Russian coronavirus doctors are mysteriously falling out of windows - Vox

Three Russian doctors working to treat coronavirus patients have mysteriously fallen out of windows in recent weeks, underscoring the country’s struggling health care system — and leading to suspicions of foul play.

On April 24, Natalya Lebedeva, the chief of emergency medical services at a training base for Russian astronauts, fell out of a window at the hospital where she was being treated for a Covid-19 infection and died.

Yelena Nepomnyashchaya, the top doctor at a hospital in Siberia, fell out of a window during a conference call at her hospital and died on May 1 after a week in intensive care.

The next day, ambulance doctor Alexander Shulepov fell from a second-floor window at the hospital where he worked and had been receiving treatment for Covid-19. He remains in serious condition with a fractured skull.

Russian authorities are investigating all three incidents, and there is no official indication yet of what happened to the physicians. The circumstances around their falls, though, are more than a little suspicious.

For example, Nepomnyashchaya was on a conference call with a top Russian health official about plans for turning one of the buildings at her medical facility into a coronavirus treatment ward. She disagreed with the idea, and fell out of the window during the call, according to local media.

And Shulepov had, along with a colleague, posted a video online on April 22 — the day he was admitted for coronavirus care — complaining that he had been forced to work despite contracting the disease. Five days later, Shulepov retracted his comments, saying he had spoken in “an emotional state.” Less than a week later, he fell out of a window.

The circumstances around Lebedeva’s fall at the Russian astronaut training center are less clear, with the hospital where she died releasing a statement saying she “died tragically” in an “accident,” with no additional details provided.

So what’s going on here? Is it possible this is all an unfortunate coincidence? Are Russian medical facilities, creaking under the strain of the coronavirus, struggling to keep people safe? Or is there something more nefarious going on? Is the Russian government surreptitiously killing people who speak out about the failures of the country’s coronavirus response?

Nobody yet knows for sure, but it’s worth looking into what we do know about each incident and the theories surrounding them.

What we know about the lives and falls of the three doctors

The amount of available details on each case varies widely. But what’s available at least allows for some idea of what happened.

Not much has yet come out on Lebedeva, the 48-year-old who led the emergency medical team in the astronaut training base in Star City, just on the outskirts of Moscow. Some reports indicate she may have helped treat Moscow’s coronavirus “patient zero.”

After she contracted the coronavirus, she was hospitalized at the Federal Scientific Clinical Center in Moscow on April 20. Four days later, she fell out of a sixth-floor window and died instantly.

The hospital labeled her plunge an accident in a statement, also offering some kind words about her time leading the medical team: “She was a true professional in her field, saving human lives every day!” But other than that, much remains a mystery.

More is known about what happened in the case of Nepomnyashchaya, the 47-year-old who ran the Krasnoyarsk Regional Hospital for War Veterans.

During an April conference call with Boris Nemik, the regional minister of health, she pushed back on demands for her to make 80 beds in a part of her hospital available to treat coronavirus patients. Reportedly, her biggest concern was that her staff didn’t have enough personal protective equipment to treat Covid-19 patients.

The local Ministry of Health denied that her 50-foot fall from her office window had anything to do with the conference call. And Aleksey Podkorytov, the deputy head of the Krasnoyarsk region’s government, offered some alternative explanations for her plunge.

“So many things could have happened,” he told reporters in April. “It could have been because it was spring, the overall stress, something in her family. It’s difficult to say what could have happened. ... There was nothing extraordinary happening at the time, just a routine conference call with doctors’ reports.”

As for Shulepov, who fell out of the Novousmanskaya hospital’s second-floor window last Saturday, more is known because of what he posted online. On April 22, the 37-year-old physician and his colleague Alexander Kosyakin made a video in which they claimed they still had to work at their hospital despite falling ill with the coronavirus.

“Ambulance doctor Alexander Shulepov is next to me, he is just confirmed Covid-19,” Kosyakin said in the video. “The chief doctor is forcing us to work. What do we do in this situation?”

“We are not leaving the shift,” Kosyakin continued. “Myself and Alexander ha[ve] been working together for a month. This is the situation. Everyone says it’s fake [but] these are real facts for you.” They also noted that the southwestern city of Voronezh — where they both work — was low on personal protective equipment.

But five days later, Shulepov had changed his message in a new video posted to Instagram. “I have a runny nose, otherwise all is well,” he said, adding that “we were high on emotions” when he and Kosyakin made the first video.

Some think it’s possible authorities put pressure on Shulepov. His colleague, Kosyakin, had previously complained about the lack of medical equipment and hospital leadership, leading police to question him for allegedly posting fake news.

Kosyakin, who spoke to CNN on Tuesday, seems suspicious about what happened to Shulepov. When he last checked in with his colleague on April 30, “He felt fine, he was getting ready to get discharged from the hospital,” Kosyakin said. “And all of a sudden this happened, it’s not clear why and what for, so many questions that I don’t even have the answer to.”

