Coronavirus: Why Russian doctors are falling to their deaths

News that three critics of Russia’s coronavirus response had plunged to the ground caused some to howl foul play. It’s likely the true circumstances are somewhat different — but no less horrific. Oliver Carroll reports from Moscow

(Tass/Getty)

In Russia, the news this week should have been about Covid-19 taking ever greater chunks out of the country. An unexpected surge in infections has, after all, made it the fifth-most affected nation on earth — with little sign of the crisis abating.

Instead, headlines around the world have been dominated by a more unusual effect of the virus in Russia – a spree of frontline workers falling out of windows.

In the course of eight days from 24 April to 2 May, three medics plunged to the ground. Two have already been buried by their colleagues; one is fighting for his life in intensive care with a fractured skull. In all three cases, there is evidence of serious conflict with hospital authorities over the coronavirus response.

Some international media have used these tragedies to tempt readers into the assumption that Russian medics are being shadowed by government hitmen. In doing so, they draw attention away from a far more likely reality, and one that is no less horrific.

From conversations with friends and colleagues of the victims, The Independent has pieced together a picture of medical staff working under intolerable strain. The victims were pinched at least two ways: inadequately protected while working face to face with an invisible killer; and pushed to the brink by a management class petrified of losing status and privilege.

Russia would not be alone in seeing its medical staff succumb to apparent suicide amid the Covid-19 pandemic. Across Europe and the United States, doctors, nurses, and ambulance staff have taken their lives as a direct result of the virus. Some were fearful after contracting the disease, and left suicide notes about their despair. Others feared infecting others.

But in Russia, a cocktail of guilt, secrecy and scapegoating seems to be exacerbating the stresses and strains of working through the pandemic.

Scapegoating seems to be the most obvious trigger for the first of the deaths on 24 April. Up until her untimely end, Natalya Lebedeva was an experienced ambulance service manager working in Star City, the restricted cosmonaut training outpost fifteen miles east of Moscow. Lebedeva died after falling from the fifth floor of a hospital in southeast Moscow where she had been receiving treatment for Covid-19. She was 48.

According to a colleague, bosses had placed Lebedeva in charge of hospitalising important Covid-19 patients from Star City. Unfortunately, she became infected in the process and unwittingly formed part of a chain of infections that saw almost two dozen people hospitalised. The colleague, who asked to remain anonymous, confirmed to The Independent that superiors had blamed Lebedeva for failing to contain the virus locally. This seems to have led her to take her own life.

Just one day following Lebedeva’s apparent suicide, a second medic would fall five floors from a hospital window. Yelena Nepomnyashaya, 47, the acting head doctor at the veterans’ hospital in the Siberian city of Krasnoyarsk, died from her injuries a week later.

A source in the veterans’ hospital described the manager as an upbeat individual who was well-liked by staff. But she was also reportedly uneasy with the local authority’s plans to use the hospital to fulfil a presidential quota for additional Covid-19 capacity. The hospital wasn’t yet ready for such a switch, Nepomnyashaya believed: it had only one ventilator and inadequate stocks of protective equipment. Right up to her death, the head doctor was pushing to have the equipment in place, the source said.

There is some confusion as to what conversations took place between the hospital chief and Boris Nemik, the local health minister. The regional bureaucrat denies any contact was made. But The Independent’s source insists otherwise: that a conference call took place shortly before Nepomnyashaya fell to her death.

“Yelena wasn’t unstable or an obvious suicide risk, but god only knows the threats and impossible demands that were made,” the source said. “The thing we all fear now is that her death will be written off as the suicide of an unhinged woman who could not cope.”

The thing we all fear now is that Yelena’s death will be written off as the suicide of an unhinged woman who could not cope

The third incident, which took place a week later, is more enigmatic. Paramedic Alexander Shulepov, 37, fell from the first floor of a hospital while receiving treatment for Covid-19. He remains in intensive care with serious injuries including a fractured skull.

Again, there are signs of a conflict with management over Covid-19. Just 10 days earlier, Shulepov recorded a video with fellow paramedic Alexander Kosyakin. In the widely shared clip, the two ambulance workers are seen complaining about lack of protective equipment and, in Shulepov’s case, allegedly being forced to work with an active coronavirus infection.

Kosyakin was later summoned by police and cautioned about spreading “fake news” about Covid-19, a criminal offence under Russian law. Shulepov would in time retract the video, saying that he had recorded it in “an emotional state”.

It is impossible to know what might have gone on in Shulepov’s mind or on the ward that caused him to fall out of a window. But foul play would on balance seem unlikely: a first-floor window is not the most effective way to do away with an opponent without leaving a trace. It will likely be many weeks, if ever, before we get clarity about the affair. Both relatives and colleagues said they had been asked not to comment while the investigation is ongoing.

Dmitry Belyakov, chair of Russia’s independent ambulance workers’ union and a working paramedic, said he had no reason to doubt the three incidents were suicides or attempts. But even so, he could not accept the cause of their death was accidental.

The system is not set up for people to work normally or honestly, and it provokes incidents such as this

Alexei Erlikh, head of intensive care, Hospital Number 29

Instead, Belyakov placed the blame firmly at the door of management. Bosses are struggling to cope with an upsurge in Covid-19 across the country, he suggested, and had prioritised relations with their superiors over the wellbeing of staff.

“Managers don’t know what to do, so they have taken to scapegoating the middle-rung people,” he said. “Exhausted enough by the pandemic, they are throwing themselves out of windows.”

Belyakov said many of his members had contacted him to complain about unrealistic demands and working without proper protective kit. As a rule, his members have little leverage over working conditions. Most ambulance workers in Moscow are not local, the union activist said, so are beholden to huge debts, rents and mortgage payments, alongside the whims of managers. “No one has declared a state of emergency or cancelled repayments,” he added.

Other medics suggested that the Covid-19 pandemic had simply cast new light on an age-old problem. Deaths among medical staff had become more tragic because people were “paying attention,” said Alexei Erlikh, a consultant cardiologist and head of intensive care at Moscow’s Hospital Number 29. “The system is not set up for people to work normally or honestly, and it provokes incidents such as this.”

In the absence of official statistics, Erlikh is one of a group of doctors who have taken to compile a “memorial list” of colleagues who have fallen victim to Covid-19. The list, which includes four medics from neighbouring Belarus, currently stands at 113. Lebedeva and Nepomnyashnaya stand at positions 57 and 68 respectively.

The doctor said it was inevitable that more doctors, paramedics and nurses would take their lives as the pandemic widens its reach across Russia in the coming weeks and months. Moscow is one story, he said; when the virus properly hits the regions, things are only likely to get uglier.

“There you have lack of protective clothing and equipment on one hand, and lack of expertise and organisational capacity on another,” he said. “Add in the secrecy of provincial Russia as you move away from Moscow, and you have all the ingredients for a perfect storm.”