Minds

Global oil prices rebounded to more than $30 a barrel for the first time in almost a month on Thursday after Saudi Arabia and Russia signalled a possible truce in a price war that has triggered the fastest oil market collapse in decades.

The price of Brent crude leapt by 30% after the US president, Donald Trump, fanned hopes of a new deal between Riyadh and Moscow to help stabilise the oil market.

Oil prices fell to 18-year lows of $23 a barrel earlier this week as Russia and Saudi Arabia prepared to wrestle for a greater share of the market by increasing production despite falling energy demand because of the Covid-19 pandemic.

Trump tweeted on Thursday that he had spoken to Saudi crown prince Mohammed bin Salman and expected Riyadh and Moscow to cut output by as much as 15m barrels a day.

The president initially said the oil production cut should be about 10m barrels a day, but raised the figure to 15m in a subsequent tweet. “If it happens,” he wrote on Twitter, it “will be GREAT for the oil & gas industry!”

Hopes of renewed cooperation in the oil market were later dampened by a spokesman for the Russian president, Vladimir Putin, who reportedly told journalists that “no one has started talking about any specific or even abstract deals”.

Riyadh and Moscow roiled global oil markets last month by vowing to raise production to record levels after the failure of talks to cut it in response to the collapse in energy demand caused by the coronavirus.

Saudi Arabia said it would increase production to 13m barrels a day after Russia refused to comply with the plan for cuts, and Moscow retaliated by threatening to increase its own production.

Oil industry analysts said Trump’s plan would not go far enough to offset the devastating effect of the coronavirus pandemic on energy markets.

The economic slowdown across major global economies currently in lockdown could wipe 20m barrels a day from the world’s demand for oil, according to analysts at Redburn Energy. “Whilst no form of output agreement could hope to offset the 20m barrels of demand destruction currently being wrought by Covid-19, it could set up a more rapid recovery on the other side,” they said.

Trump is expected to meet the chief executives of some of the largest US oil companies at the White House on Friday to discuss how the industry can weather the crisis. The Exxon Mobil boss, Darren Woods, the Chevron chief executive, Mike Wirth, and the executive chairman of Continental Resources, Harold Hamm, are among those expected to attend.

The British government has rejected an EU request to open an office in Belfast, in the first major row over the implementation of the post-Brexit Irish border protocol.

The EU closed its offices across the UK when the country left the bloc on 31 January, but its officials have a right to be present to monitor the checks and controls on goods crossing the Irish Sea.

The Foreign Office has rejected Brussels’ request for a permanent physical presence in Belfast on the grounds this would go beyond what is stipulated in the withdrawal agreement.

There are concerns it would be seen by some as a step towards joint policing of the customs border between Northern Ireland and the rest of the UK.

The British government fought during negotiations over the withdrawal agreement to ensure that checks and controls on goods crossing the Irish Sea would not be jointly carried out.

The row highlights the potential for the protocol on Northern Ireland to be a cause of contention between the EU and UK in the months to come.

Under the withdrawal agreement, Northern Ireland effectively stays in the single market. It also remains within the UK’s customs territory to allow it to benefit from any future trade deals secured by the British government. But the full EU customs code has to be enforced on goods travelling between Northern Ireland and the rest of the UK. All goods deemed at risk of travelling from Northern Ireland into the Republic of Ireland would attract tariffs.

The messy compromise allowed for the avoidance of a border on the island of Ireland but brings with it a host of potential flash points.

The issue of a Belfast office was raised on Monday during the first teleconference meeting of the EU-UK joint committee, set up to supervise the operation of the withdrawal agreement. The chancellor of the Duchy of Lancaster, Michael Gove, is the UK’s senior figure on the committee.

Under article 12 of the Northern Ireland protocol, the UK government is “responsible for implementing and applying the provisions of [EU] law” but EU officials “shall have the right to be present during any activities” relating to checks and controls.

The UK is obliged to “facilitate such presence of representatives and shall provide them with the information requested”. The EU wants a base for its customs and veterinary experts.

