(Bloomberg Opinion) -- Coronavirus infections are hitting records again in Russia, the world’s fifth hardest-hit nation in absolute terms. This time, the provinces are bearing the brunt, with nearly three-quarters of new cases registered outside of Moscow. Worrying reports suggest some areas are running out of beds, doctors and even oxygen.Even going by official numbers that may understate the toll, this latest wave is turning into a serious test for President Vladimir Putin’s administration. The Kremlin delegated the handling of the pandemic to local authorities ill-equipped for it and now the caseload is straining a system that has centralized power and resources for much of the past two decades. At the same time, Russia’s first approved Covid-19 vaccine, a public relations coup, has hit production hiccups. Initially, Moscow was the focus of Russia’s outbreak. The city has well-equipped, world-class hospitals. A powerful mayor spoke up quickly and imposed strict local lockdown measures. That made it easier to justify a swift relaxation of restrictions in May, and likely helped Russia’s economy do better than feared. Yet failing to clamp down more broadly for longer meant new case numbers stayed high through the summer — never too far from 5,000 daily, even at their lowest. The first wave never went away. It simply built up into a trickier second round.The infections are now hitting Russia where it hurts, in often-distant regions poorly served by primary care doctors and modern technical amenities. Adjusting for population, official numbers for active cases suggest the Altai republic in southern Siberia, the oil-rich district of Yamalo-Nenets in the far north and Kalmykia in the southwest are all worse-hit than the capital. Rates of infection are accelerating in two-fifths of the country’s 85 regions, with most, like the republic of Altai , seeing far higher infection rates than in the spring, even accounting for increased testing. For now, most have only modest restrictions in place to combat the spread.While national data showed almost a fifth of beds were free, Deputy Prime Minister Tatyana Golikova said in a meeting with cabinet members at the end of October that in 16 regions more than 90% of capacity was full, and in 5, it was more than 95%. Kommersant newspaper estimated free beds in the Novosibirsk region at just 3% late last month.Some of this may have been unavoidable. Contagion is spiking throughout Europe amid colder weather, and rates of infection there are far worse; France, hit by a brutal second wave, has overtaken Russia to become the world’s fourth-most affected country, and is reporting record numbers even after a fresh nationwide lockdown. But Russia’s current crisis is also one of capacity and governance, as regions have been left without sufficient fiscal and administrative means to cope. It doesn’t help that most governors are Kremlin-backed, ushered in for loyalty rather than experience. Take Kalmykia, a drought-stricken area that's one of the country’s poorest regions. There, local deputies wrote to Putin in September to complain that their governor, a professional kickboxer who was appointed by the Kremlin in 2019 and subsequently elected, was failing to tackle overflowing hospitals. The mortality rate was higher than in the wider surrounding region, doctors were getting sick and there were too few of them, they said.It matters that the regions remain overly dependent on funding from Moscow, especially as their budgets are being hurt by low oil prices and tax receipts deferred by the virus. One-off federal support has been jacked up and more borrowing permitted, political analyst Andras Toth-Czifra says, but in Russia’s distorted federalism, privileges aren’t necessarily shared equally. As he points out, cash is being poured into an inadequate system now that a problem has emerged, whereas the regions could have been given the ability to build up capacity in advance.There is logic in allowing the states to take the lead in a pandemic — Russia is hugely diverse, and distances are vast. But it’s unreasonable to demand results from the periphery while hogging resources in the center.Moscow understands the risks here. It has sought to keep doctors from speaking out. The presidential spokesman on Thursday acknowledged “failures” in unnamed regions. That doesn’t mean the Kremlin is under pressure to abruptly change tack and rethink the balance of power in the world’s largest country. At least not yet. It works to its advantage that there are no credible internal alternatives to cast doubt on Putin’s management, as Judy Twigg, a professor at Virginia Commonwealth University who studies Russian politics and health, tells me. The Western world is struggling to contain infections too — the U.S., for one, has been hitting new records — and Russia can at least boast about (and woo developing nations with) its vaccine prowess. It’s just approved a second inoculation, albeit again without a large-scale trial. The weaknesses of Russia’s hyper-centralized system are being laid bare. Absent swift inoculation, tougher restrictions or a miraculous recovery in oil prices, they may become too painful to ignore.This column does not necessarily reflect the opinion of the editorial board or Bloomberg LP and its owners.Clara Ferreira Marques is a Bloomberg Opinion columnist covering commodities and environmental, social and governance issues. Previously, she was an associate editor for Reuters Breakingviews, and editor and correspondent for Reuters in Singapore, India, the U.K., Italy and Russia.For more articles like this, please visit us at bloomberg.com/opinionSubscribe now to stay ahead with the most trusted business news source.©2020 Bloomberg L.P.
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