Without a “hard lockdown” and with a much less expensive and luxurious health care system, Russia is apparently weathering the COVID-19 pandemic no worse than many Western countries. On top of that, Russia brought a comparable vaccine to maturity practically at the same time as Europe and North America. When the current rampant pandemic is under control, Western Europe will probably have to ask itself some unpleasant questions.
The Russian health system does not have a good reputation, not even in Russia itself. Originating from the Soviet Union’s health care system, the so-called Semashko system, the Russian health care system was heavily privatised and commercialised in the 1990s – like many other things in those years. This created a two-tier medical system in which well-heeled patients in the big cities could afford top-quality European medicine in private clinics for cash. Medical treatment and spa stays in Europe were also popular. Parallel to the rural exodus of the Russian population to the cities, the infrastructure for medical care in the countryside was also thinned out.
After 2006, the Russian state began to focus more on its responsibilities in the health sector and initiated reforms in the health system itself as well as in compulsory health insurance. These reforms produced contradictory results: Improved quality of medical care, increased qualification of staff and an expanded range of services in the cities are on the positive side, while more difficult working conditions and further thinning out of services in rural areas are on the negative side. The problem of overflowing bureaucracy, which has existed since Soviet times, could not be eliminated either.
Medical treatment in state clinics is basically free, but low wages have not made the practice of direct payments to doctors disappear. And two-class medicine also persists in the form of private hospitals.1 The share of expenditure on health in Russia has risen moderately in recent decades and currently stands at a good 5.3 % of gross domestic product, which is far less than in most Western European countries.2
It is probably more a consequence of the improvement in the economic situation of large parts of the Russian population and of changing lifestyles than of reforms in the health sector that key demographic indicators of Russian society have converged with those in Europe in recent years. For example, infant mortality fell from 11.9 ‰ in 2005 to 5.3 ‰ in 2017 – and the trend continues to fall. For comparison: In 2017, infant mortality in Switzerland was 3.3 ‰, in Slovakia 5.8 ‰.3 After a low point in the 1990s, the life expectancy of Russian women increased to 77 years, that of men to 72. This significant difference between the life expectancy of men and women is typical for Russia and distinguishes it from Western countries.4 Here, the effects of the at times unhealthy lifestyle of Russian men, which also includes alcohol abuse, are still noticeable. In recent years, however, the lifestyle and drinking habits of an urban middle class in the conurbations in particular have changed and have come closer to those of Western Europeans.
Lockdown and the measures that followed
After the outbreak of the COVID-19 pandemic in China, Russia quickly closed the border to its East Asian neighbour and was thus hit by the pandemic later than Western Europe and had a little more time to prepare. After a short, hard lockdown, the Russian government quickly relaxed the measures against the spread of the coronavirus again and did not introduce a new lockdown even in the face of the second wave. Since early summer last year, shops, cultural institutions, catering establishments and public transport have been open and usable with minor restrictions.
That domestic political considerations played a certain role here is not explicitly proven, but it is plausible. Western commentators, on the other hand, who claim that the Russian state could not afford a “hard lockdown” economically at all, should be reminded that Russian state finances are currently much more solid than those of many European countries, despite great dependence on oil and gas revenues. Russian public debt is considerably lower than that of many European countries, and Russian gold reserves are more substantial.5
All in all, the figures relating to the COVID pandemic in Russia are quite comparable to other countries in Europe and North America: the number of people infected with the coronavirus in relation to the size of the population and the number of fatalities are in similar ranges to those in European countries, and the number of tests carried out is even comparatively high.6 Of course, Western observers always like to doubt the accuracy of the Russian figures. But they should be told that the European figures are not always beyond doubt either.
Treatment of infected persons and the “Sputnik V” vaccine
People in Russia’s cities who think they have COVID symptoms are advised not to go to ordinary hospitals, but to report to specialised centres where they will be tested and given medication if the suspicion is confirmed. Depending on the severity of the disease, they are then sent home in quarantine or hospitalised. Another option is for medical professionals to visit people at home and test them.
When President Vladimir Putin announced last August that Russia had become the first country in the world to develop a vaccine against COVID-19, he caused many observers in the West to shake their heads in disbelief and others to smile condescendingly. In fact, Putin’s announcement was made before the start of the mass tests with tens of thousands of people willing to be vaccinated, but in the meantime the first promising test results seem to be confirmed: The Russian vaccine from the Gamaleja Institute of Epidemiology and Microbiology in Moscow seems to be comparable to Western vaccines in the areas of effectiveness and side effects.7 This will not surprise the unbiased observer given that the development of the vaccine was led by Denis Logunov, an experienced scientist who had previously been involved in the development of vaccines against Middle East Respiratory Syndrome (MERS) and the highly dangerous Ebola virus.8 Incidentally, the mode of action of the Russian vaccine is similar to that of some Western preparations. In this sense, it is not surprising that the Russian researchers reached a result in very similar time frames as their Western colleagues.9 The Russian government is apparently so sure of its case that it agreed to supply the vaccine to Western countries. The results in Hungary, Brazil, Argentina, India, Mexico, Kazakhstan and other countries will show what the Russian vaccine and thus Russian medical research are worth.
