‘Behave like adults’ Russia’s Sverdlovsk Region is among those hardest hit by the coronavirus. Regional authorities are blaming local residents.

Strange statistics

Russia’s Sverdlovsk Region registered its first case of the coronavirus in mid-March. By June 1, the region was recording 250–290 new cases per day. By June 24, this figure had dropped to 181 cases, but the start of voting in the constitutional plebiscite was accompanied by another spike in infections. In the past week (since July 15), the regional statistics have risen to 263–349 new cases per day. 

Now, the Sverdlovsk Region is regularly ranked second or third among Russia’s regions with the highest daily increase in coronavirus infections — only Moscow has higher numbers, and, until recently, the Moscow Region. All total, 18,250 people in the Sverdlovsk Region have contracted COVID-19 during the pandemic, resulting in 205 deaths.

What’s more, medical workers in the region have noted that even these statistics are underestimated. In conversation with Meduza, one doctor from Yekaterinburg said that the region has very limited testing for COVID-19. The regional Health Ministry denied these claims. 

That said, even the Sverdlovsk Region’s branch of Rospotrebnadzor (Russia’s public health authority) has found discrepancies in the statistics. At the beginning of June, the department’s head, regional chief sanitary doctor Dmitry Kozlovskykh, said there was a discrepancy between the number of positive coronavirus tests in the region and the number of emergency notices about COVID-19 infections. This was revealed in a letter addressed to the regional governor, Evgeny Kuyvashev. The letter said that from June 8–14, laboratories in the region confirmed 2,659 coronavirus cases, but medical workers only sent in 1,784 emergency notices to Rospotrebnadzor. During the week of June 15–21, there were 3,036 coronavirus tests that came back positive, but the number of emergency notices was nearly half as many — 1,546. “The proportion of un-submitted emergency notices from general health facilities in the city of Yekaterinburg was 18.7 percent,” the letter said. 

Kozlovskykh’s letter also noted that this situation threatens the life and health of citizens and “promotes the spread of a new coronavirus infections among the population of the Sverdlovsk Region.”

In response, the region’s Deputy Governor, Pavel Krekov, claimed that “there was no distortion of statistical data at the institutions.” On the other hand, he admitted that discrepancies in the statistics could arise due to the duplication of data, for example when a single coronavirus patient is registered by a local doctor, as well as a paramedic, and at a hospital. In turn, regional chief sanitary doctor Dmitry Kozlovskykh said that the letter was “a working correspondence between the departments for the reconciliation of data.” He also noted that Rospotrebnadzor has found similar discrepancies in the statistics several times, and claimed that the data had already been harmonized. 

Meduza spoke to six doctors working in Yekaterinburg and other cities in the Sverdlovsk Region: five of them said that manipulating statistics has been a constant practice during the pandemic. According to them, the figures were lowered the most ahead of voting in the constitutional plebiscite. And this practice is ongoing — the doctors are convinced that the real morbidity statistics in the region are several times higher than reported. 

Ongoing problems

Four of the doctors from the Sverdlovsk Region told Meduza that hospitals have been facing the same problems since the start of the pandemic. For example, some hospitals simply aren’t testing people with symptoms characteristic of the coronavirus. According to them, only patients who are in near-serious condition are being tested, for example, those with very high fevers.

A lot of medical workers aren’t being tested either. Two of the doctors told Meduza that they hadn’t been examined even once over the course of the pandemic — much like with patients, only healthcare workers with very high fevers are being tested. If a medical worker tests positive for COVID-19, more often than not their co-workers don’t get tested, even if they’ve been in close contact. The situation got worse in June — against the backdrop of rising incidences, some hospitals that were previously testing their employees for COVID-19 suspended examinations. “If there was testing then everyone would have to sit in quarantine. Who will work?” an employee from an in-patient facilities explained.

Regional doctors are convinced that all of this is meant to lower the morbidity rates in specific hospitals, so the head doctors can keep their jobs. “[The management] always has the same excuse — there’s no money [for testing],” one of the doctors said. 

Three medical workers added that their facilities are still having problems securing personal protective equipment (PPE) — for example, there’s an ongoing shortage of protective suits. Hospitals that aren’t officially admitting coronavirus patients are finding themselves in an especially difficult situation. Medical workers in the region are currently among the most active spreaders of the coronavirus, the doctors maintain.

A paramedic from Yekaterinburg told Meduza that medical workers are often put in situations where they come in contact with coronavirus patients without any protective gear, simply because people aren’t informing dispatchers that they are calling due to a suspected case of COVID-19. “Honestly, I don’t know why [people] do this. It’s possible they’re afraid we won’t come,” the paramedic said. 

As a result, regional hospitals regularly experience spikes in coronavirus infections. According to two of the doctors who spoke with Meduza, Yekaterinburg’s biggest hospital — Sverdlovsk Regional Clinical Hospital Number 1 — has seen between 180–190 of its employees fall ill during the pandemic. The hospital’s head doctor, Igor Trofimov, confirmed that more than 100 medical workers there had fallen ill.

