To begin, I fundamentally disagree with Gessen’s idea that, “Russians are dying for a lack of hope.” She does not build on this previous claim, but mentions anecdotally that her friend described the situation as being a civil war. I fundamentally disagree with this as well. I understand the case of high Russian mortality rates as being a function of not a failed state, but a failing state. Gessen lists multiple causes of higher mortality – fatty diet, alcohol consumption, mental health issues, etc. In laying out these causes, which she does thoroughly and accurately, it becomes clear that the state, whether after conscious thought or not, deemed these issues as secondary to whatever they deemed primary (oil extraction/price management, regional dominance, or potentially just the maintenance of Putin in power). This represents a failing state which cannot meet the health/security demands of its people, which as previously mentioned, are valid. Obviously, this is not the situation of a fully failed state in which there would be no government, no administrative capacities, no nothing like a Libya or a South Sudan formerly were/may still be (I apologize for not knowing precisely).
Additionally, this is certainly not a civil war. A civil war demands war – actual fighting, actual loss of life at the hands of others through direct, intentional means, This is to say that negligence and inability, two characteristics of the modern Russian state, do not constitute malicious intent, which characterizes a civil war