Months into virus, biggest one-day case spike worries Iran
Months into Iran's fight against the coronavirus, doctors and nurses at Tehran's Shohadaye Tajrish Hospital still don a mask, a disposable hazmat suit and a double layer of latex gloves every day to attempt to contain a pandemic that shows no signs of slowing.
The hiss of high-flow oxygen to wheezing patients, the beeps of equipment monitoring vital signs and the crinkling rustle of passing medics have become a daily symphony here and in other hospitals across the Islamic Republic.
Iran reported its first coronavirus cases and deaths on the same day in February – the Middle East's first and biggest outbreak of the virus – yet it only recently saw its highest single-day spike in reported cases, followed soon by the highest daily death toll in months.
The spikes, which came after a major Muslim holiday last month, have renewed fears about a potential second wave of infections sweeping across Iran. As businesses open and people begin to move around more after weeks of closures of most stores, offices and public spaces, health experts worry that growing complacency among the country's 80 million people may further allow the virus to spread.
Health Minister Saeed Namaki said he realized the extent of the challenge when he took a domestic flight. "Many people have become careless, frustrated with wearing masks,'' he said. "They did not observe (social) distancing in the flight's seating and the airliner's ventilation system was not working.''
Iran saw its highest single-day total of reported new cases – 3,500 – on 5 June. The number dropped in the days afterward but remain in the low 2,000s a day, around twice the lows in the last week of April and the first week of May.
The daily death tolls in Iran also broke the 100 mark for the first time since mid-April on Sunday, Monday and Tuesday this week.
The spike in cases occurred largely in Iran's oil-rich southwestern Khuzestan province, as well as the western provinces of Kermanshah and Kurdistan. Officials link it to the Eid ul-Fitr holiday that came in late May, during which families often travel to visit friends and relatives to mark the end of the Islamic holy month of Ramadan, when Muslims fast from dawn to dusk.
Ali Reza Zali, who is leading the campaign against the outbreak in Tehran, said last week that "some 60% of hospitalized patients travelled to other provinces before they became sick.''
Authorities also have reported concerns about Iran's eastern Sistan and Baluchistan province bordering Pakistan.
The spike also reflects an increase in testing, Health Ministry official Ehsan Mostafavi said. Iran now has 130 labs across the country, running as many as 25,000 tests a day. Some 1.3 million tests have been conducted, up from 500,000 just a month ago.
While the country is opening up, some restrictions still stand. Friday prayers in major cities remain closed, as do schools and universities, except for a few courses. Authorities have imposed rules to keep people spread out at indoor locations and ordered people to wear masks there and on public transportation.
But Iranian President Hassan Rouhani said on Saturday that only 18% of people are observing social distancing and other measures, down from 80% about a month ago.
Coronavirus in the Middle East: Lock down or play down?
Countries such as Kuwait and Israel have instituted virtual lockdowns in the face of COVID-19, while religious gatherings have been limited at a time of year ripe with ritual. Others have been slower to act. By Tom Allinson
Iran bearing the brunt: with a high number of deaths and cases, Iran has been a regional epicentre of the outbreak. Several top officials have been infected and there are concerns the number of cases are higher than reported. The government has cancelled Friday prayers but health workers have complained they are under-equipped. Iran has asked the International Monetary Fund for emergency funding
Strict measures in Saudi Arabia: Saudi authorities banned international religious pilgrims early on, leaving the Grand Mosque's Kaaba in Mecca virtually empty. Other measures have involved sanitizing streets and mosques, closing schools and universities, an extensive travel ban and fines of up to 500,000 riyals (€120,000/$133,000) for people hiding health details. It has also locked down the Shia-minority area of Qatif
Egypt restricts travel: in Cairo, hundreds of Egyptians tried to get certificates showing they have a clean bill of health after Saudi Arabia announced new travel regulations. Although Egypt has only detected a low number of cases, more than 100 tourists returning from the country tested positive for the virus. Officials have limited sermons to 15 minutes and cancelled large public gatherings
Israel and West Bank cut off from the world: gatherings of less than 100 are still allowed, leaving visits to the Wailing Wall open. But Israeli authorities have virtually halted air traffic in and out of its territory and tourists are required to self-quarantine. The city of Bethlehem has declared a state of emergency, emptying streets usually teeming ahead of Easter. Israeli researchers have said they are close to finding a COVID-19 cure
Virtual lockdown in Kuwait: as Kuwaitis kept their distance at this makeshift testing centre, the country entered a virtual lockdown, with the entire workforce given a two-week holiday from March 12. All commercial flights have been suspended from Friday on, schools have been closed and gatherings at restaurants, malls and commercial centres have been banned
In Iraq coronavirus fails to dampen protests: Iraq's protest movement has set up its own makeshift disinfection stations to counter the spread of COVID-19. Although Iraq is highly prone to the outbreak due to its proximity and close relations with Iran, protesters have been defiant, saying the government is the virus. Elsewhere authorities have closed major public spaces and religious institutions have cancelled gatherings
Yet Rouhani also said that, starting Saturday, kindergartens, coffee shops and libraries can resume activities while applying protective measures. He said the country still could revert to stricter measures if needed.
Before Iran reported its first cases in February, authorities denied it had reached the country for days, allowing the virus time to spread as the nation 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.
Today, the country has reported over 192,000 confirmed cases, with 9,065 deaths.
Even as Iran now acknowledges the crisis, questions remain over its figures from the outbreak.
A parliamentary report in April said Iran's death toll is likely nearly double the officially reported figures. Given undertesting, the report said the number of people infected at the time was probably "eight to 10 times'' higher than the reported figures.
Even today, Iranian death tolls remain based on those who died in coronavirus wards in hospitals. However, it's believed that many more died at home, and some families have reportedly asked doctors not to mention their loved ones died of the virus to avoid the stigma associated with COVID-19, the illness caused by the virus.
The Tehran municipality recently said it has prepared an extra grave site with capacity for 15,000 bodies, though it said it was intended in case of a natural disaster. It said Tehran's main cemetery had some 10,000 grave sites ready for use.
But there's a sense that Iran's government, once overwhelmed by the crisis, has adjusted. In a sign of business as usual, Iranian officials have resumed their rhetoric against the U.S., which under President Donald Trump withdrew from Tehran's nuclear deal with world powers and implemented crushing sanctions.
The public too seems to want some normalcy. On the streets of Tehran, several people who spoke to journalists acknowledged they no longer followed safety measures.
"I stopped wearing a mask,'' said Soheila Fazli, a 48-year-old mother of two who suffers from diabetes. "I cannot breathe easily when I wear it.''
Authorities largely are only enforcing mask wearing and other rules in Tehran's subway.
"I don't like wearing a mask,'' said Gholam Reza Sarrafi, a 24-year-old air conditioner technician. "Why should I wear one even though I haven't seen anyone get the disease?''
That attitude has health officials worried about a new increase in infections. Health official Mohammad Mehdi Gouya warned the public that Iran has not "passed the first wave.''
"We still have a heavy fight with corona,'' he said recently. "We are not in a position to have an optimistic view.'' (AP)