Days of denial: inside Iran’s creeping coronavirus spread

Secrecy and a slow response, how Iran first stalled and is now struggling to contain Covid-19

A firefighter disinfects a square against the new coronavirus, in western Tehran, Iran, Friday, March 13, 2020. The new coronavirus outbreak has reached Iran's top officials, with its senior vice president, Cabinet ministers, members of parliament, Revolutionary Guard members and Health Ministry officials among those infected. The vast majority of people recover from the new coronavirus. According to the World Health Organization, most people recover in about two to six weeks, depending on the severity of the illness. (AP Photo/Vahid Salemi)Show less

Appearing before the cameras coughing and sweating profusely, the man leading Iran’s response to the new coronavirus outbreak promised it was of no danger to his country.

“Quarantines belong to the Stone Age,” Iraj Harirchi insisted.

A day later, went into quarantine after getting Covid-19.

Mr Harirchi’s story is a microcosm of what has happened in Iran amid the coronavirus pandemic. Roughly nine out of 10 cases in the Middle East come from the Islamic Republic, which has reported nearly 15,000 people infected and at least 853 deaths although World Health Organisation officials warn that the true number of cases is far higher.

While most people who are infected recover, the virus spreads rapidly and can kill the elderly and those with breathing problems or other underlying illnesses.

Days of denials gave the virus time to spread in Iran as the country marked the 41st anniversary of its 1979 Islamic Revolution with mass demonstrations and then held a parliamentary election in which authorities desperately sought to boost turnout.

Although Iran has one of the Mideast’s best medical services, its hospitals appear to be overwhelmed and authorities have asked for 172 million masks from abroad. It also has asked the International Monetary Fund for $5 billion, the first such loan for Iran since 1962.

The Islamic Republic has an opportunity to limit the virus as the Persian New Year, Nowruz, approaches. But authorities appear unable or unwilling to stop travel between major cities as local towns affected by the virus threaten to set up their own checkpoints to turn away or even attack outsiders.

That’s in sharp contrast to Iraq and Lebanon, Iranian allies that have restricted movement while facing a fraction of the reported infections.

Pedestrians wear protective masks and surgical gloves while walking in central Tehran, Iran, March 15, 2020. Bloomberg

A pedestrian wears a protective face mask while walking in central Tehran, March 15. Bloomberg

A public bus driver wears a protective face mask while working in central Tehran, March 15. Bloomberg

A pedestrian wears a protective face mask while travelling down a walkway escalator in Tehran, March 15. Bloomberg

A woman wearing a face mask inspects clothes at a store in Bamland shopping mall, in Western Tehran, March 15. AP Photo

A pedestrian wears a protective face mask in Tehran, March 15. Bloomberg

People queue in line to receive packages for precautions against coronavirus by the Basij, a militia loyal to Iran's Islamic republic establishment, from a booth outside Meydane Valiasr metro station in the capital Tehran, March 15. AFP

A man wearing a protective mask carries boxes containing disinfectants, March 15. AFP

People queue in line to receive packages for precautions against coronavirus disease, March 15. AFP

Iranian firefighters prepare to disinfect streets in an effort to halt the spread of coronavirus in Tehran on March 13, 2020. EPA

Firefighters disinfect streets in an effort to halt the spread of coronavirus in Tehran, March 13. EPA

An Iranian firefighter disinfects a street in the capital Tehran, March 13. AFP

Firefighters disinfect streets in an effort to stop the spread of coronavirus in Tehran, March 13. EPA

A Revolutionary Guard member takes part in disinfecting the city in Tehran, Iran, March 4. AP

A Revolutionary Guard member disinfects an ATM in Tehran, Iran, March 4. AP

A Revolutionary Guard member disinfects a bus station in Tehran, Iran, March 4. AP

Members of Iran's Revolutionary Guard spray down streets and hospitals with disinfectants, March 4. AP

Members of Iran's Revolutionary Guard spray down streets and hospitals with disinfectants, March 1. Tasnim News Agency via AP

Revolutionary Guard members take part in disinfecting the city, in Sanandaj, western Iran, March 1. Tasnim News Agency via AP

A Revolutionary Guard member disinfects a truck in the city of Sanandaj, western Iran, March 1. Tasnim News Agency via AP

What happens next will not only affect Iran’s civilian government and Shiite theocracy, whose officials already have fallen ill, but also the wider world.

