How Russia’s Coronavirus Outbreak Became One of the World’s Worst

Russian President Vladimir Putin eased the nationwide lockdown imposed on March 30 to stem the spread of the coronavirus, even as Russia becomes Europe’s new hotspot for the infection. With more than 250,000 cases as of May 15, Russia now has the second-highest number of confirmed COVID-19 cases in the world.

In a televised address to the nation on May 11, Putin said that some sectors would return to work from the following day, though restrictions on large public events across the country would stay in place. Everyone is required to wear face masks and gloves in shops and on public transport. Still closed in Moscow are car dealers, non-food stores, hairdressers and most other service sector businesses. But some of those businesses have been allowed to reopen in Russia’s other provinces.

Residents still should not leave their home unless to shop, work or walk the dog, and must have a digital permit to travel. Individual regions, he said, would be left to decide whether to keep rules in place and that it would be a cautious “step-by-step” exit. “We have a long and difficult process ahead of us with no room for mistakes,” he said.

Across Europe, countries have gradually lifted restrictions following a decline in the number of recorded infections and virus-related deaths. However, Putin’s announcement about ending lockdown came as Russia registered a record 11,000 new infections on May 11.

How many cases does Russia have?

The first locally transmitted infections—cases not brought in by Russians returning from abroad—were confirmed on March 15. Since then, the numbers have soared, reaching 252,245 cases and 2,305 deaths as of May 14, according to data from Johns Hopkins University. Russia now has the second highest number of recorded infections in the world after the U.S. “The country has not yet reached its peak,” says Christopher Gerry, Director of Russian and East European Studies at the School of Global and Area Studies at Oxford University.

But Russia’s unusually low case fatality rate of 0.9%, compared to 6% in the U.S. and 14.4% in the U.K. has been questioned by experts.

According to analysis published by the Financial Times on May 11, the national death toll could be more than 70% higher than the official data show. Analysis of all-cause mortality — death resulting from disease or a harmful exposure — in Moscow and Russia’s second largest city, St. Petersburg, found that there were 2,074 more deaths in April compared to the historical average over the past five years. However, official COVID-19 deaths in the two cities accounted for just 629 in the same period, leaving 1,444 deaths unaccounted for. If this figure was included in the national coronavirus death toll as of May 11, it would lead to a 72% increase in the number of fatalities.

Moscow Mayor Sergei Sobyanin admitted on May 7 that the real number of infections in the capital city was at least three times higher than the official figure. Moscow—the country’s capital city and major transport hub—is the epicenter of Russia’s outbreak, accounting for more than half the country’s official confirmed cases and deaths. Prime Minister Mikhail Mishustin and Putin’s spokesperson Dmitry Peskov are among those in hospital with the virus.

Anastasia Vasilieva, the head of Russia’s Alliance of Doctors, claims the virus has spread much further than official figures indicate. “Some hospitals don’t test patients with pneumonia for coronavirus, and those that do don’t always include a positive diagnosis in the statistics. They’re afraid of having to report it,” she says. “The real picture is hidden from the population,” she adds. In January 2020, pneumonia cases in Moscow surged 37 % year-on-year, an increase which Vasilieva believes to have been caused by coronavirus.

On April 2, Vasilieva and her colleagues were detained by the police for a night while delivering protective gear to a hospital outside of Moscow, accused of violating self-isolation rules. “It is staggering that the Russian authorities appear to fear criticism more than the deadly COVID-19 pandemic,” said Natalia Zviagina, Amnesty International’s Russia Director.

“They want to silence me and stop my activities. The government don’t want me to become a hero” Vasilieva says.

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How has Putin and his government responded?

Russia was initially quick to respond to the coronavirus outbreak in China. The Kremlin closed its 2,500 mile-long border with China on January 30 and set up a quarantine facility in Siberia in early February for Russian nationals evacuated from Wuhan, the hotspot of China’s COVID-19 outbreak. The recorded number of coronavirus cases remained under 120 until March 17, when Putin said “the situation is generally under control.” Between the end of January and the end of March, “very little was done to tackle the pandemic,” says Gerry.

