themoscowtimes--2020-04-24--Explainer: How Russia’s Healthcare System Is Tackling the Coronavirus

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 : — Russia ’ s government has ordered 100,000 hospital beds for coronavirus patients , including through repurposing existing facilities .
Moscow Mayor Sergei @ @ @ @ @ @ @ 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 @ @ @ @ @ @ @ ’ 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 @ @ @ @ @ @ @ None 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 .
• None About 25 % of these ventilators are located in Moscow , the Moscow region and St. Petersburg .
• None 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 @ @ @ @ @ @ @ 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 .
• None 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 .
• None Russia currently has two domestic ventilator manufacturers , both based in the central city of Yekaterinburg .
• None Putin acknowledged @ @ @ @ @ @ @ in mid-April .
A few days later , following widespread reports of a lack of masks , gowns and other supplies , Putin ’ s spokesman doctors to send their complaints to health officials instead of the media .
• None The lack of PPE has led Russian hospitals to adopt Italy ’ s example and use • None At least three Russian regions in Siberia and the Far East have failed to buy PPE , officials • None Consumer health watchdog chief Anna Popova warned that infections in Russia 's regions were @ @ @ @ @ @ @ them in healthcare facilities .
• None 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 .
• None to local authorities that lack of data on the number of infected medical professionals conceals the true scale of the outbreak within their ranks .
• None 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 @ @ @ @ @ @ @ by corrupt practices and has seen hundreds of hospitals closed and thousands of medical jobs axed nationwide with little gained .
• None Between the beginning of 2013 and the end of 2019 , Russia more than medical staff including junior nurses and orderlies , and cut fully fledged nursing staff by 9.3 % .
• None Since 2011 , Moscow has also • None Russia ’ s wider defensive policies have also undermined its health system , experts , professionals and NGOs say .
Moscow has its medical import substitution drive in @ @ @ @ @ @ @ what equipment and medicines hospitals and pharmacies can buy from abroad as recently as summer 2019 .
• None 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 .

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.


themoscowtimes--2020-04-24--Russia's Coronavirus Cases Rise By 5,849, Bringing Total Close to 70K

Russia ’ s officially reported numbers — which are still relatively lower than those in European countries — have sparked suspicion .
Experts warn that Russia 's testing capacity is hampered by bureaucracy , while officials warn that the real number of cases is likely much higher .
The majority of Russia 's cases are in Moscow .
Since March 30 , all of Moscow 's 12 million residents have been ordered to stay in their homes with few exceptions .
Moscow Deputy mayor Anastasia Rakova has warned the city `` will face difficult weeks '' ahead .
`` The @ @ @ @ @ @ @ next two to three weeks , '' she said in a video released on social media Friday .
Under confinement rules that Muscovites have to observe until at least May 1 , they are only allowed to leave their homes to go to work , walk their dogs , take out trash or visit their nearest shop .
This week city authorities tightened the lockdown by introducing a digital permit system , requiring that anyone travelling by car or public transport obtain a pass .
Russia has carried out more than 1.7 million @ @ @ @ @ @ @ concerns about their reliability .
Worldwide , the virus has infected over 2.7 million people .

The highest number of new cases were in Moscow and St. Petersburg.
Russia's fatality rate has remained low compared to other badly-hit countries, raising speculation that Moscow could be underreporting figures.
Russian authorities began easing anti-virus measures in June ahead of a massive World War II military parade in Moscow and a nationwide vote on constitutional reforms that now allow President Vladimir Putin to stay in power until 2036.
Both events were initially postponed due the epidemic.
Moscow opened cinemas and theaters on Aug. 1. In the capital, masks are mandatory in stores and on public transport but not in the streets.
Several institutes in Russia are working on a coronavirus vaccine.
The Russian Defense Ministry has said it developed a "safe" vaccine following clinical trials on a group of volunteers.
The trials are ongoing, and the Defense Ministry expects clinical trials to be fully completed in the coming weeks.
AFP contributed reporting to this article.


