Coronavirus emergency hospital in Tehran

Prioritising own survival

Yassamine Mather reports that the death rate is far higher than the claims of the clerical regime

On October 27 Iran’s official Covid-19 cases were recorded as 581,824 infected, and 33,299 deaths. According to John Hopkins of the Coronavirus Resource Centre, this puts Iran in the 13th highest position globally.1

On October 21 the government put 43 Iranian cities, including Tehran, under “severe restrictions”. After months of neglecting the issue, the supreme leader, ayatollah Ali Khamenei, called for “decisive governance action” and stricter penalties for those flouting public health rules. That was on October 24 - a day after Iran registered a new record daily number of Covid-19 infections. As with many other countries, it was a case of ‘too little, too late’.

However, the figures are disputed by health officials inside the country. According to Dr Mohsen Shahmanesh, a retired consultant at the University Hospitals Birmingham NHS Foundation Trust, an unofficial report released by Iran’s ministry of health, which gave the names, addresses and dates of birth of all the deceased, put the deaths at twice the official figure.2 While the officially released figure reported by the ministry of health claimed only 14,405 deaths up to July 20, the leaked report stated that in fact 42,000 people with Covid-19 symptoms had died by that date.

I emphasise the figures from inside Iran, because exaggerated death tolls reported by US, Saudi and Israeli media outlets, such as Radio Free Iran (part of the US state department’s propaganda machine) or Saudi International (paid for by the Saudi royals), should not be taken seriously. If you believe figures from Radio Farda (part of the Radio Free Europe/Radio Liberty outlet), in late spring the death toll from Covid 19 in Iran was five times higher than official figures. In fact such exaggerations have actually helped the regime cover up the true extent of its failure.

However, there is no doubt that the situation has deteriorated considerably in the last few weeks. In many Iranian cities hospitals are running out of capacity, while around 300 people are dying every day from the pandemic.

So how did we get to this situation? The regime has, of course, imposed various lockdowns since March, but the authorities have been unbelievably relaxed about imposing penalties on the majority of the population who - often for economic reasons, but sometimes for recreational purposes - have ignored the restrictions. Iran’s Islamic Republic is not ‘wasting’ the resources of its security forces on the pandemic: it is well aware that if sanctions continue it will face mass unrest and it will require all such resources for confronting that situation.

That explains why such a repressive state, which often does not tolerate even the mildest forms of criticism, has actually been very ‘libertarian’ when it comes to Covid-19. A state that interferes in everything its citizens do - from what they drink to what they wear - has, for example, told Iranians they can choose whether they want to send their children to school or keep them at home.


There is no doubt that sanctions have played a major part in the current worsening situation. There is a shortage of surgical and medical equipment, some listed as dual-purpose (ie, what, according to the US authorities, can also be used in the nuclear industry, such as incubators) and many essential drugs are now scarce, including insulin and anti-inflammatory medicines.

However, this is far from sufficient for regime-change Iranians of the left and the right. Many of them are urging the Trump administration to impose more sanctions - their desperation for the overthrow of the Islamic Republic from above, thanks to the role of the current US administration under Donald Trump, has become increasingly insane over the last few weeks. Such groups are convinced that a Joe Biden presidency might lead to new US-Iran negotiations and their dream of returning from exile will not materialise.

Of course, as I have previously pointed out, there is no reason to think that during a second term Trump will not do a deal with Iran - he has said that this is possible on a number of occasions. He seems to believe that, once he starts a second term, the Islamic Republic will have no choice but to negotiate. But clearly Tehran is preparing for negotiations irrespective of who wins the presidential elections.

President Hassan Rouhani is talking of “the path taken by Imam Hassan” as the wise way forward. Imam Hassan (624-671BCE) was the eldest son of Ali ibn Abi Talib and prophet Muhammad’s daughter, Fatimah. Unlike his brother, Hossein - who died in fighting, thus becoming the first Shia martyr - Hassan was a ‘man of peace’.

This week, as rightwing Islamists called for Rouhani’s hanging for making such a conciliatory statement, Khamenei intervened in support of his president. Clearly the higher echelons of the Islamic Republic - whether ‘reformist’, ex-reformist or conservative - have made up their mind in favour of negotiations. Which means that the royalists, as well as sections of the former left, who are now pro-Trump - believing he will pursue regime change policies through even tougher sanctions and maybe military intervention - might be disappointed.

