Pictures and videos, shared widely on social media, show a health care system stretched to the absolute brink. Patients cough into face masks, another lies in bed with an IV drip in a hospital hallway. Nurses break into tears, saying they haven’t seen their kids in weeks. Facing a shortage of protective equipment, others have fallen sick themselves.
One video shared by Iran’s state broadcaster shows a well-appointed hospital, but includes a warning: “They are dying in a cruel way and there’s not much us doctors can do most of the time,” said the head of Shahid Sadoughi Hospital in the Iranian city of Yazd. “We film these scenes so that people know what’s going on.”
Another tweeted video shows a young, Iranian doctor who says that he has also fallen ill. He later died.
Here's the English translation of the video:
The scenes in Iran mirror the coronavirus outbreaks in Wuhan, China, northern Italy, and now, New York City. At least 2,234 people have died in Iran as of Friday, according to the government — although outside observers believe the number is far higher. The country is also responding to COVID-19 under the thumb of US sanctions put in place by the Trump administration after withdrawing from the Iran nuclear deal two years ago.
The measures aimed to curtail Iran’s nuclear program and block certain financial transactions and Iran’s access to foreign reserves. This, in turn, has strained Iran's imports of medical equipment — particularly protective gear for health care workers, which also has industrial uses. Despite widespread calls for lifting sanctions as Iran’s death toll mounts, the Trump administration has doubled down, adding new limitations on the country in mid-March.
“The sanctions have created a chill effect on trade with Iran that has no doubt affected the ability to transfer humanitarian goods into the country.”
“The sanctions have created a chill effect on trade with Iran that has no doubt affected the ability to transfer humanitarian goods into the country,” said Dalia Dassa Kaye, director of the Center for Middle East Public Policy at the RAND Corporation, a California-based nonprofit think tank.
The humanitarian exemptions are still narrow in scope, Kaye said, preventing key medical supplies like ventilators, X-ray machines and face shields from reaching Iran’s health care system. Sanctions on the financial sector have scared off banks who are unsure if they will be punished for exporting to Iran.
“Even before the pandemic ... the effect has been to hurt the Iranian people, unfortunately, more than the Iranian government,” Kaye said. “It’s not a good look and it’s, frankly, not strategically smart.”
One oft-repeated estimate claims that 3.5 million lives could be lost in Iran by summer, a figure from an analysis by the Sharif University of Technology in Tehran — that's three times the death toll during the Iran-Iraq war of the 1980s. The country, which attracts millions annually for both tourism and religious pilgrimages, borders Iraq, Afghanistan and Pakistan — three countries whose health systems would be deeply strained by a large-scale outbreak of the virus.
UN Secretary-General António Guterres, the Chinese and Russian governments and even US presidential candidate Sen. Bernie Sanders have called for the US to suspend sanctions during the crisis. But to reach consensus between the US and Iran would likely require an assessment of the facts — something neither administration is known for.
In public statements, Iranian officials have both denied the country’s difficulties with fighting the virus and pleaded for help. Meanwhile, the Trump administration has argued that Iran’s government is to blame for the strained response to the coronavirus, and says it introduced a “humanitarian channel” for medical supplies to bypass sanctions that analysts say does not work in practice.
In an open letter to the American public, Iran’s President Hassan Rouhani wrote that “The sanctions have drastically undermined the ability of the Iranian people to fight the coronavirus.” He added, “Can the American people accept that these malicious pressures are brought to bear on the Iranian people in their name, as a result of their vote, and by the means of their taxes?”
Offers of humanitarian assistance, however, have been rejected. This week, Iranian authorities barred the setup of an inflatable field hospital in the city of Isfahan by a French medical nonprofit, Médecins Sans Frontières. A health ministry adviser told Bloomberg that the country has empty beds and spare capacity, and that there is nothing the country doesn’t have or cannot access due to sanctions. (Iran reversed that decision a day later.)
The US has also offered assistance, which was loudly rejected by Iran Supreme Leader Ayatollah Ali Khamenei.
“This is strange because you face shortages in America. Also, you are accused of creating this virus,” Khamenei said. “You could be giving medicines to Iran that spread the virus or cause it to remain permanently.”
The claim that COVID-19 originated in the US, though widely debunked, has gained traction among government officials in Iran and China.
Last week, US Secretary of State Mike Pompeo responded to these claims as he outlined another round of sanctions on Iranian officials, and companies that are accused of doing business with Iranian petrochemical firms.
“Instead of focusing on the needs of the Iranian people and accepting genuine offers of support, senior Iranians lied about the Wuhan virus outbreak for weeks. The Iranian leadership is trying to avoid responsibility for their grossly incompetent and deadly governance.”
“Instead of focusing on the needs of the Iranian people and accepting genuine offers of support, senior Iranians lied about the Wuhan virus outbreak for weeks. The Iranian leadership is trying to avoid responsibility for their grossly incompetent and deadly governance,” Pompeo said.
Pompeo’s term for COVID-19 — calling it the “Wuhan Virus” — is widely considered to encourage racism against Asian Americans and is condemned by advocates.
Iran’s response demonstrates paranoia and factional domestic politics, said Sanam Vakil, deputy director of the Middle East and North Africa program at Chatham House. But facts are facts — the effect of sanctions is that Iran has less revenue to work with.
“Its economy has gone into a recession, and it is not able to access its foreign reserves. The mixed messages and the responses that we’re seeing from different Iranian leaders, this of course, leads to a very confused public that doesn’t know what to take seriously.”
“Its economy has gone into a recession, and it is not able to access its foreign reserves,” Vakil said. “The mixed messages and the responses that we’re seeing from different Iranian leaders, this of course, leads to a very confused public that doesn’t know what to take seriously.”
The lack of transparency has other dangers, too. An investigation from The Associated Press found that hundreds of people in Iran died after drinking methanol, after it was touted online as a cure.
US officials are suspicious that Iran’s government is using the pandemic as leverage to end the sanctions, Vakil said. Because once the sanctions are lifted, what will Iran do with greater access to the international financial system? Will it end its nuclear program? Release detained American citizens?
In the meantime, a virus that knows no borders continues to spread — killing civilians with no connection to geopolitics.
“Yeah, that’s what makes it really unforgivable,” Vakil said. “On both sides.”
Translations and additional reporting by Bijan Sabbagh in Berlin.