“Judging by the fact that Iran has now asked for a $5 billion loan from the IMF, this speaks to how dire the situation is getting and them realizing that it’s spun out of control,” said Dr Amir A Afkhami, an associate professor at George Washington University who studies Iran.

Ali Reza Zali, who is leading the Iranian campaign against the outbreak, warned on Sunday that the country’s hospitals were at risk of being overwhelmed by the virus.

Patient Zero and an Election

Poll workers empty full ballot boxes after the parliamentary election voting time ended in Tehran on February 22, 2020. West Asia News Agency via Reuters

In a country like Iran, where the state controls all broadcasters and journalists face restrictions, many things about the outbreak remain unknown. Chief among them is who was “patient zero” – the person who was first infected with the coronavirus in the nation, and where.

Public comments point to the city of Qom, 125 kilometres southwest of Tehran, on the country’s windswept central desert plateau. How the virus arrived there remains in question.

Authorities suggested that perhaps an Iranian businessman returned from China with the virus. Qom is home to major Shiite seminaries that draw Chinese students. It also is along a $2.7 billion high-speed train route that a Chinese company is building, a sign of China’s outreach to Tehran amid crushing US sanctions. China is also constructing a solar power plant there.

From late January, worries could be seen on the front page of the pro-reform newspaper Aftab-e Yazd.

“Mysterious virus at Iran’s gates,” its banner headline warned as China began a lockdown to control the outbreak.

Yet travel between China and Iran continued.

The first two coronavirus cases were reported February 19, with the announcement that both died in Qom. Since it can take up to two weeks to show symptoms, they could have become ill in early February.

Iranian authorities haven’t offered any details. Iran analysts suggest it might be because the country marked the 41st anniversary of the Islamic Revolution during that period.

Iran also held parliamentary elections February 21. The government desperately wanted a large turnout to boost its legitimacy after shooting down a Ukrainian passenger jet, killing all 176 people on board. Days earlier, a US drone strike in Baghdad killed top Revolutionary Guard Gen Qassem Suleimani, further shaking its credibility.

Iranian authorities already had disqualified thousands of candidates from running, ultimately tilting the election to conservatives. Supreme Leader Ayatollah Ali Khamenei even later accused foreign enemies of trying to influence turnout with the outbreak.

“The pretext of an illness and virus was used, and their media did not miss the slightest opportunity to discourage people from voting,” he said.

The election saw Iran’s lowest turnout since the revolution, with some voters wearing the masks that everyone soon would want. But people already were dying and fear was spreading.

Shrines and Hazmat Suits

An Iranian sanitary worker disinfects Qom's Masumeh shrine to prevent the spread of Covid-19 in Iran where there are concerns the situation is worse than officially acknowledged. AFP

Qom has long been the stronghold of Iran’s Shiite clergy. A focal point of devotion is the golden-domed shrine of Fatima Masumeh, a Shiite saint. Crowds pray there 24 hours a day, seven days a week, touching and kissing the shrine.

That raises the risks for visitors. In Saudi Arabia, authorities have closed off access to the holiest sites in Islam over concerns about the virus. Churches, mosques, temples and shrines around the world have been closed or subject to stringent disinfecting campaigns.

But in Qom and elsewhere in Iran, the shrines stayed open despite civilian health authorities demanding they close. Mohammad Saidi, who oversees the Fatima Masumeh shrine, insinuated that closing shrines was part of a plot against Shiites by President Donald Trump.

