In Kazakhstan, like elsewhere in Central Asia, COVID numbers have been disputed. Image: Vladimir Tretyakov/Shutterstock

Part one, here, looked at COVID-19 in Iran and the Caucasus.

Russia

The Western press, rarely charitable to Russia, have described Moscow’s approach to the COVID-19 pandemic as “how not to do it.” Russia is currently reporting its highest ever level of infections, and although new case rates have at times been roughly on a par with those in the UK’s ‘third wave,’ death rates have been significantly higher. That’s widely reckoned to be due to low vaccination rates, an irony given that Russia has developed five different home-grown vaccines, including the single-dose Sputnik Light and the recently approved EpiVac. The most widespread of these is Sputnik V, one of the world’s first vaccines to be rolled out en masse, albeit somewhat prematurely bypassing some stricter testing protocols. Now generally considered safe and effective according to Nature, the key problem has not been the Sputnik vaccine itself but common public refusals to be vaccinated: a Levada Centre poll claims that 54% of Russians simply don’t want the jab at all. Russian sociologist Ekaterina Borozdina claims that such vaccine hesitancy “emerges in the context of fraught relations between citizens and the state” – that it’s a question of demonstrating personal choice rather than a question of doubting the science.

The result has been some of the worst death rates in Europe: 820 in one day on August 26, 2021, and over 179,000 officially recorded as COVID-19 related since the start of the pandemic. These large numbers are likely a considerable underestimate as the ‘excess deaths’ (the number of people dying over and above the statistical norm) is around 530,000. The Russian government has tried compulsory vaccine measures in Moscow, made a failed attempt to have employers require and further incentivize vaccination, and is now proposing rewarding vaccine uptake through a prize lottery. Russian scientists are also investigating a novel alternative to injection with a ‘ryazhenka’ vaccine made from pro-biotic modified lactic acid that could be ingested as a drink or as a food additive based on baked, fermented milk.

More specific to Russia’s Caspian region, Dagestan suffered a particularly catastrophic loss of trust in May 2020 when a local health minister revealed that some 40 medics had died of COVID-19. The announcement led many to doubt the official figures for the region. Since April, the republic had only registered 36 COVID-19 deaths, categorizing some 600 other deaths accurately yet misleadingly as pneumonia. The pneumonia had almost certainly been a result of COVID-19. Cases diminished later in 2020 and stayed reasonably manageable in early 2021 but have surged in the republic during July and August. At one point, daily deaths hovered at around 16 people out of a population of around 3 million.

One video purporting to show doctors treating COVID-19 patients in a Makhachkala hospital suggests that leeches were being tested as part of the procedure.

Cases also spiked in Kalmykia in late July 2021, with five deaths on the worst day – an alarming number in a republic with a total regional population of barely 270,000. The latest data suggests around 1600 active cases. Though the infection rate is falling slightly, weekly new cases are averaging 246 per 100,000, with a total of 521 having died of Covid in the republic since March 2020 (as of August 26, 2021). That’s still somewhat worse than neighbouring Astrakhan oblast, with 199 per 100,000 inhabitants.

Turkmenistan

Infamously secretive and with minimal international journalistic presence, it is impossible to get a complete picture of the situation in Turkmenistan. Statistics on cases and deaths are not published as it’s officially claimed that the country remains free of COVID-19 – a widely doubted claim, though journalists daring to contradict this have reportedly been jailed. There have been numerous deadly cases of ‘atypical pneumonia’ that appear to be precisely what might be expected with COVID-19. Despite ‘zero cases,’ the country started demanding mask-use in July 2020.

In December 2020, the IPHR (International Partnership for Human Rights) launched a social media campaign to persuade Turkmenistan to be more open with its COVID-19 statistics. The photo shows Ashgabat’s “giant tripod,” topped by a golden statue of the country’s former president that once rotated through the day to face the moving sun.

Since then, it appears that the country has taken a radical approach to ensuring the virus stays beyond its borders, with virtually all international flights cancelled. The flight ban was initially announced to be just until April 20, 2020, but – except a few high-level delegations such as the heads of state meeting in Awaza – visiting Turkmenistan has been essentially impossible for well over a year. Locals, or those permitted to enter from abroad, are generally funnelled via Türkmenabat/Chardzhou, where there are medical checks. Turkmenistan Airlines seems to be almost hibernating altogether, no longer posting its monthly tweet repeating that no flights are operating.

In late June 2021, the IBRD/World Bank approved a US$20 million loan to provide COVID-19 prevention, detection and response systems. This led, on August 14, 2021, to the WHO delivering lab equipment to help with COVID-19 testing, suggesting that this was to strengthen ‘preparedness,’ a neat wording that doesn’t openly contradict the fact that registered cases are still officially nil in Turkmenistan. Meanwhile, a citizen journalist was reportedly jailed for simply revealing that the WHO had been in Ashgabat discussing the COVID-19 situation.

