By Polina Nikolskaya, Anton Zverev and Rinat Sagdiev
MOSCOW (Reuters) - Russia has conducted around 10% fewer COVID-19 tests so far this month than the same period a month ago, despite a surge in recorded infections, official data shows, raising questions over authorities' ability to control the spread.
Beyond affluent Moscow, people with COVID-19 symptoms can wait days to be tested and doctors sometimes refuse to test them altogether, according to Reuters interviews with patients, doctors and officials in 11 regions.
Rospotrebnadzor, the сonsumer health watchdog, ordered an increase in testing on Nov. 16 yet the number of tests conducted in the first half of December fell by 825,000, or 11%, compared with the first half of November, Reuters calculations using official data showed.
Rospotrebnadzor has since Nov. 16 allowed medical workers not to test people who have had contact with infected people but have no symptoms themselves, which analysts said could account for some of the decline.
The health ministry, Rospotrebnadzor and the national coronavirus crisis centre did not respond to requests to comment on the reason for the drop in testing.
Two local officials and a doctor from the Central, Povolzhsky and Nizhny Novgorod regions respectively told Reuters on condition of anonymity that healthcare workers in the regions had been informally instructed by their managers or the local government to reduce testing due to a shortage of doctors.
The official from the Central region said doctors were required to refer patients with flu-like symptoms for testing under official rules but that in practice that was "impossible" due to the sheer numbers.
COVID-19 cases in Russia have surged since September, climbing to a record one-day high of over 29,000 on Dec. 6.
The Kremlin has resisted a second strict lockdown, saying measures in some regions limiting gatherings and mandating remote learning and work where possible and self-isolation for the elderly are enough.
'MORE TESTS MEANS MORE CASES'
Russia, the ninth biggest country by population, has reported more than 2.7 million cases, the world's fourth-highest tally, and 47,968 deaths.
There were almost 50,000 more deaths recorded across Russia in October alone than in the same month last year, according to the state statistics service Rosstat. The Kremlin said the data required deep analysis.
Alexei Raksha, a demographer and a former adviser at the Federal State Statistics Service, said he believed the real COVID case figures were 10-15 times higher, basing his estimate based on various government data and search query statistics.
"All the official data on recorded cases can be thrown in the trash," he said.
Boris Ovchinnikov, an analyst at research firm Data Insight, said he believes the reduction in testing is one of various tools used by authorities to "manage" the statistics.
"More tests means more cases," he said.
Russia says it discloses all COVID-19 cases that it confirms in laboratories - considered the most reliable method. It is not the only country where people have reported difficulties accessing tests, but most are stepping up testing, seeing it as vital way to detect and limit the spread of the virus.
In Gusev, a town in western Russia, Margarita Yakutenko said she, her 56-year old mother, husband and three children all developed COVID-19 symptoms last month, but that medics declined to test them, referring them to their GP for regular treatment.
Her mother rapidly deteriorated and had a fever of 40 degrees, but was only tested on the eighth day of her illness when the hospital agreed to scan her lungs and diagnosed her with pneumonia, she said.
Her mother tested positive, was hospitalised and remained there weeks later. Her husband was tested 10 days after falling ill and his result was negative; the rest of the family were never tested, Yakutenko said.
In a village in Lipetsk region, Svetlana, a cleaner who declined to be identified by her surname, said doctors refused to test her even though she had a fever, cough and had lost her sense of smell - the three key symptoms of COVID-19.
She paid 1,300 roubles ($18) out of her 10,000 rouble monthly salary to be tested privately and her result came back positive.
($1 = 72.9800 roubles)