Three incidents, three mysteries. It remains unclear what happened in each case, but experts have some thoughts.

Three leading theories for what’s going on

Ask a group of Russia experts what’s going on with these cases and you’ll likely get a different answer from each one. But three explanations seem to be the most prevalent: suicides, assassinations, and the perils of an ailing health care system.

Suicide

Dr. Vasiliy Vlassov, an epidemiologist at the Higher School of Economics in Moscow, said these could be cases of death by suicide. “I believe that this cluster is a reflection of really high incidence of suicides nowadays, because chief physicians are working under high pressure,” he told me. Because guns are hard to obtain in the country, “jumping is a reasonable option.”

Judy Twigg, an expert on Russia’s health care system at Virginia Commonwealth University, agreed. She told me all three cases have “intense stress” in common, either over the lack of personal protective equipment in the hospitals where the individuals worked or because the people got sick themselves.

Further, the three cases happened outside Moscow, which has most of the funding and medical equipment needed to properly treat coronavirus patients. The facilities where the three doctors worked, like many others in the country and around the world, “are breaking more under the strain,” Twigg said.

Death by suicide is a plausible theory, as suicide is a persistent national problem. According to the World Health Organization, Russia has the third-highest suicide rate in the world. In 2016, the latest year for which there’s complete data, about 122 people a day died by suicide in Russia, adding up to around 45,000 deaths.

That explanation is bolstered by reporting from the Russian daily Moskovsky Komsomolets, which quoted some of Lebedeva’s colleagues claiming she had been accused of spreading the disease to her subordinates, so therefore it was possible she died by suicide.

Assassination

“I would not be surprised if the security services were involved, sending a message to keep quiet on the crisis,” said Alina Polyakova, president of the Center for European Policy Analysis.

For many, that might sound conspiratorial. Would the Russian government really kill medical professionals just because they questioned or criticized the country’s handling of the coronavirus crisis?

But this theory is not as far-fetched as it may seem. “It’s not a conspiracy theory,” Toomas Hendrik Ilves, Estonia’s president from 2006 to 2016, tweeted on Monday. He added that “defenestrations are a long term practice,” using the technical term for the act of throwing someone out of a window.

There are previous cases of Russian officials allegedly trying to kill adversaries by pushing them out of windows. In 2017, Russian lawyer Nikolai Gorokhov was due to testify in a Moscow court against the government. But the day before he could do so, he fell from his fourth-floor apartment. The first news outlet to arrive at the scene? LifeNews, an outlet closely associated with Russia’s security services.

In a 2017 interview with NBC News, Gorokhov — who’d fractured his skull but ultimately survived the fall — said what happened to him was likely foul play. “This was no accident,” he said. “Someone planned this, but unfortunately I do not remember the details.” He refused to elaborate further, saying he feared for his life and for the safety of his family.

There’s also a pattern of Kremlin adversaries being assassinated through other, even more elaborate means. For example, in 2009 Russian lawyer Sergei Magnitsky was poisoned in prison, likely because he had uncovered a massive government-linked fraud scheme that threatened top officials. Six years later, Boris Nemtsov, a top rival to President Vladimir Putin, was killed in the heart of Moscow. And in 2018, two Russians tried to kill with a nerve agent a former Kremlin spy living in the UK.

Murder, then, may not be completely out of the question.

A stressed health care system

At a time when Russia’s medical facilities are full and safety isn’t a top concern, it’s possible that three health care providers over the span of a few weeks made tragic missteps simply because they were tired and overworked.

“This is really about the destruction of our healthcare system,” Anastasia Vasilyeva, a staunch Kremlin critic and head of the Alliance of Doctors Union, told CNN on Tuesday. “A lot of clinics and hospitals have been closed. ... And, of course, this means it is very difficult to treat in such conditions a lot of patients with coronavirus.”

This is conceivable. Though Russia’s health care system was relatively well prepared for a large public health crisis, at least compared to many other countries, it has a problem with old and faulty equipment. And many facilities outside the country’s two major urban areas — Moscow and St. Petersburg — lack the resources to provide proper care.

But, as even President Vladimir Putin admits, the coronavirus crisis in the country is getting worse and worse.

“Ahead of us is a new stage, perhaps the most intense stage of the fight against the epidemic,” Putin said in a national address last week, in which he also announced an extension of his nation’s lockdown until May 11. “The risks of getting infected are at the highest level, and the threat, the mortal danger of the virus persists.”

As Russia becomes one of Europe’s worst-hit countries, it’s possible that weary, ill physicians may have taken some missteps in such trying times.

The hope is that Russian authorities not only fully investigate what’s happened but provide detailed, truthful answers. But given Russia’s track record, that outcome could be the least likely of all.

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