A European commission spokesman said: “We can confirm that we have sent letters to the UK regarding a proposal to open a technical office in Belfast with specific technical capabilities to ensure the implementation of the protocol on Ireland/Northern Ireland. This issue was raised in the joint committee on Monday. We remain in contact with the UK on this point.”

A cross-party group of members of the Northern Ireland assembly has written to the prime minister backing the commission’s proposal.

Michelle O’Neill of Sinn Féin, who is the deputy first minister of Northern Ireland, along with the leaders of the Greens, the Social Democratic and Labour party and the Northern Ireland Alliance, wrote: “As party leaders representing a majority of citizens who voted to remain within the EU, we feel strongly that an office in Belfast is necessary to ensure the implementation of the protocol on Ireland/Northern Ireland which you negotiated with the EU …

“To oppose the opening of such an office by the EU in Belfast represents an act of bad faith by your government and a breach of trust at this critical stage of the process.”

A spokesman for the UK government said it was considering the issue. He said: “We received an initial request from the EU and responded to decline the proposal in February. We have since received a follow-up letter to which we will respond in due course.”

The coronavirus pandemic in Spain is taking a disproportionate toll on the poor, the elderly, the marginalised and those working in low-paid but vital jobs, experts have warned.

An interactive map produced by the Catalan regional government showing the distribution of the virus reveals that residents of poor Barcelona neighbourhoods are six or seven times more likely to contract the virus than those in wealthy areas.

While much of Spain has bounced back from the 2008 economic crisis, many parts of the country suffered deep, lingering cuts. The unemployment rate, which stands at 13.7%, is more than double the EU average, while youth unemployment is at 30.6%. About half the population has some difficulty making ends meet, and poverty is persistently higher for children, migrants, and Roma populations.

According to the Catalan government figures, the rate of infection in working-class Roquetes is 533 per 100,000 inhabitants, while in upmarket Sant Gervasi it’s only 77. Similarly high rates are found in the satellite towns of El Prat de Llobregat (604) and Badalona (597).

Dr Nani Vall-llosera, a GP in Bon Pastor, a low-income Barcelona neighbourhood, and former president of the Catalan primary care forum, points out that many of those deemed essential workers by the government work in low-status, poorly paid jobs where they have high exposure to the virus.

“People who work in shopping centres, supermarkets and old people’s homes, as well as cleaners, are working without protection, often without masks,” she said. “These people get infected, they go home and infect those around them because there’s little possibility of self-isolating if you live in a small apartment.”

She added: “Furthermore, poverty and poor health are a vicious circle – the poorer you are the more likely you are to have health problems. And so the chances of becoming seriously ill with the virus are concentrated in poor neighbourhoods.”

Like many colleagues, Vall-llosera, is in no doubt that the ability of the health system to react has been “debilitated” by years of spending cuts in public health, especially in Madrid and Catalonia, adding that “those parts of Spain where there have been least cuts are dealing with the virus better”.

The doctor also warns of the distortion to the health system caused by the epidemic. “While we focus all our resources on the coronavirus, which is probably what we have to do, it’s also reducing our capacity to deal with other issues,” she said.

Manuel Franco, a professor of epidemiology and public health at the University of Alcalá in Madrid and the Johns Hopkins School of Public Health (USA), agrees that austerity measures – particularly around Madrid – have weakened the healthcare system.

He also says that inequalities in income, gender, education and country of origin are becoming increasingly apparent as the pandemic continues.

“In many societies, care work – cleaning, looking after children and the elderly – is mostly carried out by foreign women,” said Franco. “A lot of them are not on the payroll so they have no rights when it comes to unemployment pay. They also probably live in the worst housing conditions in a city like Madrid.”

He said that homeless people were also at risk and the NGOs and charities that helped them were forced to close.

“How do these people get the minimum they need to survive? We don’t have really good maps or ways to track these people and know what their living conditions are like,” said Franco.

As Spain experiences its third week of lockdown, with all but essential workers ordered to remain at home, income disparities are becoming more apparent.

People need to heat their homes as they stay away from work. But they also have to home-school their children, which usually means a computer, tablet or smartphone is needed for distance classes – as is a good internet connection.

Franco said that while Spain’s socialist-led coalition government was working to minimise the economic impact of the health crisis and protect the most vulnerable, basic structural inequalities were persisting and worsening.