Sanctions have affected the buying power of ordinary Iranians, and Iran’s currency, the rial, has been spiralling down to historic lows - last week the exchange rate was 317,000 rials to the dollar! This new low was a direct consequence of 18 major Iranian banks becoming the latest targets for the sweeping sanctions imposed by the Trump administration. According to treasury secretary Steven Mnuchin, “Our sanctions programmes will continue until Iran stops its support of terrorist activities and ends its nuclear programmes.” But he claimed hypocritically that “Today’s actions will continue to allow for humanitarian transactions to support the Iranian people.”

In reality, as everyone knows, sanctions have played a significant role in enriching the sons, daughters and associates of Iran’s senior clerics and other sections of the elite, who have accumulated astronomic wealth through sanction-busting, profiteering from black markets and general corruption. Many such people are very close to the centres of power controlling imports and exports; they often benefit from favourable rates of exchange and so have actually benefited from sanctions. So the Trump administration is deluding itself if it seriously believes that sanctions are weakening those in power: they have impoverished ordinary Iranians, while allowing the elite to flourish.

Although most people have public health insurance, this does not cover expensive antiviral drugs like remdesivir and favipiravir. As elsewhere in the world, medical treatment for the rich is very different from what working class and poorer Iranians receive. According to Mahmoud Sadeghi, a member of the Islamic majles (parliament), “Some 20,000 favipiravir pills, gifted to Iran from China, were secretly imported to the country to treat high-ranking officials.”3 All this despite the fact that Mostafa Ghanei, who heads Iran’s coronavirus expert panel, claimed in early July that the drug actually exacerbates Covid-19.


Of course sanctions are only part of the problem. The Rouhani government and its conservative majles - not to mention sections of the former revolutionary left - have also played their part in making the situation worse.

The first lockdown for Tehran and major other cities was declared just before the Iranian new year (March 20), yet photos taken nationwide showed major traffic jams immediately afterwards. (Compare this with another repressive dictatorship, China, where all travel during the February new year celebrations was banned and the state used its security and military forces to enforce compliance.)

Then on April 20, shops and bazaars reopened, as did parks and recreation areas two days later. In early May the government allowed all mosques to return to normal and later that month major Shia religious shrines, restaurants, cafes, museums and historical sites reopened - with very relaxed rules about social distancing, wearing masks, etc. The spread of the deadly virus subsequently increased.

The harsh economic conditions have left many Iranians with a dreadful choice: not going to work and not being able to feed their family; or returning to their workplace and risking infection. In June a poll organised by the ministry of health suggested only 40% of the population were keeping to social-distancing rules (down from 90% earlier in the outbreak); 32% were following the rules on self-isolation (down from 86%).

I mention this because there is no point presenting arguments about Covid-19 in Iran by citing how many political prisoners the country has or making general statements about the oppression imposed by the regime. Some writers on the left have used such generalities to argue against those who have written articles sympathetic to the Islamic Republic’s response to Covid-19.4

One notable example of the state’s failure - not insignificant when looking at the recent rise in infections - is the Islamic government’s decision not to impose its own regulations, when it came to recent religious ceremonies, such as the Shia day of mourning for Arbaeen, and the Day of Ashura, which marks the death of Imam Hassan.

Social media reports of gatherings throughout the country show how only three weeks ago - at a time when the rate of infection and deaths had soared - the religious state did not clamp down on these ceremonies, mainly because they play an important role in maintaining the cohesion of the Islamic regime’s dwindling, but still substantial, religious and political base.

Of course, we should also recognise that, irrespective of the state’s failure, doctors and other workers from primary healthcare centres have played a crucial role in tracing and contacting those who came into contact with patients. However, they have also paid a heavy price in terms of casualties. As early as May, the semi-official news agency, ILNA, quoted a deputy health minister who said that 10,000 Iranian healthworkers had been infected by the virus.5

So it is not just economic needs that pull in the opposite direction to health and safety measures: political expediency, together with the actual survival of the regime, adds a new dimension of complexity, when it comes to the measures taken by the Islamic Republic.

  1. coronavirus.jhu.edu/map.html.↩︎

  2. youtube.com/watch?v=SWmEGEEzw_s&t=1759s.↩︎

  3. dw.com/en/iran-coronavirus-cases-treatment/a-55127145.↩︎

  4. See, for example, newleftreview.org/issues/II122/articles/vira-ameli-sanctions-and-sickness.↩︎

  5. physiciansweekly.com/iran-says-10000-of.↩︎