Seven days later ‘Meduza’ recaps the week’s worth of events surrounding Alexey Navalny’s poisoning

Prominent Russian opposition politician and anti-corruption activist Alexey Navalny has been in a coma since August 20. He became violently ill while on board a plane, on his way back from a trip to Siberia. Meduza recaps the main events and revelations of the past week, including theories about Navalny’s poisoning, the treatment he received, the reactions of the Russian authorities and Western governments, and predictions about when he could regain consciousness.

How it all started

Alexey Navalny landed in Novosibirsk (a city in southern Siberia) on the evening of August 13. He made the trip to support independent candidates who are planning on running in this September's city duma elections in Novosibirsk and Tomsk. While in the region, he planned to film an investigation about local deputies from the ruling party, United Russia. According to MK.ru, the security forces (siloviki) were constantly monitoring the opposition politician’s movements in the region. A source from one of his local offices also told Meduza that they were “tailed.”

Having reached the nearby city of Tomsk, Navalny checked in for his stay at the Xander Hotel (the local publication Taiga.Info later connected the hotel’s owners to the regional authorities). Before his flight out of the city, around 8:00 a.m., on Thursday August 20, he drank a cup of tea at the “Vienna Coffee House” in the Tomsk Airport. This is the only thing he ate or drank that morning, underscored his press secretary Kira Yarmysh, who was travelling with Navalny. 

During the flight from Tomsk to Moscow (Flight S72614), Navalny became ill almost immediately after take off, Yarmysh recalls. He started screaming and lost consciousness (the airline company S7 later reported that Navalny didn’t have anything to eat or drink while on the flight). The crew made an emergency landing in the city of Omsk (southwestern Siberia).

Navalny’s hospitalization in Omsk: conflicting diagnoses and confrontations with doctors

At the Omsk airport, Navalny was loaded into an ambulance and taken to the toxicology department of Emergency Hospital Number One. Officials from the Federal Security Service (FSB) and the Investigative Committee arrived at the hospital almost immediately, and police officers began patrolling the grounds.

Several hours after Navalny was hospitalized, the hospital’s deputy chief physician, Anatoly Kalinichenko, came out to speak with journalists. He said that the opposition politician’s condition had stabilized — to be more precise, he was in “stable, but serious condition.” At the same time, Navalny was put into an induced coma (that said, on the evening of August 20, the Omsk Regional Health Ministry was still reporting that Navalny was “in a natural coma and continuing artificial lung ventilation”). 

From the moment he fell ill, Navalny’s family and co-workers believed he had been poisoned — probably with something mixed into the tea he drank at the Tomsk Airport. Navalny’s aides also referred to a conversation they had with an unidentified transit police officer at the hospital, who claimed that a dangerous substance was discovered in Navalny’s body, which threatened his own life and the lives of those around him (law enforcement officials have denied these claims). 

“We were sitting with Oleg Navalny and [Alexey Navalny’s personal physician] Anastasia Vasileva in the chief physician’s office. At that moment, a woman came in, introduced herself as a transit police officer, and said that they had asked [her] to urgently pass on that they had found this kind of substance; she went over to [chief physician Alexander] Murakhovsky and showed [him] her phone. To which Murakhovsky replied that [he] had no such information as of yet,” said Ivan Zhdanov — the director of Navalny’s non-profit, the Anti-Corruption Foundation (FBK) — when describing the events of the morning of August 20 to Meduza. He followed the woman out of the office, but she refused to tell him anything, citing the secrecy of the investigation, Zhdanov recalls. Nevertheless, she did say that the “substance is very dangerous, everyone who’s nearby should be in protective suits.”

The Omsk doctors “were ruling out and confirming several diagnoses,” Dr. Kalinichenko said at the time, and they had “no certainty that the reason for [Navalny’s] condition is poisoning.” 

The doctor also refused to answer questions about whether or not the opposition politician’s life was under threat, but promised to diagnose him by the end of the day. Later, Dr. Boris Teplykh, an intensive care specialist brought in from Moscow for consultation, confirmed in an interview with Meduza that the doctors in Omsk really had saved Navalny’s life. 

That same day, August 20, Navalny’s physician, Yaroslav Ashikhmin, told Meduza that he needed to be taken to a hospital in Hanover or Strasbourg for treatment, as western clinics could “potentially have more experience in finding the substances which could have caused the poisoning.”