“In the beginning of March I wrote to the government to tell them we need to prepare, we need supply medical staff with PPE, otherwise they will die. A lot of doctors understood what was coming — we watched what was happening in Italy. We had time to prepare,” Vasilieva says.

Even as the number of infections has soared, Putin has repeatedly insisted that the situation is “under control.” Experts say he seems to be taking a backseat in managing the pandemic, an unusual move in Russia’s centralized political system, where power is concentrated in the president. He retreated to his country residence outside of Moscow in March, leaving local governors to decide on what restrictions to introduce.

Read More: Where’s Putin? Russia’s President Stays Out of Sight as Coronavirus Hits Economy

“There has been a genuine decentralization of command that has left responsibility and the margin of error to local authorities and not to the Kremlin, and definitely not to Putin,” says Mathieu Boulegue, a research fellow at the Russia and Eurasia Program at London think-tank Chatham House.

Putin postponed on March 25 the nationwide vote on the country’s constitutional amendments that had been planned for April 22, citing safety concerns. Since the beginning of the year parliament has been working on a series of amendments that would allow Putin to remain in power beyond the end of his current term in 2024.

The Russian president’s approval ratings hit a historic low of 59% in April, according to a survey published May 6 by the independent polling agency, the Levada Center, down from 69% in February. Levada also said in April that more Russian respondents approved of local officials’ measures against coronavirus than they did of Putin’s.

Putin has been very “worried about his approval ratings” ahead of the postponed public vote on the constitutional amendments that could keep him in power beyond the end of his current term in 2024, says Boulegue. “He is trying to create a buffer zone around him for any criticism and public discontent. It’s too early to tell how the epidemic will affect Putin’s popularity in the long-run, but it is unlikely to get out of the pandemic unscathed.”

In the meantime, Moscow Mayor Sobyanin has emerged as a leading figure in the fight against the virus. He placed restrictions on the city on March 30, stricter than those in New York City, closing all parks and non essential restaurants and stores. Following Sobyanin’s lead, leaders of about 20 regions so far have made it mandatory for residents to stay at home.

Why are cases continuing to rise?

The lockdown was introduced too late, experts say. By the time it was brought in, “the virus had already taken hold in Moscow, similar to the U.K. in a way,” Gerry says.

Poor testing early on blinded the authorities in tracking how far the virus had spread, Gerry says. In February and March, the testing regime was “inadequate,” he says. “There was a very convoluted, three stage testing regime that involved sending tests to Western Siberia and waiting a few days for the results. People could have been carrying the virus for a week or more without knowing the test results,” Gerry says.

Compliance with the lockdown has also been “relatively low,” partly because of the mixed messaging that the Russian public are receiving, says Gerry. “It was certainly much lower than was required to stop the virus from taking hold,” he adds. More than 70,000 people from Moscow and St. Petersburg were booked to visit other regions by planes and trains around the country during the long May holidays (April 14 to May 12) despite the stay-at-home orders. While international flights were grounded with a few exceptions on March 27, domestic flights have continued to operate (though demand has sharply fallen).

Russia has recently scaled up coronavirus testing, with Putin saying on May 11 that 170,000 tests are being conducted daily. However, questions over the reliability of the tests remain. Moscow’s Department of Health released a statement on May 7 saying that tests being used across the country have been wrongly showing that people in the late stage of coronavirus are disease free.

