Russian system of care struggles

MOSCOW -- When Yekaterina Kobzeva, a nurse at a preschool in Russia's Ural Mountains, began having trouble breathing, she called an ambulance. It was four days before she managed to find a free hospital bed.

The ambulance first took her to get a scan -- which showed damage from pneumonia to 50% of her lungs, an indication she had coronavirus. The paramedics then drove her around the city of Perm and its surroundings for hours as seven hospitals, one by one, turned her down, saying they didn't have any beds available. At dawn, she went home.

The journey took her through "circles of hell," Kobzeva, 60, recalled in a phone interview from a hospital, where doctors confirmed she had the virus. She was admitted there days after her first attempt -- and after her story made local headlines.

Russia's health care system, vast yet underfunded, has been under significant strains in recent weeks as the pandemic surges again and daily infections and virus deaths regularly break records.

Across the country, 81% of hospital beds that have been set aside for coronavirus patients were full as of Wednesday. Three times last week, the Russian government reported a record number of deaths, and the number of new infections per 100,000 people has more than doubled since Oct. 1, from 6 to over 15. Overall, Russia has recorded over 2 million cases and over 35,000 deaths, but experts say all numbers worldwide understate the true toll.

Reports in Russian media have painted a bleak picture. Hospital corridors are filled with patients on gurneys and even the floor. Bodies in black plastic bags were seen piling up on the floors of a morgue. Long lines of ambulances wait at hospitals while pharmacies put up signs listing the drugs they no longer have in stock.

Russian authorities have acknowledged problems in the health system. President Vladimir Putin even urged regional officials not to paper over the situation, saying that "feigning the impression that everything is perfectly normal is absolutely unacceptable."

Yet Russian authorities continue to insist there's no need for a nationwide lockdown or widespread closures of businesses, instead urging people to observe the measures ordered by regional governments.

But in most regions, those measures don't go beyond mask mandates, limiting the hours of bars and restaurants, ordering the elderly to isolate, forbidding mass public events and requiring employers to have some staff members work from home.

Health experts say the moves are clearly not enough.

Paramedic Dmitry Seryogin says Kobzeva's experience is not unusual. In the southwestern Oryol region where he works, patients can wait for up to 12 hours for an ambulance and then might spend five more in it, looking for a hospital bed.

Those who happen to arrive when others are being discharged get lucky, he said, but the rest are sent home.

While the Perm region, where Kobzeva sought treatment, was among the top 20 of more than 80 Russian regions in terms of daily new infections last week, Oryol ranked somewhere in the middle.

Still, 95% of hospital beds set aside for coronavirus patients there were full last week, reflecting the pressure on a system crippled by widely criticized changes that sought to cut state spending.

"We're witnessing simply a collapse of the health care system in the region," Seryogin said. "It is absolutely not coping."