COVID-19 pandemic in Russia

As of 28 April, the Ministry of Health approved the 6th version of the temporary methodological recommendations: prevention, diagnosis and treatment of the new coronavirus infection (COVID-19). The focus is on early intervention prior to receiving test results for suspected cases in an outpatient setting. On 17 April the second version of the officially not approved temporary guidelines was published - "Drug treatment of acute respiratory viral infections (ARVI) in outpatient practice during the COVID-19 epidemic" by the Ministry of Health. This is designed to provide recommendations of the combination of antiviral drugs that can be used for urgent outpatient treatment of patients with ARVI symptoms without waiting for the results of testing. These documents advise that it is clinically proven that an early start to treatment provides an easier and shorter course of the disease, while no scientific data yet support this statement. Recommendations for drug treatment of ARVI were published on the website of the Ministry of Health.[45]

The definition of a suspicious case in the guidelines (translated from Russian) is as follows "any case of acute respiratory infection (body temperature above 37.5 °C and one or more of the following symptoms: cough - dry or with sputum, shortness of breath, feeling of stuffiness in the chest, blood saturation with oxygenpulse oximetry (SpO2) ≤ 95%, sore throat, runny nose and other catarrhal symptoms) in the absence of other known causes that explain the clinical picture"

The guidelines define a mild ARVI as follows:

• body temperature below 38 °C;
• respiratory rate less than 22 per min;
• oxygen saturation (SpO2) more than 95%;
• lack of shortness of breath;
• lack of clinical and auscultatory picture of pneumonia.[46]

The guidelines clearly stated that no one drug is experimentally proven effective as antiviral agent against COVID-19. It recommend "several drugs that can be used both in monotherapy and in combination: INN: chloroquine, INN: hydroxychloroquine, INN: mefloquine, INN: lopinavir/ritonavir, INN: azithromycin. Among the drugs that are being tested in vitro and already are in clinical trials in patients with COVID-19 are the following: INN: umifenovir, INN: remdesivir, INN: favipiravir and others."[46]

Initial treatment prior to laboratory confirmation of diagnosis is the "use of reduced dosages INN: hydroxychloroquine and INN: mefloquine, which reduces their risk cardiotoxicity without a significant decrease in effectiveness." with a rider "Given the little experience with mefloquine with COVID-19, its use is recommended only when hydroxychloroquine is unavailable." [46]

According to the guidelines, after laboratory confirmation of diagnosis the treatment is as follows:

1. recombinant interferon alfa: Drops or spray in each nasal passage 5-6 times a day (single dose - 3000 ME, daily dose- 15000-18000 ME) + hydroxychloroquine 600 mg on the first day (3times 200 mg), 400 mg on the second day (2 times 200 mg), then200 mg per day for 5 days;
2. umifenovir: 200 mg 4 times a day + hydroxychloroquine 600 mg the first day (3 times 200 mg), 400 mg on the second day (2 times 200mg), then 200 mg per day for 5 days;
3. recombinant interferon alfa: Drops or spray in each nasal passage 5-6 times a day (single dose - 3000 ME, daily dose -15000-18000 ME) + mefloquine 500 mg on the first and second day (2 times 250 mg), then 250 mg per day for 5 days *;
4. umifenovir : 200 mg 4 times a day + mefloquine 500 mg in the first and the second day (2 times 250 mg), then 250 mg per day for 5days *;
5. recombinant interferon alfa: Drops or spray in each nasal passage 5-6 times a day (single dose - 3000 ME, daily dose -15000-18000 ME) + umifenovir, 200 mg 4 times a day - during 5 days**.[46]

Both recombinant interferon alfa and umifenovir are unique recommendations from Russian authors. They have no international recognition, because are not based on the appropriate research data.

* when hydroxychloroquine is unavailable; ** - if there are contraindications to the appointment hydroxychloroquine and mefloquine[46]

More detailed treatment plans for different severalties along with diagnosis and treatment pathways are in the appendices to the guidelines.[46]

The guidelines state that "Given the lack of objective evidence of effectiveness the use of the above drugs with COVID-19, the appointment of treatment must necessarily be accompanied by voluntary informed consent of the patient (or his legal representative)."[46]

On 30 May, the Health Ministry approved Avifavir as having been "highly effective" in the first phase of clinical trials. 330 patients are taking part in the final stage of clinical trials and the results are expected to be announced on 1 June. Avifavir was developed with the backing of the Russia Direct Investment Fund (RDIF) and is a generic form of favipiravir which has been used in Japan since 2014 for severe influenza.[47][48][49]

On 2 June, the Russian Academy of Sciences announced the results of a study of 76 patients that showed that 71% of patients with acute respiratory failure could be treated with non-invasive lung ventilation provided this was applied in the early stages. This is significant because the death rate is as high as 70% for those that are not treated early enough and have to have invasive lung ventilation with drugs for sedation.[50]

On 19 March 2020, the Russian Government reported the following data. More than 55 thousand beds for infectious cases were deployed, including more than 12 thousand intensive care units and 396 observatories. 7.5 thousand Melzer boxes were prepared. Medical organisations have more than 40 thousand devices for artificial lung ventilation, 124 devices for extracorporeal membrane oxygenation (ECMO). The government of the Russian Federation has allocated resources for the additional purchase of more than 500 devices, including 17 ECMO devices. Today, 6,000 infectious diseases doctors and almost 2,000 pulmonologists, more than 18,000 nurses are ready to provide medical assistance.[51]