“I think there’s a will to protect those who will be hardest hit and to cover the gaps that are becoming wider and wider,” he said.

“But there are many small details of daily life and the social determinants of health are becoming more relevant: housing, income, education.”

Franco said the global epidemic, which has so far claimed 8,189 lives in Spain, called for action that went well beyond improving health systems.

“Of course healthcare workers are in a very tough situation, dealing with overstretched intensive care units but there are also people working in food stores, police officers, paramedics, firefighters – they’re also suffering the same lack of equipment,” he said.

“We never thought about that; we never thought that we could have such a big public health crisis – and mortality crisis in cities like Madrid, where the usual morgues can’t cope with this situation. But I think that almost every decision that we have to take right now should be taken from the point of view of these social inequalities.”

A report published by Oxfam Intermon last year showed that, as well as a wide disparity of income, there is a difference of life expectancy of nearly 11 years between Barcelona’s richest and poorest neighbourhoods, and seven years in Madrid.

A prominent Pakistani journalist who fled the country after receiving death threats has gone missing in Sweden where he had been granted political asylum.

Sajid Hussain, 39, went into self-imposed exile in 2012 after his reporting on forced disappearances and human rights abuses in the turbulent region of Balochistan had led to death threats. He had continued to run an online newspaper, the Balochistan Times, from abroad covering the same topics.

Hussain was last seen at around 11am on 2 March in the Swedish city of Uppsala where he was living. A day after he stopped answering calls, a friend told the police about his disappearance and he was officially registered as a missing person on 5 March.

Daniel Bastard, the Asia Pacific head of Reporters Without Borders, said: “Hussain could be a victim of enforced disappearance, given the circumstances of his case and testimony by his family and colleagues. Now, when you think about who could find interest in suppressing a dissident journalist, the first hypothesis leads to Pakistan’s security agencies.”

Hussain’s family have not accused anyone of involvement in his disappearance and are simply urging the Swedish police to give them an answer.

Hussain’s wife, Shahnaz Baloch, is still in Pakistan with their two children, aged five and nine, but was due to join her husband in Sweden this year. She wasone of the last people to speak to him on the morning he went missing. She said he had been in good spirits and they had spoken about his plans to move apartments before he started a master’s degree at Uppsala University.

“Sajid never went anywhere without informing me and his close friends,” Baloch said. “This is very unusual and disturbing. Swedish police have been slow in working on the case as they believe people go in isolation in Sweden.”

She added: “He was a voice for thousands of people living inside and outside of Balochistan. I believe an outside force is involved in his disappearance because Sajid would not disappear without informing anyone. He was an influential journalist and writer and had faced threats before.”

Hussain is from a well-known political family in Balochistan, which has long been a battleground between armed insurgents and security forces. His uncle Ghulam Mohammad Baloch was killed in 2011 while heading a nationalist movement.

Hussain had worked for numerous news outlets in Pakistan, reporting on abuses in Balochistan around drugs, human rights and enforced disappearances, but fled the country in 2012 when police raided his house, taking his laptop and interrogating his family, and intelligence services visited his associates. Hussain had continued his journalism as he moved from the United Arab Emirates, Oman and then Uganda before settling in Sweden in 2018, and was given political asylum in 2019.

Talat Aslam, the editor of News International, one of Pakistan’s largest English-language newspapers, who worked with Hussain for five years, said: “The case is so baffling and I am so worried for him. His asylum case had been accepted and everything was going well. He had told me that he even planned to take his family out there as the authorities in Sweden had interviewed them.

“This is very mysterious and very depressing. I have tried to write to police in Sweden and contacted other concerned authorities about the case, but they are very evasive.”

Pakistan is one of the most dangerous countries to be a journalist and there have been increased reports recently of exiled reporters and bloggers based in Europe facing threats. In February, Ahmad Waqass Goraya, a Pakistani blogger living in Rotterdam, was attacked and threatened outside his home by two figures allegedly from the Pakistan intelligence agency.

