Russia hit a grim Covid-19 milestone this week: According to Johns Hopkins University, the country now ranks second in the world for confirmed coronavirus cases.

The Russian capital has been hardest hit. Of Russia’s total of 272,043 confirmed cases, around half — 138,969 — are in Moscow, according to the country’s coronavirus headquarters. But the virus is now spreading across Russia’s regions, an enormous landmass that covers 11 time zones and includes some of the country’s most remote and impoverished places.

In a video conference meeting on Monday with Russia’s 85 regional heads, Russian President Vladimir Putin said the burden would fall to local leaders to decide whether to continue lockdown measures or to begin cautiously lifting restrictions to reopen the economy.

“We have a big country,” he said. “The epidemiological situation varies across the regions. We factored this in before, and now at the next stage, we have to act even more specifically and carefully.”