“Defeating Qom is the dream of treacherous Trump and his domestic mercenaries, but this dream will not be realized even in their grave,” Mr Saidi said on February 22.

That decision likely gave the virus time to spread. Police later arrested those who posted online video of themselves licking and kissing shrines.

“The city’s religious epithet – ‘the nest of the Prophet and his family’ – was intended to reassure believers worldwide that it was insulated against epidemics and other disasters,” wrote Mehdi Khalaji, a Qom-trained Shiite theologian who is an analyst at the Washington Institute for Near-East Policy. “If early reports about the spread of the coronavirus prove correct, Qom’s status as the ideological capital of the Islamic Revolution helped make it the pathogen’s transmitting centre to the rest of Iran and at least seven other countries.”

Since then, hazmat-suited workers have fogged disinfectant and cleaned the shrines. Some mosques even hand out alcohol as a disinfectant to the poor despite Islam forbidding its consumption.

By Monday night, the Fatima Masumeh shrine and another one in Mashhad had closed, only to see online videos purport to show hard-line faithful storming the shrines’ courtyard, demanding they open. But by that point, the virus had spread, reaching the highest levels of Iran’s theocracy.

‘The situation is terrible here’

Men wearing protective gear carry the body of Fatemeh Rahbar, a lawmaker-elect from Tehran constituency, who died on Saturday after being infected with the new coronavirus at Behesht-e-Zahra cemetery outside Tehran. Fars News Agency via AP, file

Like blood from a beating heart, the infections in Qom coursed out across Iran in maps later shared by the Health Ministry. In Tehran, the virus began moving through the government and the Shiite theocracy.

Among those first infected was Mr Harirchi, the deputy health minister who tested positive only a day after he downplayed the virus in a televised news conference.

It didn’t stop there.

The virus killed Expediency Council member Mohammad Mirmohammadi, described as a close confidant of Mr Khamenei. Hadi Khosroshahi, Iran’s former ambassador to the Vatican, and Ahmad Tuyserkani, an adviser to Iran’s judiciary chief, also died along with several lawmakers and a member of the country’s Assembly of Experts.

The sick included Vice President Masoumeh Ebtekar, better known as “Sister Mary,” the English-speaking spokeswoman for the students who seized the US Embassy in Tehran in 1979 in the 444-day hostage crisis.

The virus also infected senior Vice President Eshaq Jahangiri and two other Cabinet members, along with Revolutionary Guard members and doctors.

Soon, even 80-year-old Mr Khamenei was seen wearing disposable gloves at a tree-planting ceremony. President Hassan Rouhani, 71, was pictured at a teleconference with the nearest official a few meters away.

People wearing face masks walk on a sidewalk in downtown Tehran. AP

People wearing face masks walk on a sidewalk in downtown Tehran. AP

A woman rides her bicycle wearing a face mask in downtown Tehran. AP

An Iranian medic treats a patient infected with the COVID-19 virus at a hospital in Tehran on March 1, 2020. AFP PHOTO / HO / MIZAN NEWS AGENCY

An Iranian lab technician loads a centrifuge with blood samples, taken from patients suspected of being infected with COVID-19 virus, at a hospital in Tehran. AFP PHOTO / HO / MIZAN NEWS AGENCY

An Iranian medic treats a patient infected with the COVID-19 virus at a hospital in Tehran on March 1, 2020. A plane carrying UN medical experts and aid touched down AFP PHOTO / HO / MIZAN NEWS AGENCY

An Iranian medic treats a patient infected with the COVID-19 virus at a hospital in Tehran on March 1, 2020. A plane carrying UN medical experts and aid touched downAFP PHOTO / HO / MIZAN NEWS AGENCY

In this Sunday, March 1, 2020 medics wearing protective gear work in a quarantined ward for coronavirus infected patients, at a hospital in Tehran, Iran. Mizan News Agency via AP

In this Sunday, March 1, 2020 photo, a paramedic works with a centrifuge to test blood samples taken from patients suspected of being infected with the new coronavirus, at a hospital in Tehran, Iran. Mizan News Agency via AP

A medic treats a patient infected with coronavirus, at a hospital in Tehran, Iran. A member of a council that advises Iran's supreme leader died Monday after falling sick from the new coronavirus, becoming the first top official to succumb to the illness striking both citizens and leaders of the Islamic Republic. Mizan News Agency via AP

The numbers soared. Iran’s death rate from the virus is now higher than in other hard-hit nations.

