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‘This situation is very scary’: Coronavirus is disrupting Vladimir Putin’s Russia

In Yakutia, in Russia’s far north east — easily one of the most remote resource regions on the planet — isolation appears to be the least of concerns among its more than 10,000 oil field workers.

“We’re infected! Where’s the f—ing quarantine? Where are the f—ing masks?” employees shouted in an angry rant aimed at their company and local government posted on a Russian social media site earlier this week.

As many as 10,500 workers at the Chayanda oil field site have been tested for COVID-19, and though the results haven’t been released, the website Meduza quotes the regional governor as saying the number of positive cases is “very significant.” 

The availability — or rather scarcity — of protective gear at facilities and institutions closer to the country’s major population centres appears to be equally problematic.

“Here is the real truth about Reutov hospital [near Moscow] — there is no personal protective equipment in the coronavirus department!” one hospital worker wrote this week on a whistleblower Facebook page set up by frustrated Russian health-care workers.

“Staff wear [their] disposable protective equipment over and over again.”

Another video viewed by CBC News showed COVID-19 patients in a hospital in the city of Derbent, Republic of Dagestan, crammed into makeshift bunks in what appears to be storage room, coughing and hacking with IVs in their arms. They were being tended by a nurse who wasn’t wearing a mask or any other protective gear.


Social media video from Derbent, in the Russian republic of Dagestan, shows patients stacked in bunk beds to get treatment for coronavirus, with staff who aren’t wearing face masks or protective gear. (MoshebabaV/YouTube)

COVID-19 appeared to come late to Russia, compared with North America and Europe, but now it’s striking with a vengeance, the damage compounded by the lack of personal protective equipment for hospital workers.

There are almost daily reports across the vast country — from St. Petersburg to Siberia — of hospitals being quarantined because of coronavirus outbreaks among staff.

On Thursday, the state news agency RIA novesti reported that Prime Minister Mikhail Mishutsin tested positive for the coronavirus and is in self-isolation. He is so far the most senior member of government known to have contracted the virus. President Vladimir Putin has not been seen in public with Mishutsin in weeks, and the prime minister broke the news by video conference.

Doctors dying

Among health care workers, the toll has been so high over the past fortnight or so that colleagues have started compiling the names of the dead on an online memorial page — 74 names as of Tuesday night and growing.

Among them was Natalia Lebedeva, who headed up medical services at Russia’s cosmonaut training centre outside Moscow. She allegedly died after falling out a window — a fate that has become strikingly common over the years for those who either disapprove of or disappoint Russian authorities.

Independent Russian media reported Lebedeva may have committed suicide after being blamed for letting the coronavirus spread throughout the facility.

Another doctor from Siberia may also have tried to take her life by similarly jumping out of a fifth-storey window at her workplace in Siberia.

As in the cosmonaut hospital case, local media reported that Yelena Nepomnyashchay was blamed by authorities for an outbreak of the virus. She survived but is in critical condition.


A screenshot from the popular Russian Information program Vesti Nedeli, or News of the Week, shows doctors handling wards of COVID-19 patients in Moscow. (Russia 1 Television)

Putin’s plan

For the first time, Putin has acknowledged Russia is having trouble meeting the demands for enough personal protective equipment for its health-care workers.

In an address Tuesday, Putin admitted that “there is still a shortage of some technical items, equipment and disposable materials,” despite increasing production of masks 10-fold in April and making more than 100,000 protective suits every day.

“We have concentrated and mobilized all our industrial resources,” he said.


Protesters in Vladikavkaz, North Ossetia, stage a protest on April 20, urging the government to end the lockdown and allow them to return to work. (Youtube)

Russia is poised to surpass 100,000 confirmed COVID-19 cases in the country, with approximately 900 reported deaths. Those are extremely low numbers compared with the experience of western Europe, where more than 20,000 people have died in each of the United Kingdom, France, Italy and Spain.

Many doctors — even those sympathetic to the government — have told CBC News part of the challenge is that Russia’s tests return an unusually large number of false negative results.

Other health officials linked to opposition groups believe many deaths are also either deliberately or unintentionally misrepresented.

For example, the Russian business publication RBC quoted Moscow’s deputy mayor as saying cases of pneumonia increased more than 70 per cent in the past week, filling up urgent-care beds in the city. 

Since many coronavirus patients develop pneumonia, the head of a doctors advocacy group told CBC News in an earlier interview that it’s fair to assume most of those patients had COVID-19.

