When Alexei Sidnev saw the horror caused by coronavirus in European care homes he knew he had to act fast. Way back in March, before any lockdown in Russia, he began sealing off the six homes he runs near Moscow and buying-up protective clothing for staff.
“I don’t sleep much. It’s probably the hardest time of my life and I’ve been through perestroika and all the crises,” Mr Sidnev confides, recalling the Soviet Union’s reform and eventual collapse.
But while the businessman shares his own trials on social media, the struggle in Russia’s state care sector plays out old-style, largely behind closed doors.
“I know of many care homes right now fighting the virus, it’s just not public,” Mr Sidnev says.
We don’t have the true picture [of the epidemic]
‘In our place no-one does autopsies’
The story of a Covid-19 outbreak at the Vishenki home for the elderly in Smolensk, 400km (250 miles) west of Moscow, is one hint at how that wider picture may look.
“What’s happening here is a nightmare,” a carer told the BBC by telephone, one of dozens from the state-run home who are now off sick after residents and staff caught coronavirus.
At the start of this month, residents and staff began catching Covid-19 at this home in Smolensk.
All those we spoke to asked to remain anonymous because they want to keep their jobs.
“By 3 May lots of residents had a fever and they started dying,” the nurse recalled. “I think about eight people died and that’s just on my floor.”
She believes their “accompanying illnesses” were given as their cause of death, rather than Covid-19. “In our place, no-one does autopsies,” she said.
“No-one even told us there was Covid-19 in the home!” an orderly complained bitterly, in a separate call. “We found out when the ambulances came and they were dressed in those suits.”
“We sent a lot of people to hospital,” she said, and confirmed that other residents had died.
The local governor’s office did not respond to a BBC enquiry about fatalities and as of Tuesday Smolensk region had counted just 21 coronavirus fatalities in total.
Is Russia unusual in Europe?
Across Europe, frail care home residents account for up to half of all coronavirus fatalities.
The figures in Smolensk are in line with the unusually low overall mortality rate that Russia is reporting in this epidemic, at around 1%.
The government insists that’s down to early diagnosis and treatment, though it only counts those found to have died of Covid-19 directly.
More from Sarah on Russia’s pandemic:
So is Russia some kind of exception to a shocking trend?
The official mantra is that the country used its couple of weeks’ grace to good effect, bracing before the full force of Covid-19 hit.
The government certainly advised care homes to stop group gatherings and restrict access in early April.
On 17 April, a telegram then recommended “full quarantine”, with carers living in at work for a fortnight at a time to reduce exposure to the virus.
“The statistics from the UK were terrifying and that helped places here hunker down, desperate not to let the virus in,” explains Elizaveta Oleskina, the head of the Starost’ v Radost (Joy in Old Age) charity which works with many state-run homes.
Starost’ v Radost
Carers left everything, many of them stressed and in tears, and went to live at work. I think that’s a huge achievement
‘Nothing to pay us with’
But the homes are funded from limited regional budgets and full quarantine is expensive as carers must self-isolate for a fortnight between shifts.
Staff at Vishenki said their home was already stretched to the limit before the epidemic, with even incontinence pads in short supply.
Managers did consider locking-down from 1 May, they said, then decided against it.
“The director said she had nothing to pay us with,” a nurse explained.
By then, coronavirus had already penetrated.
“When the elderly started getting sick, we guessed what it was and said it was time to quarantine,” a third employee recalled. “But the director said it was just flu, and we shouldn’t worry.”
The Smolensk governor’s office told the BBC its care homes had been informed of all government recommendations and were funded “in full”.
The Fear Factor
Covid-19 is now spreading through Russia’s care system.
“There are cases in places out in the Taiga, 300km from any town, and in a village care home where no Muscovite has ever been,” Elizaveta Oleskina explains.
Her charity says at least 95 homes have reported cases so far, out of 1,280 in total.
Many are old with large, shared rooms and bathrooms.
“If a home is big, the virus is like a forest fire – it spreads instantly,” Ms Oleskina warns, stressing repeatedly that the sector here is battling the same extraordinary challenges as the rest of the world.
But there is one very Russian factor.
A report by sociologists at Moscow’s Higher School of Economics describes what they call the “total concealment” of incidents in care homes, driven by a fear of prosecution for negligence.
On Tuesday, the prosecutor’s office announced it was looking into the situation at Vishenki; the director has already been cautioned.
‘We don’t really know death toll’
Alexei Sidnev believes in transparency, so that everyone learns vital lessons in this unprecedented crisis.
But the man who runs six facilities called Senior Homes near Moscow suspects that old habits die hard.
“We now know what happened roughly 30 years ago: we learned about it from an HBO series,” the businessman says, referring to the Chernobyl nuclear disaster and Soviet cover-up, recently dramatised on TV.
“The true amount of the death toll and what’s happening, we don’t really know,” he says. “Maybe we’ll find out later.”
Coronavirus in Europe’s care homes: