Russia's health system under strain as the virus surges back

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 mand to find a free hospital bed.

ambulance first took her to get a scan — which showed dam from pneumonia to 50% of her lungs, an indication she h coronavirus. paramedics n drove her around city of Perm and its surroundings for hours as seven hospitals, one by one, turned her down, saying y didn’t have any beds available. At dawn, she went home.

journey took her through “circles of hell,” Kobzeva, 60, recalled in an interview with Associated Press by phone from a hospital, where doctors confirmed she h virus. She was only mitted re days after her first attempt — and after her story me local helines.

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

Across country, 81% of hospital beds that have been set aside for coronavirus patients were full as of Wednesday. Three times last week, Russian government reported a record number of daily deaths, and number of daily 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 true toll of pandemic.

Reports in Russian media have painted a bleak picture in recent weeks. Hospital corridors are filled with patients on gurneys and even floor. Bodies in black plastic bags were seen piling up on floors of a morgue. Long lines of ambulances wait at hospitals while pharmacies put up signs listing drugs y longer have in stock.

Russian authorities have ackwledged problems in health system. President Vlimir Putin even urged regional officials t to paper over situation, saying that “feigning impression that everything is perfectly rmal is absolutely unacceptable.”

Yet Russian authorities continue to insist re's need for a nationwide lockdown or widespre closures of businesses, inste urging people to observe measures ordered by regional governments.

But in most regions, those measures don’t go beyond mask mandates, limiting hours of bars and restaurants, ordering elderly to self-isolate, forbidding mass public events and requiring employers to have some staff work from home. Health experts say moves are clearly t eugh.

Paramedic Dmitry Seryogin says Kobzeva's experience is t unusual. In southwestern Oryol region where he works, patients can wait for up to 12 hours for an ambulance and n might spend five more in it, looking for a hospital bed. Those who happen to arrive when ors are being discharged get lucky, he told AP, but rest are sent home.

While Perm region, where Kobzeva sought treatment, was among top 20 of more than 80 Russian regions in terms of daily new infections last week, Oryol ranked somewhere in middle. Still, 95% of hospital beds slated for coronavirus patients re were full last week, reflecting pressure on a system crippled by widely criticized reforms that sought to cut state spending.

“We’re witnessing simply a collapse of health care system in region,” Seryogin said. “It is absolutely t coping.”

A partial six-week coronavirus lockdown in March only ded to long-brewing public frustrations over Russia's alrey weakened ecomy. Soon after that, Putin delegated powers to impose virus-related restrictions to regional goverrs. Critics saw move as an effort to iculate himself from any more fallout over pandemic.

During fall resurgence of virus, Kremlin has consistently pointed fingers at regional goverrs.

“Colleagues, you have received bro powers for implementing anti-pandemic measures. And body has relieved you of personal responsibility for opted measures — I really do hope that y were opted on time,” Putin reminded goverrs last week.

But just like Kremlin, governments in vast majority of Russian regions have been loath to shut businesses or impose lockdowns. only exception has been Siberian republic of Buryatia, where last week region’s goverr ordered cafes, restaurants, bars, malls, cinemas, beauty parlors and saunas to shut down for two weeks.

Regional goverrs find mselves in an impossible position, explained political analyst Abbas Gallyamov. y face public frustration if y don’t impose tough restrictions and outbreak continues to r, and y face it if y do because y don’t have funds to ease pain of closures.

“All finances have been long centralized, and regions don’t have spare money,” Gallyamov said. “So de jure, a goverr’s hands are untied, but de facto y’re still tied because y don’t have money to impose a lockdown and compensate people for ir financial losses.”

In dition, Putin has so thoroughly centralized power that regional goverrs are t used to acting independently, ted Judy Twigg, a professor of political science at Virginia Commonwealth University, specializing in global health.

In meantime, many Russian regions are buckling under growing tide of patients.

In Buryatia, Siberian republic that has imposed country's strictest measures, Dr. Tatyana Symbelova told AP that as number of patients rose, her hospital kept ding beds — “in corridor, in outpatient ward next door” — but “ situation, still, grew worse and worse.”

Symbelova, chief doctor at Republican Infectious Disease Hospital in Ulan-Ude, and her colleagues are w taking patients whose condition was “severe or of moderate severity” and turning down those with milder cases. A new coronavirus ward with 180 beds opened last week in city, and she hopes that and shutdown will help.

But in meantime, she is worried.

“Such risks we're taking! Telling patients (with milder cases) y can go and treat mselves at home, when y may come in three days later with ir lips blue," Symbelova said. "We’re very seriously choking.”