According to the OECD, Russia ranks third in the number of beds per capita. However, bed equipment varies from hospital to hospital. In terms of equipment – for example, CT and MRI devices – Russia is in 28th place with a dramatic gap from the leaders. Rosstat does not publish data on the number of places in intensive care units and equipment. In total, there are 1 million 172,000 beds in Russian hospitals, according to Rosstat data for 2018. These include intensive care units. An intensive care bed means a bed equipped with a set of equipment for resuscitation and intensive care, including ventilators. The Institute of Phthisiopulmonology and infectious diseases of the Ministry of Health estimated the number of intensive care beds at just 12,000, which is three times less than the Ministry of Health's standard. The proekt.media independent investigative website was able to find data on the number of intensive care beds in only 23 regions. Only Moscow, Kalmykia, Altai, and Komi reached a standard of 3%. Other regions are significantly below the standard.
Separate ventilators in hospitals should be more than intensive care beds. The number of ventilators in a region should be at least 1.5 times more than the number of intensive care beds. There are no official statistics on the number of ventilators. Federal authorities with the beginning of the epidemic conducted their own calculations: Deputy Prime Minister Tatyana Golikova said that Russia has 40,000 ventilators. This is 3.4% of the total number of beds in Russia, and more than 12 thousand devices are missing from the standards of the Ministry of health. This is a total deficit of 23%, but in some regions, it is much larger. The proekt.media website tried to find sources of information to evaluate that all the devices included in the statistics are in working order. 58% of ventilators are more than 9 years old. Components may require more frequent replacement. For example, the oxygen sensor of the American model common in Russia, Puritan Bennett, is subject to replacement every two years.[52]

Data collected by the news website Meduza indicates that Russia's supply of ventilators is quite extensive: Even the number available per capita in some geographically peripheral regions, not to mention Moscow, significantly exceeds ventilator supplies in Western countries.[53]

A Meduza investigation revealed that the areas with the highest proportions of elderly residents (Tula, Tambov, Ryazan, and Tver regions) are most vulnerable to the epidemic because of the few numbers of ventilators and, in particular, Tula and Tver governors didn't issue general stay-at-home orders.[54]

On 24 January, the first testing systems were developed and deployed to laboratories around the country.[67]

As of 23 March, Russia had 4 testing systems and had carried out over 165 thousand tests for the virus[68][69] which is among the highest testing numbers in the world.[70] Two private lab companies started testing on 26 March. According to Deputy Prime Minister Tatyana Golikova, as of 25 March 141 state laboratories were conducting tests in 79 federal subjects.[71] There are plans to increase the number of reference centres across the country to 15.[72][68][73] On 27 March, the Federal Service for Surveillance in Healthcare (Roszdravnadzor) registered two more test systems.[74] In Moscow on 21 March the average of those tested was low at 35 years and starting to rise to 37–39 years.[75]

On 9 April, Russia passed the 1 million test mark and in addition to the laboratories of Rospotrebnadzor 200 state medical laboratories and 22 private laboratories are carrying out testing. There is a drive to further expand testing with any laboratory being able to carry out tests by submitting a notification to the central website.[76]

On 27 April, Russia passed the 3 million test mark.[77] On 28 April Anna Popova head of Federal Service for Surveillance in Healthcare (Roszdravnadzor) in a presidential update stated that there were now 506 laboratories testing and that 45% of those tested have no symptoms with the number having pneumonia reducing from 25% to 20% and only 5% of patients with a severe form. 40% of infections were from family members. The speed of people reporting illness has improved from 6 days to the day people find symptoms. Antibody testing was carried out on 3,200 Moscow doctors and 20% have immunity.[78]

Russia continued to have the 2nd highest rate of testing in the world with 4.1m tests at 3 May,[79] 5.2m tests at 9 May,[80] 6.1m tests at 14 May,[81] 7.1m tests on 18 May,[82] 9m tests on 26 May and 10m tests on 29 May.[83]

Dr. Melita Vujnovic, the World Health Organization's representative in Russia, stated that Russia, in accordance with WHO recommendations, "started testing literally at the end of January."[84] Coronavirus testing in Russia was provided by the State Research Center of Virology and Biotechnology VECTOR in Novosibirsk and had to be verified there.[85][86] There was concern that the tests may have insufficient sensitivity,[85][86] despite the fact that the tests were verified in China since early February, showed the degree of sensitivity similar to or higher than other tests and the lab has been approved by the World Health Organization.[85] Since 23 March, European Russia doesn't send their batches to Novosibirsk for verification, verifying them instead in a Moscow reference centre.[73]

In a study announced on 14 May, 5.6% of symptomless patients in St. Petersburg had detectable levels of antibodies to coronavirus. The study covered 1,276 coronavirus-positive volunteers aged from 11 to 93 with no COVID-19 symptoms. The study was carried out by Virology Center of St. Petersburg's Hospital No 40 who have carried out 22,000 coronavirus tests since the study started on 1 April. Antibody testing was carried out on the basis of enzyme-linked immunoassay. The announcement stated "The idea is that many hope that after having mild forms of the disease they could be spared from it. Practice however shows that it is not so. So, people should not relax. The immunity stratum is not that thick,"[87]

Social distancing signs in the Moscow Metro on 1 April.

On 23 January, the Russian city of Blagoveshchensk, near the Chinese border, limited access to the country. Cultural exchange and official visits to China were cancelled. The Governors of the Amur Oblast Vasily Orlov, and of the Penza Oblast Ivan Belozertsev, called on residents to abandon trips to China altogether. Residents of large cities were told to avoid contact with tourists from China.[88]

On 31 January, Deputy Prime Minister Tatyana Golikova said Russia will restrict the entry of foreigners arriving from China, except for flights to Moscow Sheremetyevo Airport.[72]

On 20 February, the entry of Chinese citizens was banned. The temporary suspension is for Chinese citizens entering Russia for employment, private, educational and tourist purposes.[72]

On 28 February, Moscow announced that it would deport 88 foreigners for allegedly violating quarantine measures.[56] Russia barred Iranian citizens from entering Russia and said it would also restrict the entry of South Korean citizens from 1 March. Flights between Russia and South Korea are suspended, except for those operated by Aeroflot and Aurora.[72]

On 4 March, Russia suspended its train service from Moscow to Nice, France.[72] Aeroflot suspended flights to and from Hong Kong since 9 March.[72]

Flights to and from Italy, Germany, France and Spain are limited since 13 March. Russia also stopped issuing tourist visas to Italian citizens and closed the border to Italian citizens and foreigners coming from Italy.[72]

