Russia, spanning two continents ravaged by the coronavirus pandemic, remains an anomaly: a population of around 145 million, but just 495 confirmed cases of the disease and one possible death, though the cause has been disputed.
But the statistics have prompted skepticism - of both the method of testing and whether a nationwide uptick in pneumonia cases could be, as some doctors and government critics believe, linked to covid-19.
President Vladimir Putin said last week that "the situation in our country looks a lot better" than Europe and was "under control." But visiting one of Moscow's coronavirus hospitals Tuesday, state television showed Putin wearing a full hazmat suit.
Two hours earlier, Moscow's mayor told him that the number of cases is likely much higher than what has been reported because of limitations in testing.
"The testing volume is very low and nobody knows the real picture," said Moscow's mayor, Sergei Sobyanin.
Moscow saw a 37% increase in pneumonia in January compared to a year ago, according to Rosstat, Russia's statistics agency. The data showed 6,921 pneumonia cases in January, up from 5,058 in the same period in 2019.
"While the whole world is facing an outbreak of a new coronavirus, Russia is facing an outbreak of a community-acquired pneumonia. And, as usual, we're facing the lie of the authorities," Anastasia Vasilyeva, president of an independent trade union called the Doctors' Alliance, said a YouTube video that made headlines last week.
Vasileyeva, an ally of opposition leader Alexei Navalny, said in a phone interview that it remains unclear how many of the pneumonia cases might actually be linked to the coronavirus. Her claims, she said, stem from consultations with medical professionals in doctors's union, which has divisions in 40 regions across Russia.
At issue, she said, is that doctors treating patients with pneumonia don't wear the same heavy protective gear as those treating coronavirus in a special hospital for infectious disease.
Russian authorities have denied Vasilyeva's assertions, and the Kremlin's southing messaging appears to be working. The deep worries and sweeping precautions in many parts of the world are relatively absent in Russia.
True, borders have been sealed, sporting events canceled and schools put on hold. But Russia has held back on large-scale commercial closures, curfews and shelter-in-place orders.
Russia has even dispatched medical equipment, other aid and, according to the Kremlin, "teams of Russian specialists" to Italy, which has the highest death toll of the pandemic. The gesture was interpreted as Moscow's confidence in its low numbers are genuine and will remain.
Melita Vujnovic, the World Health Organization's representative in Russia, said the organization doesn't see anything to question the number of cases, praising the country for taking early preventive steps in closing its border with China in January and recommending two-week periods of self-isolation for anyone entering the country from a coronavirus hub.
The country has administered nearly 186,000 coronavirus tests, its consumer health watchdog said Tuesday. Separately, 94,000 people are under medical observation, but it's unclear if they've all been tested for the covid-19. A 79-year-old woman is the only person in Russia whose death was attributed to covid-19 in Russia, though Moscow authorities say she died from a blood clot, so it shouldn't be counted as a coronavirus fatality.
Sobyanin, the Moscow mayor, said Tuesday that two coronavirus patients are on ventilators and in critical condition. In a televised meeting with Putin, Sobyanin also cast doubt on Russia's official numbers, adding that Moscow might have 500 alone. As of Tuesday, the city has reported 290 cases.
"We see quite a lot of people who are staying at home and just not getting tested - people who have returned from abroad," he said. "They're feeling fine, thank G od. In reality, there are far more people who are infected."
Until this week, all of Russia's coronavirus tests went through a single laboratory in a suburb of Siberia's Novosibirsk, which is more than 2,000 miles away from Moscow and St. Petersburg, the country's most populous cities.
Moscow, which has more than half of the country's coronavirus cases, announced a change in that procedure Monday. Going forward, testing will be done within the city and a diagnosis can be given after a single positive test rather than awaiting confirmation from the Vector State Research Center of Virology and Biotechnology in the Novosibirsk region.
"How much biomaterial can be sent to one laboratory?" said Vsevolod Shurkhay, a doctor at a Moscow neurosurgery clinic. "It will simply drown. It is absolutely not possible."
PCR. News, a medical science publication, pointed out that the tests used by the Vector laboratory have a lower sensitivity than some others. The danger is that negative tests could come from patients in the early stages of the disease or those recovering but still contagious, the report said.
The WHO's Vujnovic dismissed concerns about the tests' sensitivity. If a test comes back inconclusive, she said, the lab repeats it to confirm the result.
"I do not think that at the moment there is any space for testing speculation about the quality," she said. "The WHO is working closely with the institute producing the test. . . . We are looking into the comparative and the quality of testing, and for the moment, there are no major concerns."