Russia: Publish Data About Covid-19 in Institutional Care

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(Moscow) – Russian authorities should publicly release detailed information about the spread of Covid-19 in state institutions for older people and people with disabilities, Human Rights Watch said today. Releasing this information would allow state officials and private actors to respond effectively and prevent further deaths.

News media and charitable groups have highlighted dozens of known outbreaks in institutions, where in some cases, up to half of residents and workers have been infected by the virus. Yet federal officials do not appear to publish detailed regular statistics about the numbers of infections or deaths in institutions. Human Rights Watch sent an email requesting data from the Ministry of Labor and Social Protection on May 27 but has not received a response.

“Across the world, people living in nursing homes are among the hardest hit by Covid-19,” said Hugh Williamson, Europe and Central Asia director at Human Rights Watch. “The Russian government should immediately publish information about the course of the virus in institutions that care for older people and people with disabilities, to help public and private actors respond quickly and effectively slow its spread.”

Russia announced its first confirmed cases of Covid-19 on January 31, 2020 and now has over 414,000 confirmed cases, the third highest in the world, after the United States and Brazil. An increasing number of reports show the heavy toll of Covid-19 on health workers: the Ministry of Health put the number of medical workers’ deaths at 101 as of May 26, though some reports estimate the number is at least 2 or 3 times that high.

The impact on residents of nursing homes and state institutions for people with disabilities has been less publicly reported, but the toll also appears to have been severe. On April 12, a nursing home in the town of Vyazma announced that 86 people out of about 300 residents and staff tested positive for Covid-19, in what would become the first known major outbreak in a state institution.

On April 6, the Ministry of Labor and Social Protection, which oversees state residential institutions, issued guidance to institutions encouraging basic precautions against Covid-19, including screening residents and staff for symptoms, limiting outside visits, providing necessary personal protective equipment to staff, and offering temporary accommodation for residents with relatives or others.

On April 23, Deputy Minister Olga Batalina said that all institutions had been told to go into lockdown and that staff would work 14-day shifts, during which they would remain at the institution. She also said that 457 people, including 67 staff, had been infected in 16 institutions for older people and people with disabilities.

It is unclear how this data is collected or how many tests have been conducted in state institutions and with what frequency. However, recent reports by Russian media and charitable organizations suggest that once an outbreak occurs in an institution, large numbers of people are sickened by the disease, raising concerns that actual numbers may be higher than stated.

On May 25, authorities in the Astrakhan region said that 124 of 323 residents and staff of a nursing home tested positive for Covid-19. On May 22, a psychoneurological institute in Rostov region with a 420-bed capacity announced that 270 people had been diagnosed with Covid-19.

On May 18, officials in St. Petersburg said that 411 out of 1,020 residents of a psychoneurological institute were infected. Similarly, on May 11, an institution in Smolensk region said 94, or almost half, of its residents and numerous staff were infected.

Nearly 250,000 older people and adults with disabilities in Russia live in state institutions, many housing hundreds of residents in close quarters, exacerbating the risk that the virus could spread rapidly. Human Rights Watch research from 2012 to 2014 found that children with disabilities in some state institutions often lived in overcrowded conditions and faced neglect and little or no access to medical care.

Since Batalina’s statement on April 23, the government has not updated public information about the number of infections in state institutions. The National Association of Social Service Participants, a nonprofit organization of state and private care providers, found 42 mentions in news and social media of institutions reporting Covid-19 cases as of May 25, though many did not include the number of infections.

Starost v Radost (“Old Age is a Joy”), a charitable group that works towards nursing home reform across the country, said on May 21 that they knew of 98 institutions in 38 regions with confirmed cases. Overall, the piecemeal information available suggests that the virus is widespread in state institutions, underscoring the need for a cohesive and transparent response.

Elizaveta Oleskina, director of Starost v Radost, has suggested that publicly available numbers most likely understate the true impact of the virus, given that directors of institutions might fear retaliation, firing, or even criminal charges for disclosing an outbreak. “I know that people (in nursing homes) are sick already in St. Petersburg, Moscow, in many regions,” she said in an interview with the newspaper Kommersant. “The dangerous thing is not that they (residents) are getting sick, but rather that many regions try to hush this information up, saying instead that people have typical [non-Covid] acute respiratory infections.”

According to research conducted by the Higher School of Economics, experts have noted a trend in the “total covering-up of cases of infection because of the risks of criminal prosecution” among institution directors during the pandemic. There has been one publicly reported case in which authorities opened a criminal case into the allegedly negligent response of an institution to Covid-19. Care workers who have spoken to media outlets about the rapidly rising number of cases in the institutions where they work have done so anonymously, saying they fear they could lose their jobs if they speak out.

There has also been virtually no reporting about Covid-19 in the growing number of private nursing homes in Russia, where according to some estimates, approximately 25,000 older people live.

People with nongovernmental groups that work in state institutions for older people and people with disabilities told Human Rights Watch that these facilities are often understaffed, with 1 person caring for 25 or more people. Many of these residents may have high support needs, requiring assistance with tasks such as eating, bathing, and using the toilet.

Given the known high numbers of infection among staff in some facilities, Russian authorities need to take steps to ensure that additional staff are hired where necessary and that all are equipped with personal protective equipment, Human Rights Watch said. On May 18, the Russian government announced a significant measure to provide bonus payments for staff of state institutions with confirmed Covid-19 cases.

Covid-19 poses a higher risk to populations living in close proximity to each other, and it disproportionately affects older people and those with underlying health conditions, who make up a significant portion of the population in Russian state institutions. Older people and others living in such institutions across Europe and the US have borne the burden of a vastly disproportionate number of deaths from Covid-19.

The higher risk to populations in institutions makes it all the more important for the government to quickly publish detailed data about the spread of the virus in state and private institutions, including rates of infection and deaths, to facilitate an effective public health response, Human Rights Watch said.

The Ministry of Labor and Social Protection’s policies introduced in April were positive steps toward improving institutions’ ability to respond to the virus, but further transparency is necessary to boost these efforts. If they are not already doing so, Russian authorities should carry out testing across all nursing homes and institutions and put in place other important health measures such as strict hygiene and physical distancing. Where possible and safe, the government should move older people and people with disabilities out of closed institutions and similar settings and suspend new admissions.

“Many examples from the rest of the world have shown just how devastating Covid-19 can be in institutions for older people and people with disabilities,” Williamson said. “Russia should go beyond steps already taken to prevent outbreaks in state institutions and publish detailed public health data that can inform policy and save lives.”