Moscow — When a Russian intensive care doctor spoke out last month about the lack of protective gear and ventilators, she was summoned by police and threatened with charges for spreading "fake news," an offense that carries up to five years in prison.

Russia’s hierarchy of fear — from the president down to head doctors in hospitals — appears to be stepping up its intimidation against anyone speaking out about shortages and infections in health-care ranks as the coronavirus pandemic expands across the country.

“Everyone is afraid of the head doctor,” said the ICU doctor, who spoke on the condition of anonymity out of concern for making her situation worse. “A head doctor in a district hospital is like a czar. It’s rare that doctors speak up.”

“I am under pressure from all sides,” she added. “It’s awful. We have such censorship we can’t say anything openly.”

Allegations that Russian officials are covering up critical truths — such as infection rates for health-care workers — is the latest example of how the need for public facts in the pandemic fight can often collide with authoritarian controls.

For regional officials and hospital bosses in Russia, the reflexive response is to hide their failures to avoid controversy and potential dismissal, critics say. The perception of secrecy has frayed many Russians’ already low trust of health authorities and their skepticism of official information about the crisis.

Quandary for Putin

It also comes as Russian President Vladimir Putin seeks to boost his legitimacy after ditching the two-term limit on the presidential office. A nationwide vote on potentially extending Putin’s rule until the 2030s had to be postponed because of the pandemic.

Local authorities and hospital chiefs have played down the shortages of protective gear, even as more doctors and nurses fall ill and Russia dispatched massive amounts of equipment to the United States, Italy, Serbia and other countries. Russia’s infections reached nearly 58,000 cases Wednesday with 513 reported deaths.

A March poll by independent opinion pollster Levada Center showed that 59 percent of Russians did not believe or only partly believed official information about the virus, and 48 percent did not believe the health system was ready for the pandemic.

Russian authorities have not detailed the number of medical workers who were infected or died of covid-19, the disease the novel coronavirus causes.

But Russia’s deputy prime minister, Tatyana Golikova, said Monday that most of Russia’s 285 super-spreader hot spots were hospitals and clinics.

The growth has been striking. On April 10, Anna Popova, head of Russia’s Federal Service for Health and Consumer Rights, said that of 74 hot spots, 41 were hospitals or clinics. She acknowledged the highest percentage of infections was among medical workers.

In Ukraine, many health workers also have covid-19, although Kyiv offers numbers: Of the 6,592 cases reported by Wednesday, 1,245 were medical personnel.

In St. Petersburg’s Botkin Memorial Hospital for Infectious Diseases, a third of the 405 suspected or confirmed covid-19 cases are medical staff, head doctor Denis Gusev told local media.

Doctors union speaks out

Anastasia Vasilyeva, a member of the Alliance of Doctors, a small but vocal independent doctors union aligned with the opposition, disclosed many cases of medical workers infected because of lack of proper protection.

She has been called in for questioning by criminal investigators and was detained overnight by police earlier this month on a trip to deliver personal protective equipment, or PPE, to a Novgorod region hospital in western Russia. She faces charges for disobeying a police officer.

“Many doctors have nothing, just one or two surgical suits, and that’s all. We are doing our best to provide medical staff, doctors and nurses who ask for help with protection,” she said. “Only the state interferes with our work.”

Vasilyeva warned in February of the need to buy equipment to prepare for the pandemic, “but I was accused of creating panic and destabilizing society. I got a lot of threats then.”

In the past few days, staff at 146 hospitals contacted the organization reporting a severe shortage of PPE or none. She posted a report from a staffer at Moscow’s sprawling Botkinskaya Hospital reporting that 36 doctors were sick with covid-19 because of a lack of PPE.

Yuri Boiko, a paramedic in Novgorod and a member of the alliance, told local media outlets that he had to buy his own goggles and masks and that other equipment was limited.

“Of course we have no respirators. There are no safety glasses. I don’t know what management is thinking. Do we feel no pity for our employees?” he said.

Vasilyeva said Russia sent a large amount of medical equipment to the United States and aid to Italy, Serbia and elsewhere “and let our people die.”

One infected ambulance worker tearfully filmed the torn and stained sheets in her hospital ward in a series of furious posts on Twitter on Friday.

“I waited in line at CT with many other patients who were coughing, and we were all together there. And many of them had X-rays proving that they had pneumonia,” she said. “There were doctors next to me, for example doctors from hospital number 4, and they had been diagnosed with pneumonia.

“We are sending planes, we are helping other countries! But we can’t help our own doctors, who treat all these sick people,” she said.

The Washington Post contacted Popova’s office and the health minister’s spokesman repeatedly with a request for the numbers of infected medical staff, the numbers who had died and details on the numbers of quarantined hospitals. The health minister’s spokesman said figures were unavailable.

Hospitals sealed off

Many hospitals have been sealed off and quarantined.

A Moscow clinic was shuttered for disinfection after a covid-19 outbreak that included the chief doctor and deputy.

The main hospital in Ufa, about 725 miles east of Moscow, with 1,200 medical staff, workers and patients, was sealed off after 170 staff members and patients tested positive.

Komi Republic, a remote northern region with a scattered population, shot up to be the second-worst covid-19 locale in the country per capita after an outbreak that began in one hospital and spread to another. At least two medical staff members died, according to a local activist, Ernest Mezak, who compares the situation to “living inside a disaster movie.”

Mezak took to social media last week urging doctors and health workers to document the problems online and to report each covid-19 case and death.

“Do not play down the consequences of the pandemic,” he urged. “Lying about the scale of the disaster is the worst that you can do for your countrymen in general, and for the relatives of those who died of covid-19 in particular.”

Putin on Monday warned that the worst was ahead and said protection for health workers was crucial.

“Let me stress that increased, reliable protection from the infection must be ensured for medical personnel, and right now, every single one of them counts,” he said, adding that Russia had begun to step up production of protective gear as well as importing from China.

A day earlier, he said the situation was “fully under control.” Earlier this month, he blamed the problems emerging in Russia’s regions on “sloppiness.”

But anger is growing.

Video surfaced of a shouting match at Sunzhenskaya Central District Hospital in the southern republic of Ingushetia as staff members demanded protective equipment.

Meanwhile, ambulance drivers and paramedics in Moscow have faced queues of up to nine hours for admission to some hospitals or have had to dash from one hospital to another with patients, only to find no beds available.

It was only on April 10 when Health Minister Mikhail Murashko admitted a shortage of protective equipment for staff: “We can see that all health care systems are under stress now due to a shortage of consumables — personal protective equipment and … ventilators,” he told Russian television.

Natasha Abbakumova contributed to this report.