesses tax relief, but the program still has not been set up, she said.
While she’s able to continue working on her interior design projects by sketching and planning while under lockdown, her other job planning events has collapsed.
“Everything is basically canceled at the moment,” she said.
She described central Moscow, where she lives, as eerily quiet and empty with the occasional police car cruising by with a loudspeaker blaring out commands telling people to go home. Many of the center’s residents are wealthier and fled to dachas in the countryside.
But Shakhbazyan is worried that Russians are not taking the virus seriously and the outbreak will be prolonged.
“In the suburbs, people say nothing has changed,” she said, citing conversations she has with friends on the city’s outskirts. “People are living their normal lives, which is a bit scary. People just don’t care. They go out with their children, they have barbecues. The general mood in Russia is, ‘Don’t believe anything official that is said.’”
In this case, people do not believe the virus is as bad as the state media now says it is, she said. She said this cavalier attitude Russians have toward the virus reflects a national propensity toward fatalism.
“I have heard several times: ‘If I am supposed to die, well then I am supposed to die,’” she said. “My hope is that there will not be a new wave.”
For now, the lockdown in Moscow is doing something else: It’s put a lid on opposition voices from demonstrating against Putin, who is seeking to pass constitutional changes to allow him to remain president until 2036. Putin is now 67. But once the lockdown is lifted, dissent may boil up.
“His grace period is not that long,” Kortunov said. “If there are not positive changes in the next two, three months, if there is no light at the end of the tunnel, people will get tired.”
Russia is scheduled to hold regional elections in September and voters may turn against Putin. Voters will also need to approve constitutional amendments to extend his presidency in a referendum. Here too, voters could show their dissatisfaction.
Kortunov said opposition to Putin also may spring up among the political elite, for example regional governors. He said the Russian president faces an erosion of support.
“It doesn’t mean there will be a revolution, some kind of second edition of 1991,” he said, referring to the year the Soviet Union collapsed.
Putin has been strangely absent from dealing with the pandemic and instructed regional and municipal leaders to take the lead. He’s held lackluster televised addresses from his office in the Kremlin. Journalists and pundits — so-called Kremlinologists — are remarking on how bored he looks. He’s appeared to sigh in his televised remarks and was seen playing with a pen during one cabinet meeting dealing with the pandemic.
“This is definitely not his favorite operation,” Kortunov said. “He would prefer to be doing big geopolitical issues: Brokering a deal over Iran or doing an arms deal. But he should see this is the only game in town.”
Kortunov said Putin risks being blamed for failing to keep promises he’s made over the years to raise living standards and greatly improve people’s lives. The looming economic crisis will make it even harder for the government to boost living standards.
Russians rallied behind Putin during the crisis over Ukraine and the annexation of Crimea in 2014, but that support is slipping. A recent survey by pollster Levada found his support at a historic low of 59%.
“There was what I call the ‘Crimea consensus,’” Kortunov said. “People supported the leadership on the basis of the great power status, but this consensus was eroding before the pandemic. Now the government will need a new social contract, it will need to get people to agree to a ‘corona consensus.’”
He said Putin likely will try to sell the notion that Russia handled the pandemic well thanks to its centralized decision-making and his leadership. A low death toll will help him in that endeavor, he said.
“He can say, ‘Look at the United States, look at the number of deaths. The United States is polarized; they are fighting each other. Do you want us to be like the United States, Spain, Italy, the United Kingdom? Probably not. So you should extend my leadership,’” Kortunov said.
“Whether you can make a convincing case for that is not over,” he added. “We are far from the final stage in this drama.”
Louis said he is not optimistic for Russia’s future and he doubts much will change for the better due to the pandemic.
“This isn’t North Korea where people are in terror of [Putin],” the newspaper editor said. “This is someone people realize will be there for life. The constitution has been hijacked, as has the politics, the courts. The police have extra powers, they can break into buildings with no document; they can shoot to kill, there is no oversight. There is a national guard, a whole new structure, that has been created, a whole new force, with wide sweeping powers. There is this control over everything, all independent media has been shut down.”
“That is the future we have now,” he added. “It is heading toward North Korea, but not quite there yet.”
Courthouse News reporter Cain Burdeau is based in the European Union.