Permission to die: rejected

How Russia’s fight against COVID-19 relies on fiddled statistics

On May 11, Vladimir Putin ostensibly brought an end to Russia’s “non-working days.” In reality, regional leaders are responsible for using epidemiological statistics to determine exactly when and how to lift measures imposed to contain the spread of the coronavirus. The same day that the president ostensibly reopened the nation, Deputy Prime Minister Tatyana Golikova proudly announced that COVID-19’s lethality in Russia is 7.4 times below the global average. Demographers, however, say these numbers are a cause for investigation, not celebration. Russia’s abnormally low coronavirus mortality rate has already attracted the attention of the Anglophone media, including The Moscow Times, The New York Times, and The Financial Times, where journalists have concluded that the problem lies in the methodology Russia uses to count deaths. Meduza correspondent Liliya Yapparova has discovered, however, that Russia’s methodology actually allows state officials to conceal coronavirus deaths deliberately, in order to paper over what is actually happening in regions outside major metropolises. Doctors and demographers told Meduza when morgues started overflowing, who’s calling the shots for pathologists, and how federal statistics on deaths and infections missed an entire city of nuclear physicists.

Russia’s abnormally low coronavirus mortality rate has attracted global attention. Just how low are the reported fatalities? In Russia, official numbers indicate that fewer than one in every 100 confirmed COVID-19 cases results in death, whereas the disease has proved fatal in between 1.5 and 16 of every 100 cases, elsewhere in Europe.

State authorities have argued that Russia’s low coronavirus mortality rate is due to the country’s high quality of healthcare. Sources in the Moscow Mayor’s Office also say Russian pathologists are particularly scrupulous and (unlike their Western colleagues) required to perform autopsies on each patient, which allows them to distinguish between deaths “caused by COVID-19” and deaths “accompanied by COVID-19.”

Pathologists who spoke to Meduza, however, say they are under instructions from Russia’s Health Ministry and encouraged by their own hospitals’ chief physicians to attribute the deaths of coronavirus patients to other causes.

Demographers studying Russian healthcare statistics say they are confident that mortality data are being manipulated deliberately, which distorts both the public’s and the federal government’s understanding of what is happening on the ground in Russia.

These distortions are nothing new. Massaging federal health statistics has been a common practice in Russia since Vladimir Putin’s May 2012 orders, when the president instructed regional officials to reduce certain diseases’ mortality rates. The authorities in many regions across the country are now relying on the same tricks to fudge the numbers on coronavirus deaths.

“The May orders”?

A series of 11 executive orders signed by Vladimir Putin on May 7, 2012 — the day he began his third (nonconsecutive) presidential term. The orders contained 218 separate instructions for the government, to be implemented between 2012 and 2020, including targets for reducing the lethality of cardiovascular disease, cancer, tuberculosis, traffic collisions, and infant mortality.

In 2018, researchers from the Russian Presidential Academy of National Economy and Public Administration under the President of the Russian Federation (RANEPA) confirmed that statistics did show a drop in deaths among Russians diagnosed with diseases identified in Putin’s May orders.

When calculating coronavirus deaths, Russian statistics also include errors that no bureaucratic logic can explain. This, for instance, is how an entire city disappeared from Nizhny Novgorod’s regional data.

On May 11, the city of Sarov reported its first COVID-19 fatality, but the death was never reflected in regional statistics because the city — reserved for nuclear physicists and closed to the general public — was removed from general coronavirus calculations on what appear to be official orders from the regional authorities. “Sarov is not included in Nizhny Novgorod’s regional data,” the city’s surgeon general, Irina Ignatieva, confirmed on May 7.

“Since May 1, due to changes in the verification methodology, the city of Sarov is not reflected in Nizhny Novgorod’s regional data,” says the fine print under tables with COVID-19 data, shared on Instagram by Nizhny Novgorod Lieutenant Governor David Melik-Guseinov.

The caveat in small print started appearing on state infographics only in May, but the lieutenant governor’s reports on COVID-19 started diverging from Sarov’s own numbers back in April. For example, on April 30, Melik-Guseinov still referred to 43 coronavirus patients in Sarov, though the city’s number of confirmed cases had already reached 55. “In just three days, [the Nizhny Novgorod region] has fallen from 20th to 24th place in regional rankings of infections per 100,000 people,” the lieutenant governor rejoiced on social media.

Reports about the spread of the coronavirus in Sarov are apparently absent altogether from federal data. The government-run website StopCoronavirus.rf has not registered any new cases in Sarov since the start of May. The website duplicates the official numbers supplied by Nizhny Novgorod’s regional government, which excludes information reported in the closed city of Sarov, Meduza confirmed by comparing federal records with reports published by Lieutenant Governor Melik-Guseinov.

“They only added this footnote about whatever methodology excluding Sarov after people started asking questions!” a woman who lives in the city told Meduza on condition of anonymity. “They say it’s because our hospitals are part of [Veronika] Skortsova’s FMBA [Federal Medical and Biological Agency] and the figures are counted there. But where are the figures? Why isn’t there a separate page on StopCoronavirus.rf showing all the data for cities covered by the FMBA? Why did we suddenly become ‘FMBA stats’ when the outbreak got worse?”

Sarov’s coronavirus data is, in fact, uploaded meticulously to the Federal Medical and Biological Agency’s website, but neither the agency nor Nizhny Novgorod’s Health Department could explain to Meduza why this is the case.

On May 13, the closed city had 79 reported cases of COVID-19, but the regional government’s website still showed just 43 infections. “Management at the town’s major employer [a subsidiary of the Rosatom State Nuclear Energy Corporation] is just trying to keep these big numbers quiet [on the federal level] because you need to reopen and you don’t need to be under quarantine,” a local woman told Meduza. “Everyone here is still going to work. Even right now I’m at a toy store and there are a ton of people. Everyone needs clothes for their kids because the daycares are reopening.”

Story by Liliya Yapparovawith assistance from Darya Sarkisyan and Adnrey Pertsev

Summary by Kevin Rothrock