On 15 March, the land borders with Norway and Poland were closed to all foreigners. Russian Railways announced it would stop passenger trains from Moscow to Berlin and Paris. Earlier it was announced that train connections to and from Ukraine, Moldova and Latvia would be suspended because those countries had closed their borders.[72]

Since 16 March, flights to and from the European Union, Norway and Switzerland were limited to regular flights between capital cities (Geneva in the case of Switzerland) and Moscow Sheremetyevo Airport, and charter flights.[89] Prime Minister Mikhail Mishustin announced that the border with Belarus has been closed for the movement of people and an entry ban for foreigners will be imposed from 18 March to 1 May.[90][91] On 17 March, Ministry of Foreign Affairs said Russian embassies and consulates had stopped issuing all types of visas, including e-visas, with exceptions for diplomats, people attending funerals and transit passengers.[92]

On 23 March, Russia restricted air travel from all over the world, except for certain flights from Moscow to major capitals, and charter flights intended to move foreign citizens to their respective countries and Russian nationals back to Russia, until everyone is evacuated.[93]

On 25 March, the Russian government loosened the travel ban to allow the entry for relatives of Russian citizens.[94]

All regular and charter international flights were suspended on 27 March, except for those aimed at bringing Russians home.[95]

On the same day, Grozny Airport refused to receive passengers without permanent or temporary registration in Chechnya.[96]

Following a request from the Government of Moscow,[97] BlaBlaCar carpooling service decided to suspend its activities across Russia starting from 30 March.[98]

On 28 March, the Russian government decided to close all automobile, railway, pedestrian, river, or other border checkpoints, including on the Belarus border, with exceptions similar to that of the air travel restrictions. The ban must be enforced on 30 March.[99]

President Putin, Prime Minister Mikhail Mishustin and Moscow Mayor Sergey Sobyanin visited the Coronavirus Monitoring Centre on 17 March

Call centre for the coronavirus situation in Moscow at Khodynsky Boulevard located in the gym of school No. 1409.[100]

On 14 and 15 March, Ministry of Education and Ministry of Science and Higher Education recommended regions to adopt distance learning if it becomes necessary.[72][101]

On 17 March, Ministry of Culture announced closing all cultural institutions under its jurisdiction, including museums, theatres, symphonies, and circuses.[102] On the same day, President Vladimir Putin said that the situation was "generally under control".[103]

On 18 March, Minister of Education Sergey Kravtsov announced that all Russian schools would be closed from 23 March to 12 April.[72]

On 19 March, Russia's Chief Sanitary Doctor, Anna Popova, required all people arriving from abroad to undergo a two-week self-isolation.[104] Russian courts stopped considering all but most urgent cases because of the pandemic until 10 April.[105]

On 24 March, the Russian government adopted a number of decisions, including an instruction to regional authorities to suspend activities of any nightclubs, cinemas, children's entertainment centres, and to ban hookah smoking at any restaurants or cafes.[106] The Central Bank recommended all the banks to keep the money for 3–4 days before giving it to clients or loading it into ATMs, and to restrict usage of cash recycling ATMs.[107]

On 25 March, President Putin, in a televised address to the nation, announced that the 2020 Russian constitutional referendum would be postponed due to the coronavirus.[23] He added that the next week would be a nationwide paid holiday and urged Russians to stay at home.[24][25] Putin also announced a list of measures of social protection, support for small and medium-sized enterprises, and changes in fiscal policy.[108]

On 26 March, Minister of Science and Higher Education Valery Falkov ordered all universities to close from 28 March to 5 April.[109]

On 27 March, as a follow-up to Putin's address to the nation, Prime Minister Mikhail Mishustin ordered all reservations at pensions or holiday houses to be cancelled from 28 March to 1 June, recommended regional authorities to close all the pistes at resorts for the same period, instructed them to force all the public eating places (except for delivery services) to suspend activities from 28 March to 5 April, and recommended that citizens refrain from travelling.[110] On the same day, the Ministry of Education announced the postponement of the Unified State Exam from the end of May to the beginning of June.[111]

On 30 March, as Moscow and Moscow Oblast declared a lockdown, Mishustin urged all regions to follow the example and take similar measures. He also announced a bill that would raise fines for breaching quarantine requirements.[112][113]

On 31 March, the Federal Assembly approved a law allowing the executive cabinet to declare a state of emergency on its own. Previously, only a commission led by the Minister of Emergency Situations could do that.[114]

On 1 April, Prime Minister Mishustin and the Minister of Communications Maxut Shadayev announced creating a system of tracking quarantine violation based on data of mobile network operators. Violators will receive a text message, and if they breach it systematically, the information will be sent to the police.[115]

On 2 April, President Putin extended the non-working period to 30 April.[116]

Map of federal subjects that have announced the "self-isolation regime".

  Stay-at-home order

  Partial restrictions or recommendations

Playground closed for quarantine, 7 April 2020

On 28 March, Chechen authorities urged the population of the republic to stay at their places of permanent residence, and banned entry to Grozny for anyone except emergency services, food supplies, government officials, police, and journalists.[117] On the next day, Chechnya closed its borders, with a full lockdown coming into effect on 30 March.[118]

On 29 March, Moscow issued a stay-at-home order for all residents starting on 30 March. Muscovites were not allowed to leave their homes except in cases of emergency medical care and other threats to life and health, to travel to work for those who are obliged to, to make purchases in the nearest shop or pharmacy, to walk pets at a distance not exceeding 100 metres from the place of residence, as well as to take out the garbage. People were instructed to keep a distance of 1.5 metres from other people. Those recently unemployed will receive 19,500 rubles a month.[119][120] After that, a similar regime was introduced in Moscow Oblast at 20:00 MSK on 29 March.[121] Senator Andrey Klishas, chair of the Federation Council Committee on constitutional legislation and state construction, criticised this decision, saying that such restrictions are the exclusive competence of the Federal Assembly and the President.[122]