That could be from the initial lack of testing kits and facilities. It also could be from what outside experts, Tehran lawmakers and other local leaders have alleged from the start: Iran was hiding the true number of infections and deaths.

Authorities initially denied that, especially after the BBC’s Persian service said deaths far exceeded those reported at the beginning of the crisis. But that denial appeared to weaken over time.

“We found out a little late that the coronavirus had entered Iran because we mistook it for the flu,” Reza Malekzadeh, a deputy health minister, later said.

A man in Qom filmed rows of bodies in black bags and caskets awaiting burial for days in a trench lined with lime. He alleged all had tested positive for the coronavirus, although officials later said the bodies had been held pending test results.

Paramedics treat a patient infected with the new coronavirus, at a hospital in Tehran. AP

“The situation is terrible here and I hope God helps us,” he said while walking through the mortuary.

Authorities later arrested him.

Past experiences, new worries

Diseases have influenced Iranian history. Cholera outbreaks plagued its Qajar dynasty, long indebted to British and Russian powers. The chaos and debt set the stage for Iran’s 1906 Constitutional Revolution and the creation of parliament.

That cholera outbreak saw Shiite religious leaders lash out at the West. Now, Iranian leaders, such as the head of its Revolutionary Guard and Mr Khamenei himself, traffic in the baseless conspiracy theory that the coronavirus is a biological weapon created by the US, something echoed by Chinese officials as well.

“The psychology of the leadership in Iran has sort of an almost self-destructive need to double down on a lie just to sort of portray itself as competent,” Mr Afkhami said.

That’s contrasted with the response to the El Tor strain of cholera that caused a pandemic through the 1960s. Iran produced millions of vaccine doses and inoculated its people, controlling its spread. It even gave broad-range antibiotics from the US to pilgrims visiting Shiite shrines, he added.

“This rapid mobilization and this rapid response allowed the country to control the epidemic,” Mr Afkhami said.

That was under Iran’s shah, toppled in the 1979 revolution. But even after, Iran fought off other outbreaks, and its hospitals, doctors and nurses are known as some of the best in the wider Middle East, with a network of clinics from villages to big cities.

However, the system appears to be stretching at the seams, with online videos purporting to show field hospitals going up. Meanwhile, Iran’s 80 million people, whose sense of high risk has been dulled by years of international isolation, crowd into grocery stores and butcher shops, suspicious of anything in the state media.

Customers wait as a pharmacist prepares medicines in Tehran, Iran where nine out of 10 cases of the virus in the Middle East come from the Islamic Republic. AP, File

Nowruz, the Persian New Year, looms on Friday, a holiday when millions travel. The government repeatedly stopped short of ordering any major travel restrictions. It hasn’t explained why, but there could be worry about further angering its people or slowing down its anaemic, sanctions-hurt economy.

Online videos show Iranians ignoring government demands to stay home and moving instead toward the coast of the Caspian Sea and the Persian Gulf. Residents of hard-hit Rasht, on Iran’s coast, have threatened to attack out-of-towners.

“We expect that, God willing, we can contain the rising trend of the disease, not the disease itself, by March 26,” said Mr Harirchi, the health official who is recovering from Covid-19. “But I say this very frankly: if the great people don’t cooperate, the disease will continue to be there until late May or even in June, and turn into a huge crisis.”

And the man who once called quarantines a thing of the past added: “I beg the people to minimize their trips and contacts, and isolate the infected people from others completely.”