The bursting of an underground oxygen pipe has killed nearly a dozen COVID-19 patients in the ICU unit of a hospital in Russia’s North Ossetia province. While the hospital staff could use two oxygen cylinders to hook up many of the most severely ill patients to a ventilator, it took up to an hour to fully restore oxygen supplies, far too long for nine of the patients.

Two more patients died the following night. It is not clear whether there was a direct relationship between their deaths and the disruption of oxygen supplies the day before. All the patients had reportedly been in serious condition and hooked up to ventilators, with up to 90 percent lung damage. Overall, the hospital in Vladikavkaz had some 71 patients in its ICU unit at the time of the incident.

An unnamed source told Interfax that the “deterioration of equipment” had caused the pipe to burst. A preliminary report by local authorities found that technical deficiencies and negligence contributed to the disaster. The oxygen tanks that the hospital received five or six years ago were apparently acquired without the proper legal documentation. As is often the case in such incidents, the hospital’s chief physician has now been made the scapegoat. He was arrested on Tuesday and is awaiting criminal charges.

The horrific incident in Vladikavkaz, a city in the deeply impoverished Caucasus region, gives a sense of the large number of preventable deaths that are the direct result of the disastrously underfunded and run-down social infrastructure. While the official number of COVID-19 deaths in Russia stands at 164,000, the real death toll is believed to be higher by a factor of at least five.

The country has had an official total of more than 6.5 million coronavirus infections. While a summer surge, driven by the Delta variant, peaked in July, there are still well over 20,000 new cases recorded every day. For over a month now, well over 750 people die every day from COVID-19.

Monday’s incident was one of the deadliest in a series of fires and oxygen-supply disruptions at Russian hospitals that have claimed dozens of lives since the beginning of the pandemic. Last May, several people died in Moscow and St. Petersburg hospitals after ventilators went up in flames. The deaths of up to 13 patients at a hospital in Rostov-on-Don have been linked to the explosion of an oxygen tank in October. Three patients died at a hospital in the Moscow region in February after oxygen supplies were cut off. Another fire in June in a hospital near Moscow claimed three lives.

Understaffed and underfunded hospitals in Russia have operated on the brink of collapse for the entire pandemic, with many buildings completely dilapidated and in unhygienic condition.

Speaking on the state of Russia’s hospitals, a doctor at a regional hospital in St. Petersburg angrily stated last October, at the height of the second wave, “There is a constant feeling that there is a shortage of everything: supplies, personnel, even elementary new buildings. Patients are treated in hospitals built in the middle of the last century. You can’t even take a normal shower there. So how can you speak of medical treatment [under these conditions]?”

The disastrous state of Russia’s health care system is a direct result of the restoration of capitalism in the former Soviet Union. Despite the Stalinist degeneration, the Soviet health care system was one of the best in the world, and Soviet scientists contributed significantly to the eradication of diseases such as polio. With the restoration of capitalism, previously suppressed diseases such as tuberculosis made a comeback, while the worst HIV epidemic outside of Africa has ravaged the country for years.

Over the past 20 years, the Putin government has implemented further devastating cuts, under the pretext of the “optimization” of health care. Between 2000 and 2020, the number of hospital beds was cut by 35 percent, from 1.6 million to 1 million. If in 2000, there were 116 beds per 10,000 people, in 2020, there were only 70. The situation is particularly bad in rural areas, where 40 percent of hospital beds were cut. At the height of the COVID surge this summer, images of COVID patients lying on the floors of hospitals that had run out of beds circulated widely on social media.

The number of doctors declined by 8 percent over the past two decades and the overall number of nurses by 14 percent. The exodus of medical personnel has been caused by both layoffs and extremely poor working conditions. Even highly qualified medical personnel often only earn salaries of just a few hundred dollars a month.

Austerity measures have been particularly severe in emergency services, where the number of employees has been cut in half since 2000 to just 9,000 in 2020. A recent investigative report by Istories found that 20 million people in Russia, or one in seven inhabitants, have had to wait over 35 minutes for an ambulance. Some 650,000 people have had to wait for more than two hours. Even an official report recently acknowledged that emergency services provided for the population of 140 million were “insufficient.”

Further cuts were imposed even as the coronavirus pandemic has been mercilessly ripping through the population.