Muscovites are dying from extreme heat and smoke faster than their bodies can be stored, cremated or buried, and Russians are worried the death toll could be far higher than the official count.
Morgues are overflowing and one crematorium in the Russian capital is working around the clock in three shifts, according to staff, even as the health ministry disputes a senior doctor's statement that the monthly death toll doubled in July.
In Mitino on Moscow's northwest, a note at a crematorium warned that it was not accepting any new orders for cremation.
The crematorium's four furnaces are currently "processing" 49 bodies per day, with cremations every 20 minutes, according to a timetable available at the reception.
"Furnaces overheat in these temperatures, and we have to cool them," Vladimir, a security guard, told Reuters. "In practice, there are up to 80-90 cremations per day, and the crematorium's teams work in three shifts day and night to cope."
The Khimkinskoye cemetery in northern Moscow was packed with funeral buses, with a dozen burial ceremonies taking place.
"Since this heat nightmare started ... there has been a drastic increase in funerals over the past two months, two or three times above the average," a cemetery worker said.
As the scorching heat sets new temperature records almost daily and a thick acrid smog from forest fires chokes the giant city of over 10 million, the question of the real number of heat-induced deaths has become a political issue for Muscovites.
Official data show at least 52 people have died in severe fires raging in parts of European Russia in the past few weeks.
But there are no statistics referring to Moscow, amid some media reports that the city's paramedics are told not to include "heat stroke" in death records "to avoid panic."
But the head of the city's health department Andrei Seltsovsky said Monday that deaths had almost doubled to 700 daily, with heat being the main killer.
"The average death rate in the city during normal times is between 360 and 380 people per day. Today, we are around 700," Seltsovsky told a city government meeting.
He said heat stroke was the main cause of the recent increase in deaths. Ambulance dispatches in Moscow were up by about a quarter to 10,000 a day and problems linked to heart disease, bronchial asthma and strokes had increased, he said.
The Health Ministry criticized Seltsovsky, saying it was "bewildered by these unofficial figures" and that Moscow's death rates had actually fallen in January-June.
Health Minister Tatyana Golikova told a news conference that the heavy smog with the severe heat was "a real test" indeed for Moscow's residents with vascular and heart diseases. But she said she had no data about a rise in Moscow's death rates
Acrid smog blanketed Moscow for a sixth straight day Monday, with concentrations of carbon monoxide and other poisonous substances two to three times higher than what is considered safe. Those airborne pollutants reached a record over the weekend — exceeding the safe limit by nearly seven times.
About 550 separate blazes were burning nationwide Monday, mainly across western Russia, including about 40 around Moscow, according to the Emergencies Ministry. Forest and peat bog fires have been triggered by the most intense heat wave in 130 years of record keeping.
Alexander Frolov, head of Russia's weather service, said judging by historic documents, this heat wave could be the worst in up to 1,000 years.
"Our ancestors haven't observed or registered a heat like that within 1,000 years," Frolov said at a news conference. "This phenomenon is absolutely unique."
He said the heat in Moscow reflects the global climate's increased volatility.
No respite aheadDaily highs have reached up to 100 degrees Fahrenheit, compared to the usual summer average of 75 F. And, according to the forecast, there will be no respite this week.
Diarmid Campbell-Lendrum, a climate change and health expert at the World Health Organization in Geneva, said deaths could certainly double with higher temperatures alone — a phenomenon seen during Europe's 2003 heat wave.
"The impacts tend to be more severe in places that are not used to these kinds of temperatures," he told The Associated Press. "These temperatures wouldn't be out of place in the southern U.S. or Australia, but in Russia, the infrastructure is not used to these temperatures and the risk of death will increase."
Few apartments in Moscow have air conditioning and the city's overcrowded subway is poorly ventilated.
Campbell-Lendrum said it would be difficult to pinpoint whether the majority of new Russian deaths were due to the heat or to the smog, but said there was no question the combined effect was dangerous.
He said elderly people and those with health conditions like heart or lung problems were most at risk, but with extreme conditions, there could also be a spike in deaths of otherwise healthy people. He said the increased deaths would likely continue for as long as the heat wave persists.
Many Muscovites have been braving their trips to work, wearing facemasks to try to filter the smoke, but the masks were increasingly hard to find and some doctors raised concerns about an official whitewash of the real impact of the smoke in Moscow.
An unnamed doctor at a Moscow clinic wrote on his Internet site over the weekend that he was wary of diagnosing patients with heat- and smoke-related illnesses for fear of dismissal.
Another doctor at a major hospital, speaking on condition of anonymity, told Reuters on Sunday that senior management had instructed staff not to link patients' illnesses with the heat.
Not enough firefightersAt least 52 people have died directly in the wildfires and over 2,000 homes have been destroyed. Flights to Moscow have been delayed and diverted.
Russian authorities have acknowledged that the 10,000 firefighters battling the blazes aren't enough, and sent thousands of soldiers to help fight the fires.
Wednesday's international soccer match between Russia and Bulgaria was moved from Moscow to St. Petersburg, 370 miles to the northwest, due to the smog.
The severe drought and wildfires have destroyed 20 percent of Russia's wheat crop, prompting the government last week to introduce a ban on grain exports for the rest of the year. The news drove the price of wheat, which has already jumped 70 percent on world markets this summer, even higher.
On the Russian blogosphere, one of the country's last outposts of unfettered expression, the mood was bleak and angry that the situation had become so serious. One blogger on the popular LiveJournal site suggested that Prime Minister Vladimir Putin, Moscow's mayor and other top officials be fired for not stopping the fires. Another LiveJournal blogger said the polluting haze had prompted her to quit smoking.
Others focused on immediate issues — like getting a good night's sleep.
"Every night it's like we prepare for war," blogger Tsirtsis wrote on the independent newspaper Novaya Gazeta's Web site. "With open windows, it's impossible to breathe because of the burning, and with closed windows we choke in the stifling heat."