Iran has reported eight deaths and 43 infections from the new coronavirus, prompting neighbouring states to cut travel links with Tehran amid concerns authorities failed to respond fast enough to the rapidly-spreading epidemic.
Turkey, Pakistan, Afghanistan and Armenia closed their land borders with Iran on Sunday as officials in Tehran reported three new deaths and 15 new cases in one day.
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Since the infection, officially known as COVID-19, was first detected in the Iranian city of Qom on Wednesday, there has been a sharp increase in cases in the country while Lebanon and the United Arab Emirates (UAE) said people travelling from Iran had tested positive for the pathogen upon entering their territories.
The death toll in Iran is the highest number reported outside China, the epicentre of the outbreak, where the virus has claimed more than 2,400 lives and infected over 77,000 people.
As the virus spread in Iran, authorities closed down schools and cancelled art and film events in a bid to stem the outbreak. They also designated at least 230 hospitals across the country to treat infections.
But some medical staff are expressing concern over what they called a lack of adequate equipment at hospitals, while some members of the public accused the government of failing to take adequate preventive measures.
A senior official from the World Health Organization (WHO), meanwhile, expressed concern crippling sanctions imposed by the United States as part of a “maximum pressure” campaign could affect Iran’s ability to deal with the epidemic.
A nurse in the city of Rasht in Gilan said there was a lack of equipment at hospitals in the northern province, where four cases of the infection have been recorded.
“We are [at] the forefront of dealing with people who are suspected of being infected. But we do not have the standard protective clothes or masks. We’ve been given the gowns that are used in operation rooms, we know that it is not effective. We also do not have the necessary disinfectant and sanitizer liquids.”
Meanwhile, a physician in Tehran, also speaking on the condition of anonymity, said: “They [authorities] are not prepared to tackle the disease at all. Even hospitals are not well-equipped.”
Fahimeh, a civil servant in Tehran, echoed the sentiment, saying she feared for her 42-year-old husband, who suffered a heart attack two years ago.
“I’m concerned about my husband, because I am not sure whether hospitals are really prepared to provide required services to patients,” said the 32-year-old, who preferred to give one name, noting the warning by the WHO the infection posed risks to elderly patients or those who have underlying conditions such as heart disease and diabetes.
“I am not happy with the government response, because they are not well-prepared even though they knew the coronavirus could come to Iran. For example, the health ministry keeps saying that there’s no shortage of masks and hand-sterilising gels. But, on the ground it’s not like this,” she said, noting how pharmacies in the city were facing a shortage of masks and hand sanitizers.
In the hard-hit city of Qom, an important Shia religious city, a journalist said one sign of health officials not being prepared for a potential outbreak was how they only “conducted diagnosis tests only after deaths happened”.
The situation in Qom, where 26 infections and several deaths have been recorded, “will get worse”, he said.
Some also questioned why authorities were slow to cut air links with China, one of Iran’s closest trading partners. Tehran suspended flights to Beijing on February 3, four days after WHO declared the outbreak that emerged in the central Chinese city of Wuhan a global health emergency.
Ali Fathollah-Nejad, a visiting fellow at the Brookings Doha Centre, said the outbreak has further eroded the Iranian public’s trust in the government, as it comes amid widespread dissatisfaction over perceived mismanagement at a time of a worsening economy, as well as anger at the Iranian authorities’ heavy-handed crackdowns on dissent including a bloody crackdown on people protesting a rise in fuel prices in November.
“There is concern that Iranian authorities delayed informing the public of the outbreak, similar to the actions of the Chinese government,” he said, referring to anger in China after it emerged that authorities there had been aware of a deadly new viral outbreak in late December but only began taking precautionary measures weeks later, in late January.
Fathollah-Nejad added: “It deepens the feeling [in Iran] that the government failed to take the precautions necessary to protect the health and the lives of the people. Because of Iran’s need to keep its contacts with China intact, they kept up flights and other links to China, while other countries were more careful.”
But Iranian authorities have defended their conduct, with government spokesman Ali Rabiei saying on Friday that the health ministry has acted “honestly and transparently” in handling the outbreak.
Health Minister Saeed Namaki told the semi-official ISNA news agency that the government has “acted honourably in preventing the epidemic of infectious diseases”.
“The latest such example is our colleagues’ management in dealing with countrywide floods in March last year when no pandemic broke out,” he said, referring to measures to deal with waterborne diseases in the wake of unprecedented and deadly flooding that hit 25 out of 31 provinces in Iran in March last year.
Peyman Saberian, head of Tehran’s emergency services, told PANA news agency on Wednesday the capital was ready for an outbreak. “We have no shortage of clothing and equipment,” he said. “The most important thing is for people to take care of their own health and personal hygiene.”
Dr Abdinasir Abubakar from WHO’s Regional Office for the Eastern Mediterranean also expressed confidence in Iran’s ability to handle an outbreak.
“Iran has one of the best healthcare systems in the region and they have the capacity to handle the outbreak,” he told Al Jazeera on Sunday. However, he said US sanctions could hurt Tehran’s ability to respond to the crisis.
“The embargo may have impacted [the] overall economy and Iran may not [be] able buy [the] technology required to produce essential equipments and medicine. However, Iran is one of the countries in the region with adequate preparedness and capacities for such outbreaks.”
Additional reporting by Virginia Pietromarchi and Zaheena Rasheed in Doha, Qatar