Less than a month ago, while countries across the world scrambled to contain the devastating spread of COVID-19, Russia’s president had all but declared victory over the deadly virus. “Thanks to the prompt measures taken in advance,” he proclaimed in late March, “we were able to contain the mass penetration and spread of the disease in Russia. Despite the potentially high level of risk, we must say that the situation as a whole is under control.” The self-congratulatory remarks were coupled with spectacular PR stunts involving the shipment of medical supplies to Italy and the United States, as well as sharp criticism of European authorities for their “mismanagement” of the pandemic.

Behind the official triumphalism, however, the realities faced by Russian doctors treating patients with respiratory symptoms told a starkly different story. According to the Russian government’s own statistics, Russians were contracting “pneumonia” at significantly higher rates than in the past. In January, Moscow physicians reported a 37% increase in pneumonia cases compared to the same period the year before. “While the whole world is facing an outbreak of a new coronavirus, Russia is facing an outbreak of a community-acquired pneumonia. And as usual, we’re facing the lie of the authorities,” said Anastasia Vasilyeva of the Doctors’ Alliance trade union in March.

After weeks of debate over the accuracy of the statistics provided by government authorities, an official letter to Moscow hospital directors from Aleksei Khripun, head of Moscow’s health department, seemed to support the allegations that Russia’s relatively low figures were false. The letter acknowledged that testing had been compromised by a “very high number of false results” that concealed the true extent of the spread.

The high number of false negatives has been partially explained by deficiencies in the testing devices used. Tests were initially conducted with a locally manufactured device that was viewed by many as faulty. This was compounded by the fact that samples had to be sent to a single lab in Siberia, leading to a massive backlog. As a result, for weeks Russians continued to go about their daily lives, with scant information on the actual risk of infection.

It wasn’t until mid-March that government authorities decided to shut down schools and some businesses, restrict air travel, and launch an economic stimulus package providing limited financial relief. But by then it was impossible to track the spread of the disease, and it was clear that Russia would soon see a troubling rise in infection rates.

An Admittedly “Problematic” Situation

Today, the seriousness of Russia’s COVID-19 situation is undeniable. As of April 21, 52,763 cases of infection have been reported nationwide, with an overall death toll of 456. Cases of infection have now been reported in all regions. On April 10, Sergei Sobyanin, the mayor of Moscow, acknowledged that “the virus is gaining momentum” and that “the situation is becoming increasingly problematic.” The city of Moscow has been the hardest hit in Russia so far, and local health authorities have admitted that the city’s ambulance service and hospitals are now stretched to the limit. In the past few days, winding lines of ambulances have been reported at Moscow hospitals, with ambulance drivers reporting they have had to wait up to 15 hours to drop off patients. The virus has also started to take hold in Russia’s vast hinterland, where the crumbling health system raises serious concerns over the ability of hospitals to deal with a surge in cases.

Russia’s healthcare system as a whole is woefully unprepared to deal with a pandemic, after years of cutbacks and hospital closures in what has been officially referred to as a process of “optimization.” The latest healthcare reform began in 2010, and its stated goal was to optimize costs by closing down inefficient hospitals and expanding the use of high-tech medical facilities. In practice, this meant that healthcare institutions received more funding if they performed well financially. As a result, a number of institutions operating in remote areas were pushed to the brink of survival, and access to healthcare became increasingly limited outside of the most densely populated regions. By 2019, there were fewer hospitals in Russia than in 1932 and more than two times fewer hospital beds than in 1991. Healthcare services have also been increasingly privatized, and the number of paid services increased from 15,828 to 66,085 from 2005 to 2018.

The dismal outcome of this optimization process has even been acknowledged by state officials. In November of last year, Deputy Prime Minister Tatyana Golikova told Russian news agency Interfax that the administration had been “frankly unsuccessful” in correcting the errors made in the optimization process in many regions of the country. Finance Minister Anton Siluanov also noted that some district clinics and hospitals were in “poor, if not terrible” condition.

Despite the unquestionable gravity of the situation, quarantine measures taken in large Russian cities have been lax. In Moscow, no official quarantine has been declared. Instead, authorities have imposed what has been called a “state of high alert,” with many companies continuing their normal operations.

The federal government has also started easing quarantine measures throughout Russian regions, putting thousands of workers at risk. On April 8, Putin held a meeting with the governors in which he declared “The economy cannot be stopped (…) We need to create the conditions for companies, organizations and business people to return to their normal work schedule.”

“Sensible governors are in a panic,” said a source close to the government. “There will be a surge in infections.” According to sources close to the cabinet of ministers, the ultimate goal of gradually lifting the quarantine measures is to reduce business losses so that the state will not be required to provide significant financial support.

Persecuted for Speaking Out

According to a survey commissioned by Russian media outlet Kommersant in early April, 55% of Russian doctors believe that their health facility is unprepared to treat patients with COVID-19. 49% reported a lack of PPE, 35% said their facilities lacked medical equipment, and 28% indicated a lack of staff.

“Since the outbreak of the coronavirus epidemic,” says Vasilyeva of the Russian Doctor’s Alliance, “our union has received dozens of complaints from medical professionals all over the country. They report a total lack of PPE and the inability of hospitals to fight the virus. Many of them (…) are forced to sew masks for themselves out of gauze.”