On 30 March, similar orders were announced in Adygea, the Komi Republic, Mari El, Tatarstan, Chuvashia, some districts of Yakutia, Arkhangelsk, Astrakhan,[123] Belgorod, Irkutsk, Kaliningrad, Kursk, Lipetsk, Murmansk, Nizhny Novgorod, Novgorod, Ryazan, Saratov, Sverdlovsk, Ulyanovsk and Vologda oblasts, the cities of Bryansk and Saint Petersburg.[124][125] Leningrad Oblast banned movement of people between districts and introduced a lockdown in the town of Murino.[126]

On 31 March, the "self-isolation regime" was announced in republics of Altai, Bashkortostan, Buryatia, Dagestan,[127] Ingushetia, Kabardino-Balkaria, Kalmykia, Karachay-Cherkessia, Karelia,[128] Khakassia, Mordovia, Udmurtia and Tuva, Altai, Khabarovsk (for those over 65), Krasnodar, Krasnoyarsk, Perm, Primorsky, Stavropol and Zabaykalsky krais, Bryansk, Chelyabinsk, Kaluga, Kemerovo, Kirov, Kostroma,[129] Kurgan, Magadan, Novosibirsk, Omsk,[130] Penza, Pskov (for those over 65), Rostov, Sakhalin, Samara, Smolensk,[131] Tambov, Tomsk, Vladimir, Volgograd, Voronezh and Yaroslavl[132] oblasts, Khanty-Mansi[133] and Yamalo-Nenets autonomous okrugs, the Jewish Autonomous Oblast,[134] the city of Sevastopol.[135][136][137][125] Republics of Yakutia and Karelia limited the sale of alcohol.[138]

On 1 April, the "self-isolation regime" was announced in the disputed territory of Crimea and Sevastopol,[139] the republic of North Ossetia–Alania,[140] Kamchatka[141] and Khabarovsk[142] krais, Ivanovo[143] and Orenburg[144] oblasts. On 2 April, the measures were announced in Amur Oblast (for those over 65), Tyumen Oblast,[145] and Chukotka Autonomous Okrug.[146] On 3 April, the measures were announced in Oryol Oblast[147] and Tula Oblast (for those over 65).[148]

Russia has regularly reported the number of people under medical supervision because they were suspected of having the virus.

• On 25 April 168,000 people[149]
• On 26 April 170,000 people[150]
• On 27 April 183,000 people[77]

On 5 May Russia reported that a total of 806,709 people had been under medical supervision to date during the outbreak and the current number was 222,500.[151]

On 8 May 292,000 people were under medical surveillance.[152]

On 9 May 242,000 people were under medical surveillance.[80]

On 4 March, Russia temporarily banned the export of medical masks, gloves, bandages, and protective suits.[72]

On 28 April president Vladimir Putin summarised progress on producing additional equipment as follows:

• Ventilator production increased from 60–70 per month to over 800 in April and 2,500 in May
• Face masks from 800,000 per day to 8.5m in April
• Protective suits for doctors from 3,000 per day to 100,000 per day by end of April and 150,000 per day by mid-May

Additional production was required and the Ministry of Industry and Trade was given the task to further increase daily production.[153]

On 15 June 2020, Human Rights Watch documented that healthcare workers in Russia were facing threats and reprisal from employers and law enforcement. The medical workers were being targeted for speaking about lack of adequate personal protective equipment (PPE) to safely treat suspected patients and prevent the spread of Covid-19.[154]

President Putin visits coronavirus patients at Moscow hospital on 24 March.

Denis Protsenko (middle), the medical director of the Kommunarka hospital visited by President Putin (left) and Moscow Mayor Sobyanin (right), tested positive for the coronavirus on 31 March 2020.

Construction of an infection centre in Moscow in connection with the spread of coronavirus started on 12 March.[155] The photo shows progress as of 16 March 2020.

21 March 2020.

Infectious Diseases Hospital in Voronovskoye was opened on 17 April.

Moscow started the construction of a special hospital for the coronavirus patients near the villages of Babenki and Golokhvastovo in Troitsky Administrative Okrug.[156][157]

From the beginning of the outbreak, Moscow patients have been brought to already-in-place newly-constructed yet underused City Hospital No. 40 in the district of Kommunarka, which is located outside MKAD and only recently got a metro station.[158] Subsequently, almost 30 hospitals in Moscow started to receive suspected COVID-19 patients, with being the City Hospital No. 15, Infectious Hospital No. 2, Bashlyaeva Children's Hospital, Infectious Hospital No. 2, and the hospital in Kommunarka being the most capacious of them.[159] In mid-April, it was announced that additional 24 hospitals would be repurposed to receive coronavirus patients, bringing the total number of beds available in the city to 21 thousand.[160]

On 6 March, Mayor of Moscow Sergey Sobyanin announced a "high alert regime", ordering self-isolation for two weeks for Russians returning from China, South Korea, Iran, France, Germany, Italy and Spain.[72]

On 10 March, Mayor Sobyanin signed a decree for banning mass events in Moscow with more than 5,000 participants from 10 March to 10 April.[161]

On 12 March, the Governor of Moscow Oblast Andrey Vorobyov has announced a high alert status, banning large events with over 5,000 people.[72]

Since 16 March, school attendance was optional in Moscow and Moscow Oblast. According to RBK, Moscow recommended that private schools go on a two-week holiday or switch to distance learning. On 21 March, schools were closed for three weeks.[72]

On 16 March, Moscow extended measures to closing public schools, athletic schools and supplemental education institutions from 21 March to 12 April; banning indoor events with more than 50 attendees and all outdoor mass events. The compulsory 14-day self-isolation which had been previously enforced to people coming China, South Korea and Iran, was extended to those coming from the United States and all European countries.[162]

On 23 March, Mayor Sobyanin ordered all people over 65 to self-isolate at home starting Thursday, saying each would receive 4,000 rubles (around $50) for following the order.[72] He also suggested that older residents leave Moscow and stay in their dachas. School students' public transportation cards were temporarily suspended, starting from the 5th grade.[163][164]

On 24 March, it was announced that Moscow hospitals would receive up to 200,000 rubles (around $2,500) for each coronavirus patient from the city's health insurance fund.[165]

