Iran's Coronavirus Crisis: Implications for U.S. Policy

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Middle East Institute


A combination of economic, political, and ideological factors can be blamed for Iran’s rapid, large-scale coronavirus outbreak. The country’s initial exposure to the pandemic was predictable due to China’s status as its principal commercial partner, but the government’s failure to take preemptive measures allowed the virus to enter earlier and spread faster than in other Middle Eastern states.

Initially, officials were unwilling to restrict Iranian exports to China, impose travel restrictions, or implement the necessary quarantine measures for fear of harming the economy. Politics also played a role—the leadership may have delayed certain measures in order to ensure a larger turnout for the February parliamentary election, which was considered a litmus test for their legitimacy following the Ukrainian airline scandal in January and the mass protests that began last November.

Historically, Iran has been quite successful at combating epidemics. When the El Tor cholera pandemic came knocking in 1964, the country responded quickly and transparently, relying on the leadership of healthcare professionals and pairing international cooperation with indigenous capabilities to develop vaccines and an antimicrobial control approach. In contrast, the neighboring Soviet Union withheld reporting of cases, placed the security services in charge, and maintained a state of denial. The outcome was predictable: Iran got the situation under control within a matter of months, but the epidemic raged in the USSR for another five years.

Unfortunately, Tehran is using the secretive and militarized Soviet-style approach today. Lack of accountability and a state of paranoia are dominating the government’s policies, which include shunning multinational collaboration, rejecting aid, and barring the entry of international organizations such as Doctors Without Borders. President Hassan Rouhani claims that Iran has “flattened the curve,” but even conservative models from the University of South Wales and MIT-Virginia Tech predict that COVID-19 will not peak there until summer.

Through April 19, official Iranian statistics indicate the country has 55,000 virus cases and 3,500 fatalities. In the past few months alone, however, 178,000 cases of acute respiratory syndrome have been reported there, with 13,000 ARS-related fatalities—far higher than the 2019 average of less than 5,000 ARS cases per month. These numbers indicate inadequate testing and reporting for coronavirus; some Iranian experts estimate the country has actually experienced closer to 500,000 cases, including asymptomatic ones.

Whatever the exact tally, the coming months will place major pressure on Iran’s healthcare sector, particularly with regard to intensive care units. The country has only 2,500 ICU beds for the 100,000 or more individuals who may need treatment for respiratory distress. To effectively combat COVID-19, the government needs to return leadership of the health system back to the civilian sector, which would allow for greater efficiency and cooperation with international entities.

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