The anatomy of COVID mortality in Russia's regions, 2020–22.

Counterfactual estimates of excess deaths in Russian regions in the period 2020–21 are compared with officially reported COVID deaths to analyse underreporting. COVID mortality levels at the end of years 2020 and 2021 as well as annual growth during 2021 and the first half of 2022 reveal that COVID is a real threat to high labour productivity regions and those with relatively bigger defence and civilian sectors. Corruption lowers COVID mortality growth, suggesting a public health system where better care is obtained informally. Improved access to a doctor just before the pandemic lowered the level of mortality during the worst year (2021) but did not impact the mortality growth or the mortality level in 2020. Better prevention of any virus including COVID in the future would include more regionally decentralised vaccine and testing initiatives to boost compliance plus a fundamentally reformed health system that includes access to foreign-made vaccines and higher quality mortality data. [ABSTRACT FROM AUTHOR]