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‘The minister realized a catastrophe was brewing’ The authorities in Dagestan admitted to underreporting statistics on COVID-19 deaths. What has this changed?

Source: Meduza

During a recent interview with local blogger Ruslan Kurbanov, Dagestan’s health minister acknowledged that the region has significantly under-reported coronavirus deaths in official data. The admission came a week after Meduza published a report on the critical situation the coronavirus pandemic has caused in this republic on Russia's southern edge. The interview with the minister, streamed on Instagram, became a national sensation. Now, even the Russian state media says the minimum number of coronavirus deaths reported here could be significantly higher than the official numbers indicate. In a follow up report on the situation in Dagestan, Meduza journalist Vladimir Sevrinovsky spoke to the interviewer who got the republic’s health minister to admit that the government's statistics are bogus.

How the information on the coronavirus situation in Dagestan has changed 

On May 13, a report appeared on the website of Russia’s federal healthcare watchdog, Rosdravnadzor, containing the results of its analysis of the Dagestani Health Ministry’s activities during the coronavirus pandemic. The document describes a number of critical issues: an insufficient amount of coronavirus testing, clinics lacking necessary medicines and personal protective equipment (PPE), personnel shortages, problems providing patients with oxygen, and long waits for test results. Meduza had previously disclosed all of the aforementioned issues in a report from Dagestan (the original Russian-language article was published on May 9). Following this report, Rosdravnadzor announced an inspection of the republic’s Health Ministry. 

Dagestan’s Health Ministry made its move to respond on May 16: the republic’s Health Minister, Dzmaludin Gadzhiibragimov, gave an interview to journalist Ruslan Kurbanov — a doctoral candidate in political science and the former editor-in-chief of the magazine “Kavkazskaya Politika” (“Caucasian Politics”). The interview was broadcast on Kurbanov’s Instagram, as well as on his YouTube channel, where Kurbanov has been regularly interviewing patients and medical workers critical of Dagestan’s healthcare system. During the interview, the minister revealed that over 40 doctors in the republic have already died from the coronavirus. His words became a national sensation, seeing as on May 16, the official statistics, published daily by Russia’s public health agency Rospotrebnadzor, claimed that the republic had registered a total of 27 deaths. The health minister said that 657 people in Dagestan had died from community-acquired pneumonia.

Gadzhiibragimov also revealed another figure the differed significantly from official data: the minister said that in Dagestan, 13,697 people had fallen ill with COVID-19 and community-acquired pneumonia since the beginning of the pandemic (at that time, the region officially had just 3,280 coronavirus patients). “We are working on it [community-acquired pneumonia], as well as with coronavirus patients, and treating them in practically the same way,” the health minister said. “But since we don’t have confirmation from laboratory data, those statistics are being kept.” 

The head of the Health Ministry implicitly assigned responsibility for “those statistics” to another department: “Initially, units from Rospotrebnadzor’s research laboratories were working in the republic, then laboratories subordinate to the Health Ministry joined in. But only the units under Rospotrebnadzor were working on pneumonia.” During the interview, Kurbanov raised the question of where aid given to the republic by senator and billionaire Suleiman Kerimov, as well as other donors, is going (Meduza previously reported that Kerimov spent 1.5 billion rubles, more than $21 million, on equipment for the republic and a hospital in his hometown of Derbent. However, local doctors continue to complain about a lack of PPE). The Minister redirecter the question “to the philanthropists’ trusted people,” who are allegedly working on the distribution of the aid. 

Prior to Kurbanov’s interview, journalists were only able to obtain written comments from Dagestan’s Health Ministry; Meduza’s own questions about the statistics on community-acquired pneumonia went unanswered. In conversation with Meduza, Ruslan Kurbanov explained that the ministry’s decision to break its silence was driven by the fact that the media had amassed too much evidence that the actual number of infections and deaths was much higher: “The minister realized that a catastrophe was brewing. And it threatened defeat. [He] had to play to get ahead so as not to become responsible for this entire nightmare. Now he’s the person who spoke the truth first and actually became the reason for the Kremlin’s involvement.” According to Kurbanov, he requested an interview with the minister through the press service and convinced him to speak on an Instagram livestream. The fact that Kurbanov had appeared on state-owned television, as an expert on talk shows hosted by Vladimir Solovyov and Artem Sehynin, may have helped.

Quotes from this interview spread across Russian state media, even among those that denied that the number of COVID-19 victims in the country had been underestimated. “In Dagestan, 40 doctors died of the coronavirus — 40 DOCTORS,” wrote RT’s Editor-in-Chief, Margarita Simonyan. “I really don’t want to believe that this is true.”

The Health Ministry quickly attempted to clarify that this number referred to doctors who had died during the coronavirus pandemic, for various reasons (not just due to COVID-19). Then, on May 18, President Vladimir Putin held a video conference with Dagestani Governor Vladimir Vasilyev, the Chairman of the republic’s People’s Assembly Khizri Shikhsaidov, and the Mufti of Dagestan Akhmad-Khadzhi Abdulayev. During the meeting, Vasilyev assured the president that the problems with personal protective equipment for healthcare workers had been resolved. He also said that in 2018 and 2019, more than 1,300 people died in the republic due to respiratory illnesses each year. As such, it is impossible to include all deaths from community-acquired pneumonia in the coronavirus infection statistics automatically. In the majority of cases, it’s impossible to establish the exact cause of death, Vasilyev said, since only three percent of Dagestanis will allow an autopsy of the deceased.