themoscowtimes--2020-04-24--Coronavirus Lockdown Pushes Muscovites Into Underpaid Jobs

Founder and director of Moscow ’ s Komnata4 theater , Daniil Romanov , was among the first to be hit hard by the coronavirus lockdown when the city ordered all cultural venues to close .
With money running short , he decided to sign up as a delivery worker for a major grocery chain .
Romanov , 34 , has since taken to social media to document his new way of life , describing the people he meets , the challenges he faces and the funny or mundane moments of delivery work .
“ We ’ re kind of seeing @ @ @ @ @ @ @ its social values and moral standards , ” he told The Moscow Times .
“ I believe that for someone as creative as me , who is so closely linked with art , it would be a crime to stay home and miss this unique opportunity to record our history.
” As Russia ’ s coronavirus outbreak has forced nearly all businesses to shutter their doors over the past four weeks , a growing number of Moscow residents are finding themselves without work and seeking out jobs they ’ re overqualified for because @ @ @ @ @ @ @ to fund life in the capital .
But not everyone has fared as well as Romanov .
An employee of Moscow ’ s Domodedovo Airport who asked not to be named told The Moscow Times that her boss ordered her to take ” an unpaid sabbatical vacation ” in March , with no details of when she would be able to return to work .
“ I effectively became jobless .
I was panicking for about a week .
I just had no idea how to make ends meet , ” she said @ @ @ @ @ @ @ the official unemployment rate has risen more than 50 % in Moscow alone .
Alexei Kudrin , head of the state Audit Chamber and a former finance minister , has warned that the lockdown could leave some 8 million Russians without a job this year .
President Vladimir Putin has said that all Russians who lose their jobs due to the lockdown will receive monthly unemployment pay of up to 12,130 rubles ( $ 160 ) .
Moscow residents who become unemployed will receive 19,500 rubles ( $ 256 ) per month .
@ @ @ @ @ @ @ city , was recently ranked 86th in the Economist Intelligence Unit ’ s Worldwide Cost of Living index , suggesting that 19,500 rubles a month is far from enough for ordinary people to live on in the city .

Founder and director of Moscow’s Komnata4 theater, Daniil Romanov, was among the first to be hit hard by the coronavirus lockdown when the city ordered all cultural venues to close.
With money running short, he decided to sign up as a delivery worker for a major grocery chain.
Romanov, 34, has since taken to social media to document his new way of life, describing the people he meets, the challenges he faces and the funny or mundane moments of delivery work.
“We’re kind of seeing a shake-up of our society, of its social values and moral standards,” he told The Moscow Times. “I believe that for someone as creative as me, who is so closely linked with art, it would be a crime to stay home and miss this unique opportunity to record our history.”
As Russia’s coronavirus outbreak has forced nearly all businesses to shutter their doors over the past four weeks, a growing number of Moscow residents are finding themselves without work and seeking out jobs they’re overqualified for because state unemployment pay isn’t enough to fund life in the capital.
But not everyone has fared as well as Romanov.
An employee of Moscow’s Domodedovo Airport who asked not to be named told The Moscow Times that her boss ordered her to take ”an unpaid sabbatical vacation” in March, with no details of when she would be able to return to work.
“I effectively became jobless. I was panicking for about a week. I just had no idea how to make ends meet,” she said.
Over the past three weeks, the official unemployment rate has risen more than 50% in Moscow alone. Alexei Kudrin, head of the state Audit Chamber and a former finance minister, has warned that the lockdown could leave some 8 million Russians without a job this year.
President Vladimir Putin has said that all Russians who lose their jobs due to the lockdown will receive monthly unemployment pay of up to 12,130 rubles ($160). Moscow residents who become unemployed will receive 19,500 rubles ($256) per month.
Moscow, Russia’s most expensive city, was recently ranked 86th in the Economist Intelligence Unit’s Worldwide Cost of Living index, suggesting that 19,500 rubles a month is far from enough for ordinary people to live on in the city.


