Moscow’s health department hit back at media reports that it was underreporting Covid-19 fatalities, saying its data was “absolutely open,” but acknowledging that it only counts deaths that were found through postmortem autopsy to have been caused directly by coronavirus complications. In a statement Wednesday, the Moscow health department said authorities conducted autopsies on 100% of suspected coronavirus victims and confirmed that 639 people died directly of coronavirus complications in April. “In other cases, it’s impossible to put Covid-19 as the cause of death,” the health department said in a statement Wednesday, acknowledging the April spike in mortality rates. “In more than 60% of [suspected] cases, deaths were caused by obvious alternative causes, such as heart failure, stage four malignant diseases, leukemia … and other incurable deadly diseases,” it said. City health officials argue that a mandatory autopsy is performed on all patients with suspected coronavirus to establish diagnosis and cause of death “in contrast with the practice in most other countries,” adding: “Post-mortem diagnoses and causes of death recorded in Moscow are therefore extremely accurate, and mortality data is completely open. It is impossible to name the cause of death as Covid-19 in other cases.” CNN and other news outlets reported this week that Moscow saw a surge in mortality in April, according to civil register’s data. The city registered 11,846 death certificates that month, which is about 20% higher compared to a ten-year average of 9,866 deaths. The statistics in the Russian capital have come under scrutiny as observers note the comparatively low overall number of deaths in Russia – a total that currently stands at 2,305 according to Johns Hopkins University – even as the country takes second place in the world for the number of confirmed cases, over a quarter of a million. Russia has the second-highest number of cases behind the US, and Moscow is the country’s worst hit-city. According to official statistics, Moscow has seen a total of 1,290 deaths out of an official total of over 130,000 cases recorded as of Thursday, although Moscow Mayor Sergey Sobyanin has said the total number of people infected is likely higher, based on screening studies. The statement from the Moscow health authorities argued that even if all mortality figures for April in Moscow were adjusted to attribute more cases to coronavirus, the overall mortality rate from Covid-19 infections would be far lower than the official mortality rates in New York and London.