As the coronavirus began its spread around the world early this year, Iran quickly found itself facing the worst outbreak in the Middle East.

Iranian officials sluggishly imposed restrictions and different lockdowns to try to stave off the deadly pandemic as it claimed more and more victims.

The government was blamed for its slow response, a lack of transparency, mismanagement, and a reluctance to shut down the economy, which had been devastated by U.S. sanctions.

With little relief from the virus over the past 10 months, COVID-19 has now caught a second wind and returned with great ferocity.

The death toll from the coronavirus pandemic in recent weeks has skyrocketed, with new records being set several times in recent days.

The daily averages have increased by nearly 400 percent since early September, with over 400 new deaths being confirmed each day in November.

More than 40,000 people have officially died of COVID-19 in the country while a deputy health minister has suggested that the real number of fatalities is likely to be twice as high. Other observers estimate the death toll to be even greater than that. The official number of infections surpassed 700,000 this week.

On November 12, the Health Ministry announced 457 deaths in the last 24 hours. On November 10, the official death toll stood at 462, a record high.

Infections have also been climbing recently, with a record 11,780 new cases being reported by the Health Ministry on November 11, the highest in what officials say is the third wave of the coronavirus to hit the country.

On November 12, the number of reported infections stood at 11,517.

'A Coronavirus Massacre'

Health officials and others -- including the heads of 65 medical faculties and universities -- have called for a two-week nationwide shutdown and severe restrictions on intercity travel.

The situation is particularly worrying in the capital, Tehran, which accounts for more than half of the coronavirus deaths, according to officials.

Hospitals have been flooded with patients, with some reportedly running out of beds, while the situation at Tehran's massive Behesht-Zahra cemetery, the largest in the country, has been described as "unprecedented" in the past 50 years.

The head of Tehran's city council, Mohsen Hashemi, said over the weekend that the capacity of the cemetery had been tripled through the use of "three-story graves."

The head of epidemiology at Shiraz University, Haleh Ghaem, warned on November 10 that without a strict lockdown, the country would experience a "coronavirus massacre."

"It's the duty of the government to impose a full quarantine in these difficult days," Ghaem said, while also blaming people for not respecting health regulations. "Our youth get together without masks. Unfortunately, some think death from COVID-19 happens only to their neighbors," she said.

The head of Iran's Medical Council, Mohammadreza Zafarghandi, said a lockdown for at least two weeks was necessary to create some rest time for exhausted medical staff.

According to Zafarghandi, 300 Iranian medical workers have died of COVID-19 while caring for patients. Independent medical activists put the number of deaths among hospital staff at more than 350. Thousands are believed to have been infected.

The photos of some of them were published earlier this week on the front page of the daily Etemad, which said that "these men and women were the valuable assets of the country" who lost their lives while caring for coronavirus patients.

Minoo Mohraz, a well-known physician and member of the national Task Force To Combat the Coronavirus, said the lack of lockdown in Tehran, home to more than 8 million people, was "a disaster."

"Countries that have not listened to their health officials have faced problems," said Mohraz, who tested positive for the coronavirus and cited the United States as an example of such a country.

Mahdiar Saeedian, a physician, medical activist, and health reporter in the city of Mashhad, said that at this point only a "military" lockdown can help slow the major surge in infections the country is experiencing. "Our problem has been from the beginning a lack of proper management. The Health Ministry did not have enough authority and support to deal with the crisis and there was no real lockdown," he said.

Corruption, Incompetence Blamed

Authorities initially downplayed the outbreak in the country while also failing to quarantine cities such as Qom, which had become an epicenter of the virus.

Limited lockdowns were declared in late March, with many defying travel restrictions during Norouz, when Tehran residents often spend their holidays in the north along the Caspian Sea. Officials were also accused of covering up the extent of the outbreak. There has also not been sufficient testing, experts say.

"Also, the response was slow, our colleagues had been saying since [January] that they're having cases of patients with severe lung problems who die quickly," he added.

Saeedian also blamed crippling U.S. sanctions for the situation, saying many Iranians who are struggling to make ends meet due to the economic crisis and astronomical prices of food can't afford to stay home.

The pandemic is raging amid public frustration with the establishment, which many accuse of corruption, incompetence, and not prioritizing the lives of citizens.

In November 2019, the authorities used lethal force against people who took part in anti-establishment protests, killing several hundred.

In a sign of the seriousness of the crisis, the government ordered a nightly curfew on restaurants and nonessential businesses in the capital and other major cities for a month starting on November 10, the first time such a restriction was implemented.

The Health Ministry also announced that testing will increase from 20,000 to 100,000 tests per day.

Hope In Biden

Meanwhile, all eyes in Iran are turned toward U.S. President-elect Joe Biden and his upcoming administration, with the hope that it might offer Tehran an easing of sanctions.

In April, Biden said the United States should take steps to offer relief to countries that have been hit hard by the pandemic, including Iran.

"While the Iranian government has failed to respond effectively to this crisis, including lying and concealing the truth from its own people, and it continues to act provocatively in the region, the Iranian people are hurting desperately," Biden wrote, adding that U.S. sanctions had limited Iran's access to medical supplies and equipment.

He added that the United States should take "immediate steps to address the problem and facilitate Iran's access to humanitarian aid to help combat its coronavirus crisis."