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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