MOSCOW — It took a three-day holiday in Spain to turn Irina Sannikova from a respected infectious-diseases doctor into the scandalous subject of a headline in Russian state-owned media calling her "Dr. Death."

Sannikova, from the southern Russian city of Stavropol, failed to undergo mandatory 14-day self-isolation after returning and continued holding university lectures and meetings before coming down last week with covid-19, the disease caused by the novel coronavirus. Charged with endangering lives, she could face five years in prison if she infected someone who later dies of the viral illness.

As a result of her trip, about 1,200 people had to be tested, at least 11 of whom were found to have the virus. Russia has reported fewer than 700 cases of the novel coronavirus and just one death possibly linked to covid-19, but Moscow authorities said the death was caused by blood clots, not the virus.

Still, Russian officials are concerned that the threat of five years in prison is not harsh enough to deter possible coronavirus spreaders. On Monday, Russian Prime Minister Mikhail Mishustin ordered that the government develop tougher measures against people who breach mandatory quarantines.

“We are managing to hold back the virus, but Russia can’t completely seal itself off from the threat,” President Vladimir Putin said in a nationwide address Wednesday.

The authoritarian toolbox

Russia has pulled some tools from its authoritarian toolbox to battle the disease, including the use of facial-recognition technology to track people ordered into self-isolation. The government is also developing a system using geolocation data from mobile operators to monitor individuals.

Russia closed its border with China in January and this month required anyone returning from abroad to self-isolate for 14 days.

Teams of police and doctors have been conducting raids on hotels, student dormitories and apartments to track people who traveled from China before the border closure, according to Moscow Mayor Sergei Sobyanin.

“Conducting raids is an unpleasant task but is necessary, including for the potential carriers of the virus,” he said last month. A student from China, ordered to self-isolate, was caught on surveillance cameras violating her quarantine when she went outdoors to meet a friend, he said.

In Soviet times, the rules were suffocating, but people found ways to get around them. The workaround culture was celebrated in the saying of those times: “If it’s forbidden, but you really want to, that means you can.”

It’s not so easy in the time of the coronavirus pandemic. Authorities in Russia and elsewhere are refocusing their surveillance-state apparatus from political dissent to health controls.

At the height of the crisis in China, drones were deployed to harass people not wearing masks, and police were outfitted with equipment to scan passersby for signs of fever. South Korea, Singapore and other countries used security cameras, credit card data and other digital crumbs to retrace the movements of patients before they were diagnosed.

The cameras are watching

In Moscow, authorities announced this month that those returning from outside Russia would be monitored using the city’s more than 178,000 facial-recognition cameras. Moscow Police Chief Oleg Baranov said last week that facial-recognition cameras had detected more than 200 people who had violated mandatory self-isolation.

Police have the details of every person who returns to Russia by plane, car or train, according to Russian officials. More than 90,000 people in Russia are under observation for possible contact with the virus.

Kirill Koroteev of the legal and human rights group Agora said the surveillance of people in self-isolation was creating public distrust of the authorities, as was the seeming randomness of mandatory quarantines in state infectious-diseases hospitals — including of people who tested negative or had completed 14 days of self-isolation.

“It looks more like a police operation, not a medical one,” he said. “I think people are reluctant to accept that they will be facially controlled each time they need to throw out the garbage or buy some bread and buckwheat. Now Muscovites are realizing the potential for abuse.”

According to one foreigner who flew to Moscow on Feb. 23 through Milan, monitoring was intense when it was found that another passenger, David Berov, had contracted the virus. Berov was the first Russian to be diagnosed with covid-19.

The 31-year-old advertising sales manager, who was identified only as Artyom by the news site Mediazona, was on the same plane as Berov and said he was later given a warning for violating self-quarantine rules — after taking out the trash. Two police officers in sanitary masks turned up at his door the next day, serving a notice warning him against violating the rules again.

'Cops are at our building'

Russian media last week reported the case of a woman, Marina F., one of four patients who fled the Kommunarka state hospital on the outskirts of Moscow where patients are being quarantined.

The woman’s daughter wrote on Twitter, under the handle @awkwardsock_, that her mother was told March 15 that she had tested positive for the novel coronavirus after flying to Moscow from Latin America via Milan the previous month. Nurses came to her house to take her to the Kommunarka hospital.

“My mom went to Kommunarka where she was left in the admissions area full of other patients without any food or water or any place to sit down.

“Naturally my mom didn’t like such conditions, so she told them that she was leaving and they threatened her with the police, courts and other ‘pleasures.’ But my mom was not afraid of such threats, she went home,” the daughter wrote.

Her mother arrived home around midnight.

“Today, on March 16 I woke up and heard the news that my mom had fled the hospital in her slippers and there are cops at our building,” Marina F’s daughter tweeted, posting a photo of what she believed was an undercover policeman next to her apartment.

She also posted a photo of a doctor in a hazmat suit who she said sat in her apartment for six hours and played with her cat. Then more police showed up.

“There were six policemen in protective suits at our building including our district policeman,” she wrote. “They knocked on our door, threatening to break it and to file a case with the court.” Her mother would have gone to hospital if she had been given her test results and an apology from the authorities, she said.

“My hands are shaking, my mom is in tears and hysterical, all our neighbors, my mom’s colleagues are worrying,” she said.

Russian authorities are also cracking down on people who spread rumors or disinformation about the virus on social media, with around 50 cases a day, according to a state center set up to provide public information about covid-19. Those who post disinformation face fines of up to $37,500.