The spread of COVID-19 in Iran may be far worse than reported

The spread of the coronavirus in China was aided by a government crackdown on news about the virus. Government officials showed up at the home of the doctor who initially tried to spread word about the virus in a chat room. They forced him to sign a document warning him about his illegal behavior. Something similar may be happening in Iran. Officially, there are 6,566 cases of the virus in Iran. However, the Atlantic published a piece today suggesting the actual number could be far higher.

Of course the whole problem is that Iran, motivated by domestic and international political concerns, may be lying about the actual number of people infected. But there are other ways to estimate the spread of the virus within Iran and all of those methods suggest the real numbers are much higher than the official count:

  • A paper by the University of Toronto’s Ashleigh Tuite and others noted that, by February 23, cases of Iranian origin had surfaced in Canada, Lebanon, and the United Arab Emirates. Given the volume of air travel between Iran and these countries, Tuite’s team estimated how many native COVID-19 cases must have occurred in Iran to produce one case each in these other countries. Their estimate for February 23: 18,300. Since the epidemic reached 100 cumulative cases, the official numbers have doubled roughly every three days. If that rate held, the estimate as of today would be 586,000…
  • A government website invited Iranians to submit details of symptoms they were experiencing. After 2 million responses, about 9 percent reported COVID-19 symptoms. In the United States, among those whose symptoms and history have led them to be tested for COVID-19, about 10 percent have eventually tested positive. If that rate holds, Iran would have 730,000 cases.
  • On March 4 and 5, two evacuation flights of Chinese citizens were allowed to leave Tehran for China’s Gansu province. Chinese authorities were of course wary of introducing more coronavirus carriers into the country, so they tested passengers and found 11 COVID-19 cases out of 311 passengers. If Chinese people in Iran got the disease at the same rate as Iranians, that suggests a rate of 3.5 percent, for a total of 5.7 million at the time of the flight.

That’s a sample but other means of estimating yield figures between half-a-million and 8 million cumulative cases. The average would be somewhere around 2 million:

The messages coming out of Iran on social media, especially from health-care workers, do little to convince me that my doomsday figures are inaccurate. David N. Fisman, a colleague of Tuite’s at the University of Toronto, notes that the virus reportedly spread after panicked residents of Qom and Tehran fled to smaller cities, thereby sowing COVID-19 all over the country. Circulating on social media are reports that some provinces, such as Mazandaran, have set up roadblocks to keep more people with the infection from spilling into their territory.

The situation the doctors describe is desperate, with nurses wrapping themselves in tablecloths because they have long since run through their supply of proper gear. They swear that the official numbers are wrong. “Just stay overnight in the hospital to find out what I’m talking about,” one wrote. Or if you want to live, go home, and don’t come out until the plague passes. “[Our] society now needs fear more than hope.”

I’ve seen some of the social media posts Atlantic author Graeme Wood is talking about. For instance:

And another:

And another:

Here’s video of a nurse complaining she lacks proper equipment:

This is from just over a week ago. Some locals apparently set this clinic on fire because sick patients from a heavily infected area were being brought in:

If the estimates above are accurate, even the lower ones, then the situation in Iran is desperate as they will not have hospital beds to treat people. I wonder what the Iranian people are going to make of this. It has only been a couple of months since Iran admitted that it shot down a passenger jet full of people. Iranians were reportedly furious that the government had lied to them about what happened for several days. Now it appears the regime may be lying once again only this time the consequences will be far more deadly. As of yesterday, 194 people have died of the virus in Iran, a jump of 49 deaths from the previous day.