The Mufti lamented overcrowding at local hospitals and the republic’s high death rate: according to his data, more than 700 people had died, including around 50 medical workers. “But the problem is that these are only the confirmed cases of deaths in hospitals,” Abdulayev said. “No one is collecting statistics on people who are dying from the disease in their own homes. They die, they are buried according to customs, and no one counts them.”

The People’s Assembly Chairman, Shikhsaidov, told Putin that Dagestanis are grateful to the president, and asked him, on their behalf, not to delay the adoption of the amendments to the Constitution.

Immediately after the meeting, Putin ordered the Russian Defense Ministry to set up a 1,600 bed mobile hospital in Dagestan within two weeks. 

Why did the epidemic hit Dagestan so hard?

Ruslan Kurbanov has cast doubts even on the increased mortality figures: “For all of these one and a half to two months, Dagestan got by thanks to the instant mobilization of communities that bought medications and medical equipment during a situation of complete collapse and chaos of the Health Ministry's lower structures. They possess real information. We set up a broadcast with representatives of all the major peoples of Dagestan — the Avars, Dargins, Kumyks, Laks, Lezgins, — and each one had statistics on their villages.” Therefore, he says, there is a reason to say that “even the figures provided by the minister, which frightened Russia, are three times underestimated.” He also confirms what Mufti Abdulayev said during his meeting with Putin: “In many villages there are no hospital, or even paramedic stations, people die quietly at home and they are buried immediately according to Muslim tradition, without autopsies.”

Rospotrebnadzor head Anna Popova also voiced statistics during the meeting with Putin that confirmed serious problems with the infection rates in Dagestan. According to Popova, the largest wave of the epidemic hit the republic from April 23 to May 5–6, when the infection rate doubled. Moreover, Popova claimed that if on average the proportion of coronavirus patients with pneumonia across the country is 20 percent, in Dagestan it’s 60 percent. In contrast, the number of identified asymptomatic carriers is significantly lower, just 25 percent compared to 45 percent countrywide. On average, in Russia about 10 to 12 percent of people tested are infected with COVID-19. In Dagestan, it’s more than 35 percent.

In Ruslan Kurbanov’s opinion, the underestimated statistics played a significant role in residents’ mass non-compliance with the self-isolation rules, which representatives of the Health Ministry and the republic’s governor are complaining about. “These figures — 15 or 20 dead — sounded on television screens and led people towards a monstrous misconception. When officials talked about the dangers of the virus, but the number of victims remained practically unchanged, Dangestanis, who don’t trust the authorities already, said ‘you are scaring us, the mortality rate is low, and we need to feed our families.’ And they continued to go to work, violating the self-isolation regime, and spreading the infection.” According to Kurbanov, the main complaint that residents have of the leadership is that if the authorities had honestly admitted the real rate of infection and mortality, without the double statistics, this would have “sobered up Dagestanis much faster.” 

“Dagestanis are one of Russia’s most organized communities,” Kurbanov underscores. “In the past two and a half decades they have grown accustomed to relying on their own strength, expecting nothing from the government. They do not apply to state banks for credit, but instead offer each other loans. They do not appeal to the state courts, preferring to resolve everything at the level of amicable agreements or Sharia courts. They do not appeal to law enforcement agencies, but pursue justice themselves, as it is understood among them. They resolve any problems themselves: hunger, helping the needy, purchasing medicines and personal protective equipment. So for Dagestanis, it was somewhat easier to mobilize themselves than for others, regardless of the gravity of the trial that weighs [on them].” 

P.S. What happened to the heroes of Meduza’s report on the epidemic in Dagestan?

The heroes from Meduza’s report on Dagestan are continuing to adapt to life during the pandemic. Saniat Magomedova, who spoke with Meduza via What’sApp while hospitalized in an ICU, was released from the hospital on May 18 — and has returned there once again, this time as a doctor. Magomed Musayev, the acting head physician of the Khunzakhsky Central District Hospital, has reported a decrease in the flow of patients — and says that patients from neighboring regions could be offered the vacant places. According to the coordinator of one of the federal charitable foundations supplying the regions with PPE, they have received their first three official requests from hospital administrations in the past week and a half, along with spontaneous requests for assistance from doctors. 

The authorities in the Lak District removed quarantine checkpoints at the entrances to the village of Kara, where three residents were infected at “a small wedding of 400-500 people.” According to Meduza’s source among the village residents, the villagers in Kara now want to block the road themselves, to prevent townspeople and residents of the district from entering. The district has confirmed 28 cases of the coronavirus already. A WhatsApp group, where residents of the village agreed to report their temperatures twice per day, has turned into a forum for conversations and exchanging photographs.

On May 19, young men from Kara received summons to the district conscription office. There were plans to draft a total of 4,200 Dagestanis into the army this spring. “First they drove [us] into [our] homes, now they are asking everyone to gather in one place,” an indignant, elderly resident of the aul said in the WhatsApp group. “I told my daughters to keep their sons at home, they aren’t going anywhere! If they come to arrest them, let them take me. May Allah protect us from this infection and give a drop of reason to those who are on the [draft] commission.”