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When oxygen ran out, local residents went on long trips to help replenish canisters in their hospital
Dr Ibragim Yevtemirov still coughs every so often as he talks. A paediatric trauma surgeon in Dagestan, in the Caucasus region of southern Russia, his ward had been full of Covid-19 cases for a couple of weeks when he got infected himself.
He says seven colleagues in his town have now died, including nurses, orderlies and laboratory staff, according to a count kept by local medics themselves.
“All three doctors on my team got sick. We were replaced by dentists until we recovered,” Dr Yevtemirov told the BBC by phone from Khasavyurt, where he’s now back at work in the central hospital.
“At the peak, there were 10, 11 patients dying a day here,” he says.
How Dagestan’s disaster was revealed
The doctor’s account of dire shortages and deadly chaos is just one, stark snapshot of a Covid-19 crisis in Dagestan so serious that the republic’s chief mufti this week described it to President Vladimir Putin as a “catastrophe”.
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Local Dagestanis put up checkpoints in an attempt to stop the spread
As the holy month of Ramadan ends this weekend, Akhmad Afandi has been urging people in the mainly Muslim republic not to gather to celebrate Eid with friends and extended family – as it may cause a further dangerous spike in cases.
But it was a startling interview with the local health minister that first exposed Dagestan’s struggle with this epidemic.
The minister told a blogger that 40 medics had died in the republic: more than the total, official number of Covid-19 fatalities.
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Much of Russia’s republic of Dagestan is mountainous
“At the start, the kit we were given was very primitive,” Dr Yevtemirov explains, from his personal experience.
“It’s not that we weren’t worried, but when this epidemic hit there was no alternative. It’s like we had to rush straight into battle,” he says.
Why Dagestan’s true toll is unclear
The health minister’s interview also revealed that hundreds of people had died of “community-acquired pneumonia” in Dagestan – with all the same symptoms as Covid-19 – casting further doubt on Russia’s low official mortality rate from coronavirus.
“Our hospital is full of Covid cases, but only a tiny handful of patients have a confirmed diagnosis,” Dr Yevtemirov clarifies, saying that most of the swabs the hospital sends off for analysis are recorded as pneumonia.
Like other countries, Russia only adds cases with a positive test result to its daily death toll.
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Russia’s emergencies ministry this week sent disinfection equipment to Dagestan as the scale of the crisis emerged
“Perhaps there’s a problem here with the tests, or something. Some think there’s been an order from above not to diagnose Covid, but I can only guess,” the doctor says.
Was Moscow’s messaging to blame?
Data on how deeply the infection has penetrated Dagestan is also hard to be sure of.
Until recently, the republic was conducting fewer than 1,000 tests a day, lacking both the equipment and laboratory capacity for more.
“The hospitals only dealt with the seriously sick, no-one was testing anyone else,” e