On 25 March, following the respective decision of the federal government, Mayor Sobyanin ordered the closure of all municipal libraries and clubs, as well as cinemas and nightclubs, banned hookah smoking in cafes, and suspended any organised leisure social activities, including amusement parks. He also instructed dental clinics to see patients with acute pain or other emergencies only. Municipal multiservice centres suspended services, except for those unavailable online. Free or concessionary use of public transport was suspended for people aged over 65, with chronic diseases, students of vocational schools or high schools.[166]

On 26 March, Mayor Sobyanin ordered restaurants, cafes, bars, canteens, parks, commercial, and retail businesses requiring personal attendance, except those providing essential services, like grocery shops and pharmacies, to close during the week from 28 March to 5 April, the holiday week announced by President Putin.[167]

On 28 March, Sobyanin urged Muscovites to stay at home, except for seeking medical help, work travel, local shopping, walking pets not further than 100 m from home, taking out trash. He announced that a "smart control system" would be introduced to control these rules.[168]

On 3 April, Sobyanin announced that the city bike-sharing system Velobike would resume operation after the winter break on 10 April, but will be available for delivery agents and volunteers only, free of charge.[169]

On 4 April, he ordered all the businesses in the city that were working to secure a social distance of at least 1.5 m between the workers and the customers.[170]

On 10 April, Sobyanin introduced a system of electronic permits due to the increase in violations of the stay-at-home regime, ordered most types of companies and institutions in the city to halt operation, paused the work of the world's largest carsharing system.[171] Starting from 15 April, people using private cars, taxis or public transport, will have to get a digital pass indicating the purpose of travel. The number of permits available will be limited, except for unlimited passes for work trips.[172]

In February, drivers of Mosgortrans were required to inform their dispatchers if they see Chinese nationals in their vehicles, to call the police.[173][174] Moscow Metro employees were required to ask Chinese nationals to fill in questionnaires.[174]

On 21 February, Mayor Sobyanin confirmed that Mosgortrans and Moscow Metro were asked to work together with police forces to "monitor those who arrived from China". Facial recognition was also used to track these people.[174]

On 24 February, the Chinese Embassy in Russia asked Moscow authorities to put an end to these "excessive measures" in transport.[72] Sobyanin insisted that the measures were not discriminatory but helped control those who were required to stay self-isolated upon arrival from China.[175]

In early March, numerous cases of deportation of Chinese students who allegedly broke the quarantine rules were reported.[176][177]

However at the later stages many of these Russian measures were applied to all foreign arrivals, including for Russian citizens coming back from abroad, with them being forced into self quarantine and facecam profiling. 200 cases of quarantine-breakers by Russian citizens were reported to be recognised with facecam profiling, tracked by public surveillance cameras in Moscow.[178][179]

On 13 March, the governors of Saint Petersburg and Leningrad Oblast Alexander Beglov and Aleksandr Drozdenko announced a high alert status and banned events with more than 1,000 and 300 people respectively.[180]

On 18 March, Governor of Saint Petersburg Alexander Beglov banned events and gatherings with more than 50 people.[72] On 26 March, he ordered restaurants, cafes, bars, canteens, parks, places of worship, commercial and retail businesses requiring personal attendance, except those providing essential services, like grocery shops and pharmacies, to close during the holiday week from 28 March to 5 April. Free and concessionary tickets for public transport will be suspended during the week. Leisure facilities including nightclubs, children's playrooms, and recreation centres will be closed until 30 April. In Leningrad Oblast only pharmacies, grocery shops, building material and household shops will remain open during the holiday week.[181]

On 1 April, the Saint Petersburg Metro will start closing at 22:00 MSK instead of 0:00–0:45 MSK. Ground transportation will end at 23:00 MSK and its intervals will be increased.[182]

Chechnya was the first region to close restaurants and cafes on 24 March[72] and to announce closure of its borders on 5 April.[183]

On 15 April, it was reported that Murmansk Oblast will use electronic bracelets to monitor those suspected to have the coronavirus and self-isolating at home.[184]

On 27 April, the governor of Nizhny Novgorod Oblast, Gleb Nikitin, said that entry to the region would be banned unless one has an emergency permit or proof of residence there.[185]

On 18 May, Saratov Oblast reinstated its ban on walks and outdoor activities a week after easing restrictions due to an increase in cases.[186]

In early February, aid was sent to China.[187][188]

On 21 March, it was announced that Russia delivered over 100,000 test kits to 13 countries, including Armenia, Belarus, Kyrgyzstan, Uzbekistan, Serbia, Egypt, Venezuela, Iran, and North Korea.[189]

On 22 March, after a phone call with Italian Prime Minister Giuseppe Conte, Russian president Vladimir Putin arranged the Russian army to send medical help to Italy, which was the European country hardest hit by coronavirus.[190]

On 1 April, a Russian military plane was sent to the United States to deliver medical equipment.[191]

On 25 March, the 2020 constitutional referendum, which was originally scheduled for 22 April, was postponed by President Putin in a televised address to the nation.[220][221]

On 13 May 2020, the governors of Arkhangelsk Oblast and Nenets Autonomous Okrug announced their plan to merge following the collapse of oil prices stemming from the pandemic.[222] A referendum on the issue was planned to be held on 13 September 2020.[223] This could be the first merger of Russia's federal subjects since the unification of Chita Oblast and Agin-Buryat Autonomous Okrug in 2008.[224] After protests in Nenets Autonomous Okrug including from local United Russia representatives, on 28 May the referendum was postponed indefinitely.[225]

On 1 April, President Putin signed legislation imposing severe punishments for those convicted of spreading false information about the coronavirus and breaking quarantine rules.[226]

