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22 May 2020 00:32

KFC Drive-through Coronavirus

Doctors and activists in Dagestan have described the death toll in the Russian region as "tragically high", after officials said more than 600 people had died from pneumonia since April – far more than the official Covid-19 death toll for the region of 36. "In some towns, five to seven people were dying a day … some have seen 20 or 40 people die," said Ziyatdin Uvaisov, the head of Patient Monitor, a Dagestani NGO that advocates for the rights of patients and medics and has canvassed for information about coronavirus deaths. At least six doctors have died at a single hospital in the closed-off city of Khasavyurt. Patimat, a doctor in the cardiology department there, told the Guardian that a majority of the doctors had contracted coronavirus, including herself, and a "considerable number" had died or at one point been too sick to work. Another doctor said seven health workers had died at the hospital.

Dagestan doctors speak out over 'tragically high' death toll

Patimat said her first wave of patients fell ill after attending a funeral for another person who had died from coronavirus. "People went in crowds to their funerals," she said. "My main wave of patients early in the epidemic told me they had been there." At the height of the crisis, Patimat said, her department ran out of oxygen to treat all the patients and could not get test results to confirm coronavirus diagnoses. She said most of the samples sent for analysis were either returned or scrapped. "There was a colossal shortage of medicines and equipment," she said. "We never expected waves [of patients] like this." Earlier this month Daniyal Alkhasov, another doctor who had volunteered at the hospital, said he had fallen ill with coronavirus after two shifts there. At least two doctors who died at the hospital were later reported to have died from "community-acquired pneumonia". The lack of coronavirus testing and frequent opposition from family members to autopsies has meant the official death toll from Covid-19 in Dagestan is far lower than the toll of deaths attributed to other diseases such as pneumonia. Officials say there may also be unreported deaths in isolated villages and towns that still have not been canvassed. The scale of the pandemic in the region was confirmed publicly on Sunday when Dagestan's health minister, Djamaludin Gadzhiibragimov, said during an interview with a local blogger that in addition to 29 official Covid-19 deaths, 659 people had died of pneumonia and another 7,000 were in hospital. He said 40 health workers had died since the beginning of the crisis (officials say they did not all die from coronavirus). After pleas from senior officials and clerics, Vladimir Putin intervened personally this week, pledging aid from federal agencies during a nationally televised conference. Meanwhile, the region's most famous son, the MMA fighter Khabib Nurmagomedov, issued a call on Instagram for adherence to lockdown measures. His father has contracted coronavirus and is reportedly in a medically induced coma in a Moscow hospital after being airlifted from Dagestan. "Hospitals are overflowing, many people have been sick, and very many people have died," Nurmagomedov told his 20 million followers online. Officials have blamed distrust of local authorities and lockdown violations for the severe outbreak, noting that mass events such as weddings, funerals and religious celebrations sped the spread of the disease. Putin has called on people in Dagestan – a majority Muslim region of 3 million people in the North Caucasus – to celebrate the end of Ramadan at home. Doctors and paramedics in three areas of Dagestan said they had been undersupplied with medical and personal protective equipment, a situation that had only begun to stabilise in recent days. "The hospital system was totally unprepared," said Uvaisov, whose NGO has raised funds to buy and deliver medics masks and other basic PPE. Dagestan is not the only region where deaths attributed to pneumonia have far outpaced official coronavirus deaths. This month the St Petersburg governor said at least 694 people had died of pneumonia since March – 10 times more than the official number of dead from coronavirus at the time. The region of Karelia, has reported just two deaths from coronavirus, while data on official sites shows that 49 people have died from pneumonia since the beginning of April. Pneumonia patients are "repeatedly tested for Covid-19", the reports say. In most other regions, statistics on deaths from pneumonia for April and May have not been made public yet. Patimat and another doctor at the hospital in Khasavyurt said they were unable to confirm many coronavirus diagnoses, so deaths were coded as pneumonia. "We could not get test results. Samples were returned, others were scrapped. So I'm sure the numbers [of dead from coronavirus] are much, much higher," Patimat said. The scale of the crisis in Dagestan has caused medics to speak out, some demanding better PPE and others bonuses that had been promised by the government. Patimat said she had not seen her family in more than a month as they had self-isolated at home in Makhachkala, the region's capital. She and other doctors described conditions at the hospital as dire, though now improving with better supplies and testing.