‘The Health Care System Has Reached the Point of Total Collapse’

From Republic.ru, Nov. 9, 2020, https://republic.ru/posts/98447. Excerpt:

The autumn phase of the [coronavirus] pandemic in Russia continues to break records. By the end of [last] week, the daily number of new cases far surpassed 20,000, as predicted. Such figures differ so drastically from what the authorities were predicting in the summer that they quite literally do not know what to say. The situation in Moscow is a perfect example. There, despite the usual assurances that the epidemic is under complete control, officials are making increasingly incongruous statements.

“This week, we are seeing numbers that do not surpass last week’s figures. And this suggests that there is no surge in case numbers and that they have stabilized,” Moscow Mayor Sergei Sobyanin reassured Muscovites in late October.

But here is the public position of the Moscow leadership a week later:

Deputy Mayor Anastasia Rakova: “Today, for the first time since mid-May, we passed a [daily] mark of 6,000 new coronavirus cases. Of course, this trend is alarming us once again. And unfortunately, we cannot call the situation stable now.” Sergei Sobyanin: “There has been no stabilization at a certain level; COVID continues to gain momentum.”

Of course, the aggressive virus is behaving unpredictably, so incidence trends can deviate significantly from the trajectory outlined by officials. But no conclusions are being drawn: These same people continue to contradict themselves and each other, further disorienting society in an exceptionally uncertain situation.

The same effect is evident in efforts to prepare the nation for mass vaccination. From all appearances, those preparations are being made at a faster clip than development of the injection itself. Deliveries of the Sputnik V [vaccine] were supposed to have started over the weekend in Moscow and the regions. Aleksandr Gintsburg, head of the Russian Health Ministry’s N. F. Gamaleya Research Institute, has already announced that vaccinations will start in the capital region in the next two weeks. But exactly a month ago, Sergei Sobyanin, who is undoubtedly in the loop on how work [on the vaccine] is progressing, urged Muscovites to hold out for a few more months until the vaccine arrives. And just the other day, [Russian President] Vladimir Putin publicly predicted a shortage of equipment for its manufacture:

“There are certain problems associated with the availability or lack of a certain amount of equipment – ‘hardware,’ as they call it – for rolling out mass production.”

Sources of The Bell directly associated with launching serial production of the vaccine in the country explain that getting a vaccine ready usually “takes a year, but we are trying to do this in a matter of weeks.”

The Russian authorities have absolutely no desire to follow Europe’s lead and reintroduce quarantines, states of emergency and curfews (as several European Union countries had to do this week), and they continue to insist that they do not see the expediency of strict restrictions. Meanwhile, they are taking no measures to support health care. In mid-October, at a meeting with the president, Deputy Prime Minister Tatyana Golikova estimated that the reserve of beds specially set aside for coronavirus patients had 24% [available] capacity. By the end of the month, this official figure (apparently grossly overestimated) had fallen to 19.1%.

To ease the burden on hospitals, the authorities are doing all they can to keep infected people at home. This directly follows from the Health Ministry’s revised rules that it released on Sunday [Nov. 8]. A day earlier, Denis Protsenko, head physician [at Moscow Hospital No. 40, the main treatment center for COVID‑19 – Trans.], where there are currently no beds left for COVID-19 patients, reiterated the criteria for hospitalization in an interview with RT.

“While in March, a COVID [diagnosis] and a fever were indicators for hospitalization, now we are hospitalizing [only] critically ill patients.*** This [means patients with a] fever resistant to antipyretics, a temperature above 38 degrees [Celsius], shortness of breath with a respiration rate of 28 times per minute (the normal range is 16-20). And saturation (oxygen saturation of the blood – Rep.) levels less than 92% (the normal range is 98% to 99%).”

Meanwhile, more and more regions cannot cope with the avalanche of seriously ill patients and are trying to draw the federal center’s attention to their desperate problems, bypassing the local officials who are unable to help:

“A difficult situation has developed in the province with the spread of coronavirus,” reads a letter addressed to Anna Popova, head of Rospotrebnadzor [Federal Oversight Service for Consumers’ Rights and Human Welfare] and Prime Minister Mikhail Mishustin, signed by the doctors of Kurgan Province. “Regional authorities are not taking proper measures. The health care system has reached the point of total collapse. Hospitals are at capacity; there is not enough medical staff.” “Beds are sorely lacking,” says a video message from doctors in the Republic of Khakassia to President Vladimir Putin and Defense Minister Sergei Shoigu. “We are taking patients to inpatient medical treatment facilities merely as a formality, to free doctors from liability, and then they are sent home for treatment.”

The Health Ministry is trying to respond by sending its specialists to the most problematic regions. Yesterday alone, officials from Moscow were sent to St. Petersburg to provide “organizational and methodological support,” and to Khakassia to conduct an “audit of medical assistance to residents.” But dispatching officials won’t alleviate the shortage of everything needed to diagnose patients in a timely manner and give them urgent care. In Novosibirsk Province, Meduza reports that practically no administrative preparations were made for the second wave of the pandemic. As a result, there are now “no ambulances, no test kits, no room in hospitals, no [supplemental] oxygen and no medicines.”

Several years ago, there was talk among impressionable observers about the quasi-[free] market Russian economy potentially shifting into mobilization mode, and the weak and corrupt system of government turning into a monolithic foundation of the regime. If anyone actually had such fears, the year 2020 largely dispelled them. Now the country has immeasurably more entropy than controllability. In the face of an epidemic, the notorious Russian power vertical, built of people in uniforms of all stripes, is proving incapable of taking effective emergency action.

After coming to grips with the destructive force of the pandemic, the state could have gotten its act together and spared no resources during the summer to prepare the impoverished health care system for a difficult autumn. Instead, the Kremlin conceitedly lectured the world on how to deal with the epidemic, while the [Russian] government and regional leaders instilled a false sense of security in their own citizens. And in recent weeks, we have witnessed the natural consequences of such recklessness. . . .