On 13 May, the State Duma submitted and passed amendments allowing electoral commissions to introduce postal or internet voting during elections and referendums. Previously, voting by mail could be allowed only in regions, but now it has been extended to the federal level. The amendment does not affect the 2020 constitutional referendum, the procedure of which is covered by a separate law. In addition to that, collecting voter signatures for registering a candidate or organising a referendum will be allowed through the Russian Public Services Portal, however the number of such signatures can't exceed 50%. The procedure of filling signature sheets has been changed as well, now voters have to fill their names personally. The number of maximum invalid signatures has been lowered from 10% to 5%. The Communist Party, LDPR and A Just Russia opposed the amendment, saying that the draft was not consulted with them. The law has been passed with 250 votes in favour and 83 against.[227][228]

On 25 April, two cases were confirmed in the State Duma, the lower chamber of the Federal Assembly, the Russian parliament. They included deputies from the Communist Party Leonid Kalashnikov and Dmitry Novikov.[229]

On 6 May, United Russia deputy Svetlana Maksimova was diagnosed with COVID-19. She was hospitalised in Tver earlier.[230]

On 13 May, the Chairman of the State Duma Vyacheslav Volodin announced that five deputies had been infected in total. Three of them were hospitalised, one of which had been recovered. Oksana Pushkina from the United Russia party said that she is one of the two new confirmed cases.[231] On 18 May, the advisor of the chairman Anastasia Kashevarova said that six deputies had positive tests, two of them had recovered, two were hospitalised, another two were quarantined at home.[232]

On 20 May, the Chairwoman of the Federation Council, the upper chamber, Valentina Matviyenko said that five senators had recovered from COVID-19.[233]

On 30 April, Prime Minister Mikhail Mishustin announced that he had tested positive for the virus. President Putin as a result signed an executive order to appoint First Deputy Prime Minister Andrey Belousov as Acting Prime Minister while Mishustin recovers.[33] On 19 May, President Putin reappointed Mishustin as the Prime Minister.[234]

On 1 May, Minister of Construction, Housing and Utilities Vladimir Yakushev and his deputy Dmitry Volkov were hospitalised because of positive tests. Another deputy, Nikita Stasishin was appointed as the acting minister.[235]

On 6 May, Minister of Culture Olga Lyubimova was confirmed to have tested positive for the virus. Her First Deputy, Sergey Obryvalin was appointed as the acting minister.[236]

On 14 May, President Putin said that Education and Science Minister Valery Falkov had recovered from COVID-19.[237]

On 12 May, Kremlin spokesman Dmitry Peskov confirmed that he tested positive for the virus. He said that the last time he met President Putin in person was over a month ago.[238] Peskov was discharged on 25 May and returned to his duties.[239]

In a poll carried out by the Levada Center from 24 to 27 April 2020, 46% of respondents approved of the president's and federal government's measures in combating the virus, while 48% disapproved with 18% believing it was excessive and 30% believing it was not enough. In the same poll, 50% of respondents approved of their local government's measures, while 45% disapproved with 15% believing it was excessive and 30% believing it was not enough.[240][241]

In another poll by the Levada Center carried out from 22 to 24 May 66% said that they approved of the measures taken by the president and federal government, while 32% disapproved. In the same poll, 63% approved of their local government's measures while 33% disapproved.[242]

President Putin's approval rating and trust rating fell during the pandemic. Putin's approval rating fell from 63% in March 2020 to 59% in April and May in polls by the Levada Center - the lowest recorded by the pollster during his time in power. In May, Putin's trust rating fell to its lowest: 25% said that they trusted Putin the most (out of a list of politicians) compared to 59% in November 2017 when the Levada Center began the polls.[243][244]

On 5 March, First Deputy Prime Minister Andrey Belousov announced the cancellation of the St. Petersburg International Economic Forum which was due to be held from 3 to 6 June 2020.[72]

On 11 March, Russian Defence Minister Sergey Shoygu cancelled the Moscow International Security Conference which had been scheduled for 22 to 23 April.[72]

On 17 March, TASS reported that all football, hockey and basketball games were suspended until 10 April.[245] This was later extended to 31 May.[246] On the same day, UEFA confirmed postponing Euro 2020 until summer 2021, one of the venues of which is Krestovsky Stadium in Saint Petersburg.[247]

Despite the fact that a conscription started on 1 April, conscripts won't be sent to duty stations until 20 May.[248]

On 16 April, President Putin postponed the 2020 Victory Day Parade.[249][250] On 26 May, President Putin announced that the 2020 Victory Day Parade would be held on 24 June, coinciding with the Moscow Victory Parade of 1945.[36]

On 17 March, the leadership of the Russian Orthodox Church published Instructions to rectors of parishes and monasteries’ town churches, abbots and abbesses of the monasteries of the Russian Orthodox Church over the threat of spreading coronavirus infection (in English), which said it had been approved by the ROC's Holy Synod and instructed the ROC's clergy to use disposable cups, gloves, and facial tissue during sacraments and celebrations, disinfect church plates and premises regularly, and refrain from offering the hand for kissing.[251] A nearly identical Russian-language Instructions were addressed to the clergy of the Moscow diocese and said it had been approved by the Patriarch of Moscow and all Rus'.[252] When in St. Petersburg attendance of places of worship was restricted for the public on 26 March, the Moscow Patriarchate's lawyer deemed it unlawful.[253]

On 29 March, the ROC's Patriarch Kirill delivered a sermon in the Cathedral of Christ the Saviour that urged people to refrain from visiting church, citing the life of St. Mary of Egypt.[254] On 3 April, Kirill issued an encyclical for the clergy and faithful of the "dioceses in the territory of the Russian Federation" urging the clergy to conduct church services without laypeople's presence.[255] As the city of Moscow decided to tighten lockdown measures starting from 13 April, and following a request from chief sanitary doctor of Moscow, the Patriarch's Vicar instructed that church services in the city diocese be held without public (laypeople).[256] A similar decision was taken in St. Petersburg.[257] As of 16 April 2020, according to RBK, 42 out of 85 federal subjects including Moscow, Moscow Oblast and Saint Petersburg, issued instructions to close places of worship for general public, which would extend into the Easter period, which in the Orthodox Church was to begin on 19 April.[258] Equivocation and occasionally contradictory instructions issued by the Moscow Patriarchate's top officials undermined the authority of the Church's leadership while restrictive measures caused opposition on the part of conservative circles of the ROC's congregation.[259][260] On Easter Sunday, the degree of admission restrictions, if any, to religious ceremonies varied significantly from region to region (federal subject), the ROC's branches outside the RF territory given free rein to find appropriate arrangement with local authorities.[261] While Patriarch Kirill presided over the Easter night service in Moscow's cathedral church with no laypeople in attendance, the ROC's most venerated St Trinity monastery in the Moscow region, which is under the Patriarch's direct spiritual authority, defied his directions by conducting Easter services as normal. This and similar incidents in other major monasteries led to massive spread of the COVID-19 infection in a number of the ROC's monasteries and seminaries in Russia as well as in Belarus and Ukraine.[260][262][263][264][265]

