Russia’s official statistics indicate that the country has virtually no coronavirus within its borders. With 116,000 tests for the coronavirus carried out and 114 returning positive, Russia’s ratio of tests to positive cases is 0.09%, the lowest among all of the countries infected by the coronavirus. The second lowest ratio is Taiwan’s 0.3% — three times higher than Russia’s. Not even the Russian authorities, however, trust those numbers. “The figures are likely a lot higher,” Alexei Kurinny, a deputy on the State Duma’s health protection committee, told The Moscow Times. “Unfortunately we were slow to get around to doing comprehensive testing.” The new coronavirus pandemic has brought a host of countries to a near halt in recent days and killed nearly 8,000 people around the world. On Tuesday, President Vladimir Putin judged the situation in Russia “under control.” But the country has nonetheless revved into gear over the past few days, announcing that it will ban the entry of foreign nationals and stateless people until May 1 in an effort to slow down the spread of the coronavirus. Meanwhile, Moscow has banned all public events larger than 50 people until April 10. But despite these measures, medical experts are now questioning whether Russia’s official coronavirus statistics reflect reality in the country — which ranked 116th last year in the Global Health Security Index for “detecting” pandemics. If the numbers are significantly higher, officials may have missed their opportunity to stem the tide — leaving the weight on the shoulders of doctors already stretched thin by a teetering healthcare system.

A view of the site for a new hospital in Moscow for coronavirus patients. Valery Sharifulin / TASS

Testing monopoly A month after the coronavirus outbreak began in neighboring China, a state virology and biotechnology center in a Siberian town announced that it had developed test kits for the new virus. For the nearly two months since, Vektor, which is based outside the city of Novosibirsk some 3,380 kilometers east of Russia’s most populous city of Moscow, has been the only lab in the country that can officially determine whether a test was positive. The procedure is as follows: Doctors do a test and send it to a local center for a preliminary test, which then sends it onward to Siberia for confirmation. “We are going to have a center like this in Moscow soon so we don’t have to send the tests so far away,” said Kurinny, the State Duma deputy, noting that he expected Moscow officials to announce the new testing lab at any moment.

As a result of the testing procedure, only the state health watchdog Rospotrepnadzor, which oversees Vektor, can determine how accurate the tests have been. Rospotrepnazdor declined multiple requests for comment for this article. But at least one concern has been raised by medical experts in recent days over the fact that the test, which detects the virus by replicating DNA using a primer that fits coronavirus DNA, is not sensitive enough to accurately register positive tests. According to the Moscow-based PCR News website, which reports on medicine, Vektor’s kit uses a cycle total of 10 to the fifth power per millimeter to register a positive test. “This is low by modern standards,” PCR News wrote Friday. “If a patient is clearly infected but the concentration of the virus is lower than 10 to the fifth power, the test result will be negative.” In this case, the outlet continued, doctors might decide that the patient is healthy and cannot infect others. “But now they are walking on the street while still infected.” Gaetan Burgio, a geneticist specializing in infectious diseases at the Australian National University, echoed PCR News’s assessment. “Testing 10 to the fifth power per millimeter seems low,” he said. “With such a large sample size, you would expect the percentage of those confirmed sick to be higher.”

“Unfortunately we were slow to get around to doing comprehensive testing," a lawmaker said. AP / TASS

Although Vektor is the only lab that can make official calls on coronavirus tests, it’s not the only one to have developed tests in Russia. PCR News reported that several other state-run labs have tests ready to go — but that they are waiting to be put to use. And earlier this month the Kommersant business daily reported that two commercial labs had produced tests but were looking to sell them to other countries as they couldn’t do so at home. “The problem is incomprehensible bureaucratic barriers,” said Vladimir Kolin, who runs the Moscow-based firm DNK Tekhnologiya — or DNA Technology — which produced one of the tests. He noted that the lab’s test has a sensitivity of 10 to the third power — which, if true, means it could detect more positive results than Vektor’s test. There is also the question of sheer quantity. Anastasiya Vasiliyeva, head of the Doctor’s Alliance trade union set-up by Russia’s most prominent opposition critic Alexei Navalny, told The Moscow Times that in recent weeks doctors have been reporting to the union that many tests have been coming back late. Some said that they never saw the results at all. “How can one lab handle all this work?” Vasiliyeva said. Limited sample size Along with the Vektor test’s potential flaws, Russia’s testing procedures might also explain its low ratio of tests to positive cases. As lessons are being learned on the fly from countries like China and South Korea, which three months into the pandemic have begun limiting the spread of the coronavirus by conducting thousands of tests a day, the WHO is recommending “rapid testing of any suspect case” and “immediate isolation.” “Those were the measures that stopped transmission in China, not the big travel restrictions and lockdowns,” the organization’s assistant director general Bruce Aylward told the New Scientist on Monday. As of Wednesday, Russia is reportedly now opening up test development to other companies in addition to Vektor. But medical experts have also raised concerns over Russia's testing size sample — which has included only those people who are exhibiting symptoms and who have entered the country within 14 days of visiting a country on Russia’s black list, such as Iran and Italy. On Tuesday, Kurinny, pointing to lessons from China and South Korea, admitted that this policy was a mistake. Even those who know Vektor well have their doubts. “I cannot find any explanation [for the fact that a low number of people have been diagnosed with the virus in Russia] and that is why doubts gnaw at me,” Alexander Chepurnov, a virologist who previously headed research into ebola at Vektor, told The Siberian Times last weekend. “What is worrying, in my opinion, is that I do not understand why they do not take samples from all people with pneumonia.”

Later Tuesday afternoon, Rospotrepnadzor announced that it now would be testing anybody who has returned from Europe — with or without symptoms — over the past two weeks. But when The Moscow Times reached Rospotrepnadzor’s hotline on Wednesday morning, multiple operators said that they had not heard of any new guidelines. Now, there are worries about how hospitals will be able to handle all the incoming patients. On Tuesday, the Meduza news outlet reported that hospitals in St. Petersburg had reached capacity, while Moscow’s Mayor Sergei Sobyanin told Putin that the city is set to build a new hospital within a month designated for coronavirus patients. As for Russia’s western exclave of Kaliningrad, where five people have so far tested positive for the coronavirus, the region’s governor Anton Alikhanov told The Moscow Times that his administration will be renting a hotel to accomodate the 200 people currently identified as needing quarantine. “The situation is tense but manageable,” Alikhanov said. Special perks If Russia isn’t testing correctly at home, that’s not stopping it from trying to gain a foothold on the world stage. Last week, Russia announced that it had sent hundreds of tests to countries including Iran, North Korea and a host of post-Soviet states. During a video press conference Tuesday evening, the WHO’s European Region Health Emergencies Coordinator Dorit Nitzan rated Russia’s testing capacity highly. “We are working together hand-in-hand,” Nitzan told The Moscow Times. “We are using their tests as well.”