Russia's Covid nightmare driven by vaccine rejection

Near the darkened entrance of Hospital Number One in the city of Vologda in Russia's north-west, an ambulance crew delivers yet another Covid patient, an elderly man struggling to breathe and barely alive.

Inside the hospital, the wards are teeming with the sick and the dying. Doctors here say out of 750 patients currently in the hospital with Covid, 700 of them had not been vaccinated.

Lives are being lost here in this region every day and this is just one of Russia's many regions.

The Covid pandemic which began in March 2020 has hit Russia particularly hard and it is now facing a virulent fourth wave of the virus.

More than 1,000 people are dying each day across the country, with a total of more than 220,000 deaths so far. These are record numbers for Russia, making it the worst-hit in Europe.

The scale of new infections and deaths has alarmed authorities so much that all workplaces are to shut down for a week from the start of November and Moscow is closing non-essential services for 11 days from next Thursday.

One of the key explanations for this record number of cases and deaths is a lack of trust in the Sputnik V and other Russian-made coronavirus vaccines amongst many in the Russian population.

This, in part, is the result of many years of scepticism of what the authorities say or do.

As a result, campaigns to persuade people to have the vaccine are only gradually having any impact.

For the medical teams in the Vologda hospital as elsewhere in the country, there is a real concern about the uptake of the Covid vaccines.

In Vologda just 26% of the population has been vaccinated, one of the lowest levels in the country.

"I am very worried about this," says Pavel Sheprinski, head of Hospital Number One. "The more unvaccinated people we have in our hospital, the more patients we have."

At one of the vaccine centres set up in a large sports hall in the city, there was just a trickle of people waiting to get jabbed on Wednesday afternoon.

The situation recently prompted the governor of Vologda, Oleg Kuvshinnikov, to post a series of messages on social media pleading with people to get vaccinated.

The governor also sharply criticised those opposed to the vaccine who have taken to social media to spread anti-vaccine messages across the region.

"I'm calling on all anti-vaxxers who have unleashed merry hell on social media against vaccinations, look into the eyes of those who have lost loved ones," he said. "Our Russian vaccine is absolutely safe."

Doctors in Vologda are also shocked by the scale of anti-vaccination sentiment in the region, highlighting how those opposed to vaccination are putting elderly and vulnerable members of their families and relatives at risk.

But in her office in the city, a vaccine sceptic called Elena described why she was wary of the vaccine. She argued there was a lot of contradictory information coming from many sources including the authorities in the region. People were afraid of the unknown, she said.

"We don't understand what this vaccine is," she told the BBC. "If we had all the information, all the statistics and the results of the research, I think people would have been much more loyal, but we have not seen all this."

Meanwhile, in Vologda city's main cemetery there continues to be a massive increase in the number of burials.

Previously it had an average of 50 burials a week, now it has double that.

For families burying loved ones there is no escape from the coronavirus restrictions.

Those carrying the coffin to the grave must do so wearing full protective equipment.