Various Muslim communities closed their mosques. In Moscow, the Cathedral Mosque, the Old Mosque, and the Memorial Mosque on Poklonnaya Hill closed on 18 March.[266] On 23 March, mosques in Crimea and Sevastopol were shut down.[267] On the next day, all the mosques in Krasnodar Krai and Adygea were closed as well.[268] Same measures were planned in Dagestan.[269]

On 18 March, Rabbi Berel Lazar closed the Bolshaya Bronnaya Synagogue, Maryina Roshcha Synagogue, and Zhukovka Jewish Centre.[270] Eleven members of the community were hospitalised, with four COVID-19 cases confirmed, the first one being a rabbi who felt sick after Purim celebration on 9 March.[271][272] On 24 March, Rabbi Berel Lazar and the Federation of Jewish Communities recommended that all synagogues to close down and the community centres and Jewish schools switch to distance education.[273]

For clerics of the Russian Orthodox Church: Only those serving in Russia included

• 11 April – Abdurakhman Martazanov, 64, chief mufti of Ingushetia, tested positive for COVID-19[274]
• 21 April – Alexander Ageykin, 48, protoiereus, dean of the Moscow Yelokhovo Cathedral[275]
• 23 April – Vladimir Veriga, 70, archpriest, head of the icon painting workshop "Alexandria"[276]
• 25 April – Yevgeny Trofimov, 61, protodeacon, priest of the Moscow Yelokhovo Cathedral[277]
• 26 April – Benjamin (Korolyov), bishop of the Zheleznogorsk and Lgov eparchy[278]
• 3 May – Yevgeny Korchukov, 65, protoiereus, 65, cleric of the Khotkovo Monastery of the Intercession of the Virgin[279]
• 4 May – Jonah (Karpukhin), 79, metropolitan of the Astrakhan and Kamyzyak eparchy[280]
• 5 May – Tikhon (Barsukov), 65, сhief physician of the Trinity Lavra of St. Sergius and the Moscow Theological Academy[281]
• 7 May – Ambrose (Yurasov), 82, archimandrite, founder and ghostly father of the Presentation Nunnery in Ivanovo, died of pneumonia (suspected infection)[282]
• 7–8 May – Laurentius (Postnikov), 87, archimandrite of the Trinity Lavra of St. Sergius (suspected infection)[283]
• 8 May – Callist (Kosulin), 58, hierodeacon of the Trinity Lavra of St. Sergius[284]
• 9 May – Aleksandr Voskoboynikov, 59, archpriest, senior priest of the Apostle Peter Church, died of pneumonia (suspected infection)[285]
• 11 May – Ilian (Plemenyuk), 77, archimandrite of the Trinity Lavra of St. Sergius[286]
• 13 May – Aleksey Penkov, 53, archpriest of the Life-Giving Trinity church in Moscow[287]
• 13 May – Peter (Gribov), hieromonk, priest of the Shuya eparchy of the Ivanovo metropolitanate[288]
• 14 May – Modest (Panchenko), 45, hieromonk of the Trinity Lavra of St. Sergius, died from complications caused by COVID-19.[289]
• 15 May – Therapont (Appolonov), 60, hegumen, resident of the Trinity Lavra of St. Sergius[290]
• 1 June – Varnava (Kedrov), 89, Metropolitan of Cheboksary and Chuvashia[291]
• 23 June – Jampel Lodoy (Apysh-ool Sat), 44, Kamby Lama (Supreme Lama) of Tuva, tested positive for COVID-19[292]

• 19 April – Alexander Vustin, 76, composer, COVID-19 (not proven)[293]
• 20 April – Ivan Shchyogolev, 59, actor and director, died from complications caused by COVID-19 (not proven)[294]
• 30 April – Sergey Litovets, 58, director[295]
• 26 May - Samvel Gasparov, 81, filmmaker, director[296]
• 29 May – Yulyen Balmusov, 79, actor[297]
• 31 May – Anatoly Goldfeder, 69, general producer of the game show Pole Chudes, tested positive for COVID-19[298]
• 9 June – Anatoly Trushkin, 78, satirical writer, tested positive for COVID-19 in the beginning of May[299]

On 25 April 2020, it was reported that doctors had published and were updating a public list of colleagues who had died during the pandemic which, as of 27 June, has 507 names.[300][301]

• 26 April – Alexander Filatov, 34, employee of the 6th Government Communications Management Division of the Federal Protective Service, died from pneumonia caused by COVID-19, according to Meduza[302]
• 30 April – Alexey Titov, 42, major of the Federal Protective Service, duty officer's assistant of the Moscow Kremlin's Commandant's Office, died from pneumonia caused by COVID-19, according to Meduza[303]

• 18 April – Ivan Zhukov, 63, Moscow Oblast Duma deputy, deputy head of the United Russia parliamentary group, tested positive for COVID-19[304]
• 25 April – Konstantin Gergishan, 63, deputy of the Sochi City Assembly from United Russia[305]
• 16 May – Viktor Shudegov, 67, former member of the Federation Council and the State Duma, leader of A Just Russia party's regional office in Udmurtia[306]
• 17 May – Yevgeny Kuznetsov, 71, deputy of the Legislative Assembly of Zabaykalsky Krai from the Communist Party, allegedly tested positive for COVID-19[307]
• 26 May – Vladimir Lopukhin, 68, Minister of Fuel and Energy of Russia (1991–1992)[308]
• 18 June – Mikhail Ignatyev, 58, former Head of the Chuvash Republic (2010–2020)[309]

