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‘Essentially, a war is going on’ Doctors in St. Petersburg are dying from the coronavirus, but not all of their deaths are officially recorded. Here’s how this is happening.

Source: Meduza

In St. Petersburg, hundreds of healthcare workers have already contracted the coronavirus. There are currently 190 specialists undergoing treatment at the Botkin Infectious Diseases Hospital — four of them are on ventilators. Over a dozen St. Petersburg doctors between the ages of 30 and 84 years old have already died during the pandemic. Meduza spoke to their relatives and colleagues about what’s happening to Russia’s medical workers when they become infected with COVID-19.

The Memory Wall

The St. Petersburg Health Committee is located at the very center of the city, in a historic building on Malaya Sadovaya Street, not far from the famous Gostiny Dvor shopping center. During the pandemic, the committee has taken on a prominent role: it is now responsible for reporting the deaths of St. Petersburg residents from the coronavirus, discussing the lack of protective equipment, and determining how the city will pay compensation to the families of doctors who have died.

At the end of April, portraits of these doctors appeared below the Health Committee building’s windows. The spontaneous memorial was the work of St. Petersburg activist Irina Maslova, who hung portraits of the deceased doctors on the fence of the building across the street. “[The memorial] is a memory of the doctors, who refused help and saved the lives of St. Petersburgers,” Irina Maslova explained in conversation with Meduza. The idea of creating a memorial came to her after a group of Russian doctors launched the “Memory List” — a record containing data on the doctors who have died during the coronavirus pandemic, regardless of their official diagnoses. Maslova drew her information on the deceased doctors from that very list.

The number of portraits continues to grow: since the beginning of the epidemic, Smolny has recorded the deaths of ten St. Petersburg doctors officially, and four of them passed away on May 5 alone. Among them was 67-year-old Vladimir Mankovich, a 67-year-old senior doctor from the operations department of the City Ambulance Station’s Central Substation. The St. Petersburg newspaper Fontanka called him a “legend” among the city’s doctors — he was on duty during all of the city’s major public events, including the St. Petersburg Economic Forum. 

There are already more than a dozen portraits on the “Memory Wall” itself. “Information about the deaths of doctors appears in the official data within 7–10 days, but here a loved one [can hang] a portrait the very next day. For me, this kind of memorial is more important than official data,” Maslova says. Sometimes doctors who want to memorialize their colleagues get in touch with her themselves. On May 5, a portrait of 84-year-old Antonina Antonova, another employee at the City Ambulance Station, appeared on the “Memory Wall” — her grandson put up her picture. Antonova worked as a cleaner in the station’s technical facilities; according to her husband, she died in the hospital on May 4. The City Ambulance Station’s press service confirmed her passing, but the official cause of her death remains unknown.

“Essentially, a war is going on”

In St. Petersburg, the first doctor to die during the pandemic was 50-year-old anesthesiologist Sergey Beloshitsky, from the Alexandrovskaya Hospital. His colleagues told Meduza that he had health problems, but he refused to leave the hospital when it was placed under quarantine due to a coronavirus patient on April 1.

“[Sergey Beloshitsky] was advised to spend this dangerous time at home, to leave. He refused, this was his decision. Now it's precisely the intensive care anesthesiologists who are bearing the main burden on the frontline — too many lives depend on them,” Beloshitsky’s colleague told the St. Petersburg medical news outlet Doktor Piter. 

He says Beloshitsky continued to work during the quarantine until the middle of April, when he himself became ill. The doctor was hospitalized with a “covid-pneumonia” diagnosis, but was in “relatively normal condition and breathing independently.” However, the pneumonia later began to progress. Beloshitsky was put on a ventilator and then switched over to extracorporeal life support (ECLS). He died a week later, on April 24. The Health Committee officially named the cause of death as “cardiopulmonary failure caused by pneumonia,” but the committee also confirmed that he had the coronavirus.

Beloshitsky did not have a wife or children. He had previously worked at St. Petersburg’s Yelizavetinskaya Hospital for more 20 years and transferred to the Alexandrovskaya Hospital just a couple months ago. “I want people, knowing that doctors are dying at work, to understand: essentially, a war is going on now (every crisis in our country is 1941),” said Vladimir Sulima, a friend of the deceased and the head of the intensive care unit at St. Georgy’s City Hospital. He is currently being treated for coronavirus himself. “The vast majority [of people] do not notice this, because only medical workers are engaged in [this war]. [It’s] brutal, we have great losses, still, fortunately, [there is] sanitation more often (doctors are becoming infected and are unable to work, [they are] taking patients’ places). People should understand that they need to stay at home, wear the notorious masks, and practice personal hygiene. This helps us.”

“She left for work, worked a shift, and then didn’t return”

The youngest person on the list of deceased medical workers is a nurse from the War Veterans Hospital, Maria Tyshko — she turned 30 years old on March 8. According to her mother, Maria had a mild form of cerebral palsy since she was a child, but she finished her education, and went on to become a nurse. In the last five years she only took sick leave once, and devoted all of her time to her work.

After coming back from one of her shifts during the pandemic, Tyshko told her mother that her supervisor had contracted the coronavirus, she then began to complain about her own health. A family doctor prescribed Maria antibiotics, but they didn’t help, she developed a cough. After a couple days she began complaining about having difficulty breathing, and following an examination, emergency room doctors suspected that she had pneumonia. Tyshko was hospitalized at the same facility where she worked, and then transferred to intensive care and put on a ventilator. She died on April 15.

By that time Maria’s mother, Margarita Tyshko, had also been hospitalized: she had a fever and a cough, too. One of her tests for the coronavirus came back positive, but she then recovered. She has already been discharged.