At the start of the outbreak, there was “misplaced hubris and arrogance that the pandemic wouldn’t hit Russia seriously,” says Judy Twigg, a Professor of Political Science at Virginia Commonwealth University. As infection numbers in Russia reached over 27,000 on April 1, the Kremlin sold protective gear and ventilators to the U.S., prompting criticism at home. “We raise money all over the country to buy protection for doctors, and our authorities sell personal protective equipment to the U.S. What a mockery,” the Doctors’ Alliance, an independent trade union linked to opposition figure Alexei Navalny, tweeted on April 2. Less than two weeks earlier, the Kremlin sent 122 military doctors, personal protective equipment (PPE), ventilators and mobile disinfection machines on cargo planes to assist Italy.

Meanwhile, Vasilieva says that even in Moscow, there’s not enough PPE. “Some doctors have to wear the same mask for the whole day when they should change it every two or three hours. And of course they’re taking public transport to get home. They’re fighting fire without protection,” she says.

Shortages of personal protective equipment (PPE) equipment have led to a high transmission rate within hospitals among patients, doctors, nurses and healthcare workers. An advocacy group of Russian doctors recently launched an online “in memoriam” list of the health workers who have died from coronavirus. The list names 190 people as of May 14, the youngest person being 26 years old. “That’s tragic. And it didn’t have to be that way,” Twigg says.

Regional authorities, suddenly given an unprecedented level of responsibility, have also been ill-equipped to manage the crisis. “They are not used to being handed such duties. They’re unclear about the resources they can use when health systems are short of supply. PPE hasn’t been delivered to the hospitals that really need them.” Gerry says.

Healthcare systems in some areas outside of Moscow have been struggling to cope with the rise in cases, says Gerry. Although Russia has a higher rate of hospital beds per capita than Western Europe, much of the medical equipment is out of date, he says. “Even where there are intensive care facilities, it’s questionable whether they have the workforce to manage those,” says Gerry.

“In some areas that have emerged as hot spots, there is a lack of specialists, placing healthcare workers under enormous pressure” Twigg says. She says hospitals have made pleas on social media for help from anesthesiologists, respiratory therapists and others. “They are very much in demand in some places to the point where the system is desperate for them,” she adds.

Twigg points to the cases of three doctors who fell out of hospital windows in Russia within the space of two weeks in April and May as an indication of the intense pressure that healthcare workers have been facing.“These doctors probably committed suicide from all the strain and stress,” she says.

Why does Putin want Russia to begin easing its lockdown?

The main motivation for taking the decision to reopening public life was economic, analysts say. Two thirds of Russians have no financial savings, according to a May 2019 survey by Levada, making it more urgent to get people back to work.

“Russia is in dire economic straits,” says Boulegue. In a country where the energy sector makes up two-thirds of exports, the drop in prices of oil and natural gas has posed a real threat to people’s livelihoods. Experts are now predicting the worst recession in a generation. Putin himself conceded on April 24 that Russia now faces a bigger economic crisis than the 2009 global recession. As he announced an easing of restrictions, Putin said that unemployment has already doubled to 1.4 million. As many as eight million people could be left without a job, according to the former Finance Minister, Alexei Kudrin.

Russians who have already found themselves out of work have had little recourse to financial support from the government. Unlike most European countries, Russia has not unveiled a major package to support people who are out of work. The government’s first two economic rescue packages amount to 2.8% of GDP, whereas in the U.S. it comes to about 10% of GDP. Russia is now preparing a third package and Minister of Finance Anton Siluanov has argued that the actual amount of state support is at 6.5% of GDP.

What’s next for Russia?

Significant challenges lie ahead, not least for the public health system, which is under increasing strain.

Twigg is mostly worried about the regions outside of Moscow, including some big cities and towns and rural areas. “They’re under funded, under staffed, and under equipped. That’s a story that’s still evolving,” says Twigg. But the absence of a lockdown will be “a major obstacle to saving lives in the end,” Gerry adds.

For Boulegue, the pandemic has revealed the paradox of Putin’s 20-years’ consolidation of power. “Russia is a fragile power that has neither the economic means nor ability to enforce a strict lockdown. The pandemic is the ultimate stress test.”

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