Days off instead of celebrations: How dangerous is the “fourth wave” of the coronavirus in Russia?

President Vladimir Putin on Wednesday ordered the introduction of non-working days in Russia from October 30 to November 7. In recent weeks, the country has witnessed almost daily records in the number of new cases of H1N1 and deaths. Doctors and experts warn that the “fourth wave” of the pandemic could be more dangerous than previous outbreaks.

Deputy Prime Minister Tatyana Golikova proposed declaring a federal holiday. This proposal was almost immediately supported by Prime Minister Mikhail Mishustin. Some of the non-working days were already weekends due to November 4 – the Day of National Unity.

On Wednesday evening, Putin signed a decree on non-working days, but the published document does not clarify how businesses will operate and how their employees’ work will be compensated.

In Moscow, the regime of non-working days can turn into a lockdown, according to the draft decree of Mayor Sergei Sobyanin, which is available to the BBC. The lockdown may be introduced if the indicators of coronavirus infection next week are worse than the current week, according to the document. In this case, restaurants, cafes, fitness clubs, beauty salons, theaters, cinemas, zoos and other recreational facilities will be closed. In addition, school classes will be suspended and the use of subsidized transportation passes will be frozen during the non-working week. There will be no exceptions even for vaccinated citizens: the introduction of QR codes is not planned.

Earlier, Forbes magazine wrote about the draft decree. Some representatives of the catering and fitness business have already studied the document. At the same time, the interviewed BBC businessmen said that the document has not been finally approved yet, and the authorities have not informed them about the details of the closure measures. “Everything will depend on the number of available beds and the dynamics of the disease. For now, nothing is clear,” said Igor Bukharov, the president of the Federation of Restaurateurs and Hoteliers of Russia, BBC.

Oleg Berezin, the head of the Association of Cinema Owners, says there have been no orders to close city cinemas. Moscow gyms are not planning to close for the time being, despite the news of record-breaking cases of illness and the introduction of regional restrictions. However, according to Olga Kiseleva, the head of the Association of Fitness Industry Operators of Russia, their revenues have dropped significantly across the country. “Superimposing information about the holidays from October 30 to November 7 only adds to the panic in the industry and the realization that the risk of bankruptcy is enormous,” she says.

The ombudsman for the protection of small and medium-sized businesses, Anastasia Tatulova, told the BBC that official notifications from the mayor’s office regarding the closure are expected in the coming days, and in the meantime businesses are “preparing for the worst”. “Even a week of downtime threatens companies with billions in losses, and we still don’t know how long this could last,” she said.

We explain quickly, simply, and clearly what happened, why it matters, and what happens next. The number of episodes must remain fixed. The end of the story: Podcast Advertising The BBC has sent a request to Moscow City Hall and is awaiting a response.

Coronavirus-related restrictions have already been introduced in most regions of Russia. Ingushetia is the only region in Russia that has not yet introduced mandatory vaccination for certain categories of citizens. In some regions, QR codes for visiting restaurants, theaters and cinemas have been introduced or announced.

On Tuesday, Moscow Mayor Sergei Sobyanin announced restrictions in the capital: Muscovites over the age of 60 and residents with chronic illnesses will have to stay at home from October 25 to February 25, and employers will have to shift at least 30 percent of their employees to remote work. Measures to control the wearing of masks in the capital may become stricter.

As “Kommersant” reports, Moscow City Hall has demanded that shopping centers connect the cameras at the entrances to the city’s video surveillance system in order to monitor compliance with mask-wearing regulations.

“The hospital in Kommunarka is rapidly filling up with Covid-19 patients, and the situation in the intensive care units is difficult – there are a large number of sick people. It was clear that with the start of the school year, the end of the vacation period and the traditional increase in infectious diseases in the fall, the situation with the corona virus would worsen. Too few people have been vaccinated,” says Denis Protsenko, chief physician at Kommunarka hospital, describing the coronavirus situation.

The BBC asked doctors from different regions to describe what is happening in hospitals and how the fourth wave differs from previous ones. The doctors agreed to speak anonymously because they are not authorized to comment to the media.

“Nowadays a lot of children get sick. Right from birth. In the past, there were no children at all. According to their parents, they have a high temperature that is difficult to bring down. Then they have a subfebrile temperature of 37.0 for a long time. But most of the time, [covid in children] progresses like a common cold. There are no complications,” says a doctor from one of the hospitals in Vorkuta. According to him, in Vorkuta children are hardly given PCR tests, and all the sick are diagnosed with acute respiratory viral infection (ARVI). According to the doctor, this is done “apparently to avoid increasing the statistics in the city”.

