At least 38 people were killed early Friday in a fire at a Moscow-area “special regime” mental hospital, meaning that most of the patients were confined to the facility. It’s unclear if this is a factor in the high death toll, although the region’s acting governor, Andrei Vorobyov, said the fire spread rapidly. The nearest fire station is a 40-minute drive from the clinic. “Some windows were fit with security bars, but some were not,” Vorobyov said. Russia’s lax security code has been known to lead to inadequate fire exits. Authorities had identified 20 victims by midmorning.