However, Navalny’s wife, Yulia Navalnaya, — who got on the first available flight to Omsk on August 20 — wasn’t allowed to go into the intensive care ward to see her husband for quite some time. Hospital officials demanded to see her marriage certificate (which she didn’t have on her) and maintained that Navalny, who was in a coma, hadn’t “consented to visitation.” 

On the night of August 21, a plane from Germany arrived in Omsk to evacuate Navalny. Later, his associate Leonid Volkov explained that Russian businessman Dmitry Zimin (the founder of Vimpelcom) had paid for the air ambulance with money from his family’s fund. 

Earlier that same day, the doctors from Berlin had been allowed into the Omsk hospital, but Yulia Navalnaya wasn’t allowed to meet with them. Shortly afterward, the German doctors were removed from the facility. Kira Yarmysh and FBK director Ivan Zhdanov tried to stop their car, but “were forcibly dragged away by plain clothes officers.” 

Throughout the entire day local doctors were unable to diagnose Navalny. The Omsk hospital’s chief physician, Alexander Murakhovsky, said that “the ‘poisoning’ diagnosis was definitively excluded,” on the basis of chemical and toxicological tests. His deputy, Dr. Anatoly Kalinichenko, spoke more cautiously, specifying that “From the studies that have been conducted to date, no poisons have been detected in the blood or urine. [...] Therefore, at the present time, the ‘poisoning’ diagnosis probably remains somewhere in the back of our minds, but we don’t think that the patient has suffered poisoning.” 

Shortly afterwards, the Omsk doctors announced that Navalny’s condition was caused by a “carbohydrate deficiency” (specifically, they claimed he has a metabolic disease, caused by low blood sugar). Pro-Kremlin Telegram channels and journalists from state media simultaneously started reporting that the night before his sudden illness, Navalny had allegedly been drinking, and then took a hangover pill, provoking the poisoning. Another version of the events surfaced, claiming that Navalny’s deteriorating condition was allegedly linked to his “brutal” weight-loss diet. 

Later, the Omsk Health Ministry reported that while alcohol and caffeine were found in the politician’s urine, the tests had come back clean for poisons. Navalny’s press secretary, Kira Yarmysh, denied these claims, maintaining that he didn’t drink alcohol or take any pills before the flight.

By evening, police officials in Omsk reported that the industrial chemical 2-Ethylhexyl diphenyl phosphate had been found in samples taken from Navalny’s clothing, hands, nails, and hair, but it was impossible to establish its concentration. On the other hand, they clarified that this plastic polymer could have gotten into Navalny’s system through a plastic cup.

At the same time, the hospital administration denied a request from Yulia Navalnaya and Navalny’s associates, seeking to transfer him to a German clinic. Hospital officials said it was impossible given the patient’s condition. During a press briefing, the hospital’s chief physician said that the decision “to keep Alexey in Omsk” was taken “in consultation with the German doctors.” Kira Yarmysh claimed that this was a “gross lie.” According to her, the German doctors who examined Navalny — who are intensive care specialists — came to the conclusion that he could be transported and confirmed that their plane was properly equipped to take him to the Charité Hospital in Berlin safely and immediately, in accordance with Yulia Navalnaya’s wishes. Navalny’s aides suggested that the doctors in Omsk were deliberately wasting time and refusing to transfer Navalny to Germany for treatment, in order to allow time for “traces of the poison to disappear.”

On the afternoon of August 21, Yulia Navalny appealed to Vladimir Putin seeking permission to transport her husband to Germany for medical treatment: earlier, Putin’s spokesman Dmitry Peskov had said that the Kremlin was prepared to offer its assistance (if requested). That same day, German Chancellor Angela Merkel and French President Emmanuel Macron said that they were also prepared to help organize treatment for Navalny, and demanded that Russia clarify the circumstances surrounding the opposition politician’s hospitalization as soon as possible. 

That same evening, the Omsk doctors agreed to send Navalny to Germany for treatment, stating that his condition had stabilized. The flight’s departure was postponed until the morning of August 22: the Omsk Health Ministry clarified that the delay was due to a request from the German crew and the regulations of Germany’s air transport union.

Navalny’s hospitalization in Germany: confirmation of poisoning, but no criminal case

On August 22, Alexey Navalny was transported to the Charité Hospital in Berlin, after the doctors in Omsk finally discharged him into his wife’s care. The flight took place without any issues. 