Tajikistan & Kyrgyzstan

Plenty of skepticism has been levelled at Tajikistan’s COVID-19 numbers, too, even if the levels of denial don’t quite match Turkmenistan’s. The virus was first reported in Dushanbe in April 2020, and during that year, almost 13,000 cases (and 90 deaths) were recorded – figures considered by some sources to be a very serious underestimate. Skeptics were similarly doubtful when Covid was declared conquered on January 13, 2021, and no further cases were reported for over five months. On June 21, figures started being rereleased, and since then, there have officially been around 3100 infections. Many still believe this to be a vast underestimate. With the Taliban takeover across the border in Afghanistan, Dushanbe will likely have its energies distracted in the foreseeable future.

Kyrgyzstan has had ten times as many total cases as its southern neighbour (over 167,000), with 1136 of 2207 currently reported Covid-positive patients being hospitalized, according to reports on August 30, 2021. However, in terms of daily cases, the trend has been declining steadily since a peak approaching 1500 in late June. Despite sub-10% vaccination rates and lack of a lockdown, daily COVID-19 deaths are now into low single digits. Nonetheless, recognizing that the pandemic is far from beaten, the Bishkek cabinet is planning a working group to formulate a more consistent two-year COVID-19 response lasting into 2023.

Uzbekistan & Kazakhstan

On August 15, 2021, the virus claimed the life of Uzbekistan’s top cleric – 71-year-old grand mufti Usmonkhon (Usmankhan) Alimov marking another sad milestone in a very tough 18 months.

Early in the pandemic, Uzbekistan had appeared to be doing relatively well in keeping its COVID-19 cases low, though the use of crude container box huts to create makeshift quarantine camps was described by one report as creating virtual refugee camps for at-risk citizens. Amid strict lockdowns, nearly half a million Uzbeks returned from Russia, where that country’s pandemic-hit economy no longer needed so many migrant workers (up to 2 million Uzbeks typically work there). With so many on the move, many likely brought the virus with them, infecting each other at camps where they waited at borders to wend their way home. The result was a summer spike in cases that started when the first lockdowns were relaxed in June and lasted till autumn.

Uzbekistan’s vaccination programme has made relatively long strides, and of nearly 18 million doses so far imported into the country, around 75% have been the so-called “Sino-Uzbek shot.” Though produced in China, the vaccine was renamed to honour Uzbekistan’s help in its testing. That had been necessary since Chinese cases were so few at the start of the pandemic that the country lacked an appropriate environment of its own in which to test the product. Before the stage-three clinical evidence was complete, the Uzbek government deemed it safe and has since administered millions of doses, including to virtually the entire military. At the start of inoculations, side effects and long-term impact were not known for certain, and the fears of the vaccination-phobic might have been heightened recently when a video started circulating about a woman from Namangan in Uzbekistan’s Fergana Valley. The video claimed that she had lost her legs due to the jab – a report that was rapidly debunked as fake news. Meanwhile, Uzbekistan is pioneering an original new approach to immunization: a crafty edible vaccine that comes in the form of a genetically modified tomato that does the job without the need for a needle. At least that’s the idea – it’s still currently in the animal trial phase.

Could the tomatoes in Uzbek food be used to deliver a COVID-19 vaccine in a deliciously painless fashion? Image: Dmitriy Halacevich/Shutterstock

This summer, Kazakhstan reported a record number of cases, peaking in the first week of August. For much of the earlier pandemic, Kazakhstan's COVID-19 case reports had suggested a contrastingly low incidence of the virus. However, like elsewhere in Central Asia, the statistics are disputed. From the start of the pandemic up to May 2021, there appears to be an extreme discrepancy between the official numbers of COVID-19 fatalities (31.6 per 100,000) and figures for total ‘excess deaths’ (459.2 per 100,000).

Meanwhile, with over 11 million doses delivered, Kazakhstan’s vaccination process is well underway. Most of these doses are locally made versions of Russia’s Sputnik V, but since April 2021, the country has also been producing its own, home-grown QazVac (Qaz-Covid-in) jab. Developed by the government-run Research Institute for Biological Safety Problems, the vaccine has been celebrated as a triumph for Kazakh bioengineering. However, the (relatively small scale) rollout has come well before the results of the phase-three testing being made public. Botagoz Kaukenova, a doctor behind Medsupportkz (a social media group where doctors answer the public’s questions), expressed doubts about the responsibility of using QazVac without all the clinical trial data. July 11 saw the last experimental stage of these trials, but the full paper has not been published yet. Thus, a level of mystery still shrouds the vaccine’s efficacy. As has been the case with other new inoculations, that lack of concrete information is likely to increase hesitancy.

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