Russian medical experts prepare to check passengers arriving from Italy at Moscow’s Sheremetyevo International Airport this month.

Alexander Zemlianichenko/Associated Press

For weeks, Russia seemed to have dodged a bullet. As coronavirus disease 2019 (COVID-19) raged just across the border in China, Russia was virtually untouched, reporting just seven confirmed infections as recently as 10 March. Since then, the number has risen fast: Russia has now reported 840 infections, about two-thirds of them in the Moscow region.

Some health care providers have questioned whether Russia truly kept the novel coronavirus at bay. Anastasia Vasilyeva, head of Russia’s Alliance of Doctors trade union, has pointed out that pneumonia cases in Moscow spiked in January—they were 37% higher than in January 2019, according to Rosstat, Russia’s statistics agency. She asserts that COVID-19 must have accounted for at least part of the increase. Others attribute the increase to a greater number of pneumonia patients, anxious about the new coronavirus, seeking treatment.

With COVID-19 cases now indisputably on the rise in Russia, authorities are moving fast to ramp up detection and hospital bed capacity. Russia’s federal coronavirus coordination council says 193,000 tests based on the polymerase chain reaction (PCR) have been done to date. Swabs initially had to be shipped to Siberia for analysis at the State Research Center of Virology and Biotechnology VECTOR. Russia’s Federal Service for the Oversight of Consumer Protection and Welfare (Rospotrebnadzor)—the country’s analog of the U.S. Centers for Disease Control and Prevention—has just expanded testing to its regional laboratories and the Anti-Plague Research Institute.

The agency says it has created a reserve of 700,000 test kits that it will regularly replenish. And the coronavirus council announced yesterday it is allotting 1.4 billion rubles ($17.7 million) to VECTOR, the antiplague facility, and several Rospotrebnadzor labs to spur vaccine and drug development.

To cope with a rising tide of patients, Russia’s federal government is building a new hospital on Moscow’s outskirts. Authorities have called on Moscow residents over age 65 to self-isolate at home—an admonishment that Russian President Vladimir Putin, 67, exempted himself from. But Putin on 24 March donned protective gear while visiting a hospital treating COVID-19 patients, and yesterday he ordered all nonessential workplaces to close from 28 March to 5 April, declaring that “the safest thing is to be at home now.” Today, the government suspended international travel into and out of Russia—starting tomorrow—except for charter flights for bringing expatriates home.

As Russia contends with the mounting COVID-19 threat, Science caught up with Sergey Alkhovsky, a virologist who studies emerging and zoonotic viral infections at the Russian Ministry of Health’s D.I. Ivanovsky Institute of Virology. This interview has been edited for brevity and clarity.

Q: How do you explain the success of Russia’s containment efforts while cases in China were skyrocketing starting in late January?

A: The border with China was closed at the end of January. The border is long, but in total there are only 16 [legal] crossings. All of them were closed, and only one still worked for evacuation of Russians from China. The railway from China was stopped, and all charter flights were canceled. Only a few airlines remained in operation, arriving at one terminal in Moscow with medical supervision of all arrivals and recording of their residence and contacts. By the way, the first two cases in Russia were found on 31 January in two Chinese tourists.

Q: Yet infectious disease wards in the Moscow region are already reaching capacity.

A: Sick people who had contact with foreigners have been isolated in hospitals starting in early February. So, starting last month, hospitals were full of suspected patients, and their relatives were warned about the danger of infection. [Russia’s coronavirus commission yesterday said 112,000 people are in self-isolation in their homes.]

courtesy of Sergey Alkhovsky

Q: Where are all these patients coming from?

A: There is some community transmission, but the majority of patients who tested positive arrived from Europe. Unfortunately, measures to restrict air travel with Europe were introduced too late, when outbreaks had already occurred in Italy and other countries. [The first genome of the novel coronavirus sequenced from a Russian patient—a woman in St. Petersburg—placed it in a clade circulating in Europe.]

Q: Initially, Russia allowed work on the novel coronavirus in biosafety level 3 (BSL-3) labs. Last week, it relaxed the regulation to allow research in BSL-2 facilities. Why the change?

A: It had become clear that the virus is not so dangerous.

Q: What do you mean?

A: The initial decision of the authorities was to allow work with the virus only at VECTOR. This decision seemed excessive, as it meant many research groups could not get the virus for development and testing of vaccines and antiviral drugs. Now we know more about the virus and these strict requirements are canceled. This will allow for PCR testing in more BSL-2 laboratories and will allow scientists from other institutions to get involved in the work on the virus.

Q: In vaccine and drug R&D?

A: Russia has developed vaccines against tick-borne encephalitis, polio, smallpox, influenza, and other infections. Groups from scientific institutions at Rospotrebnadzor, the Ministry of Health, and the Federal Biomedical Agency have declared they will conduct early vaccine trials in the near future. Within several months, we expect to have two to three vaccine options. But the development of anticoronavirus drugs is still at the very initial stages.

source: sciencemag.org

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