As a global pandemic spreads, governments around the world act to contain it. More specifically, a government should “provide reliable information on the risk, severity, and progression of a pandemic and the effectiveness of interventions used during a pandemic”. To contain and combat the coronavirus, governments worldwide have placed orders for social distancing, quarantining inside homes, and requiring masks when entering stores.

However, some governments are doing what is in their own best interest. For example, Iran waited to announce the coronavirus within their country for political reasons and disbelief of the severity. Iran continued its diplomatic ties with China and did not enforce a travel ban until much later when the news had spread. This has caused a late reaction to preventive measures which resulted in an epicenter in Tehran where citizens rushed to the overcrowded hospitals, are struggling to get materials and help that they need, and the true statistics are unknown.

The statistics of the coronavirus in Iran is relatively low compared to the rest of the world - depending on who you ask. The World Health Organization and other international organizations report the total cases of coronavirus in Iran to be 10th and total coronavirus deaths to be 9th, globally. More specifically, according to worldometer and as of May 10, 2020, Iran currently has 106,220 coronavirus cases. There are 85,064 declared as recovered, 14,567 are infected, 11,871 in mild condition, 2,696 in critical condition, and an outcome of 6,589 deaths so far (See image carousel below). The huge recovery rate compared to the total amount of cases that Iran had was commended by Richard Brennan, the Acting Region Emergency Director for the World Health Organization East Mediterranean Regional Office (EMRO). Brennan said that the impressive increase in control measures that were taken by the government is responsible for the flattening and now declining of the country’s curve. Although, he mentioned that assistance from the World Health Organization supplied enough testing kits for about 110,000 people along with 7 tons of protective equipment and medical supplies to contribute to the decline.

On the other hand, Hamid Souri, a member of the COVID-19 task force in Iran, estimates that approximately half a million people are infected. He even suggested there may be more because of the inability to identify asymptomatic patients. Iranians are concerned about the country’s lack of medical equipment and fear that they do not have the ability to fight this pandemic. In addition, the US sanctions are making it difficult to internally buy basic face masks because they are exempt. The financial system and transportation industry in Iran add to the difficulty of receiving masks and other supplies through imports as well. Furthermore, Seyed Abbas Mousavi, Iran’s spokesperson for the Foreign Ministry, accuses Trump for committing crimes against humanity through economic and medical terrorism. This is thought to contribute to the growing numbers that are not being reported because the citizens are not able to get supplies when organizations like WHO and US Sanctions say that there is equipment available. Kianush Jahanpur, an Iranian health ministry spokesman, estimates that in every hour there are 50 new people contracting the virus and in every 10 minutes, 6 people die. The BBC filmed a video in a morgue located in the religious city of Qom, the mortuary worker stated that bodies are piled up for 5 to 6 days, alluding to Iran’s struggle in coping with the amount of deaths. Dr. Amir Afkhami, an associate professor at George Washington University wrote a report on the cholera epidemic in Iran and claimed he is not surprised by the mass grave digging (Figure 1) to cover up the death toll numbers.

Iran is one of the epicenters for coronavirus with a population of 83 million and cases that could be 5 times higher than the WHO statistics. The government is not admitting, therefore reporting, accurate case numbers. Among China’s critical conditions in January, there were no restrictions on travel placed in Iran between the two countries - presumably to keep the strong diplomatic connections. A travel ban decision was finally made on January 31st, but Mahan Air carried on business as usual and even assisted China-bound travelers in other countries. This continued until February 23rd. The avoidance to take action on preventive measures and notify the public was deterred by cynicism and religious ideology. On February 15th, the Supreme Leader Ali Khamenei went to a recurring meeting with religious eulogists where it is customary to approach the leader and grant a kiss on his hand. Khamenei’s security did not allow this to happen, said eulogist Nariman Panahi.

The first notifiable public announcement from the government was on February 19 for 2 confirmed deaths in Qom, which has a population of 1.2 million. No announcement was made about the actual coronavirus inside and outside Iran. In 2019, the Associated Press reported 66 people died from alcohol poisoning. From February 20, 2020 to April 7, 2020, over 700 people have died. The Iranian government did not want to interfere with the parliamentary elections on February 21 with the preexisting fear of a low turnout because of political turmoil in the months prior that took down a passenger plane, killing 176 people. In efforts to take their own preventive measures, Iranians turned toward toxic methanol to rid the coronavirus (Figure 2). Unfortunately, it was proven a fatal illness and over 5,000 people have been poisoned using this ‘remedy’.

On February 24, the president of Mashhad University of Medical Sciences, Mohammad Hossein Bahreini, took an interview with the state-run Iranian Students News Agency. During the interview, he said the 700 chinese students in Qom prepared for dissemination for the virus over Iran. This publication was later removed by state media. During the same day, a parliament member from Qom quoted Bahreini in addition to saying that the two deaths from COVID-19 was actually on February 13th, not the 16th when the government announced it. The administration under President Hassan Rouhani established a “national headquarters for fighting the coronavirus”, but it was notorious for denying organized quarantine measures since it was built. Iran’s Deputy Health Minister, Iraj Harirchi did not agree with quarantine measure and said “quarantines belong to [the period] before World War I for [diseases like] plague and cholera, and even the Chinese are not satisfied with the quarantine that has been put in place”. Harirchi later tested positive for the coronavirus. The Iranian military set up a base to combat COVID-19 and established preventive measures on March 13. This included to monitor and identify anyone suspected of infection or those who noticeably have it. They built 1,000 mobile stationary clinics to examine and screen people while campaigning to depopulate public places. Military officers and officials ignored this campaign statement to lessen the chances of economic fallout in their opinion. And without a strong and stable government, recovery is difficult.

The Washington Post reporters reached out to survivor families to recall what is going on within the country. This included the valiant medical workers, overtaxed hospitals in an economic downfall, and a government too slow to alert the people and take action (Note: All reports remain anonymous due to the danger of discussing sensitive public affairs in Iran).

A political science professor at the University of Tehran, Hamed Mousavi, thinks the Iranian government did not take the outbreak seriously When it initially happened, which caused them to be unprepared. The effectiveness of the government declined as officials were infected in the first week. The massive amount of testing that was needed was not able to occur due to the lack of having enough test kits to conduct results. Appropriate resources and accurate numbers are vital to take necessary actions. An emergency room Doctor in Tehran, the capital of Iran, insists the hospitals still need technology, not only drugs and testing kits. With the lack of intense equipment for chronic patients, the mortality rate is increasingly impacted in Iran.

Iran's late reaction to provide reliable information and take cautionary measures caused mass panic, overcrowded hospitals, mass graves. An epicenter formed inTehran where citizens sought medical attention and struggled to get materials they needed. The true statistics remain unknown.