The definition of COVID-19 cases and suspected cases has been officially disseminated to all health institutions through the “Preliminary guidelines on the prevention, diagnosis and treatment of COVID-19” first published by the Ministry of Health on 29 January (v.1), and updated on 3 June (v.7) (http://static.consultant.ru/obj/file/doc/minzdrav_030620.pdf):
1. Definition of a suspected case: presence of clinical manifestations of acute respiratory infection (temperature above 37.5 and one or more of the following symptoms: cough, shortness of breath, blood oxygen saturation (SpO2) ≤ 95%, sore throat, runny nose, loss of smell, loss of taste, conjunctivitis, weakness, headache, muscle pain, vomiting, diarrhoea, skin rash), in the absence of other known causes that explain the clinical picture without epidemiological history
2. Definition of a probable case:
a) Clinical manifestations of acute respiratory infection (as described above), in combination with the following epidemiological history:
- return from a trip abroad 14 days before the onset of symptoms
- close contact with persons under medical surveillance for COVID-19 over the past 14 days if the person became symptomatic
- close contact history with a laboratory confirmed COVID-19 case over the past 14 days
- professional contact with confirmed or suspected COVID-19 cases
b) Clinical manifestations of severe pneumonia with characteristic lung alterations confirmed by CT scan even if there is no laboratory test confirmation and no epidemiological history
c) Suspicious case of COVID-19 when laboratory tests cannot be performed.
3. Definition of a confirmed case: laboratory test by polymerase chain reaction (PCR) positive, regardless of presence or absence of clinical manifestations
On 2 April, the Ministry of Health launched a centralized information system of patients with laboratory confirmed COVID-19 infection, hospitalized patients with signs of pneumonia, and their contacts. The data is collected from all medical organizations, regional branches of the Federal Biomedical Agency, the Ministry of Communications and the Ministry of Transport. At the federal level, information is anonymized. At the regional level, it is available for prompt decision-making by medical organizations. Moscow authorities have developed a smartphone app to monitor the movement of coronavirus patients (and people with COVID-19 symptoms) in self-isolation, which is used in conjunction with a network of tens of thousands of cameras installed with facial recognition software. Murmansk region uses electronic bracelets to monitor the movements of coronavirus patients who are self-isolating at home as well as people who are suspected of having coronavirus. On 9 July, a draft legal act establishing a contact tracing procedure based on mobile phone data and geolocation was proposed by the Ministry of Communication and is now under review (https://regulation.gov.ru/projects#npa=105648).
Inspections of specific facilities have been carried out to better understand localized COVID-19 outbreaks. In July, such inspections of orphanages and kindergartens resulted in providing them with more PPE and other necessary equipment (https://genproc.gov.ru/smi/news/genproc/news-1874594/)
At the end of May, the MoH and Moscow region started to increase communication about the methods used for registering the causes of death in the context of the COVID-19 outbreak. On 27 May, MoH guidelines for coding the main cause of death in mortality statistics associated with COVID-19 were published (https://static-1.rosminzdrav.ru/system/attachments/attaches/000/050/527/original/27052020_MR_STAT_1.pdf). The Mayor of Moscow communicated on the new approach to death classification in Moscow and on the large database of chest CT examinations carried out on suspected COVID-19 cases (https://www.pnp.ru/social/v-moskve-razrabotali-detalnuyu-klassifikaciyu-prichin-smertnosti-pri-koronaviruse.html?utm_source=pnpru&utm_medium=story&utm_campaign=main_page). Since June and with some delay, Rosstat publishes the monthly number of people who died with COVID-19, and official numbers on death from COVID-19 will include only those for which it was the main cause of death.