MOSCOW — As Russia begins a week-long nationwide vote on constitutional changes that could keep President Vladimir Putin in power until 2036, the official line is that the coronavirus pandemic has retreated, Russia’s health system coped just fine, and that it is now safe to vote and go to gyms, restaurants, shops and hair salons.

But sometimes information slips out, telling a more dire story for Russians grappling with mixed messages: the Kremlin’s upbeat assessments versus statistics showing that Russia’s confirmed cases of the novel coronavirus are still climbing.

When infectious-disease doctor Victoria Adonyeva predicted in a newspaper interview that the nationwide vote would cause a spike in new cases, many readers applauded her honesty.

Adonyeva, chief infectious-disease specialist of the Orlovskaya region, about 220 miles south of Moscow, also called into question the accuracy of Russia’s statistics on coronavirus deaths — now at 9,152 — in the interview with the Orlovsky Novosti newspaper.

“The numbers are going up. There’s no plateau,” she said. “What kind of stabilization, what kind of lifting of restrictions can we talk about?” Her hospital and others in the city of Oryol had no free beds, she added.

Authorities push back

But prosecutors swiftly called her in for questioning. No reason for the summons has been given, but other people who contradicted the official line have been called under a law against “fake news” on coronavirus information, which carries a penalty of up to six years in prison. Local officials fell over themselves to contradict her.

The regional governor, Andrei Klychkov, blamed a journalist at the newspaper for “misinterpreting” the specialist’s words, although the interview was published as a question-and-answer transcript.

Under pressure, Adonyeva herself was soon trying to backtrack.

A similar boomerang effect came after the startling admission earlier this month from Alla Samoilova, an official from Russia’s Federal Service for Surveillance in Health Care, that 489 Russian medical staff had died of the disease caused by the coronavirus, covid-19 — some 6 percent of the country’s official death toll. The agency swiftly backtracked, saying the figure was “unofficial,” even though the number was broadly in line with a memorial list of health-worker deaths maintained by doctors, which had 496 names on it by Wednesday.

Putin is not alone among leaders trying to portray the pandemic as a fading threat. But, as in other countries, the crisis has laid bare some hard truths.

In Russia — where more than 640,245 confirmed cases represent the third-largest caseload after the United States and Brazil — the pandemic also has dented Putin’s image just when he wanted it in top shape with voting ending July 1 on the constitutional changes, which include allowing Putin to seek two more terms after his current one ends in 2024.

Questions over death count

Questions have been raised about possible manipulation of statistics on covid-19 deaths, fiercely denied by officials. The uneven medical care has exposed the entrenched inequality between wealthy cities and remote poorly serviced regions where health services have been cut.

In some places, ventilators were broken, lacked parts, malfunctioned or even caught fire. Medical staff have walked off the job at some hospitals over lack of protective equipment.

Although Russia has succeeded in decreasing the daily percentage increase in cases, new infections keep rising stubbornly, adding more than 7,000 cases a day.

In an address to the nation Tuesday, Putin said the health system has coped well, thanks to the government’s work to improve and better equip hospitals. While the danger was not fully over, he said Russians have “forced the epidemic to recede.”

“We are overcoming it,” Putin said. “But the virus is still dangerous: Thousands of people still encounter this disease daily. I am asking you to remain careful, vigilant and cautious.”

But Adonyeva told the Orlovsky Novosti newspaper that the Russian health statistics were in a state of disorder, with many regions omitting deaths of patients with covid-19 from the count unless there was severe respiratory tract damage.

She said the nationwide vote on the constitutional changes would inevitably cause an increase in cases. “But we have nowhere to put them,” she said, referring to her hospital and others in Oryol.

“If growth continues, there will be no one to treat people,” she said in the interview published June 18. “Doctors treat people, but they themselves become ill and are unable to treat people. Doctors are already working to the limit.”

'Fake news' law

Authorities have imposed tough new penalties for those who post information about the pandemic deemed to be “fake news.” Dozens of doctors, journalists, medical union officials and activists have been targeted.

But health authorities have struggled with a credibility gap amid images that have surfaced during the pandemic of hospital beds in corridors and queues of ambulances.

Since 2012, Putin’s centralization of the health-care system closed many small, rural hospitals. Countrywide, medical staff declined by 9.3 percent to 1.3 million from 2013 to 2019, according to the Federal State Statistics Service.

Deputy Prime Minister Tatyana Golikova said in November that health-care reforms had failed in many regions. Anton Siluanov, now finance minister, said at that time that district hospitals and clinics were in “poor, if not terrible, condition.”

Activists, opposition figures and an independent health union have filled the information vacuum on the coronavirus. 

Alexei Minyaylo, who spent seven weeks in custody for participating in anti-government protests last summer, set up a civil society think tank, Razoom, and organized Zoom meetings with 67 experts from 16 Russian regions. Razoom also analyzed Russian and foreign scientific evidence to produce a report on what went wrong in Russia, and what could go wrong in the future.

“In European countries, we see a plateau, but in Russia we don’t see any plateau. So we started to think of what the society can do to cope with the situation because we really can’t rely on the government,” Minyaylo said. “They say that there is really not a lot of deaths, but when we dig into the statistics, we find that a lot of deaths from coronavirus are hidden as deaths from pneumonia,” he said.

Activists step in

The report identified more than 200 cases of official pressure on journalists and activists exposing information about the pandemic.

Dmitry Kolezev, editor of independent online news site Znak based in Yekaterinburg, Russia’s fourth-largest city, said the region had one of the highest rates of covid-19, but that many pneumonia patients had told him they were unable to get tested for the coronavirus. This suggested that statistics on covid-19 cases and deaths were unreliable, he said.

“They wanted to be tested, but either they had to wait for a long time, or tests are just not done,” he said. “Unofficially, according to our sources in the administration and also from patients, we know that there are not enough vacant beds in hospitals.” Some patients were being discharged before they recovered, he added.

The mortality figures, he said, have led many people to let down their guard. At the same time, Putin’s government is appealing for a high turnout in the constitutional vote.

“People are very relaxed. They get together in the streets; they’re outside today, or in gyms that started working. They meet in groups, and it seems to me this is because the statistics they are given about infections are low.”