More than half of Moscow’s deaths of coronavirus patients are not being included toward the overall death toll, according to a report in The Moscow Times, citing city officials.

The officials reportedly said more than 60 percent of patient deaths from “alternate causes” have not been recorded in the COVID-19 death toll, according to news outlet.

“Over 60 percent of deaths occurred from obvious alternate causes, such as vascular accidents, stage 4 malignant diseases, leukemia, systemic diseases linked to organ failure and other incurable deadly diseases,” Moscow’s Health Department said in a statement to the newspaper. 

Moscow has seen a lower mortality rate compared with other major world capitals, causing critics to say the reported numbers should be doubled. 

The city reported 1,232 deaths out of 126,004 infections as of Wednesday, according to The Moscow Times. 

Data released by Moscow’s civil registry office, first published by The Moscow Times, showed 20 percent more fatalities in April than the average April mortality rate over the past decade. The newspaper noted the jump in deaths could be linked to COVID-19. 

The health department told the newspaper it is “incorrect to compare monthly death rates.” The department also refuted claims that it was underreporting its coronavirus deaths. 

Nationwide, Russia has reported 252,245 confirmed COVID-19 cases and reported just 2,305 deaths, based on data compiled by Johns Hopkins University. 

By contrast, countries that have reported just slightly less confirmed cases, have reported far more deaths. For example, the U.K. has reported 230,985 confirmed COVID-19 cases and 33,264 deaths, and Spain has reported 228,691 cases and 27,104 deaths, based on the Johns Hopkins data. 

Globally the virus has infected more than 4.3 million and killed 287,682, based on the same database.