Russia’s healthcare system is under considerable strain from the country’s coronavirus outbreak, which officials warn is still weeks away from its peak.

As of Friday, Russia had officially recorded 68,622 cases, the 10th-most in the world, and 615 deaths.

Here’s a brief overview of how Russia’s medical system — with its sharp regional disparities in quality of healthcare — is tackling Covid-19:

Bed numbers

— Russia’s government has ordered 100,000 hospital beds for coronavirus patients, including through repurposing existing facilities. Moscow Mayor Sergei Sobyanin has pledged to allocate approximately 20,000 hospital beds for Covid-19 patients as hospitalizations spiked in the week starting April 20.

 — Of Russia’s 800,000 regular hospital beds, 15% could be quickly transformed into intensive care facilities, according to Yury Krestinsky, who previously worked in the Health Ministry and now leads Sberbank’s healthcare business. That means 120,000 patients with more serious conditions could be treated at one time. 

— Moscow’s Health Department warned in mid-April that the city could run out of intensive care beds within two weeks. Only 57 of the city’s 248 hospitals are authorized to take in coronavirus patients so far.

— Moscow is treating mild Covid-19 cases at home, with doctors advising patients over video calls. 

— Health officials have authorized doctors across Russia to diagnose coronavirus without lab tests after reported studies showed a high rate of false negative test results. About half of Russia’s Covid-19 cases are asymptomatic, according to officials. 

— Russia’s bed shortage endangers the lives of thousands of patients with rare diseases including hepatitis and HIV, advocacy groups warn.

Problems

Lack of ventilators

  • Russia has a total of around 42,000-43,000 ventilators in its state hospitals nationwide — an average of about 29 ventilators per 100,000 residents, according to figures shared with The Moscow Times by Russia’s state tender monitor Headway Group.
  • About 25% of these ventilators are located in Moscow, the Moscow region and St. Petersburg.
  • While some of Russia’s wealthiest citizens are believed to be buying up and hoarding ventilators, some hospitals in less affluent parts of the country have been supplied with ventilators that expired more than 15 years ago. 
  • Doctors’ concerns about the quality of Russian-produced equipment used in hospitals have grown in recent years, a Moscow-based pulmonologist told The Moscow Times.
  • Last summer a dozen Russian healthcare NGOs wrote to President Vladimir Putin urging him to reconsider a proposed ban on importing some kinds of ventilators from abroad. The letter went unanswered, one of the signatories told The Moscow Times, and the ban ultimately came into force.
  • Officials say Russia currently has two domestic ventilator manufacturers, both based in the central city of Yekaterinburg.

Lack of personal protective equipment (PPE). 

  • Putin acknowledged shortages of protective equipment for medical personnel in mid-April. A few days later, following widespread reports of a lack of masks, gowns and other supplies, Putin’s spokesman warned doctors to send their complaints to health officials instead of the media.
  • The lack of PPE has led Russian hospitals to adopt Italy’s example and use snorkel masks to safeguard medical staff and patients.
  • At least three Russian regions in Siberia and the Far East have failed to buy PPE, officials said.

High risk of doctors spreading the disease.

  • Consumer health watchdog chief Anna Popova warned that infections in Russia’s regions were spreading through hotspots, over half of them in healthcare facilities.
  • Clinics have become the main “superspreaders” in the remote northern republic of Komi, which has one of the highest reported per-capita rates in Russia.
  • Doctors have complained to local authorities that lack of data on the number of infected medical professionals conceals the true scale of the outbreak within their ranks.

“Optimization.”

  • After his return to the presidency in May 2012, Putin prioritized a policy to trim and modernize a bloated and decrepit health system inherited from the Soviet Union. Critics say the policy was driven by corrupt practices and has seen hundreds of hospitals closed and thousands of medical jobs axed nationwide with little gained. 
  • Between the beginning of 2013 and the end of 2019, Russia more than halved medical staff including junior nurses and orderlies, and cut fully fledged nursing staff by 9.3%.
  • Since 2011, Moscow has also reportedly cut nearly 2,200 infectious disease treatment beds.
  • Russia’s wider defensive policies have also undermined its health system, experts, professionals and NGOs say. Moscow has stepped up its medical import substitution drive in recent years, tightening the screws on what equipment and medicines hospitals and pharmacies can buy from abroad as recently as summer 2019. 
  • Since the coronavirus outbreak emerged, the government has mobilized additional healthcare workers, recruiting medical school teachers, researchers and post-graduate medical students and providing 1.1 million medics with additional online courses.

AFP contributed reporting.