This week started with a major presentation by President Putin of Russia’s plans for gradually lessening the strictures of lockdown, restarting the economy and restoring normal life as the epidemic in the country passes stabilization, which was just reached, and enters the ebb phase of contagion, hospitalization and death. The setting was a virtual conference with major players in the government responsible for managing the health crisis. However, since Putin’s lengthy speech which came to 17 typed pages was televised live by all Russian state channels, it could just as easily be called an address to the nation. The main focus was on the economy and assistance to citizens and to business.
That speech has received little attention in the West and I will come back to it in a follow-up tomorrow, because it tells us a great deal about the guiding principles of Russian governance and its ‘social economy.’
In this essay I deal with the second major appearance by Putin this week dedicated to the coronavirus which took place this afternoon, Friday, 15 May. It also was carried live by all state television channels. It also was nominally remarks made within a virtual intragovernmental conference. And it also was a major policy statement that merits our greatest attention, not only for what it says about Russia, but more importantly for what is says about us, in the West, and how we are badly handling the challenges of the pandemic because of our stubborn and proud disparagement of China.
I listened closely to two of the reports to Putin from the ‘regions’, meaning territories outside Moscow on what is being done right now to handle the growing case load of coronavirus sufferers, and Putin’s comments which may be characterized as ‘programmatic’ insofar as they seek to use the ongoing experience in combatting the coronavirus to deliver, at long last, a substantial rebuilding of medical infrastructure across the country with the help of the military.
The regions reporting were St Petersburg, which is still relatively healthy compared to Moscow but has seen a growing number of infections and hospitalizations in the past few weeks, and Voronezh, which more typically represents the Russian provinces and till now has had a very low level of infection, but is preparing for the worst. In each case the governor read a report of what is being done to build dedicated hospitals for treatment of coronavirus cases both by the local administration and with the help of the Ministry of Defense, represented by the senior officer standing at their side who is overseeing construction of modular hospitals by military personnel and staffed by military doctors.
In Petersburg, which is Russia’s second largest city with a population of approximately 5 million, there are specialized hospitals for light cases with 1,000 beds being completed and specialized hospitals with Intensive Care Units in the size of 200 to 600 beds also reaching completion. A similar approach is being implemented in Voronezh.
The involvement of the Armed Forces in building some of these hospitals is very significant, because they have developed modular solutions that can be applied uniformly across the vast continent that is Russia.
In a way, these projects are similar to what Moscow did as first mover when it opened the state of the art hospital at the city’s periphery in a district called Kommunarka. The logic is to remove the coronavirus patients from the general hospital system. This leaves the general hospitals free to continue to serve their traditional ‘clientele,’ the community of those with other ailments. It focuses training, equipment, medicines in locations where maximum attention can be given to ensuring sanitary conditions that protect medical staff and encourage application of well-rehearsed solutions to the challenges of each patient.
Now where would the Russians have gotten this idea from? It is not hard to imagine. We need only think back at the response of the Chinese authorities following the recognition that the outbreak in Wuhan posed existential questions for the local population, indeed for the nation as a whole if it were not contained and wiped out. We all were stunned at the construction of the first specialized facility to deal with the epidemic in one week!
The Russians are less “Stakhanovite” these days, and the hospital projects mentioned above are being executed on a 6 week schedule. But they are being implemented at the highest technical level. Putin gave the figure 5 million rubles as the cost of one hospital bed in the new units; that comes to $60,000 and in Russia’s price equivalency to the dollar probably represents a US cost double or triple the nominal ruble cost. So they are not skimping, not planning to put the incoming patients on matrasses on the floor as happened in Bergamo, Italy.
We also know from the day’s press, that the Russians are now entering into mass production of the few medicines which the Chinese told them proved to be effective in treating their coronavirus patients. Which ones Putin did not say.
And now I must ask, how does Russia’s borrowing from the Chinese playbook compare to what we see around us in Western Europe and the United States? Here China comes up in the coronavirus story only as a punching bag, the people who ‘kept us in the dark’ about the dangers of this plague, not as providers of solutions and advice from their own first and successful experience snuffing it out.
The question I must pose is this: are the Russians being especially clever, or are we being especially stupid?