It was long said to have been the most significant decision of Angela Merkel’s 14 years as German chancellor. Now the political and social drama of the refugee crisis in 2015 has been turned into a feature film based on a bestselling book.

Merkel: The Driven charts the twists and turns surrounding the decree that allowed almost a million refugees into Germany.

The film culminates in her resolve, despite opposition from many of her political friends and foes, not to close Germany’s borders after thousands of refugees, mainly from Syria, boarded trains at Budapest’s Keleti station and headed for Germany, after the police who had been stopping them from leaving were withdrawn.

The film’s director, Stephan Wagner, said the film was as much a political thriller as it was “a portrait of Merkel, focusing on a turning point in her time in office”.

It is based on Robin Alexander’s 2017 bestseller The Driven Ones: Merkel and Refugee Policy, in which the long-time political correspondent for Die Welt offered a behind-the-scenes account of the 63 days of political intrigue and back-biting that changed modern Germany.

It shows Merkel sticking doggedly to the idea of a political solution before dividing opinion among both her opponents and party colleagues with her decision not to close Germany’s borders. She calls her stance as a “humanitarian imperative”, but the film portrays it in much more ambiguous terms, suggesting Merkel was reluctant to be seen as the “refugee chancellor”.

Imogen Kogge, who plays Merkel in the film, well-known to German viewers as police commissioner Johanna Herz in the popular series Polizeiruf 110, said the film threw light on the complexities of communication, “on how communication occurs on the highest level when there is quite simply a lack of solutions”.

She said that playing one of the most famous women in the world had not been straightforward: “That everyone inside and outside of Germany believes they know Merkel well did not make it particularly easy to approach the role. But once I was assured it was not about impersonating her, but in the first instance to find certain recognisable characteristics, I felt relatively free.”

The drama starts with Germany stuck in the middle of the Greek debt crisis, when Merkel’s finance minister, Wolfgang Schäuble, is pushing for a “Grexit”, the expulsion of Greece from the eurozone, against Merkel’s will. She is then abruptly informed that Hungary intends to build a border fence to stop the refugees from war-torn Syria entering the country and a whole new crisis starts to unfold.

It is shaped by Merkel’s attempts to push the issue away and put off any concrete decision-making, as well as the increasing divide between those Germans who want the country to welcome refugees and those who angrily reject the idea. The resulting tension continues to define German politics today.

The film was set for a German cinema release at the weekend but will now be shown by the state broadcaster ARD on 15 April due to the coronavirus crisis – which, unlike in 2015, did lead Merkel to close the borders.

“The events of 2015 continue to shape German politics very much to this day,” the producer, Alexander van Düllman, said. “As Germany prepares to bid farewell to Angela Merkel the refugee question still remains a very fragile one.”

A nationwide lockdown has left Ireland’s public spaces hushed and deserted amid overwhelming public support for extreme measures to control the coronavirus pandemic.

Central Dublin and other usually bustling urban centres were like ghost towns on Sunday on the second day of sweeping restrictions that are to last two weeks, until 12 April.

The vast majority of the population appeared to be following appeals to stay at home except to buy food, care for vulnerable people, do work deemed essential or briefly exercise within 2km (1.2 miles) of home.

The state has deployed hundreds of extra police on the streets and passed laws to enforce the restrictions – violators can be arrested, fined €2,500 (£2,241) and jailed for six months.

But the hope is that community spirit will ensure compliance. “I’m appealing to every man, woman and child to make these sacrifices for the love of each other … show that you care for your family and friends: stay home,” the taoiseach, Leo Varadkar, said on Friday when he announced the restrictions.

Neon signs reminding people about not grouping together and keeping 6ft (1.8 metres) apart have sprouted across Ireland. The finance minister, Paschal Donohoe, encouraged the mixed martial arts fighter Conor McGregor to reinforce the message to his social media followers.

An opinion poll published on Sunday showed 97% of people agreed that the government should have powers to detain those with the virus for as long as necessary if they refused to self-isolate. About 95% agreed it should also be able to stop people travelling.

The Business Post/Red C poll was taken before Varadkar’s speech but after a series of other measures – including closure of schools, universities and businesses and a ban on sporting events – that have been phased in since 13 March.