• 7 April – Mishik Kazaryan, 72, physicist, professor, tested positive for COVID-19[310]
• 14 April – Danila Tlisov, 36, physicist at Institute for Nuclear Research[311]
• 24 April – Igor Goncharov, 80, Doctor of Medicine, professor, employee of the State Scientific Centre of the Institute for Biomedical Problems of the Russian Academy of Sciences[312]
• 5 May – Yevgeny Mikrin, 64, principal designer of manned programs and RSC Energia, tested positive for COVID-19[313]
• 12 May – Ernest Vinberg, 82, mathematician at Moscow State University[314]
• 20 May — Vyacheslav Bely, 74, physicist at IZMIRAN[315]

• 13 May – Magomed Aliomarov, 67, head coach of the Russian women's national wrestling team, former wrestler[316]
• 31 May – Valery Ilyin, 72, modern pentathlon coach, former fencer[317]

The reason for such a relatively low number of deceased people from COVID-19 infection may be resulting from the vaccine programs, including the BCG vaccine, launched in the Soviet Union and Russia. Alexander Myasnikov, calling the phenomenon a "Russian Miracle", also quotes a healthy microbiota among Russians as a reason. Other medics and biologists, such as Alexander Ginzburg, director of the Epidemiological and Microbiological Research Institute in Honour of Gamaleya, also cite a high immunity among Russian people. Anna Popova, head of the Rospotrebnadzor, mentioned the effective epidemiology in Russia.[320]

In March, there was some scepticism about the accuracy of Russia's reported infection figures. Anastasia Vasilyeva, leader of the Doctors' Alliance organisation loosely aligned to the Russian opposition and doctor for opposition figure Alexei Navalny, made a series of videos accusing the authorities of concealing the true number of coronavirus cases by using pneumonia and acute respiratory infection as a diagnosis instead. Health officials rejected the allegation, and President Putin addressed concerns about statistics, saying that the government is not covering up the number of cases, though might not have the full picture. The WHO's representative to Russia, Dr. Vujnovic, also expressed scepticism at the allegation.[85][86][61][321]

In May, as Russia's mortality rate was much lower compared to other hard-hit countries, a number of media outlets including the Financial Times and New York Times have said that the number of deaths in the country may have been under-reported, based on a spike in mortality rates officially reported in Moscow where approximately 1,800 more deaths were registered in April compared to the monthly average, while the Financial Times noted a similar surge in St. Petersburg, concluding that there could be around 70% more deaths than reported.[322] The reported excess deaths however were still considerably smaller compared to other hard-hit areas in other countries.[323] Russian officials have criticised the media reports. Foreign Ministry spokeswoman Maria Zakharova called the reports disinformation and said that letters demanding a retraction would be passed. Officials have said that the relatively low number of deaths is due to effective measures taken to fight the virus and that the scope of testing has significantly increased, allowing for infections to be spotted quickly. Moscow's health department also rejected the allegations, saying that autopsies were being conducted in all suspected coronavirus deaths, which was why "post-mortem diagnoses in Moscow and causes of death, in the end, are exceedingly accurate, and the mortality data absolutely transparent" – it said that over 60% of deaths in the city with suspected coronavirus infections were ascribed to other causes. The World Health Organisation's guidelines on reporting deaths, issued in mid-April, states that "deaths due to COVID-19" should be considered as such "unless there is a clear alternative cause of death that cannot be related to COVID disease."[322]

On 28 May, Moscow's health department said in a statement that the death toll for the city for April was 1,561 using a new methodology, where originally it was 636. It said that this included 756 people diagnosed with the virus but determined to have died of other causes and 169 people who tested negative but were suspected to have had the virus. The official death toll for the city or country had not been revised.[324]

On 3 June, the city of St. Petersburg reported a 32% higher death rate in May compared to the previous year. The city government said that 6,427 death certificates were issued, compared to 4,875 the previous year. For the same month, the official coronavirus death toll was 171 people.[325]

On 10 June, Moscow's health department increased the city's coronavirus death toll from 1,895 to 5,260 for May. It said in a statement that "COVID-19 as a main or an accompanying cause of death was registered in 5,260 cases". It also said that the difference was due to changes made by the Health Ministry in the approach of counting deaths, saying that "new recommendations allowed us to improve the calculation of cases where COVID was the main cause of the death and of those where it became, with a high degree of probability, a catalyst...for other illnesses".[326]

On 13 June, the Russian Federal State Statistics Service published data on natural population changes in April. 2,712 people with COVID-19 died during April across Russia, including 1,660 as the primary cause of death. According to daily updates of the Emergency Operations Center, there were only 1,162 deaths from COVID-19.[327] Rosstat's published death toll includes both those where the virus was determined to the main cause of death, as well as where the main cause of death was determined to be something else. 1,270 deaths are where the virus was determined to be the main cause, 435 deaths where the virus had a "significant influence", 617 deaths where the virus was present but did not play a major role, and 390 deaths where the person tested negative but it was later determined to be the main cause of death. Officials including Tatiana Golikova said that the changes in the counting method follows WHO recommendations. She also said that the figures represent a 2.6% death rate among those infected, and that the death rate for May will be higher.[328] Pavel Malkov, the head of Rosstat, said in an interview with RBK published on 23 June that the statistics agency had published a higher death toll for April because it receives more complete data than the national coronavirus crisis centre and that it has a different calculation methodology, saying that the agency receives data from the Civil Registry Office and deals with death certificates that can take up to 45 days to complete following testing while the crisis centre publishes operational data manually entered into the system. He also said that "one of the biggest secrets in statistics is that it's practically impossible to manipulate" and that "if we're talking about a qualitative indicator with a developed methodology, then any attempt to affect the final numbers by distorting the input data will become immediately evident".[329][330]