CAIRO (AP) — They are regarded as heroes, their fallen colleagues as martyrs. But for doctors and nurses still dealing with Iran’s growing number of coronavirus infections, such praise rings hollow.
While crippling sanctions imposed by the U.S. left Iran ill-equipped to deal with the fast-moving virus, some medical professionals say government and religious leaders bear the brunt of the blame for allowing the virus to spread — and for hiding how much it had spread.
Those medical workers say they were defenseless to handle the contagion. And as a result, doctors and nurses in Iran have been hard hit by the virus. During the first 90 days of the outbreak alone, about one medical staffer died each day and dozens became infected.
“We are heading fast toward a disaster,” said a young Isfahan doctor who has been working tirelessly, checking dozens of suspected coronavirus patients before referring them to hospitals.
It is no secret that Iran has been hit hard by the coronavirus. Official government figures show that around 100,000 people were infected by the virus and around 6,500 have died. But a report by the research arm of Iran’s parliament said the number of cases could be eight to 10 times higher, making it among the most hardest hit countries in the world. The report said the number of deaths could be 80% higher than officials numbers from the Health Ministry, about 11,700.
The Iranian government is currently reporting a decline in the number of COVID-19 infections and deaths, even though local authorities are expanding cemeteries in places like Tehran where the municipal council said it had to add 10,000 new graves to its largest cemetery, Behesht e-Zahra.
Interviews with more than 30 medical professionals and a review of communications by doctors on messaging apps and other documents by an Associated Press reporter in Cairo revealed many previously unreported details. The reporting paints a fuller picture of the roots and extent of the country’s disjointed response as the deadly virus spread throughout the population.
In the beginning, medical staffers faced the outbreak with very limited equipment. Some washed their own gowns and masks or sterilized them in regular ovens. Others wrapped their bodies in plastic bags they bought at supermarkets.
The makeshift equipment didn’t help as dozens of medical professionals without adequate protection died along with their patients.
Iran’s leaders, several medical professionals said, delayed telling the public about the virus for weeks, even as hospitals were filling up with people suffering from symptoms linked to the virus. And even as doctors and other experts were warning the Iranian president to take radical action, the government resisted, fearing the impact on elections, national anniversaries, and economy.
One doctor interviewed by The Associated Press -- who, like all medical workers interviewed for this story, spoke only on the condition that they not be named for fear of persecution -- said he and his colleagues were even discouraged from using protective equipment. He said government officials claimed wearing masks would cause panic.
The country’s supreme leader, Ayatollah Ali Khamenei, proclaimed on March 10 that the doctors, nurses, and medical staffers who died in the fight against coronavirus in Iran were “martyrs.” Pictures of deceased doctors have been placed alongside those of soldiers who were killed in the bloody Iran-Iraq war in the 1980s, which claimed the lives of a million Iranian and Iraqis.
“They are normalizing death,” a Tehran-based health consultant said.
A list compiled by a group of Iranian doctors found that a total of 126 medical staffers have died since the virus was first reported, mostly in the provinces of Gilan and Tehran, while over 2,070 contracted the virus.
Health Ministry spokesman Kianoush Jahanpour, acknowledged the deadly toll of COVID-19 on the medical profession, telling the AP the total number of deaths is 107. Jahanpour said 470 had tested positive for the virus. But he places the blame on the U.S. “Remember this is a country under sanctions,” he said. Even so, Iran has maintained throughout the crisis its own industries made enough protective material to fight the virus.
Iran reported its first two cases on Feb. 19 in the city of Qom — 140 kilometers (88 miles) south of Tehran and home of highly revered Shiite shrines. It would become the epicenter of the outbreak.
But doctors interviewed by the AP said that before the official announcement, they started to see cases with the same symptoms as the novel coronavirus and warned the national Health Ministry that it needed to take action.
Some doctors shared with the AP letters sent to the ministry. The doctors at first said they attributed the respiratory problems among patients and deaths to the H1N1 flu. Days later, they started to call for testing for H1N1 and other diseases to rule them out; the rate of infections and deaths seemed unusually high.
Through channels on the Telegram messaging service, they exchanged data. They reached out to the Health Ministry and proposed a set of recommendations and actions. At the top of the list: quarantine, and restricting travel and flights with China. But it would be another two weeks before the government took action.
“We gave a lot of information to the government through letters and communication channels,” said a Mazandaran-based doctor and activist. He said he and others medical professionals were ignored by government officials.
Two days after announcing first cases, Iran held its parliamentary elections where thousands lined up to vote. That same day, doctors in Gilan — one of the worst hit areas in Iran— appealed to the governor for help, saying their hospitals were flooded with patients amid a shortage of masks and other protection equipment.
“The health personnel of the province are exposed to a huge threat,” a letter sent by the doctors read.
But government officials played down the danger of the virus, calling the physicians’ plea for a quarantine “medieval” and floating unfounded conspiracy theories that the U.S. created the coronavirus to promote a fear mongering campaign.
The feared paramilitary Revolutionary Guard kept health facilities under tight control and medical statistics were treated as top secret, the medical staffers said.
Death certificates were not recording the coronavirus as the cause of deaths -- either because not all severe cases were tested or just for the sake of keeping the numbers down. Thousands of unaccounted deaths were attributed to secondary causes like “heart attack” or “respiratory distress.”
A doctor in Tehran said the Health Ministry gave orders not to refer critical cases to hospitals to be tested for the virus -- to keep the numbers low, she said.
“We suppose they (want to) say they’re doing good,” she said.