“The support is clearly based on the overwhelming concern evident amongst the public that the virus could have a long-lasting impact on the economy,” Richard Colwell, the chief executive of Red C, wrote in the Business Post.

The poll found a resurgence in support for Varadkar’s ruling Fine Gael party. In a general election last month it slumped to 21%, behind Sinn Féin and Fianna Fáil, but now has 34% support, ahead of its two main rivals. Instead of entering opposition, as originally expected, Fine Gael’s caretaker administration is talking to Fianna Fáil and smaller parties about forming a new government.

Ireland has recorded 2,615 cases of Covid-19 infections and 46 deaths.

Health Service Executive chiefs told a media briefing they did not know when the pandemic would peak but were planning on mid-April. They will ask members of the public to opt into a mobile phone tracking app to facilitate contact tracing of people who may be infected.

Northern Ireland on Sunday recorded another 86 cases of infection, bringing its total to 410, and six deaths, pushing the death toll to 21.

The region introduced strict new restrictions on Saturday night that aligned it with the rest of the UK.

Simon Byrne, the chief constable of the Police Service of Northern Ireland, said his force would apply new laws to enforce the restrictions, including fines of up to £5,000, “only when absolutely necessary”.

The motor industry has been accused by campaigners of trying to use the coronavirus crisis to avert stricter environmental regulation, after correspondence showed carmakers had lobbied the EU to defer impending laws.

The European carmakers’ association, ACEA, and other groups representing the supply chain called on the EU to delay implementing regulations because the pandemic had affected its “plans to comply”. Laws due to come into effect include tougher targets on vehicle CO₂ emissions.

In a letter to the EU commission president, Ursula von der Leyen, the groups said production and sales of cars had stalled in many countries and companies were facing a cash crisis.

While appealing for more financial aid to maintain liquidity, the ACEA said activities such as development and testing would inevitably suffer, which “upsets the plans we had made to prepare ourselves for complying with existing and future EU laws and regulations within the applicable deadlines”.

It said: “We believe therefore that some adjustment would need to be made to the timing of these laws. Please be assured, however, that it is not our intention to question the laws as such nor the underlying objectives of road safety, climate change mitigation and protection of the environment.”

European laws on CO₂ emissions of new vehicles have applied since 2015 and a further tightening of the rules is due in January 2021. Manufacturers could potentially face huge fines for non-compliance, although the targets have pushed production towards less polluting cars.

Campaigners described the call as shameless. Greenpeace UK’s executive director, John Sauven, said: “Many industries are facing difficulties during this challenging period that require governments and corporations to protect their workers. But it would be a mistake to use this crisis as a reason to roll back on environmental regulations. One, it won’t suddenly restart car sales, and two, tackling one crisis can’t be done at the expense of another one.”

Julia Poliscanova, the clean vehicle director at Transport and Environment, said: “The priority now is to ensure the health, safety and job security of the workers affected by the current factory closures. While the overall economic recovery is crucial, we shouldn’t let some opportunistic carmakers use the crisis to shamelessly roll back the EU climate targets for cars. Selling less cars won’t impact compliance with the law. What matters is the type of car you sell.”

The big German carmakers Daimler, VW and BMW have already indicated they are aiming to comply with the new CO₂ targets regardless of the current situation.

Malian musician Rokia Traoré has been released from a French prison, after being detained since 10 March for the alleged kidnap of her daughter in a child custody dispute. Her freedom is dependent on her delivery to Belgian authorities, once travel restrictions related to the coronavirus pandemic are lifted.

Traoré was arrested under a European warrant issued by a judge in Brussels, where a court had ordered her to surrender her five-year-old daughter to the child’s father, Jan Goossens, who is Belgian. Traoré was held in Paris after getting off a plane there.

Until such time as she can be transferred to Belgium, Traoré will be under judicial supervision, a French criminal procedure imposed to prevent suspects from fleeing or recidivism, following a hearing in Paris on 25 March. Traoré appeared by video link. “Despite the fact that I live in Mali, I have always answered to the Belgian justice system,” she said, explaining that she had been travelling to Europe to attend a hearing related to her custody appeal.

