U.S. Centers for Disease Control and Prevention data make it clear that people with underlying comorbidities—heart disease, diabetes, chronic obstructive pulmonary disease—are much more likely to require intensive care if they are infected with the coronavirus. Despite progress in bringing down the prevalence of these kinds of conditions over the last fifteen years, Russia still suffers a disproportionately high burden in these areas, especially among middle-aged men. Russia also has a comparatively high burden of people with other conditions that compromise their immune systems and make them more likely to contract coronavirus in the first place: HIV, tuberculosis, and Hepatitis C. 

Pre-existing lung damage is especially important for coronavirus. Tobacco use is hypothesized to have rendered China and other heavy-smoking countries particularly vulnerable. While it’s come down considerably because of aggressive, best-practice restrictions on tobacco sales, advertising, and use over the last decade, smoking prevalence in Russia is still among the highest in the world. Coal miners are similarly at risk because of black lung disease, caused by years of inhaling coal dust. About 10 percent of underground miners in the United States suffer from this condition. This co-morbidity could make Russia’s coal regions—Kemerovo, Sakhalin, Novosibirsk, Komi—disproportionately likely to progress rapidly to severe disease, should the virus take hold there. A relatively high share of coronavirus patients requiring emergency or intensive care because of these pre-existing conditions would place a heavy strain on an already uneven health system. 

Russia also has large numbers of disadvantaged, marginalized populations whose situation with coronavirus is currently unknown. Prisons are incubators for coronavirus (hundreds of incarcerated people and staff members, for example, are infected at New York’s Rikers Island), but no data have been released on infections or measures to prevent infection in Russia’s detention centers and prisons. Russia’s millions of labor migrants often live in cramped, unsanitary dormitories or apartments where coronavirus could spread easily, and in Moscow, they’re still working at construction sites; these undocumented people have limited access to health care, and therefore are unlikely to be receiving coronavirus testing should they fall ill. 

So far, Russia appears to be faring relatively well in the face of this unprecedented global pandemic. The slope of the curve over the next several weeks will be critical. In the near term, as health systems are put to the test in Moscow, and especially in the region, any or all of Russia’s distinctive relevant characteristics may ultimately influence how it experiences and responds to the crisis.  

Judy Twigg is a professor of political science at Virginia Commonwealth University, an adjunct professor at Georgetown University, and a senior associate (non-resident) at CSIS. She consults regularly on global health and development issues for the World Bank, U.S. government, and other agencies.

Image: Reuters