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‘We just want to remember our fallen colleagues’ Russian doctors launch website to list health workers who have died during the coronavirus pandemic

Source: Meduza

An advocacy group of Russian doctors has launched a website with a crowdsourced “in memoriam” list of the health workers who have died in Russia during the coronavirus epidemic. The list already includes more than 70 names — far more than Russian officials have acknowledged. Meduza special correspondent Pavel Merzlikin spoke to Moscow cardiologist Alexey Erlikh, one of the advocacy group’s creators, to find out more about the “in memoriam” list.

Many say the list is an attempt to get reliable statistics about the number of coronavirus deaths among doctors. Is that the main goal here?

It’s about remembering these people, more than anything. This isn’t any kind of reliable mortality statistics — it’s just people coming to terms with colleagues who have died on the job from coronavirus or due to complications caused by coronavirus. This isn’t an attempt to collect statistics. 

How did this idea come about? Was there some specific catalyst, like a seriously ill colleague?

It seemed to us like a perfectly natural thing to do, how we did it or in some other way. Finding some way not to forget our fallen colleagues — it doesn’t get more natural. 

But, of course, we all have colleagues who have gotten sick. For some, the cases have been severe; for others, not so much. We realize that a lot of people are at risk, but it’s much higher for health workers. For doctors, nurses, and medics. The risk is high simply because these workers come into contact with coronavirus every day.

The list is populated by messages that can be submitted through your website. How do you verify these messages about deceased health workers?

We ask people submitting information to provide their contact information. If possible, we get in touch and verify.

Do you ask for any verification documents? Do you verify every message?

We don’t ask [for documents]. Usually, it’s enough that people inform us. In some cases, there’s a need for verification. In these cases, we verify the information by other means, including by trying to check through colleagues at the hospitals about which we’re getting reports.

The data in your list have already begun to diverge sharply from the official statistics about deaths among doctors. For example, officials in St. Petersburg say four of the nurses on your list did in fact die, but “they either had other serious illnesses that caused their deaths or they were not infected [with coronavirus] while on duty.” How do you respond?

I’d respond that it’s not important where they were infected. These are health workers who died from coronavirus, in any case. And we can argue about the other illnesses they cite as the cause of death. What we know is that these were people who were diagnosed with the coronavirus, which became the trigger for complications.

The list now has 70 names. Did everyone on the list test positive for COVID-19?

The names on the list are people whose deaths colleagues associate with the coronavirus. We do not check test results. As health workers, we just want to remember our fallen colleagues.

What do you mean by “deaths associated with the coronavirus”?

I’m not prepared to discuss this or to participate in discussions about the causes of death. There are times when pneumonia or myocardial infarction can be considered the cause of death. But if someone tests positive for the coronavirus [before dying], then the coronavirus is associated with their death.

But it’s my understanding that your project’s list includes the names of health workers who did not test positive for COVID-19. Some of them merely had symptoms. You write that you have two criteria for adding names to the list: one, that the deceased was a medical worker; and, two, that they “died during the epidemic from causes somehow associated with COVID-19, even if the diagnosis was not confirmed by testing or if the infection overlapped with other serious illnesses.”

We don’t verify tests, that's true.

For example, you get a message from a doctor about the death of a colleague during the pandemic. Judging by his symptoms, he had pneumonia, which often develops due to COVID-19, but he was never tested for the disease. Do you add his name to the list?

I think his name should be included anyway.

And what if he’d had the same pneumonia symptoms but had tested negative for coronavirus?

I don’t know. We’d consult, probably.

Did you anticipate that the list would grow to 70 names within a couple of days? That the number of reports about health workers’ deaths would be so much higher than official data?

Sadly, I personally expected as much.

Is a lack of necessary protective gear the main reason for so many deaths?

It’s not just a lack of PPE but other factors, too. For example, [incorrect] patient routing, misunderstanding the danger of infection, the concealment of infections. Many reasons.

Can you draw any initial conclusions based on the list? Like, can you identify regions where the situation is worst?

We’re not involved in any analysis like that. First, the list is being updated every day, unfortunately. Second, it’s unclear how you’d conduct an analysis like that or why we'd need to. 

Many people view your website as a list of doctors who have died directly because of the coronavirus — that their cases were confirmed. But you’re actually including people here according to broader criteria. Are you at all concerned that the authorities will ignore these nuances and come after you for disseminating “fake news”?

If that’s how they see it, then we’ll sit down with Roskomnadzor [Russia’s federal censor] or whatever. Honestly, I haven’t thought about it. The same probably goes for my colleagues who helped create the list. 

It looks like the authorities are already preparing to ease restrictions imposed because of the pandemic. As a doctor and someone monitoring deaths among doctors, would you endorse that policy?

The restrictions probably need to remain in place, in some form, but they can be slightly relaxed, in my view.

Has the spread really started to plateau in Russia?

We’ll need to wait another few days to know for sure. For the time being, it seems new cases aren’t growing too sharply. We’ll see what happens from here.

To generalize, looking only at what we can see right now, is it fair to say that Russia’s healthcare system was able to handle the pandemic?

If we’re talking about Moscow and its problems, I’d give it a C-. Nationwide, it’s too soon to say. In a strict sense, the virus still hasn’t reached many regions.