By Sarah Rainsford, BBC News, Moscow
The ticket booths at Krylatskoye ice palace are shuttered, but the rink is full: not of speed skaters and hockey players, but rows of coronavirus patients.
It’s one of five facilities in Moscow transformed into giant temporary hospitals that are now swinging into action as the number of new Covid cases reaches daily record highs.
The Kremlin describes the rate of infection as “worrying” – close to 21,000 new cases were announced across Russia on Tuesday – and it admits that healthcare facilities in some regions are “overloaded”.
But it is still resisting a national lockdown, anxious to protect the economy and optimistic that Russia’s contender for a Covid-19 vaccine can help chart a way out of this crisis.
The ice has gone for now, but the ice palace hospital is equipped with the latest digital technology and the chief doctor is insistently upbeat.
“Every day we admit between 40 and 50 patients, but we also discharge the same amount,” Andrei Shkoda told the BBC, beneath a giant screen that once displayed figure-skating scores: last winter, before Covid.
This year it’s showing films from Soviet classics to Mr Bean for the sick to watch from their beds.
The field hospital was built in a month during the first surge in Covid cases and never used. Now, a quick scan from the spectator stands shows that around one third of its 1,347 beds are full.
Critical role of field hospitals
The spare capacity is in stark contrast with some of Russia’s regions where even state TV is now reporting on provincial hospitals, stretched at the best of times, full to overflowing. The same is true of some morgues.
Moscow still has the highest number of new cases and there are periodic queues of ambulances at city clinics, long waits for free Covid tests or for doctors to make house calls. But the field hospitals, staffed partly by medics from the regions, are playing a critical role, not least in allowing regular hospitals to continue planned healthcare.
Dr Shkoda says Covid patients in this autumn’s spike in cases are noticeably younger and also sicker, after treating themselves at home. “In spring, everyone was afraid, so they came for help sooner. This new wave is probably because many people stopped taking precautions,” he believes.
If so, it was Russia’s politicians who set the tone.
Masks now mandatory in public
This summer they hailed a ‘”victory” over the virus, trying to lift the mood ahead of a constitutional reform vote that handed Vladimir Putin a way to stay in power.
Social life here in the capital promptly burst back into life, barely a mask to be seen.
Re-imposing unpopular restrictions, now that infections are rising again, isn’t so easy.
Russia’s health watchdog recently made face coverings mandatory in all public spaces, enforced with fines, but most other anti-virus measures are left up to regional governors.
In Moscow that means 30% of office staff working remotely, the elderly and vulnerable advised to stay home and high-school children studying online.
Is mass vaccine programme imminent?
This weekend the city’s mayor conceded that the infection rate hadn’t stabilised as he had hoped. But instead of a lockdown, there’s a lot of talk about Sputnik V, one of several Russian Covid-19 vaccines in development.
When Pfizer announced on Monday that its own vaccine was more than 90% effective, Russia’s health ministry immediately declared the same for Sputnik, although it’s still in the midst of mass trials.
The ministry also said that clinics would soon receive their first “industrial scale” deliveries of Sputnik V, suggesting that a mass vaccination programme is imminent.
One clinic in southern Moscow already has racks of the tiny vials stored in big freezers. The team there have been administering around 50 jabs a day to some of the 40,000 volunteers enrolled in the trials.
In a room down the hall, Alexei rolled up his sleeve for the second of two injections. The first, three weeks earlier, had caused no adverse reaction.
“Our bosses asked us to take part,” said the ER doctor who has been working with Covid cases since April. “I’ve seen a lot of people who got sick, and it’s not nice,” Alexei explained. “So I’d prefer not to get it.”
Another volunteer in the queue said he was the only one from his work who’d agreed to participate. “The others are scared,” he shrugged.
Dr Shkoda had no such reservations. He says he and seven colleagues have had the jabs and describes his subsequent antibody level as “good”. “Covid isn’t going anywhere, it’s living with us,” the chief doctor reasons, touring his ice hospital past medics in giant, white suits and respirators and patients hooked up to oxygen tubes.
Despite being confronted each day with the consequences of coronavirus, the doctor is not pushing for another lockdown. “I don’t think we need tougher measures, but each person has to act responsibly,” he argues, before being sprayed with disinfectant and heading out of the Red Zone.
“Then it’s the vaccine that will help us defeat this in the end.”