The segregation of coronavirus patients from the general flows of the ailing contrasts dramatically with what has been going on in Belgium, for example. Here about 100 hospitals around the country have been sharing the aggravated cases of coronavirus requiring hospitalization. This population reached about 5,000 at its peak with nearly one third in Intensive Care, of which to two thirds required ventilators. At the peak a couple of weeks ago, the number of patients in the last category came close to the national inventory of ventilators, a bit more than 1,000. Thankfully, the numbers in the past ten days have come down sharply and there are now half the number of hospital beds taken by virus sufferers.
However, at the peak all of Belgium’s hospitals resembled war zones with ‘extraterrestrial’ suited medics at the entrances. Normal patients did not have to think twice to shun them. Accordingly, even non-elective surgery was being cancelled; chemotherapy patients were staying at home, etc. This is one element of the mortality brought on by the coronavirus that no one has been recording. Moreover, one has to ask about the quality of medical attention when 100 hospitals, mostly without any experience in epidemics, in virology, were being used to treat Covid19 patients. This had to be a contributor to the body bag count that went into official statistics.
Finally, in closing ,a word about body counts.
In the past several days there have been news reports in Western media accusing Russia of under-reporting deaths in the country due to the coronavirus epidemic. In particular, I can point to articles in The New York Times and in the Financial Times.
With respect to the New York Times the piquant title given to one respective article pointing to a “Coronavirus Mystery” – is fully in line with the daily dose of anti-Russian propaganda that this most widely read American newspaper has been carrying on for years now. A couple of weeks ago the same paper carried an article by one of its veteran science journalists accusing President Putin of using the coronavirus to undermine American science, and medicine in particular. That article was totally baseless, a collection of slanderous fake news.
With respect to the accusation of intentional underreporting of mortality figures in Russia, the New York Times was actually borrowing from the Financial Times, which stated that Russian deaths from the virus may be 70 per cent higher than the official numbers. In both cases, even if the underreporting were true, and this is very debatable, it obscures the fact that both official and unofficial numbers are miniscule compared to the devastation wrought by the virus elsewhere in Europe (Italy, Spain and the UK) or in the USA, where the numbers continue to spike. Russia has either a couple of thousand deaths or something closer to three thousand. Compare that to the official deaths ten times greater in the worst hit European countries having overall populations less than half or a third of Russia’s. So the accusation of 72% underreporting in Russia is a debating point that can easily be shown to be deceptive if not irrelevant.
However, there is a missing element here: context. The whole issue of underreporting Covid19 deaths has been reported on by the Financial Times for a good number of countries, not just Russia. Indeed, their first concern has been to show that the official numbers posted by the UK government, now in the range of 30,000 are a fraction of the actual deaths in the UK (more than 50,000) if one uses not the death certificates case by case but the overall excess of deaths in a given month in 2020 compared to the norm in the given country over the 3 preceding years. The New York Times in its typical cherry picking approach to find what is worst to say about Russia ignores this background of FT reporting.
Why is there underreporting? There are many possible reasons, the chief one is the varying methodology used by the various countries to allocate a given death to the virus.
By curious coincidence this very issue was addressed in today’s press conference on the pandemic by the Belgian Ministry of Public Health. As is widely reported, Belgium has one of the world’s highest rates of mortality from Covid19, very close to the figures in Spain and Italy. This has been reported in the local press and the Ministry today chose to respond. As they noted, Belgium is one of the few countries to report ALL Covid-19 deaths, meaning both those in hospital and those in care homes (mostly old age homes). In Belgium, as in France, deaths have been equally split between these two sets of institutions. Almost no deaths have occurred at home or, as they say, ‘in the community.’ Moreover, deaths are attributed to Covid-19 if the symptoms were there even if no proper test was carried out to confirm this.
In total, Belgium death count today stands close to 9,000 for a general population of 11.8 million. High, but still substantially lower than the mortality in New York, for example, whichever way you count. And, to put the picture into a less dire context, it is reported that each winter Belgium experiences about 5,000 deaths attributable to the seasonal flu. Of course, the flu does not lay waste to the medical establishment, and there you have the difference that makes the ongoing Russian approach to Covid19 so relevant.
©Gilbert Doctorow, 2020
[If you found value in this article, you should be interested to read my latest collection of essays entitled A Belgian Perspective on International Affairs, published in November 2019 and available in e-book, paperback and hardbound formats from amazon, barnes & noble, bol.com, fnac, Waterstones and other online retailers. Use the “View Inside” tab on the book’s webpages to browse.]