Maria Tyshko tested positive for the coronavirus, but heart failure was listed as the official cause of death. The Health Committee acknowledged Maria’s death, as well as the deaths of three other nurses, but emphasized that “they either had other serious illnesses, which led to their deaths, or they were not infected while on the job.”

The death of 54-year-old Yulia Yasyulevich — a nurse’s aide at the “Vredena” Orthopedics and Traumatology Research Institute — is basically a similar story. Her husband Peter told the publication Doktor Piter that she graduated from the Lesgaft National State University of Physical Education, trained as a rower, and used to work in sales at a sporting goods store, but it was in her job as a nurse’s aide that she “felt truly happy.”

On April 9, the Vredena Institute closed for quarantine after identifying a coronavirus case. Approximately 700 people remained inside, including 260 employees. Within a week the center had several hundred coronavirus patients, due to a lack of personal protective equipment. Infected doctors continued providing aid to patients. The staff were gradually allowed to start going home only at the beginning of May.

Yulia Yasyulevich’s husband told Meduza that his wife also remained inside the center during the quarantine. On April 17, Yulia became ill, she was hospitalized with pneumonia. That day Peter spoke to his wife for the last time: “She left for work, worked a shift, and then didn’t return.”

What’s more, Peter was unable to contact both his wife and the attending physician — the hospital only told him that “they will call in the event of something.” On May 1, Peter Yasyulevich received a call, they told him that Yulia had died. Peter called the hospital’s information desk back several times, hoping that there had been a mistake.

Peter is sure that his wife could have been saved if the doctors had the necessary protective equipment, and if she herself had received help in time, since Yulia was already in poor condition when she was hospitalized. “They thought it would resolve itself. But it didn’t, and this oversight cost a life, I repeat, my Yulia’s life. It’s disgusting and horribly mean. God [will] judge them. But Yulia committed a heroic act,” Peter says. 

Percentages of guilt

Initially, the St. Petersburg authorities promised to pay a million rubles (around $13,600) to the families of medical workers who die “in connection with [contracting] the coronavirus infection.” Healthcare workers who become disabled are supposed to receive 500,000 rubles (about $6,800) in compensation, while the rest of the coronavirus victims should get 300,000 rubles each (a little over $4,000). The city authorities allocated 30 million rubles ($408,450) to finance compensation, but by April 30 there were already 250 cases of the coronavirus recorded among healthcare workers in the city, and eight of them had died.

That same day, April 30, the administration issued an order on the procedure for recognizing a healthcare worker as a victim of the pandemic. According to the guidelines, even if a medical worker had the coronavirus, but the official cause of death was an accompanying illness, then their family will not receive any compensation. A special commission will be assembled to resolve such cases in the city. The commission will reportedly be made up of the given healthcare worker’s immediate supervisor, a labor protection specialist, a representative of the labor union, and “other official figures according to the decision of their employer.” The commission should be led by one of the deputy heads of the hospital in question, and seek to find out exactly how the healthcare worker became infected. It should also establish the “fault of the medical worker (in percentages).” The “guilt percentage” will determine the size of the compensation payment.

St. Petersburg doctors told Meduza that because of these criteria, they fear that only a few people will be able to receive the payments they are due. The hospitals almost never establish how and from whom their employees become infected. 

Anna Shuzhina — the daughter of the now deceased nurse, Valentina Shuzhina, who worked at the St. Petersburg Scientific Research Institute of Emergency Medicine — is not expecting a payment. Her mother was 56 years old, she died on April 18. Valentina had worked at the Emergency Medicine Research Institute for over 30 years — her friends called her “the ambulance.”

At the end of March, Shuzhina was diagnosed with stage-four pancreatic cancer. Chemotherapy did away with the cancer, but soon after she was diagnosed with pneumonia in her left lung. She received antibiotic injections for two weeks, but her fever wouldn’t drop, then she started having trouble breathing. Afterwards, she was diagnosed with the coronavirus.

“Not long before her death she told her sister, my aunt, ‘Sasha, I will not survive.’ On April 17 she was transferred to intensive care once again, they were preparing to intubate. Within a day they called me from the hospital and told me about my mother’s death. They said that she had developed pulmonary failure and double pneumonia,” Anna Shuzhina recalls. 

The official cause of the nurse’s death was recorded as “extensive metastasis” (implying that her cancer had spread). Her daughter disagrees: she’s sure that her mother died because of the coronavirus. As for the compensation, no one has contacted Shuzhina’s family yet. “As I understand, if the management of the medical facility decides to pay the benefits, that means that they have somehow allowed their employees [to become infected]. In my understanding, this means [there will be] inspections of the medical facility, and they hardly want that,” Anna Shuzhina explained to Meduza. Now she is considering the possibility of going to court, but she doubts that she stands a chance at winning compensation. 

Valentina Shuzhina is one of two nurses at the Emergency Medicine Research Institute who have died during the pandemic. Her colleague, 46-year-old Olga Novikova, died as well. Right away, two of the institute’s employees told Meduza that they still had not been given the necessary protective equipment — despite the deaths of their colleagues. “How can you prepare for this [the deaths of colleagues]? Even if you know that it will be so. Everyone is scared. It’s not just scary for those who are walking on the street,” one of the employees said.

The St. Petersburg healthcare workers that Meduza spoke with emphasized that because of the leadership’s attitude, even the 300,000-ruble compensation for a case of the coronavirus without serious consequences will be difficult to obtain. According to these sources, medical workers in some city hospitals are not being tested. One of the founders of the “Memory List,” cardiologist Alexey Erlikh, spoke of this as well: “At the very least I definitely know of one [St. Petersburg] hospital where testing medical workers for a covid infection is simply forbidden. What do you think, will they die of the coronavirus or not? Some of our leaders long ago became accustomed to playing with the statistics in a way that suits them. They are probably continuing to do this now.”