As Europe’s death toll surges, how has Russia avoided a coronavirus crisis?

Outwardly at least, Russia is confident. The coronavirus is observing Russian immigration rules, say the state media broadcasts. The only Russians to be infected are those arriving from abroad. “The system is working.”

On Saturday evening, the Kremlin even announced it would be sending 100 of its military doctors and planeloads of medical equipment to help Italy, the country most affected by the pandemic.

On one level, Moscow has good reason to feel bullish. Over the last week, the number of confirmed Covid-19 cases has been rising steadily, but they aren’t yet an exponential horror. As of Sunday, the country of 146 million was reporting just 367 cases and one – disputed – death.

For a country that shares a 2600 mile border — and significant trading and tourism links — with China, things could have been much, much worse.

Russian authorities have already congratulated themselves on what they believe has been a successful public health intervention. On Friday, the Kremlin’s press secretary, Dmitry Peskov, said that Russia had bucked the trend because of “timely measures that had a definitive effect”.

So far, the World Heath Organisation isn’t quibbling with that assessment. The global body’s local representative this week commended Moscow on the “significant measures” it has taken against the proliferation of the coronavirus. “They have done enough to catch the cases and to treat them as necessary,” Melita Vujnovic said.

But what is it exactly that Russia has done differently to other countries?

Moscow certainly introduced border controls earlier than most. On 23 January, health authorities began to screen the temperatures of all those returning from China. Travel restrictions came a week later, with Russian authorities cancelling rail and passenger links on 31 January. Two weeks later, the entire border was closed to Chinese citizens.

Russia also moved to bar entry to Iranian, and then Italian, citizens once the pandemic had taken hold of both countries.

In the last two weeks, authorities have steadily stepped up travel restrictions to include most of the world. First came two-week self-isolation regulations for those returning from “at-risk countries” in Europe and Asia – in this, they were ahead of the curve. Later, the list was broadened to include the UK and America. On Wednesday the border was effectively closed to foreigners.

Authorities are now switching their attention to in-country transmission: closing schools, restaurants and, from Saturday, all swimming pools and fitness clubs. There is talk of a wider shutdown still.

Some local experts have expressed confidence that isolating Russia from other countries will be enough to avoid the kind of crisis now engulfing Europe. But many Russians are sceptical of the official reports, and believe the Kremlin is covering up an epidemic.

Conspiracy theory is, it has to be said, a default mode for Russians, but the idea is not without some historical grounding. Many remember the denials over Chernobyl. Or, indeed, the botched response to HIV, which was for many years dismissed as a “bourgeois western problem” before ravaging the former Soviet Union.

Critics have also drawn attention to an unexplained 37 per cent surge in pneumonia in Moscow compared with 2019. The one official death of a Covid-19 patient in Russia has also been mysteriously reclassified, with authorities claiming the 74-year old died from thromboembolism before the coronavirus had a chance to take over her lungs.

“The only strategy the Russian authorities have against coronavirus is moronically not to report it,” Alexei Navalny, Russia’s most prominent opposition politician, said on Friday. “Let those who can recover from it recover on their own. And those who can’t — well, what do you do, bad luck. Let’s just write it down as cardiovascular problems.”

Michael Favorov, an epidemiologist at the US Centre for Disease Control and Prevention, told The Independent that it was unlikely the Russian government was actively manipulating statistics. Like other post-Soviet countries, the pandemic has simply arrived late, he said — and has come from Europe rather than China. Russia’s outlying caseload was also explained by the specifics of its testing regime which means including only confirmed cases. That would change once testing is geared up over the next week.

Favorov, who draws on decades of experience working with health systems in the former Soviet Union and China, said that while baseline numbers were low, the trends told a different story. The recent steady rise in numbers suggested Russia was in “transition” from imported infections to a domestic epidemic.

“As soon as the numbers of domestic cases begin to outnumber imported cases, the dynamics of coronavirus in Russia will shift,” he said.

The epidemiologist said he was in little doubt that Russia would eventually see an outbreak “as wild as elsewhere”. The good news as far as Moscow is concerned is the timing. The relatively delayed onset of mass infection was an obvious advantage, Mr Favorov said: “Coronavirus will probably behave like most respiratory pathogens and become less effective in the summer months. Reduced viral load means fewer serious infections.”

Few Russians believe the country’s underfunded and unloved health system will cope if it faces a major crisis like Italy’s. On some counts, however, the Russian system is relatively well prepared for the nature of what may be heading its way. The high incidence of tuberculosis and complicated pneumonia acorss the country means the system has good capacity in the field of pulmonary illness. Moscow, for example, has 5000 ventilators, which is roughly the same amount that the UK has nationwide.

The Soviet system of acute disease control is also well-regarded and effective in a crisis. Taking its roots from Lenin’s 1919 decree on smallpox vaccination, it’s not the most subtle system, but it can clamp down and isolate quickly with force. The Chinese system of public health control, which belatedly showed its value in Hubei, is based on the same system.

For Favorov, Russia’s weak link may be its political leadership.

“They need to get it into their heads that this virus is coming at them,” he said. “And that it will come not once, but as several waves.”