Russia’s second-largest city St. Petersburg has registered 10 times the number of community-acquired pneumonia cases in May 2020 than it did in May 2019, according to official data.

The surge comes as St. Petersburg’s health authorities began reporting a drop in new coronavirus infections from 300 per day earlier in July to fewer than 200 this week. In June, city officials recorded a 10-year spike in deaths amid persisting questions over Russia’s relatively low Covid-19 mortality rate compared to other hard-hit countries.

According to its statistics office, St. Petersburg recorded 9,560 cases of community-acquired pneumonia this May, or 9.9 times more than last May.

Overall, its 20,537 community-acquired pneumonia cases in January-May were almost three times higher than the number of cases in January-May 2019.

Health officials linked the surge in community-acquired pneumonia to the coronavirus outbreak, saying the infection is the main complication from Covid-19.

“Not all patients with community-acquired pneumonia had Covid-19 confirmed by lab tests,” St. Petersburg’s health committee told the local Fontanka.ru news website. 

St. Petersburg has moved to lift Covid-19 restrictions since early June and plans to reopen restaurants and shopping malls from Monday.

The city is Russia’s third-most affected locale amid the pandemic, with 30,281 confirmed cases and 1,908 deaths as of Friday.

Russia has officially confirmed more than 800,000 cases, the world’s fourth-highest number of infections, with its daily caseload dropping to fewer than 6,000 in recent weeks.