May 20, 2022

Hospital doctors in Iran examine patients on emergency room floors and in cars parked on the side of the road. Lines extend for blocks outside pharmacies. Taxis also serve as hearses, transporting bodies from hospitals to cemeteries. Workers dig mass graves in at least one city.

Iran is under attack from the most disastrous wave of coronavirus yet, according to interviews with doctors and health workers, social media posts from angry citizens, and even some unusually frank coverage in state media. The aggressive Delta variant has caused record deaths and infections and appears to be overwhelming the health system of a country that has been affected by Covid-19 since the scourge began.

The recent phase of the crisis has exacerbated the challenges Iran’s new hardliner Ebrahim Raisi faces, testing his skills just days after taking office.

“The situation we are facing is more than catastrophic,” said Dr. Mahdiar Saeedian, a 39-year-old doctor in Mashhad, Iran’s second largest city. “The health system is about to collapse.”

Even during the war with Iraq in 1980-88, Dr. Saeedian, who was born during this conflict, “wasn’t like that.”

The official virus death toll is 500 to 600 people a day, but even these record numbers are contested as low by some government media. Iranian state television has said that an Iranian dies every two minutes – at least 720 a day.

Frontline doctors in Tehran, Isfahan, Ahvaz and Mashhad told the New York Times that the actual death toll is closer to 1,000 a day.

Doctors also say the true rate of infection is likely much higher than the official rate of around 40,000 per day due to inadequate testing and lack of access to medical care.

Medical staff who were once afraid to speak up are now openly chastising what many Iranians see as gross misjudgment, incompetence and negligence in the leadership of the nation, from Supreme Leader Ayatollah Ali Khamenei down.

They are particularly angry about the shortage of vaccines, which the Iranian leadership has refused to buy on time or in sufficient quantities, and instead have been looking for domestically developed alternatives that may come too late. They banned vaccines made in the United States and Britain and even refused donations because Mr Khamenei said they were developed by the West to “contaminate other nations.”

Less than 3 percent of the 85 million Iranians are fully vaccinated.

On state television, nurses from Covid-19 stations are shown crying. Doctors post videos on social media asking officials to act immediately before the crisis gets worse: lock down the country and buy more foreign-made vaccines, they plead.

Understand the delta variant

“Whatever your budget, whatever steps you can take, get help from the world, do it to save people,” asked Dr. Nafiseh Saghi, a renowned doctor and professor of medicine in Mashhad, told the Iranian leaders in a voice message posted on social media. “History will judge you.”

The Iranian leadership has repeatedly tried to blame the United States and its continued economic isolation in the country for a number of domestic crises, including infection with Covid-19.

Critics say the leadership mishandled the pandemic from the start: hiding accurate dates, refusing to order quarantines, criminalizing transparency by medical staff, prioritizing the development of inadequate domestic vaccines, and misleading the public with over-promising mass vaccinations.

“Those who are to blame must be held accountable,” said Dr. Muhammad Reza Fallahian, doctor and professor of medicine in the capital Tehran. “Our vaccinations come very, very late. What else can we doctors do that we don’t? We are at the breaking point in Iran. “

Updated

Aug. 12, 2021, 11:24 p.m. ET

In revelations that rocked many Iranians, Dr. Alireza Zali, the head of Tehran’s coronavirus committee, told Iranian media on Wednesday that officials did not allow the purchase of foreign vaccines because of the costs.

When World Health Organization experts came to assess Iran’s needs and offer assistance, Dr. Zali, his superiors had ordered the medical staff to portray the country as self-sufficient.

“They told us to praise the Iranian health system,” he said. “We covered up real WHO deaths and turned over international aid at the airport.”

In his first week in office, Raisi, the new president, is under fire even from supporters for refusing to lock the country for two weeks at the request of the Ministry of Health and for the shortage of vaccines.

He admitted Wednesday that “not that many” doses of the domestic vaccine have been made and that he plans to import at least 40 million doses before winter.

A spokesman for the Iranian Food and Drug Administration, Kianoush Jahanpour, promised that an unlikely 120 million doses of vaccine, including the Pfizer and Moderna brands, would be imported within three months – as long as they weren’t made in the US or the UK.

Mr Khamenei, who is responsible for Mr Raisi’s rise and is considering him as a possible successor, said in a televised address on Wednesday that the pandemic was the main topic of the country. He also said efforts to vaccinate Iranians need to be accelerated to open the door to more purchases from producers in China, Russia and India.

But Mr Khamenei has also overruled health ministry warnings to cancel the currently ongoing Shiite mourning rituals for the holy month of Muharram, when thousands of devotees congregate on shrines, crowded and often exposed – mature incubators for the super-spread of the virus.

The government’s refusal to impose such restrictions has sparked some unusually blunt expressions of anger, even from supporters who risk retaliation or at least charges of disloyalty.

“When I say, ‘Mr. Raisi, if you don’t quarantine Tehran when there are no hospital beds, you are responsible for the rising deaths. Mehdi Sasani, a Tehran who voted for Mr Raisi, asked in a Twitter post.

Mr Sasani shared about his family’s ordeal in fighting the virus, from the inability to find a hospital bed to hours of wandering from pharmacy to pharmacy in search of prescribed medication. He said that the people who stand in line for medical supplies and medicines curse Mr. Khamenei.

“We are officially facing a situation where there is no government,” said Hamidreza Salehi, a computer programmer, in a Twitter post. “You have lost control of everything.”

Despite the devastation of the recent virus wave, pictures and videos from Iran mostly show business as usual on the streets. Offices, shops and restaurants are at full capacity. No restrictions on masking, travel, or social distancing were enforced. Many people, exhausted from the pressures of the bad economy, the pandemic and distrust of the government, are not following the recommended protocols.

Deputy Health Minister Iraj Harirchi said last week that the death toll in Iran would rise by six weeks, according to estimates by international authorities. Almost all of Iran’s 31 provinces are marked “red”, the highest risk level in the Iranian warning system.

The Islamic Revolutionary Guard Corps, the powerful paramilitary force reporting directly to Mr Khamenei, said in a concession to medical critics on Thursday that its regional commanders would take steps to prevent the unhindered movement of people across the country. Details of how such restrictions would work remained unclear.

A mother in Tehran with a 13-year-old son who contracted Covid-19 said that when his respiratory symptoms worsened, she could not find a hospital bed and that doctors who made house calls at high prices told her that they had no vacancies for days. To get the prescribed antiviral drugs, she said, she waited in front of a 24-hour pharmacy from midnight to 3 a.m.

Ehsan Badeghi, a journalist for the government newspaper Iran, said in an interview that his neighbor, a 43-year-old mother of two young children, had died a few days earlier while waiting for an ambulance. He said the woman was unable to find a hospital bed and could not afford home care.

“Vaccination or quarantine both need money and planning, and nothing happens here,” he said. “So the pandemic is raging and will continue to get worse. We’re dying and nobody cares. “

Critical medical therapies such as intravenous fluids, oxygen bottles and antiviral drugs are in short supply in hospitals and pharmacies and are sold on the black market at exorbitant prices, according to interviews with doctors from four cities.

Medical staff are also physically exhausted and emotionally drained as they work double shifts in hospitals without interruption, said Dr. Ali Nikjoo, a 43-year-old psychiatrist in Tehran. He said he had received many calls from coworkers battling depression, anxiety and grief.

“The medical staff go through a minefield every day,” said Dr. Zakani. “There is an overwhelming sense of abandonment, not just with doctors and nurses, but with ordinary people as well. We float and drown. “