AUSTERITY KILLS
Russia’s Underfunded Hospitals Emerge as Key Vector for Virus

Jake Rudnitsky and Henry Meyer,
Bloomberg•April 20, 2020



(Bloomberg) -- Underfunded and poorly equipped, Russia’s regional hospitals and clinics are emerging as hot spots for transmission as the coronavirus outbreak spreads beyond the capital into the hinterlands.

In Yekaterinburg, Russia’s fourth-largest city, a single doctor who became infected by a neighbor in his apartment building led to 78 cases in City Hospital Number 1, which is now under quarantine, regional governor Evgeny Kuyvashev said on his Instagram account Monday.

Russia’s regions accounted for more new cases overnight than Moscow as the capital shows signs that it may be beginning to approach the peak of the epidemic. While overall infections rose by 4,268 to 47,121 as of Monday, the number in Moscow was up by 2,026 compared to 3,570 on Sunday.

“The absolute number may be small in these regions, but the current rate of growth should make regional leaders think twice,” Deputy Prime Minister Tatyana Golikova told President Vladimir Putin at a televised videoconference Monday. Medical facilities are the main vector for spreading the virus, said Golikova, who oversees the government’s health care policy.

With Russia imposing restrictions nationwide as the illness spreads across the world’s largest country, Putin has held frequent televised conference calls with regional heads to highlight how seriously the Kremlin takes the threat. At one meeting last week, he criticized “irresponsibility and slovenly work” for the surge of cases in some regions and warned that failure to act quickly in preparing medical facilities for the epidemic will be treated “as criminal negligence with all the consequences that come with it.”

Russia’s sprawling regions are for the most part much poorer than Moscow, where Mayor Sergei Sobyanin has quickly built up capacity to handle the spike in hospitalizations. Medical facilities often face shortages of protective gear and staff that leave them ill-equipped to prevent contagion.

In the remote northwestern Komi region, a doctor infected dozens at his hospital and led to its quarantine. Putin replaced the governor in the region, which has the highest rate of infection per 100,000 people outside of Moscow.

“Medical staff across the country are being deployed without proper protection, there aren’t even enough basic masks,”said Semyon Galperin, head of the non-profit Doctors’ Defense League. “We’ll see increasing numbers of doctors and nurses falling ill. Our clinics and hospitals today are breeding grounds for coronavirus.”

Moscow, which is entering its fourth week of shutdown, has seen the number of severely ill stabilize over the last 10 days, Sobyanin told Putin on Monday. With 26,350 cases, it has more than half of all of Russia’s recorded infections though the proportion is falling as the virus takes hold in the country.

Golikova estimates that Russia’s regions are two to three weeks behind Moscow, a hint that the shutdown could stretch into May. Putin has already canceled public celebrations of Russia’s World War Two victory on May 9, which is the country’s most important patriotic holiday.

The fundamental reason for recurring cases of mass infections at hospitals is “the dilapidated state of our medical facilities and the lack of protective wear,” said Andrei Konoval, co-chairman of independent medical trade union Destviye, or Action, which has branches in 50 of Russia’s 85 regions. Staff shortages mean hospital administrators keep employees working even if they come into contact with infected colleagues, he said.

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