The large number of infected doctors in the Sverdlovsk Region has made it increasingly difficult for non-coronavirus patients to access care. Doctors say that patients often have to wait for a long time to get an appointment — moreover, they’re forced to stand in long queues with other people, which could include coronavirus patients. According to Nikolai Tsukanov, Putin’s plenipotentiary envoy to the Urals, the Sverdlovsk Region has already seen an increase in mortality from cardiovascular diseases, because patients were unable to get medical assistance on time. 

Taken together, all of these factors have led to the Sverdlovsk Region being considered one of the most poorly organized parts of the country in terms of healthcare. According to Kommersant, this assessment was delivered during a closed meeting with federal Health Minister Mikhail Murashko on July 17. The health minister allegedly underscored that he was getting the impression that the regional department’s work was “carelessly organized.” Federal officials also pointed out that the ministry’s mistakes “were leading to a rise in mortality in various areas.” A source familiar with the events of the meeting confirmed these reports for Meduza. 

Shifting blame

On the night of July 17, Yekaterinburg had not one, but two religious processions marking the 102nd anniversary of the Russian Imperial Romanov family’s execution. The main procession from the Church on the Blood took place under the leadership of Metropolitan Kirill and drew a crowd of up to 10,000 people. The “alternative” procession, which drew no more than a thousand participants, was led by the recently defrocked Schema-Hegumen Sergii. Most of the attendees weren’t wearing masks or maintaining social distancing. In addition, the security guards from the Sredneuralsk Monastery — a nunnery outside of Yekaterinburg, which is currently under Father Sergii’s control — directly demanded that visiting pilgrims take off their masks. 

The official religious procession took place with permission from the authorities, and they didn’t interfere with Father Sergii’s “alternative” gathering either. Governor Evgeny Kuyvashev maintained that it would have been impossible to ban the procession. “It was obvious that a lot of believers, even knowing the risks associated with the new coronavirus infection, wouldn’t refrain from walking in the cross procession along the traditional route,” he explained, adding that those who participated were given masks.

The day after the religious processions, downtown Yekaterinburg hosted another mass event — a street disco outside of the regional government building drew several hundred people. Unlike the religious processions, the party was broken up by police. Three students were deemed responsible for organizing the event and received administrative protocols for “failure to comply with the rules of conduct during an emergency.” Law enforcement underscored that the organizers regretted hosting the party.

The authorities are blaming local residents for the high rates of coronavirus infection — shifting the focus to the people who are going to parties or the beach during the pandemic. “Today 349 new cases of the infection were added to our statistics. And, for example, people were crowded on the banks of the Verkh-Isetsky Pond! No distancing, no masks. There were even children there, and [elderly] people...Therefore, I will say this: when we all start to behave like adults, then we’ll end self-isolation and open everything back up,” Governor Kuyvashev said on July 16. 

Officially, the high alert regime in the region has been extended until July 27. Local shopping centers remain closed, and masks are required in public places. At the same time, as of July 20, holding open-air public events is officially permitted, and museums and libraries have reopened.

In conversation with Meduza, Fyodor Krasheninnikov, a political scientist from Yekaterinburg, attributed the inconsistencies to the regional authorities trying to follow the federal government’s example to a tee, while the federal point of view on the pandemic changes regularly. “Currently, the [Yekaterinburg] authorities are trying to resolve several problems. And the fight against the pandemic is hardly the first one. First is preserving the authorities’ prestige. Not quarreling with the Church. Then comes resolving things with the economy. After that, calming people down, and so on,” he explained. 

Yekaterinburg City Duma Deputy Konstantin Kiselev agrees with Krasheninnikov’s assessment — he pointed out that it’s strange to blame the development of the pandemic on ordinary people, especially on the heels of holding the vote on constitutional amendments, permitting religious processions, and putting on a Victory Day parade. “I’m categorically against the rhetoric that the people themselves are to blame from the increase in infections. All of these inconsistencies come from federal trends. Since neither Putin nor [Defense Minister] Shoygu would understand if they didn’t hold [the vote or the parade],” the deputy said. 

Awaiting the peak

Five of the doctors who spoke with Meduza believed that the coronavirus situation in the Sverdlovsk Region will only get worse. “I think that we’re at the peak now, but no one can say how long it will last,” the sixth doctor added.

The medical workers noted that against the backdrop of the authorities’ inconsistent policies, a lot of residents have begun to neglect safety measures. “When you go to the store in a mask, everyone looks at you like you’re a fool,” one of the doctors underscored.

Yekaterinburg City Duma Deputy Konstantin Kiselev agrees: “Now any prohibitive measures are most likely only going to provoke hate and have the opposite effect.” At the same time, he also notes that Yekaterinburg’s urban features are contributing to the further growth of infection rates — in addition to the population’s high density and mobility, it also has strong links with Moscow, where many city residents regularly fly on business.

The local doctors said that with the increase in infection rates, hospital managers have started actively asking their employees not to tell outsiders what’s happening inside their facilities. At some hospitals, doctors were even encouraged not to discuss the situation with their relatives.