YEKATERINBURG, Russia — Patients with unexplained pneumonias started showing up at hospitals; within days, dozens were dead. The secret police seized doctors’ records and ordered them to keep silent. American spies picked up clues about a lab leak, but the local authorities had a more mundane explanation: contaminated meat.

It took more than a decade for the truth to come out.

In April and May 1979, at least 66 people died after airborne anthrax bacteria emerged from a military lab in the Soviet Union. But leading American scientists voiced confidence in the Soviets’ claim that the pathogen had jumped from animals to humans. Only after a full-fledged investigation in the 1990s did one of those scientists confirm the earlier suspicions: The accident in what is now the Russian Urals city of Yekaterinburg was a lab leak, one of the deadliest ever documented.

Nowadays, some of the victims’ graves appear abandoned, their names worn off their metal plates in the back of a cemetery on the outskirts of town, where they were buried in coffins with an agricultural disinfectant. But the story of the accident that took their lives, and the cover-up that hid it, has renewed relevance as scientists search for the origins of Covid-19.

It shows how an authoritarian government can successfully shape the narrative of a disease outbreak and how it can take years — and, perhaps, regime change — to get to the truth.

“Wild rumors do spread around every epidemic,” Joshua Lederberg, the Nobel-winning American biologist, wrote in a memo after a fact-finding trip to Moscow in 1986. “The current Soviet account is very likely to be true.”

Many scientists believe that the virus that caused the Covid-19 pandemic evolved in animals and jumped at some point to humans. But scientists are also calling for deeper investigation of the possibility of an accident at the Wuhan Institute of Virology.

There is also widespread concern that the Chinese government — which, like the Soviet government decades before it, dismisses the possibility of a lab leak — is not providing international investigators with access and data that could shed light on the pandemic’s origins.

“We all have a common interest in finding out if it was due to a laboratory accident,” Matthew Meselson, a Harvard biologist, said in an interview this month from Cambridge, Mass., referring to the coronavirus pandemic. “Maybe it was a kind of accident that our present guidelines don’t protect against adequately.”

Dr. Meselson, a biological warfare expert, moved into a spare bedroom in the home of a friend at the C.I.A. in 1980 to study classified intelligence suggesting that the Soviet anthrax outbreak could have been linked to a military facility nearby. Six years later, he wrote that the Soviet explanation of the epidemic’s natural origins was “plausible.” The evidence the Soviets provided was consistent, he said, with the theory that people had been stricken by intestinal anthrax that originated in contaminated bone meal used as animal feed.

Then, in 1992, after the Soviet Union collapsed, President Boris N. Yelstin of Russia acknowledged “our military development was the cause” of the anthrax outbreak.

Dr. Meselson and his wife, the medical anthropologist Jeanne Guillemin, came to Yekaterinburg with other American experts for a painstaking study. They documented how a northeasterly wind on April 2, 1979, must have scattered as little as a few milligrams of anthrax spores accidentally released from the factory across a narrow zone extending at least 30 miles downwind.

“You can concoct a completely crazy story and make it plausible by the way you design it,” Dr. Meselson said, explaining why the Soviets had succeeded in dispelling suspicions about a lab leak.

In Sverdlovsk, as Yekaterinburg was known in Soviet times, those suspicions appeared as soon as people started falling mysteriously ill, according to interviews this month with residents who remember those days.

Raisa Smirnova, then a 32-year-old worker at a ceramics factory nearby, says she had friends at the mysterious compound who used their special privileges to help her procure otherwise hard-to-find oranges and canned meat. She also heard that there was some sort of secret work on germs being done there, and local rumors would attribute occasional disease outbreaks to the lab.

“Why is it that your hands are blue?” Ms. Smirnova recalls a co-worker asking her one day in April 1979 when she went to work, apparently showing symptoms of low blood oxygen levels.