On August 24, the Charité Hospital — where Navalny is still being treated in intensive care —  issued a statement. The press release said that “clinical findings indicate poisoning with a substance from the group of cholinesterase inhibitors. The specific substance involved remains unknown, and a further series of comprehensive tests has been initiated.” Commenting on the statement, intensive care specialist Boris Teplykh told Meduza that the Russian toxicologists also looked for a similar poisonous substance, but “didn’t find it.” Moreover, he confirmed that the doctors in Omsk also treated Navalny with atropine — a common antidote for nerve-agent and pesticide poisonings. The Omsk hospital’s deputy chief physician, Kalinichenko, gave the following statement to Interfax: “I can’t comment on this question now. Of course, we will figure out [whether] we were mistaken or the laboratory, or [if] this is all disinformation.” Later, the German weekly Der Spiegel reported that doctors at the Charité Hospital had turned to their colleagues in Bulgaria for help, due to potential similarities between Navalny’s poisoning and the 2015 assassination attempt on Bulgarian entrepreneur Emilian Gebrev, who was allegedly poisoned with a Novichok-class nerve agent — a type of substance that also belongs to the group of cholinesterase inhibitors. 

On the day Navalny was hospitalized, his family members appealed to the police and the Russian Investigative Committee, demanding that they open a criminal case over his poisoning, Yarmysh said. Asked about these demands, presidential spokesman Dmitry Peskov said that the Kremlin saw no reason to investigate as of yet. However, on August 26, the head of Navalny’s Tomsk headquarters, Ksenia Fadeeva, confirmed that the police had questioned her in connection with “some kind of preliminary inquiry.” She specified that officers from the transit police carried out the questioning. Police officials only confirmed that they were conducting a preliminary inquiry on August 27. It also emerged that the security forces (including FSB officers, according to Taiga.Info) visited the Tomsk hotel where Navalny had stayed, and inspected the “Vienna Coffee House” where he drank tea (the cafe closed after the inspection).

Dmitry Peskov said that Moscow is also interested in establishing the reason behind what happened to Navalny. According to him, “there’s no reason” for the circumstances surrounding the opposition politician’s alleged poisoning to worsen Russia’s relations with Western countries. At the same time, during his daily conversations with journalists about Navalny’s situation, Peskov hasn’t said his last name once.

Meanwhile, on August 25, State Duma Speaker Vyacheslav Volodin expressed the opinion that Navalny’s poisoning could have been a provocation carried out by Western countries, like Germany and other European states. 

German Chancellor Angela Merkel was frustrated by Putin’s response to Navalny’s poisoning, sources close to her said. The Russian president replied that he is interested in a “thorough and objective investigation” into what happened with “A. Navalny” (as he is identified in the Kremlin’s press release), but considers the “hasty and unfounded accusations” unacceptable. This didn’t reassure Germany: without an investigation, Moscow would be "unable to lift the existing allegations” against the Kremlin and this would complicate Russia’s relations with Europe yet again, said Germany’s Foreign Minister Heiko Maas, as quoted by Interfax. 

That same day, reports surfaced that Russia’s Attorney General’s Office had officially requested legal assistance in Navalny’s case from the judicial authorities in Germany. “Despite the preliminary inquiry started on August 20, 2020, no information evidencing deliberate criminal acts committed against Navalny A. A. and allowing for this incident to be classified under criminal law has been established to date,” the department’s statement says. The department asked Germany to provide the Russian authorities with “explanations, information, and evidence of the preliminary diagnosis they gave, promising to provide the results of the tests carried out in Russia “on the basis of reciprocity.” 

When will Navalny regain consciousness?

On August 24, the Charité Hospital stated that Alexey Navalny, whose condition is still considered “serious” but not life threatening, was in a medically-induced coma. This means that he has been administered drugs to keep him in a deep state of unconsciousness. In some cases, doctors opt to induce a coma, in order to reduce the intensity of the brain’s metabolism and allow energy to be spent on recovery, rather than active work, in particular, maintaining consciousness. In addition, this is sometimes necessary to prevent the patient from experience serious discomfort while on a ventilator and to keep them from harming themselves, if they are in a state of altered consciousness (that said, in these cases, the person would be put under relatively weak sedation, rendering them unconscious, but not putting them into a full-fledged coma). 

A medically-induced coma differs from a natural one, in that it can be reversed at any time. If necessary, a person can be kept in this state for several months — although medically-induced comas usually last for a matter of days. As for the long term effects of this kind of treatment, it’s difficult to separate them from the effects of the underlying illness, which required the patient to be put into an induced coma in the first place.