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Medical specialists transport a person outside a hospital for patients infected with the coronavirus on the outskirts of Moscow on May 12. (Tatyana Makeyeva/Reuters)

MOSCOW — When Russian authorities ordered half-trained medical students into hospitals dealing with the covid-19 crisis, the students said they felt like raw military conscripts being sent into battle, barely trained to shoot.

In a sign of the crisis roiling Russian hospitals facing the pandemic, university heads last month ordered students to do compulsory practical work in hospitals, where staff complain they lack protective gear.

At least 169 medical staff have died in Russia, according to a memorial list created by Russian doctors, in the absence of any national official count on the number of who died or fell ill from covid-19.

The growing fissures on Russia’s health system are just one part of a crisis that is adding more than 10,000 coronavirus patients a day — catapulting Russia into second place behind the United States in terms of cases.

Russian medical workers are clamoring for help. But hospital chiefs are silent.

“I am worried of course. Everyone is concerned. It is dangerous, and no one wants to get sick,” said a sixth-year medical student, Svetlana, assigned to work as a nurse treating covid-19 patients. “We have a lot of work, lots of patients and one nurse for 40 patients.”

Stevlana, from Medical University No. 1 in Moscow, gave only her first name in fear of repercussions from the university and other authorities. She said hospital staff do not have the recommended N95 masks and have to reuse protective suits, which sometimes get holes.

Virus reaches Kremlin

It is also a critical test for Russian President Vladimir Putin, whose state-crafted image of total stewardship has taken direct blows by the pandemic as he delegates much of the response to provincial bosses and others. On Monday, Putin acknowledged that half of Russia’s doctors had not been paid promised bonuses for working in the pandemic.

The virus, too, has pushed its way into his inner circle. His spokesman, Dmitry Peskov, is hospitalized with covid-19. Last month, Russia’s prime minister, Mikhail Mishustin, tested positive.

But Russian officials assert Putin is not at risk. He has spent the past weeks at his retreat outside Moscow.

Meanwhile, Russia has struggled to respond to the spike in cases, leaving health-care workers fighting the system they work in. Some have taken to social media with anguished cries for help or to simply vent. At least three health-care workers have mysteriously fallen out of hospital windows in Russia in recent weeks, highlighting the escalations in the health system.

Three medical workers have fallen from window amid reports of dire conditions

Alexandra, another student at Medical University No. 1, said those students who refused to work would not be given the credit required to pass and faced effective expulsion. She also gave only her first name in fear of reprisals from authorities.

Russia on Wednesday reported a total of 242,271 novel coronavirus cases, a daily increase of 10,028.

Although the caseload continues to rise, the rate of daily increase has slowed. Russia has reported 2,212 deaths, but it counts covid-19 cases much more conservatively than other countries. Many deaths among coronavirus-infected patients have been attributed to other causes.

Health officials say Russia’s high case numbers are due to its testing: Around 6 million tests have been performed so far. Yet doctors complain the tests are inaccurate in about 20 percent of cases, throwing up false positives, exposing medical staff and patients to further risk.

About a third of Russian coronavirus cases require hospitalization, according to health officials.

Hospital crisis deepens

In a St. Petersburg intensive care unit Tuesday, a doctor watched in shock as a ventilator exploded in flames, killing five covid-19 patients, the second such incident in days. On Saturday a patient with the virus in Moscow died when a hospital ventilator caught fire.

Russian authorities on Wednesday ordered a halt to the use of ventilators produced by Ural Instrument Engineering Plant, part of a state conglomerate Rostec, which also manufactures military hardware and is under Western sanctions over Russia’s 2014 annexation of Crimea from Ukraine.

Why does Putin seem on the sidelines in the coronavirus crisis?

But the decision raised questions as to how the country will cope as virus cases continue to climb.

The Industry and Trade Ministry earlier designated the Ural Instrument Engineering Plant as its sole ventilator supplier, planning to purchase 5,700 units for Russian hospitals, Russian news agency Interfax reported.

A ministry spokesman said Monday that an examination must not only focus on the ventilators but on the conditions of their use. Some have suggested that faulty wiring may have caused the fires, with multiple electrical devices in use in ICU wards.

The lack of protective equipment and resulting sickness among health workers has seen doctors walk off the job, fearing infection and death.

Hospitals have emerged as super-spreader sites, with the infection sweeping through coronavirus wards, known in Russia as “red zone” wards and “green zones” or “clean zones” for other patients.

At least 400 hospitals had been identified as hot spots, Russian Health Minister Mikhail Murashko said Wednesday, calling it the kind of thing that “tends to happen.” He said the situation was “tense but controllable.”

The St. Petersburg governor, Alexander Beglov, said 1,465 medical workers in that city alone had been infected with the coronavirus since the outbreak of the pandemic, RIA Novosti reported.

Questions on Russia's count

“The risk of getting covid-19 in the clean zone of a covid-19 hospital is very high,” Alexandra said.

She said some students who had been contacted by hospitals to start work had been given no choice on whether they would work in red zones or green zones.

“We are talking about very serious infection and forcing students to work with such an infection and calling it practical work is inadmissible,” she said. “It’s a violation of our right to life.”

Students including pregnant women, young mothers, those with underlying health conditions that put them at risk and those with older parents whom they could infect, were ordered to work in hospitals treating covid-19 patients, she added.

“We are concerned that we won’t have personal protective equipment. There are shortages that we all know about, so where are they going to get the necessary quantities for us?” she said.

Alexey Erlikh, head of the cardiological intensive care unit at Hospital 29 in Moscow, who helped launch the online memorial list of medical workers who died of covid-19, said the tally did not purport to include all deaths, relying on colleagues and family reporting to the organizers.

“It is very important to be open about it and technically it is possible to count them,” he said. “I feel bad that the officials are talking about sacrifice of medical workers, and yet they do not count the sick and dead ones. I can only use a bad word for it.”

He is now treating covid-19 but said neither he nor his colleagues had been paid extra as promised by Putin.

“The existing health-care system is coping with the situation,” said Murashko, the health minister. “We have developed a system which balances out the numbers of hospitalized and discharged patients.”

Natasha Abbakumova contributed to this report.

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