She was rushed to the hospital with a high fever and, she says, spent a week there unconscious. By May, some 18 of her co-workers had died. Before she was allowed to go home, K.G.B. agents took her a document to sign, prohibiting her from talking about the events for 25 years.

At Sverdlovsk’s epidemiological service, the epidemiologist Viktor Romanenko was a foot soldier in the cover-up. He says he knew immediately that the disease outbreak striking the city could not be intestinal, food-borne anthrax as the senior health authorities claimed. The pattern and timing of the cases’ distribution showed that the source was airborne and a one-time event.

“We all understood that this was utter nonsense,” said Dr. Romanenko, who went on to become a senior regional health official in post-Soviet times.

But in a Communist state, he had no choice but to go along with the charade, and he and his colleagues spent months seizing and testing meat. K.G.B. agents descended on his office and took away medical records. The Soviet Union had signed a treaty banning biological weapons, and national interests were at stake.

“There was an understanding that we had to get as far away as possible from the biological-weapons theory,” Dr. Romanenko recalled. “The task was to defend the honor of the country.”

There were even jitters at the Evening Sverdlovsk, a local newspaper. A correspondent from The New York Times called the newsroom as the outbreak unfolded, recalls a journalist there at the time, Aleksandr Pashkov. The editor in chief told the staff to stop answering long-distance calls, lest anyone go off-message if the correspondent called again.

“He who can keep a secret comes out on top,” Mr. Pashkov said.

As the Soviet Union crumbled, so did its ability to keep secrets. For a 1992 documentary, Mr. Pashkov tracked down a retired counterintelligence officer in Ukraine — now a different country — who had worked in Sverdlovsk at the time. Telephone intercepts at the military lab, the officer said, revealed that a technician had forgotten to replace a safety filter.

Soon, Mr. Yeltsin — who himself was part of the cover-up as the top Communist official in the region in 1979 — admitted that the military was to blame.

“You need to understand one simple thing,” Mr. Pashkov said. “Why did all this become known? The collapse of the Union.”

The husband-and-wife team of Dr. Meselson and Dr. Guillemin visited Yekaterinburg several times in the 1990s to document the leak. Interviewing survivors, they plotted the victims’ whereabouts and investigated weather records, finding that Dr. Meselson and others had been wrong to give credence to the Soviet narrative.

Dr. Meselson said that when he contacted a Russian official in the early 1990s about reinvestigating the outbreak, the response was, “Why take skeletons out of the closet?”

But he said that determining the origins of epidemics becomes more critical when geopolitics are involved. Had he and his colleagues not proved the cause of the outbreak back then, he said, the matter might still be an irritant in the relationship between Russia and the West.

The same goes for the investigation into the source of Covid-19, Dr. Meselson said. As long as the pandemic’s source remains a matter of suspicion, he said, the question will continue to raise tensions with China, more so than if the truth were known.

“There’s a huge difference between people who are still trying to prove a point against emotional opposition and people who can look back and say, ‘Yeah, yeah, I was right,’” Dr. Meselson said. “One of them fuels wars. The other is history. We need to get all these things solved. We need history, we don’t need all this emotion.”

Unlike Covid-19, anthrax does not easily pass from human to human, which is why the Sverdlovsk lab leak did not cause a broader epidemic. Even the Sverdlovsk case, however, has not been fully solved. It remains unclear whether the secret activity at the factory was illegal biological weapons development — which the Soviet Union is known to have performed — or vaccine research.

Under President Vladimir V. Putin, revealing Russian historical shortcomings has increasingly been deemed unpatriotic. With the government mum on what exactly happened, a different theory has gained currency: Perhaps it was Western agents who deliberately released anthrax spores to undermine the Communist regime.

“The concept of truth, in fact, is very complicated,” said Lev Grinberg, a Yekaterinburg pathologist who secretly preserved evidence of the true nature of the outbreak in 1979. “Those who don’t want to accept the truth will always find ways not to accept it.”

Oleg Matsnev contributed research.

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