Russia has defended its process for recording coronavirus deaths as “exceptionally precise,” despite reports that reveal significant undercounting by officials who attributed over half of coronavirus patient deaths to other causes, The Guardian reports. Moscow’s health department last week released data that showed 1,700 more deaths in April compared to the city’s average over the past five years. “One thing is clear: The number of COVID-19 victims is possibly almost three times higher than the official toll,” Tatiana N. Mikhailova, senior researcher at the Presidential Academy of National Economy and Public Administration in Moscow, told The New York Times.

The country’s unusually low coronavirus death count is due to doctors registering deaths of coronavirus patients to “alternative causes,” which is “the infectious onset is a catalyst for the rapid progression of chronic diseases,” Meduza reported. In countries such as the United States, Italy, and the United Kingdom, anyone who dies after testing positive for the coronavirus—even if the individual had other health complications—is included in the official death count. Russian officials on Wednesday said it has performed autopsies on all coronavirus patients “in contrast to most other countries.”