The second time around

Latest mortality statistics reveal that the fall coronavirus wave was worse for Russia

Last week, the Russian Federal Statistics Service (Rosstat) published new data on mortality in all of the country’s regions, revealing that 30 percent more people died in October 2020 than in that same month last year. This data shows that the coronavirus pandemic’s second wave in Russia this fall was in fact more serious than the first wave in the spring: it appears that in September and October the number of deaths linked to the coronavirus was nearly the same as during the period from April to August. In addition, Russia remains ranked among the top-five countries with the highest death tolls from the coronavirus in the world.

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What data did Rosstat release?

Rosstat publishes data on the number of deaths per month, which allows for the calculation of excess deaths and a lot of other data related to spread of COVID-19 — including the actual number of people who have contracted the disease (asymptomatic cases included).

During the coronavirus pandemic, the excess mortality rate has emerged as the most accurate data on the epidemic. Even Russian officials rely on it: recently, a source in the federal government familiar with the work of the operational headquarters for fighting the coronavirus told Meduza that this is the most accurate data that the authorities have.

Data on mortality is also considered difficult to manipulate: Rosstat obtains these numbers from local registry offices, where death certificates are issued to relatives of the deceased. And families can’t hold funerals without obtaining death certificates.

In theory, not all excess deaths are related to the coronavirus itself necessarily: for example, some portion could be attributed to the fact that medical care for other illnesses has worsened during the pandemic. But in practice it turns out that in 90 to 100 percent of cases in 2020, excess deaths in Russia are linked to the coronavirus infection in one way or another. This is evidenced by reports from the country’s few regions where the data on excess mortality has been analyzed in detail (for example, the Moscow Health Department has been working on this since April).

The main drawback of Russia’s excess mortality data is that its publication is significantly delayed and its not broken down by week, let alone by day. Rosstat publishes its reports 35 to 40 days after the end of the month, which is compounded by the fact that on average, deaths from the coronavirus occur 20 to 25 days after infection. The data being so delayed means it can’t be used to accurately predict how the epidemic will develop in the future, or even understand how it’s developing now. Countries in Europe publish (incomplete) data every week and then update the numbers later on.

That said, Rosstat’s data is perfectly sufficient for assessing general trends, identifying where the coronavirus death tolls have been manipulated, and making rough forecasts about the near future.

Who’s distorting the coronavirus statistics the most?

Many of Russia’s regions have been underreporting the number of deaths from COVID-19. Meduza uncovered more than a dozen regions that were clearly not only providing made-up mortality figures to the public database Stopcoronavirus.rf, but also to classified government registries.

Judging by Rosstat’s data for October, the Republic of Bashkortostan (Bashkiria) remains Russia’s biggest manipulator — the region underestimated its mortality data more than 100 times over. So it’s safe to say that the republic’s official figures don’t correspond with reality at all. According to Rosstat, Bashkortostan saw 1,601 excess deaths in October 2020 compared to October 2019. Meanwhile, official reports stated there were only nine deaths in the region that were connected to the coronavirus in some way.

Neighboring Tatarstan and several other regions are not far behind Bashkortostan in terms of the severity of the apparent manipulations. And even the number of excess deaths in Moscow, which is considered one of the most honest regions in terms of coronavirus statistics, has exceeded the number of COVID-19 deaths reported on the Stopcoronavirus.rf database more than two-fold.

On average, during various months, the data on excess deaths across Russia exceeded the number indicated in the operational reports on the website Stopcoronavirus.rf four to seven times over (in October there was a 6.5-fold difference).

Where does this difference come from? Is it just manipulation?

The methodology for determining post-mortem diagnoses plays a big role here. In the spring, the federal center decided that all deaths among COVID-19 patients should be carefully investigated. As such, the final cause of death is only declared after an autopsy aimed at establishing the links between the deceased’s primary condition (for example, the coronavirus infection), complications from other diseases, and their death. Since the coronavirus often exacerbates other diseases, which can ultimately lead to a patient dying from these complications, COVID-19 may not be considered the main cause of death. According to the Russian Health Ministry’s guidelines, pathologists are expected to put down the most severe (and most resource-demanding) illness as the original cause of death.