Economic disaster

Putin is also facing increasing pressure over the enormous economic cost of the coronavirus lockdown, now into its fifth week in the capital Moscow.


With Moscow and most other Russian cities locked down for a over month, up to six million jobs have disappeared. (Alexey Sergeev/CBC)

Russia’s labour ministry reported Tuesday that unemployment could soon reach six million people.

Many of those out of work would only be eligible to receive a meagre maximum payout of roughly $ 200 Cdn a month.

Others who are self-employed might not get anything.

“They can’t survive in this situation if the lockdown is prolonged,” said opposition politician Dmitry Gudkov.

Gudkov is among those calling on the Putin administration to release some of the money in Russia’s huge sovereign wealth fund, which holds more than $ 150 billion US.

When oil revenues were stronger, the money was set aside by the Putin administration to help ease the shock of any future economic sanctions that might be imposed by the West. But Gudkov says the money should be spent now, by making direct payments to people, as has been done in Canada and the United States.

“He doesn’t want to spend this reserve fund,” Gudkov told CBC News.

Frustration growing

“Putin needs the money to maintain the ‘Putin forever’ model,” a reference to the Russian leader’s attempts to change the constitution to allow him to serve two more terms as Russia’s president.

Gudkov says Putin has a long list of “legacy projects” he wants built, and spending money on direct payments to people will deplete the funds for that.

But frustration is growing, as jobs dry up and the Kremlin offers people little in return, Gudkov says.

“If there is a choice to die from hunger or the virus, it’s better to die from the virus.”


Russian opposition politician Dmitry Gudkov wants the Kremlin to offer a much bigger assistance package to those hurt by COVID-19. (Chris Brown/Skype)

In his remarks Tuesday, Putin indicated the government is preparing another round of economic assistance for individuals and businesses, but he didn’t offer any clues to what it might be.

He also suggested that some parts of Russia might be able to start easing their lockdown and returning to work after a holiday period that ends in mid-May. 

‘Very scary’ for Russian government

In an online discussion hosted by the Carnegie Centre in Moscow, liberal-leaning Russian economist Sergei Guriev, who is based in Paris, suggested COVID-19 represents the most difficult challenge Putin has faced in the 20 years he has sat atop Russia’s power structure.

Guriev says street protests against the lockdown may become more frequent, as Russians run out of money and face difficulties feeding their families.

“We are in very uncharted waters,” he said. “This situation is very scary for the Russian government.”

WATCH | Russians’ frustration with the COVID-19 lockdown is growing:

Millions of Russians have become impoverished during the COVID-19 pandemic and the Kremlin is offering little financial support even though it has billions in the coffers. 2:04

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From at-home orthodontics to coconut-flavoured floss: Meet the startups disrupting the dental industry

For decades the experience of caring for your teeth looked something like this: Visit the dentist every six or nine months. Take home a new toothbrush from the hygienist. Use it to brush at least twice daily. Repeat.

If you or your child needed teeth straightened, you got a referral to an orthodontist, hoped your insurance and savings could cover it and paid whatever price you were quoted.

But today a host of companies are disrupting the dental industry with everything from at-home orthodontic impressions to coconut-flavoured dental floss in Instagram-worthy packaging to a $ 290 toothbrush alternative that promises to clean your teeth in six seconds.

Some are competing on price, slashing costs we'd come to think as fixed. Others are injecting luxury into the banal, working to position the age-old tasks of brushing and flossing into the realm of wellness lifestyle capturing the attention of kombucha and SoulCycle enthusiasts.

SmileDirectClub, the U.S.-based company that provides at-home, dentist-directed teeth straightening using clear "aligners" — similar to the ones provided by Invisalign — launched in Canada in November.

Orthodontic care from home

The teledentistry startup was launched four years ago and employs 3,000 people. It flips the traditional orthodontic business on its head by sending patients kits they can use to take impressions of their teeth themselves, eliminating the need for bricks-and-mortar clinics. 

As a result the prices are as much as 60 per cent less than traditional orthodontic care, says Alex Fenkell, who co-founded the company with Jordan Katzman. 

As you can imagine, anytime there's a disruptive element or product that gets introduced, the establishment gets excited and worried.– Dr. Jeffrey Sulitzer, SmileDirectClub's lead dentist

The two met at summer camp when they were 13 years old. Fenkell says, "We both had a full mouth of metal wired braces. It was a pain point in our youth."

As grown-up business partners, Fenkell says they were "shocked by the prices" and how much of the potential market for teeth straightening didn't have easy access to orthodontic care.

