Those medical workers say they were defenseless to handle the contagion. 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 an Isfahan doctor who has been tirelessly giving initial exams to dozens of suspected coronavirus patients.
It is no secret that Iran has been hit hard by the coronavirus. According to official figures, around 100,000 people were infected 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 11,700 may have died, 80% higher than official numbers.
The Iranian government is currently reporting a decline in the number of COVID-19 infections and deaths, though local authorities are expanding cemeteries in places. In Tehran, 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 disjointed response as the virus spread through Iran's 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 died along with their patients.
Iran’s leaders, several medical professionals said, delayed telling the public about the virus for weeks, even as hospitals filled with people suffering 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 the 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 killed in the Iran-Iraq war in the 1980s, which claimed the lives of a million people.
“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. He placed 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 south of Tehran, home to 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 and deaths among patients to the H1N1 flu. Days later, they called 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 actions. At the top of the list: quarantine and restricting travel and flights with China. 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 other medical professionals were ignored.
Two days after announcing the first cases, thousands lined up to vote in parliamentary elections. That same day, doctors in Gilan appealed to the governor for help, saying their hospitals were flooded with patients amid a shortage of protection equipment.
“The health personnel of the province are exposed to a huge threat,” a letter sent by the doctors read.
Government officials called the physicians’ plea for a quarantine “medieval” and floated unfounded theories that the U.S. created the coronavirus to spread fear.
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 of lack of testing or to keep 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.
“We suppose they (want to) say they’re doing good,” she said.