Her lawyer, Kenneth Feliho, said: “Ms Traoré never wanted to evade Belgian justice, but it is impossible in her mind to hand over her daughter.” Feliho said they would go to the French court of cassation – France’s highest court of appeal – and the European court of human rights if necessary. “The fight with Belgian justice will continue,” he told Le Figaro.

Traoré’s case embodies a clash between European and African judicial systems. A Malian court had given Traoré custody of the child. The country’s government issued a statement in support of the musician, pointing out that she has a Malian diplomatic passport that should give her immunity. In a statement issued from prison, Traoré said that she was told this was not valid in Europe.

Traoré filed complaints about Goossens in Mali, France and Belgium, which she insists have not been investigated – though later in her prison statement she claims they were a major factor in the Malian court’s decision to grant her sole custody.

In an interview with a Belgian paper, Goossens said: “All horrible and false accusations were investigated and dismissed. All attempts to negotiate and achieve solutions were refused. I’m being cut out of my daughter’s life in a brutal way … my wish is that the rule of law can do its work … so that our daughter can see both her parents again.”

Traoré had been on hunger strike at the Fleury-Mérogis prison near Paris since her arrest. Musicians including Salif Keita, Youssou N’Dour and Angélique Kidjo have called for her release. In a letter published on social media Damon Albarn, who performed with her in the group Africa Express, wrote: “We demand, for humanitarian reasons, the immediate release of Rokia Traoré, whose fragile health is deteriorating day by day.”

Lucy Durán, professor of music at Soas University of London, told the Guardian that Traoré’s arrest “smacks of the worst kind of racist misogyny”.

Forty-one health workers in Italy have died from coronavirus since the outbreak there began, as medics work relentlessly to try to turn the tide in Europe’s worst-affected country.

The virus has infected more than 5,000 doctors, nurses, technicians, ambulance staff and other health employees. The majority were on the frontline in the badly affected northern regions and contracted the illness at the start of the outbreak when protective equipment was lacking.

“It’s as if a storm hit us,” said Roberto Stellini, a doctor of infectious diseases at Poliambulanza hospital in Brescia. “The problem is that when this storm hit us we were unprepared, perhaps ignoring what might have been the consequences. Some of the dead were doctors who died at the beginning of the emergency, when we knew nothing about this storm. I knew some of them. Now we are more prepared and we continue to fight.”

Negative-pressure isolation rooms, designed to contain airborne contaminants, are needed to treat coronavirus properly, to protect doctors and medical technicians from contracting the virus from their patients. But doctors say just a small proportion of Covid-19 patients in Italy are hospitalised in negative-pressure rooms, meaning the virus can easily spread.

“It’s an ongoing struggle’’, said Giovanna, an anaesthetist at a hospital in Milan. “There is no time to think about tiredness, because when you look at Covid-19 patients and how they are living with the disease, in solitude, you realise your mother, father or grandfather could be in that bed.”

Anna, a doctor in Lombardy, said the mental torment worried her more than physical fatigue. “We are working in a context I never imagined as a doctor,” she said. “But when you see Covid-19 patients, above all when you see how they die, in complete solitude, then you forget about your own fatigue. Each doctor also has a personal situation of their own. For example, I have not seen my children for five weeks.”

A study conducted by Chinese doctors and published by the Lancet showed that 70% of health workers on the frontline in Hubei, the province where the Chinese outbreak began, suffered from extreme levels of stress, 50% had depressive orders, 44% had anxiety and 34% insomnia.

“We don’t yet have a study of this kind for Italy, but we’re collecting data that indicates the situation is practically similar to that of China,” said David Lazzari, the president of Italy’s order of psychologists.

Among the latest casualties were two dentists who died in Brescia, in Lombardy, on Wednesday and Daniela Trezzi, a 34-year-old nurse who killed herself in Monza, also in Lombardy, on Tuesday. Trezzi had been in quarantine since 10 March after testing positive for Covid-19.

It is not known why Trezzi killed herself, but the National Federation of Nurse Guilds said in a statement that her colleagues thought she had been experiencing heavy stress over fears of having infected others. “This terrible episode, unfortunately, is not the first one since the Covid-19 emergency began,” they said.