Smile Direct Club clients receive packages like the one seen here for taking impressions of their teeth at home. (SmileDirectClub)

The at-home model allows SmileDirectClub to offer straighter teeth to people who live prohibitively far from the nearest orthodontist office. 

The Canadian Institute for Health Information says that in six of the 10 provinces people have access to less than one orthodontist per 10,000 square kilometres.

The company does have some physical locations, however, so-called SmileShops where those who live in major centres can opt to have their mouth scanned. Fenkell says the company has five Canadian locations open now and will open two more by the end of the year.

Flat price and payment plans

All SmileDirectClub treatments cost $ 2,350 for Canadian customers. Alternatively, they can pay a $ 300 deposit followed by monthly payments of $ 99.

The company can offer a flat fee because it doesn't take on complex cases. 

"We focus primarily on mild to moderate misalignment, which involve crowding or spacing of teeth," says Dr. Jeffrey Sulitzer, the company's lead dentist.

If a patient presents with a bite that needs to be corrected or misalignment that's more severe, the company refers to a traditional orthodontist, he says.

SmileDirectClub follows the better known Invisalign, which pioneered the use of clear aligners as an alternative to traditional braces that adhere to the teeth.

Customers receive a set of disposable aligners each a little different based on where the teeth are meant to be, shifting gradually into their desired position.

But teeth straightening isn't the only part of the dental business to change in recent years.

Sleek toothbrushes and Insta-worthy dental floss

If you're a regular podcast listener, you may have heard an ad for a sleek looking electric toothbrush called Quip, with a subscription service that delivers new brush heads on a "dentist recommended schedule."

Danish entrepreneurs just raised $ 1.5 million through crowdfunding of their Unobrush, a device that looks nothing like a standard toothbrush and promises to clean teeth twice as well in only six seconds. The company's website explains that users bite down on a patent-pending medical foam that moulds to the teeth and uses pulsing to clean them all at once. The foam device then slides into a docking station that sanitizes the Unobrush using UV light.

Beam Dental, another company based in the United States, links data from the electric brushes it provides to the dental insurance it sells. Brush well and your insurance premiums will go down.

Sisters Catherine and Chrystle Chu created Cocofloss to make flossing more effective and appealing to customers who are otherwise engaged with wellness but falling down on the job of flossing. (Cocofloss)

Even humble floss is getting a makeover.

Catherine Chu co-founded Cocofloss with her sister, Chrystle Chu, a dentist in San Mateo, Calif., just outside San Francisco.

"She had been practising dentistry for several years in the Bay Area and she was so perplexed at this weird paradigm where she had a very healthy and young patient base who invested a lot in self-care, in going to the gym and eating the right foods, but for some reason or another were not flossing," says Catherine Chu.

The two decided to invent a floss that would remove more plaque because it's more textured, and that comes in stylish, colourful packaging that customers don't mind leaving out on the bathroom counter. It's available in some retail shops like Sephora and Anthropologie, but most customers buy through the company's website, both through individual purchases and subscriptions, she says.

Not all of these changes have been as welcome as better and prettier dental floss, though.

Concerns about treatment quality

The Canadian Association of Orthodontists has major misgiving about the quality of treatment with the SmileDirectClub model, where treatment plans and patient monitoring are done remotely, says association president Jay Philippson, an orthodontist from Duncan, B.C.

"We should be concerned about quality of care. If I start a case I want to be sure I can finish it as best as possible. People at the direct-to-consumer companies, they can't monitor the patients as well as we can," says Philippson. 

Regulatory agencies in Canada are going to have an issue with it as soon as there is a complaint.– Jay Philippson, Canadian Association of Orthodontists president

He says dentists creating and monitoring treatment plans from afar don't have as complete a picture of a patient's dental history, including X-rays and full patient files. 

"Regulatory agencies in Canada are going to have an issue with it as soon as there is a complaint."

At SmileDirectClub, Sulitzer, who has been practising for 34 years, says he doesn't find the misgivings surprising. 

"As you can imagine, anytime there's a disruptive element or product that gets introduced, the establishment gets excited and worried," he says. 

But Sulitzer says that when he talks to wary dentists and orthodontists about the treatment process, company mission and that it doesn't take on complex cases, many come around.

Fenkell draws an analogy to the auto industry, where there are vehicles at many price points. If only traditional orthodontic treatment is available, he says, it would be like saying that "unless you can afford a Mercedes-Benz, you don't deserve to drive."

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