In late March, the Doctor’s Alliance announced the launch of a fundraiser to supply PPE to hospitals treating patients with COVID-19. After the announcement, Vasilyeva was summoned to the Russian Investigative Committee in connection with an inspection regarding the “dissemination of knowingly false information about the spread of COVID-19.”

Since April 1, Russians face fines of up to 700 thousand rubles (about USD 9,460) or prison terms of up to three years for the dissemination of “intentionally false” information about “circumstances posing a threat to the life and safety of citizens or measures taken to ensure the safety of the population and territories.” The penalties are even more severe if a person is found guilty of inadvertently causing someone’s death or other grave consequences by this dissemination, in which case they could be fined up to 2 million rubles (about USD 27,000) or imprisoned for up to 5 years. The new provisions are part of an “anti-virus” package of laws that also includes hefty fines for healthy people who violate stay-at-home orders and up to seven years in prison for serious violations of quarantine rules.

On the afternoon of April 2, Vasilyeva and other members of her union were detained on a highway near Okulovka, in the Novgorod Region, where they were delivering more than 500 respirators, protective overalls, goggles and gloves to two local hospitals. Charges were filed against them under new administrative provisions sanctioning non-compliance with the rules of conduct in emergency situations. The union members spent almost an entire day at the police station and were released after 22 hours, after which Vasilyeva was again detained. The Alliance described her detention as an attack. A video of the incident shows multiple police officers violently attempting to drag her into the police station. She reportedly lost consciousness and was beaten in the stomach, according to human rights activist Dinar Idrisov. Administrative charges were filed against her for “disobeying the lawful requirements of police officers.”

In Moscow, neurosurgeon Vsevolod Shurkhai was summoned to the Prosecutor’s Office on April 7 in connection with an interview he gave to Russian media outlet Current Time, in which he denounced a lack of PPE and ultraviolet lamps for air purification at his hospital. He also reported that a single mercury thermometer had been provided for 40 doctors in his department. According to the Current Time article, Shurkhai had written to the hospital administration about the shortages but was advised not to escalate the situation. The doctor then turned to supervisory authorities and the media. His case is currently under review by the Prosecutor’s Office. When asked if he was afraid of being dismissed, he answered: “I’m not afraid, because dismissal is not death. What I’m afraid of is that someone will get sick because measures have not been taken. I think this is the hardest thing a doctor can experience, knowing that he has become just a passive part of this system and that someone paid for these mistakes with their life.”

Doctors are not the only ones threatened under the recent amendment to Russia’s Criminal Code. The first criminal case for “knowingly disseminating false information” on the coronavirus was filed in record time, just one day after the enactment of the new law. On April 2, an investigation was started in St. Petersburg into a post on Russian social media platform VKontakte by environmental activist Anna Shushpanova. She had reported that a person showing signs of coronavirus in the city of Sestroretsk had been discharged from a clinic and was allowed to go home by public transportation. “My goal was to attract the attention of the polyclinic and the hospital so that they would take the coronavirus situation more seriously,” said Shushpanova. On April 3, ten investigators conducted a search at her home, where she lives with her mother and sister. The activist’s computer was confiscated, as well as her father’s computer, a portable hard drive, her phone and a USB flash drive. Shushpanova and her sister were detained and interrogated.

According to the Russian publication OVD-Info, 12 cases had been filed by April 16 under the new Section 207.1 of the Criminal Code. Human rights groups fear that this number will increase dramatically in the coming weeks as government authorities seek to control the narrative around the now critical coronavirus situation in the country.

After the recent sharp rise in new cases, Putin also announced that the military could be deployed throughout the country to deal with the outbreak. “All capabilities” of the Russian military “can and should be used,” he said last week.

In the Moscow Region, local authorities have taken increasingly severe measures to monitor residents’ movements around the city. Muscovites are now required to obtain an electronic pass containing a QR code for any kind of personal or public transportation. On the first day of the pass system, large crowds gathered at subway stations, and severe traffic jams were reported at nearly all entryways to the city, as people waited to have their passes checked.

“It’s egregious (…) It’s genocide of one’s own people. I don’t know what word to use,” said Dr. David Matevosov of Medsi Premium, noting that in such crowded conditions a single person can infect up to ten people. “Almost two and a half weeks of quarantine have gone down the drain,” he added. “We can definitely expect another peak in 7.14 days, depending on the incubation period.”

Another method of population control used by the city of Moscow under the pretext of protecting its people by ensuring compliance with quarantine measures is a massive facial recognition system rolled out earlier this year. The system is based on the use of 175,000 cameras connected to a single data storage and processing center, where the city’s facial recognition system processes several tens of millions of faces per day. “We want there to be even more cameras so that there is no dark corner or side street left,” said Oleg Baranov, Moscow’s police chief, in a recent briefing. He added that the service will soon install an additional 9,000 cameras. According to BBC Russian News, the city has allocated about 500 billion rubles (about USD 6.6 billion) for the development of a data collection and analysis system since 2012.

In Putin’s Russia, the COVID-19 crisis is being exploited by state authorities to tighten their control over residents’ movements and build sweeping new surveillance capabilities. It has become the latest pretext for increasing state censorship, cracking down on dissent, and violating human rights. Its legacy of expanded state powers may far outlast the virus itself.