The Columbus Dispatch

Russia strained as virus resurges in country

Regions buckling under rising tide of patients

- Daria Litvinova

MOSCOW – When Yekaterina Kobzeva, a nurse at a preschool in Russia’s Ural Mountains, began having trouble breathing, she called an ambulance. It was four days before she managed to find a free hospital bed.

The ambulance first took her to get a scan – which showed damage from pneumonia to 50% of her lungs, an indication she had the coronaviru­s. The paramedics then drove her around the city of Perm and its surroundin­gs for hours as seven hospitals, one by one, turned her down, saying they didn’t have any beds available. At dawn, she went home.

The journey took her through “circles of hell,” Kobzeva, 60, said in an interview with the Associated Press by phone from a hospital, where doctors confirmed she had the virus. She was only admitted there days after her first attempt – and after her story made local headlines.

Russia’s health care system, vast yet underfunde­d, has been under significant strains in recent weeks, as the pandemic surges again and daily infections and virus death regularly break records.

Across the country, 81% of hospital beds that have been set aside for coronaviru­s patients were full as of Wednesday. Three times last week, the Russian government reported a record number of daily deaths, and the number of daily new infections per 100,000 people has more than doubled since Oct. 1, from 6 to over 15. Overall, Russia has recorded over 2 million cases and over 35,000 deaths, but experts say all numbers worldwide understate the true toll of the pandemic.

Reports in Russian media have painted a bleak picture in recent weeks. Hospital corridors are filled with patients on gurneys and even the floor. Bodies in black plastic bags were seen piling up on the floors of a morgue. Long lines of ambulances wait at hospitals while pharmacies put up signs listing the

drugs they no longer have in stock.

Russian authoritie­s have acknowledg­ed problems in the health system. President Vladimir Putin even urged regional officials not to paper over the situation, saying that “feigning the impression that everything is perfectly normal is absolutely unacceptab­le.”

Yet Russian authoritie­s continue to insist there’s no need for a nationwide lockdown or widespread closures of businesses, instead urging people to observe the measures ordered by regional government­s.

But in most regions, those measures don’t go beyond mask mandates, limiting the hours of bars and restaurant­s, ordering the elderly to self-isolate, forbidding mass public events and requiring employers to have some staff work from home. Health experts said the moves are clearly not enough.

Paramedic Dmitry Seryogin said Kobzeva’s experience is not unusual. In the southweste­rn Oryol region where he works, patients can wait for up to 12 hours for an ambulance and then might spend five more in it, looking for a hospital bed. Those who happen to arrive when others are being discharged get lucky, he told the AP, but the rest are sent home.

Although the Perm region, where Kobzeva sought treatment, was among the top 20 of more than 80 Russian regions in terms of daily new infections last week, Oryol ranked somewhere in the middle. Still, 95% of hospital beds set aside for coronaviru­s patients there were full last week, reflecting the pressure on a system crippled by widely criticized reforms that sought to cut state spending.

A partial six-week coronaviru­s lockdown in March only added to longbrewin­g public frustratio­ns over Russia’s weakened economy. Soon after that, Putin delegated the powers to impose virus-related restrictio­ns to regional governors. Critics saw the move as an effort to inoculate himself from any more fallout over the pandemic.

During the fall resurgence of the virus, the Kremlin has consistent­ly pointed fingers at regional governors.

“Colleagues, you have received broad powers for implementi­ng anti-pandemic measures. And nobody has relieved you of personal responsibi­lity for the adopted measures – I really do hope that they were adopted on time,” Putin reminded the governors last week.

But just like the Kremlin, government­s in the vast majority of Russian regions have been loath to shut businesses or impose lockdowns. The only exception has been the Siberian republic of Buryatia, where last week the region’s governor ordered cafes, restaurant­s, bars, malls, cinemas, beauty parlors and saunas to shut down for two weeks.

Regional governors find themselves in an impossible position, political analyst Abbas Gallyamov said. They face public frustratio­n if they don’t impose tough restrictio­ns and the outbreak continues to rage, and they face it if they do because they don’t have the funds to ease the pain of closures.

“All the finances have been long centralize­d, and the regions don’t have spare money,” Gallyamov said. “So de jure, a governor’s hands are untied, but de facto they’re still tied because they don’t have the money to impose a lockdown and compensate people for their financial losses.”

In addition, Putin has centralize­d power that regional governors are not used to acting independen­tly, said Judy Twigg, a professor of political science at Virginia Commonweal­th University, specializi­ng in global health.

Many Russian regions are buckling under the growing tide of patients.

In Buryatia, the Siberian republic that has imposed the country’s strictest measures, Dr. Tatyana Symbelova told the AP that as the number of patients rose, her hospital kept adding beds – “in the corridor, in the outpatient ward next door” – but “the situation, still, grew worse and worse.”

Symbelova, the chief doctor at Republican Infectious Disease Hospital in Ulan-ude, and her colleagues are now taking patients whose condition was “severe or of moderate severity” and turning down those with milder cases. A new coronaviru­s ward with 180 beds opened last week in the city, and she said she hopes that and the shutdown will help.

But in the meantime, she is worried. “Such risks we’re taking! Telling patients (with milder cases) they can go and treat themselves at home, when they may come in three days later with their lips blue,” Symbelova said. “We’re very seriously choking.”

 ?? ANNA OGORODNIK/AP ?? A medical worker looks at a monitor treating a coronaviru­s patient on an artificial lung respirator at an intensive care unit in the red zone of the hospital in Ulan-ude, the regional capital of Buryatia, a region near the Russia-mongolia border.
ANNA OGORODNIK/AP A medical worker looks at a monitor treating a coronaviru­s patient on an artificial lung respirator at an intensive care unit in the red zone of the hospital in Ulan-ude, the regional capital of Buryatia, a region near the Russia-mongolia border.

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