Policy responses for Russian Federation - HSRM

Russian Federation

Policy responses for Russian Federation

1.4 Monitoring and surveillance

The definition of COVID-19 cases and suspected cases has been officially disseminated to all health institutions through the “Temporary guidelines on the prevention, diagnosis and treatment of COVID-19” first published by the Ministry of Health on 29 January 2020 (v.1) followed by a number of updates. On 8 February 2021, the 10th revision was published (https://static-0.minzdrav.gov.ru/system/attachments/attaches/000/054/588/original/%D0%92%D1%80%D0%B5%D0%BC%D0%B5%D0%BD%D0%BD%D1%8B%D0%B5_%D0%9C%D0%A0_COVID-19_%28v.10%29-08.02.2021_%281%29.pdf):

A suspected case of COVID-19 is identified by 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 independent of epidemiological history

A probable (clinically confirmed) case of COVID-19 is defined by:
1) 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 observation for COVID-19 over the past 14 days, who subsequently fell ill
- close contact history with a laboratory confirmed COVID-19 case over the past 14 days
- professional contact with confirmed or suspected COVID-19 cases
2) Clinical manifestations (as described above in (1)) in combination with characteristic lung alterations confirmed by CT scan regardless of the results of a single laboratory test for the presence of SARS-CoV-2 RNA and no epidemiological history;
3) Clinical manifestations (described above in (1)) in combination with characteristic changes in the lungs according to imaging scans (see (2) above) if it is impossible to conduct a laboratory test for the presence of SARS-CoV-2 RNA.

A confirmed case of COVD-19 is identified by:
1) a positive laboratory test result for the presence of SARS-CoV-2 RNA using nucleic acid amplification methods (NAA) or SARS-CoV-2 antigen using immunochromatographic analysis, regardless of clinical manifestations.
2) a positive result for IgA, IgM and / or IgG antibodies in patients with clinically confirmed COVID-19 infection.

Medical facilities that have identified (or suspect) a case of COVID-19 are obliged to record it using a dedicated information resource in accordance with Federal Decree No. 373 (31 March 2020, as amended 5 June 2020) "On the approval of temporary rules for recording information in order to prevent the spread of a novel coronavirus infection (COVID-19)" (https://www.garant.ru/products/ipo/prime/doc/73733762/).

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 2020, the Federal Statistics Service (Rosstat) has been publishing the monthly number of people who died with COVID-19. According to Rosstat data of 8 February 2021, the number of deaths from all causes in 2020 was 2,124,500; this is by 17.9% higher than in 2019 (https://rosstat.gov.ru/storage/mediabank/TwbjciZH/edn12-2020.html).

The Russian Consortium of coronavirus genome sequencing, led by the A.A. Smorodintsev Influenza Research Institute under the Ministry of Health, sequenced 1547 whole-genomes of SARS-CoV-2 viruses circulating in the Russian Federation. 56 regions were covered by genetic surveillance. In February 2021, the genetic line B.1.1 and its derivatives predominated - 89% of all circulating strains (https://www.influenza.spb.ru/news/id594/).