A 49-year-old nurse from Jesolo, near Venice, killed herself last week. She had assisted Covid-19 patients at Jesolo civil hospital until she came down with a fever. The nurse was tested for coronavirus but did not receive the result before she died.

The overall death toll in Italy grew by 662 to 8,165, the civil protection agency said on Thursday, down from 683 on Wednesday and 743 on Tuesday. The number of new infections had fallen nationally in recent days but rose on Thursday to 4,492, from 3,491 the day before.

In Lombardy, 4,861 people have died since the virus emerged there on 21 February.

“On day three of the outbreak we had 2,300 calls, on Wednesday we had around 800,” said Fabrizio Canevari, an operations manager at Soreu della Pianura, a safety and first aid service that manages calls to emergency numbers covering the Lombardy provinces of Pavia, Lodi, Mantua and Cremona. “There has been a progressive slowdown in the emergency calls, which shows the quarantine is working. However, in some areas of the region the situation is still serious.”

Paulo Baldini, a nurse who answers calls to an emergency line in the Pavia area, said he had been struck by the kindness of people who either had symptoms of Covid-19 or were worried about relatives, despite having to sometimes wait for hours before a call was answered.

“They say ‘sorry to bother you’ and ‘thank you’,” he said. “Usually that wouldn’t be the case in an emergency unit, when you hear of staff being mistreated. But there’s a dignity, humanity and capacity to face the problem without shouting. We’re humans and, like all humans, we take the baggage of pain home with us, but this kindness helps us to carry on.”

When Vladimir Putin sat down for a briefing on coronavirus, Moscow’s mayor had a tough message for him: the number of infected people is far higher than you’ve been told, he said, and Russia’s healthcare system could be overrun.

Breaking with official tallies that show the disease’s conservative growth in Russia, Sergei Sobyanin told Putin on Tuesday that a serious situation was developing as the disease spread in Moscow and in the regions, and that the problem “would emerge sooner or later”.

Sobyanin estimated that the number of people who are ill in the capital may have reached 500, far higher than the 290 that have been identified by Russian doctors.

The remarks, apparently backed by municipal data, will confirm doubts about the Kremlin’s claims that it has the coronavirus outbreak under control.

“The growth is high; a serious situation is developing,” Sobyanin told Putin and top aides during the meeting. Many sick people were isolated at home and had not asked for medical care, he said. “The number who are really sick is far higher [than official estimates].” The remarks were reported on the Kremlin website.

Russia has been an international outlier in terms of coronavirus testing, claiming to have identified just 500 cases of the disease despite having carried out more than 165,000 tests. By comparison, just 70,000 people have been tested for coronavirus in the UK, with 6,650 confirmed cases of the disease. Neighbouring Belarus has an infection rate that is three times higher per capita.

Critics have questioned whether Russia’s tests were effective at identifying those ill with the virus, and whether cases of coronavirus had not been mischaracterised as pneumonia in an effort to massage the official numbers and prevent panic. Earlier, the business newspaper RBC had reported that numbers of pneumonia patients in Russian hospitals had jumped more than 30% between January 2019 and January 2020, indicating that coronavirus patients may have been misdiagnosed.

Sobyanin’s remarks made him the first senior Russian official to publicly contradict the official tally and directly urge greater action from the Russian president in response to the outbreak. He called for prophylactic measures to be taken by the heads of all of Russia’s regions, including the extension of a self-isolation regime for elderly Russians considered most at-risk from the disease.

He also saidthat Russia’s healthcare system could be overwhelmed if it was not prepared for a rise in patients, and urged greater testing throughout the country.

“No one in the world knows the real picture,” Sobyanin said.

The Kremlin has largely presented the situation with the disease as under control, with top officials including Putin telling the public that the greatest danger was panic. But Tuesday marked a change in the government’s rhetoric, with Putin suddenly donning a yellow protective suit and respirator to tour the capital’s main hospital for coronavirus patients.

Earlier on Tuesday, a woman died at the hospital in Kommunarka. Doctors claimed she had not been ill with coronavirus, and had died because of complications from cancer. Russia has tallied only one death linked to the virus.