As Meduza uncovered this summer, the broad interpretation of such rules has allowed chief physicians at hospitals in a number of regions — often not of their own free will, but rather at the behest of the local authorities — to manipulate the COVID-19 statistics by attributing the deaths of coronavirus patients to other causes.

Following the most recent set of regulations issued in July, the deaths of coronavirus patients have been divided into three categories:

1. Cases where COVID-19 is considered the original cause of death.
2. Cases where COVID-19 was not the main but rather the “other cause of death” and was “essential in the development of an underlying disease and its fatal complications.”
3. Cases where COVID-19 didn’t cause any complications at all (for example if a person with stomach cancer dies after being diagnosed with a mild case of the coronavirus).

Today, pathologists in Russia are required to list the coronavirus as the original cause of death or as a condition that significantly affected the course of another disease in almost all cases. But in practice, even in Moscow, a third of the deaths among coronavirus patients in October were classified as cases where the person “died from other causes” after testing positive for the coronavirus (maintaining that the latter diagnosis did not significantly impact the course of the primary disease).

That said, in many regions, such as Bashkortostan, it seems as though those who have died from the coronavirus aren’t being classified in any of the above groups at all.

How many people have died in Russia during the pandemic? And how many have been infected with COVID-19?

The number of excess deaths in Russia from April until the end of October was 164,057 people. In all likelihood, this figure is close to the actual death toll from COVID-19.

In October, there were 47,777 excess deaths in Russia. The combined total for September and October is 79,443, which isn’t much less than all of the previous months of the pandemic put together — the country saw 84,614 excess deaths from April to August.

According to Stopcoronavirus.rf, the official mortality rate in November was 66 percent higher than in October. The number of excess deaths will likely be higher too. As such, one can presume that a significantly larger number of people died from the coronavirus in Russia this fall than during the spring and summer.

Based on the excess mortality rate, one can roughly calculate the actual number of people who have been infected with COVID-19 in Russia since the start of the pandemic. It turns out that as of the end of October, more than 24 million Russians, or about 16 percent of the population, had “come in contact” with the virus.

If Russia were to maintain the same monthly excess death rate as in October, by the end of the year 26 percent of the country’s coronavirus patients will have recovered. However, it’s worth noting that the mortality rates in November and December are likely to be higher. Most of Russia’s regions are just approaching the peak of the infection; in Moscow, which remains the epicenter of the epidemic, the number of cases is likely to remain about the same; no longer increasing, but not decreasing as of yet.

How does Russia compare with other countries? Is it on the brink of a crisis?

Russia has already been ranked among the top-five countries in the world with the most coronavirus victims. But it’s hard to say where exactly Russia should fall on this list — the number of deaths from COVID-19 is being underestimated around the world, and data on excess mortality, as in Russia, is collected with delays. In all likelihood, the only countries with death tolls higher than Russia’s are the United States, Brazil, Mexico, and possibly India.

However, Russia isn’t being threatened with a demographic crisis comparable to that of the 1990s and the early 2000s as of yet. Even if the number of deaths in November and December is two-thirds higher than in October, the country’s total death toll for the year will be a little more than 2.1 million people. That’s 300,000 more than in 2019, but still less than the worst year of the demographic crisis — 2003, when 2.365 million people died.

On the other hand, the population decline will be very significant: Russia’s birth rate hasn’t compensated for mortality since 2016. And, judging by Rosstat’s data, it has continued to decline in 2020 — down 57,000 from January to October compared to the same period in 2019.

The decline is approaching the scale of the crisis seen at the turn of the twenty-first century: if October’s trends persist, it will exceed 680,000 people — or 2.1 million deaths per 1.41 million births. For comparison, the worst decline Russia has seen since the collapse of the USSR was 958,000 in 2000; in 2019, it was minus 317,000. However, there may be some “compensation” at the end of the epidemic — mortality rates may decrease slightly due to the number of people who were already seriously ill but died prematurely from the coronavirus in 2020.

Demographic statistics aside, however, the situation facing individual families is much more tragic. Indeed, mainly elderly people with serious underlying conditions die from COVID-19. However, as research from Harvard Medical School has shown, if it weren’t for the coronavirus, those who died in the United States would have lived another 13 years on average. There are no comparable statistics for Russia as of yet.

Story by Dmitry Kuznets

Translated and abridged by Eilish Hart