That the Russian government savoured the success propagandistically may have annoyed some observers who are convinced of the superiority of Western medicine. Those who are particularly eager will undoubtedly report heavily on the disadvantages of the vaccine, whose name “Sputnik V” is, to make matters worse, reminiscent of the great success of Soviet space research in the 1950s. It is remarkable that the researchers apparently placed great emphasis on easy storage and transport when developing the vaccine from the outset, so that it can be easily delivered to remote areas in the huge country and so that the gap between medical care in urban centres and remote rural areas does not widen even further.
If some new “cold warriors” in the West may have hoped that the outbreak of the COVID-19 pandemic would weaken Russia and its government worldwide, they will have been disappointed by now. Now that rumours about the development of the coronavirus in biological weapons laboratories and its deliberate spread in the context of biological warfare have largely been dispelled, the question can be viewed soberly. At best, the time is ripe for pragmatic cooperation between the West and Russia, because the current (current rampant) COVID-19 pandemic will probably not be the last of its kind. What is embarrassing, however, is that in view of the second wave of the disease, one has to ask why the wickedly expensive health systems of Western European countries did not produce much better results than the Russian one. •
1 https://m.bpb.de/internationales/europa/russland/analysen/301756/analyse-gesundheitsreformen-und-ihre-ergebnisse; https://www.dekoder.org/de/gnose/russland-gesundheitssystem-onkologie; https://www.gtai.de/gtai-de/trade/specials/special/russland/covid-19-gesundheitswesen-in-russland-251238; https://de.m.wikipedia.org/wiki/Liste_der_Länder_nach_Gesundheitsausgaben
2 see per capita health expenditure at https://de.statista.com/statistik/daten/studie/37176/umfrage/gesundheitsausgaben-pro-kopf/ and as a percentage in GDP: https://data.worldbank.org/indicator/SH.XPD.CHEX.GD.ZS?most_recent_value_desc=true
3 compare the corresponding figures: https://de.statista.com/statistik/daten/studie/37212/umfrage/ranking-der-20-laender-mit-der-niedrigsten-kindersterblichkeit/; https://de.statista.com/statistik/daten/studie/937771/umfrage/rate-der-saeuglingssterblichkeit-in-der-schweiz-nach-geschlecht/; https://de.statista.com/statistik/daten/studie/810933/umfrage/kindersterblichkeit-in-den-eu-laendern/; https://de.statista.com/statistik/daten/studie/753074/umfrage/kindersterblichkeit-in-russland/
4 see https://ostexperte.de/lebenserwartung-russland/
5 National debt: https://de.statista.com/statistik/daten/studie/171417/umfrage/staatsverschuldung-von-russland-in-relation-zum-bruttoinlandsprodukt-bip/#:~:text=Im%20Jahr%202019%20betr%C3%A4gt%20die,9%20Prozent%20des%20Bruttoinlandsprodukts%20prognostiziert. And the international comparison: https://www.laenderdaten.de/wirtschaft/staatsverschuldung.aspx. Gold reserves: https://de.statista.com/statistik/daten/studie/156673/umfrage/laender-mit-den-groessten-goldreserven/
6 compare the figures worldwide: https://www.worldometers.info/coronavirus/
7 https://www.vedomosti.ru/society/news/2020/08/01/835757-klinicheskie-ispitaniya-vaktsini-zaversheni; https://covid19.rosminzdrav.ru/minzdrav-rossii-zaregistriroval-pervuyu-v-mire-vakczinu-ot-covid-19/; https://www.aerzteblatt.de/nachrichten/115504/Russland-laesst-Impfstoff-gegen-SARS-CoV-2-zu; https://www.tagesschau.de/ausland/russland-impfstoff-101.html
8 to D. Logunov: https://meduza.io/en/feature/2020/07/23/russia-s-way-out
9 see https://www.google.at/amp/s/amp2.handelsblatt.com/meinung/gastbeitraege/gastbeitrag-von-biontech-bis-sputnik-v-so-unterschiedlich-wirken-die-anti-corona-impfstoffe/26683166.html; https://www.aerzteblatt.de/nachrichten/118731/Impfstoffe-Warum-Sputnik-V-eine-hoehere-Effektivitaet-gegen-SARS-CoV-2-erzielen-koennte-als-AZD1222; https://www.google.at/amp/s/amp.zdf.de/nachrichten/panorama/corona-sputnik-russland-massenimpfung-100.html
gl. Argentina, hit hard by the second wave of COVID-19, received the first 300,000 doses of the Russian vaccine “Sputnik V” at the end of December. After Mexico, Costa Rica and Chile, it was the fourth country in Latin America to be able to start vaccinating, initially medical staff. President Alberto Fernández received the vaccination in January after approval was granted by the Ministry of Health the day before. In a Twitter message, he thanked the Russian research institute Gamaleya for its development work. Another 5 million doses are expected to arrive by the end of January, followed by another 14.7 million in February.
Mexico has also ordered 7.4 million doses of “Sputnik V” among other vaccines. In Mexico, 2580 medical personnel have died from COVID-19, 47 % of them doctors.
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