St. Petersburg’s city government on Wednesday released its so-called ‘all-cause mortality’ data for May, that is the total number of deaths recorded in the city from any cause, including COVID-19.
There is a consensus among experts around the world that comparing total mortality numbers from the months of the pandemic compared with previous years offers the best picture of the real toll of the virus, since countries have such widely varying methods of counting COVID-19 deaths.
Almost every country with large case numbers where the data is available has shown steep rises in total deaths during the most intense months of their epidemics, with the numbers falling back closer to the average once they begin to ease.
Not all these so-called “excess deaths” will have been from COVID-19, but experts have said they believe the majority are. Comparisons by The Financial Times have shown the UK recording a 65% increase in excess deaths since March, Italy a 47% jump, France a 30% increase.
The release of the same type of data last month showing April's mortality in Moscow and St. Petersburg allowed the approach to be applied to Russia for the first time and also showed the excess deaths for that month were also higher than official figures for coronavirus deaths in both cities.
Reports noting the discrepancy triggered an outraged reaction from Russia’s authorities, who denied the official statistics were being manipulated. The Russian foreign ministry sent letters to The Financial Times and The New York Times demanding they retract their reports and some Russian MPs called for the newspapers’ journalists to be expelled.
With around 5,300 deaths from over 440,000 cases, Russia officially has one of the lowest mortality rates in the world, of just 1.2%, significantly lower than other countries with large epidemics. Germany has a reported mortality rate of 4.7% and Brazil 5.6%, according to data from John Hopkins University. The United States' rate is currently 5.8%.
Experts have warned that making comparison between death tolls is not worthwhile given the huge difference in approaches to calculating them. Mortality rates also only account for deaths among confirmed cases, which is dependent on testing. The number of asymptomatic cases makes the true mortality rate hard to estimate.
Russian health officials have argued they have simply taken a far narrower approach for counting coronavirus deaths than in European countries or the United States. Moscow’s health department in May acknowledged it had not included 60% of deaths of patients who had tested positive for coronavirus, because it said they had died from other underlying causes, including heart attacks and kidney failure.
Russian doctors and demographers though, have said they believe the official approach is too narrow and is intended to keep the toll artificially low.
Many health workers have told news outlets, including ABC News, that deaths they considered to be from COVID-19 have been recorded as from other causes, frequently pneumonia or else as from the failure of a specific organ. A third of medics who took part in an anonymous survey of last month of 500 health workers at Russian coronavirus hospitals said they had been told by managers to record COVID-19 deaths as pneumonia.
Last month, the health minister of Dagestan, an impoverished region in the Caucasus that has been badly hit, caused a national scandal when he inadvertently appeared to reveal a gap between official statistics there and the reality. The minister, Dzhamaludin Gadzhiibrahimov, told a local blogger only 27 people in the province had died from COVID-19, but noted 657 had died from "community-acquired pneumonia." He also said Dagestan's total infections were over 13,000 even though his ministry's own public count at the time stood at around just 3,000.
A Russian demographer with experience working with state mortality statistics last month told ABC News lowering mortality figures from diseases by manipulating the classification of deaths was a frequent practice that pre-dated the pandemic. The demographer, who asked for anonymity because he was not authorized to speak, said the pressure to provide low numbers frequently came from regional authorities, concerned about providing positive data to the central government.
Russia's federal statistics agency has still not released mortality data for the rest of the country's regions for April, saying it needs more time because of the closure of local offices by the epidemic. Russia was still in a relatively early stage of its epidemic in April, while May saw the huge surge in cases that have given Russia the third-largest epidemic in the world. It means the data for May is likely to show a significant jump in excess deaths.
The data released on Wednesday showed St. Petersburg-- with a population of 5 million-- recorded 6,427 total deaths for May, 1,552 more than last year. That was also more deaths than have been recorded in May in the city than in any year over the past decade.
Russia remains in the grip of the epidemic. Although its growth rate of new cases has flattened, Russia has continued to record 9,000 new virus cases a-day for the past three weeks, with some experts suggesting the country appears to be stuck on the epidemic's plateau.
St. Petersburg's epidemic also shows few signs of improvement, recording a steady growth rate in new cases. Ambulance workers this week told ABC News the city's coronavirus hospitals are full and that they have to wait on average several hours to deliver patients.