A doctor from the Murmansk regional hospital says that COVID-19 now generally affects a younger generation compared to last year. “The age risk group used to be 65+, but now almost 50% of people under 65 are hospitalized. Among them, there are more cases of pneumonia and fatal outcomes,” he says.

Children and adolescents are increasingly being admitted to hospitals with Covid-19. The doctor of a polyclinic in Ekaterinburg also complains about the difficult situation. According to him, doctors often lack the necessary medicines. “There is no way to visit all the sick patients, so doctors consult by phone whenever possible, which also leads to a lot of complaints. The high mortality rate is also related to the fact that patients with lung damage of 20% or more have to be treated at home due to lack of space in hospitals,” he explains.

At the same time, some of the BBC doctors surveyed say that in terms of overall workload, the “fourth wave” is not much different from previous outbreaks over the past year and a half. “There is a seasonal increase in the number of cases. I can’t say it’s worse than last year. The disease progresses normally if a person seeks help in time. At present, we have established a system to help such patients (the doctor visits them at home, medicines are delivered, saturation levels are measured, and they receive phone calls). Last year, none of this was available, we treated patients over the phone,” says a doctor from a polyclinic in Kandalaksha, Murmansk Region.

Russia has been setting new death records almost daily in recent weeks. Just on Wednesday, another record was set – 1028 people died in one day. The mortality rate is rising against the backdrop of a record number of infections: since mid-October, more than 30,000 new cases have been reported daily in the country.

However, independent experts often criticize the statistics of the operational headquarters. According to independent demographer Alexey Raksha, the actual number of deaths from Covid-19 is much higher, and the situation is likely to worsen in the coming months. “According to my calculations, the excess number of deaths since the beginning of the pandemic has exceeded 800,000. Only a small proportion of them have died from alcoholism and drugs or due to problems in the health system, but in the vast majority of cases these deaths are related to COVID,” Raksha told the BBC. Raksha used to work at Rosstat and was involved in “demography”.

If the schedule does not load, try using a different browser. According to the latest data from WHO, a total of 226,353 deaths have been recorded during the pandemic. According to Raksha, official statistics do not provide a complete picture because hospitals often do not record coronavirus as a cause of death.

Doctors and experts have already talked about it. In the spring of last year, recommendations for the work of pathological anatomy departments, coordinated with the Moscow Department of Health, were published on the website of the Russian Society of Pathologists. In the document it was suggested not to consider Covid-19 as the primary cause of death if a patient died due to exacerbation caused by coronavirus and unfavorable course of their existing serious diseases.

According to Raksha, Rosstat provides more detailed and reliable information on coronavirus mortality, but its data is published with a delay of almost a month and a half. According to Rosstat, the total number of deaths from Covid-19 in Russia during the pandemic was 400,000 people.

If we calculate the mortality rate, which is the ratio of the number of deaths to the number of new cases of the disease, Russia gradually emerges as a leader. While the mortality rate is gradually decreasing in many countries, it is increasing in Russia. The decline in mortality is often attributed to vaccination: in some countries, more than half the population has been vaccinated.

To date, 51 million people in Russia have received the first component of the Covid-19 vaccine, and 47.5 million people (32.5% of the country’s population) are fully vaccinated, according to data from the “Stopcoronavirus” portal. “Today, unfortunately, we have slightly exceeded the [herd immunity] level by 45%. And this level does not allow a significant impact on the mortality rate,” admitted Tatyana Golikova.

The Stop Coronavirus website has published data on the level of herd immunity achieved in different regions. However, many scientists say it is impossible to determine the level of herd immunity needed to defeat the pandemic.

Alexey Raksha also noted that if vaccination coverage does not reach at least 60%, it is too early to talk about herd immunity. “If the vast majority of the country’s adult population is vaccinated, the mortality rate will be acceptable, though still elevated. This is the optimal option, which many countries have already adopted. As for quarantine, only a long and strict quarantine can produce results,” says the demographer.

In terms of the level of vaccination of the population, Russia currently lags behind many countries that have also experienced major outbreaks of infection, in particular, the United Kingdom, the United States, India, and others. As Ilya Yasny has noted, in some countries successful vaccination has helped to reduce the number of infected people dramatically, but even this measure is not always completely effective. “In Portugal, for example, more than 80% of the population was vaccinated and the situation improved dramatically. At the same time, Singapore had a paradoxical situation: about 80% of the population was vaccinated, but the number of infections continued to rise. However, this can be explained by the fact that Singapore always has many visitors and they live in relatively close quarters. In addition, the level of testing there is very high, so all asymptomatic cases are detected,” says the epidemiologist.