themoscowtimes--2020-04-24--Chechen Strongman's Strategy Against Virus – Fear and Threats

The erratic and iron-fisted leader of Chechnya in southern Russia , unhappy with her journalism about the coronavirus , put out an unambiguous call for violence against the reporter on social media this month .
Elena Milashina had received death threats before .
But they were never so direct or brazen .
Ramzan Kadyrov `` was direct in saying what he was going to do with me — and how .
This was the first time he said it this way , so concretely , '' Milashina , 42 , told AFP .
`` If the threat was real ... @ @ @ @ @ @ @ my life by taking any measures .
It 's not possible . ''
Kadyrov 's response to the coronavirus pandemic is hardening his reputation as a strongman intolerant of dissent or criticism , with fresh allegations of police intimidation and press censorship emerging from his isolated fiefdom .
`` Once he understood the seriousness of the virus , he decided to fight it with characteristic excessive force , as usual employing harsh measures and intimidation , '' said Ekaterina Sokirianskaia , director of the Conflict Analysis and Prevention Centre and a longtime observer @ @ @ @ @ @ @ he knows how to do , '' she said .
`` This is something he enjoys doing . ''
Kadyrov emerged as Chechnya 's undisputed number one in the wake of the killing of his father Akhmad in a 2004 bomb attack in the Chechen capital Grozny .
The Kremlin credits the now 43-year-old with bringing stability to the region after an Islamist insurgency that followed two post-Soviet wars .
But rights groups say this has come at the expense of horrific abuses including extrajudicial murders and kidnappings .
When the pandemic hit @ @ @ @ @ @ @ of Chechen police patrolling streets and imposing a curfew with batons .
Warnings rang out from mosques in the Muslim-majority republic of punishments for breaking quarantine and not wearing protective equipment outside .
The republic has registered 347 coronavirus cases and six deaths but observers fear the figure is higher .
Russia as a whole now has more than 60,000 cases and over 550 deaths .

Elena Milashina had received death threats before. But they were never so direct or brazen. The erratic and iron-fisted leader of Chechnya in southern Russia, unhappy with her journalism about the coronavirus, put out an unambiguous call for violence against the reporter on social media this month.
Ramzan Kadyrov "was direct in saying what he was going to do with me — and how. This was the first time he said it this way, so concretely," Milashina, 42, told AFP. "If the threat was real... I wouldn't be able to secure my life by taking any measures. It's not possible." Kadyrov's response to the coronavirus pandemic is hardening his reputation as a strongman intolerant of dissent or criticism, with fresh allegations of police intimidation and press censorship emerging from his isolated fiefdom. "Once he understood the seriousness of the virus, he decided to fight it with characteristic excessive force, as usual employing harsh measures and intimidation," said Ekaterina Sokirianskaia, director of the Conflict Analysis and Prevention Centre and a longtime observer of Chechnya. "This is something he knows how to do," she said. "This is something he enjoys doing." Kadyrov emerged as Chechnya's undisputed number one in the wake of the killing of his father Akhmad in a 2004 bomb attack in the Chechen capital Grozny. The Kremlin credits the now 43-year-old with bringing stability to the region after an Islamist insurgency that followed two post-Soviet wars. But rights groups say this has come at the expense of horrific abuses including extrajudicial murders and kidnappings. 'Bandits and killers' When the pandemic hit Russia, videos circulated on social media of Chechen police patrolling streets and imposing a curfew with batons. Warnings rang out from mosques in the Muslim-majority republic of punishments for breaking quarantine and not wearing protective equipment outside. The republic has registered 347 coronavirus cases and six deaths but observers fear the figure is higher. Russia as a whole now has more than 60,000 cases and over 550 deaths.