Coronavirus: Iran outbreak raises fears of mass Middle East contagion as pilgrims and workers move across borders
- Iran has confirmed 388 virus cases and 34 deaths, with dozens of cases in neighbouring countries linked to people who travelled to Iran
- Saudi Arabia has banned foreigners from making pilgrimages to Mecca and Medina to halt the further spread of the virus
Iran’s rising coronavirus death toll amid doubts over the government’s reporting of cases is raising fears of mass contagion across the Middle East, months ahead of the most important mass pilgrimage in the Islamic calendar.
Iranian health authorities have confirmed 34 deaths, the highest death toll outside China, and 388 cases, most of them in the holy city of Qom, a popular destination for Shiite pilgrims and scholars.
“Due to Iran’s geographical positioning as a crossroads in the Middle East, the Covid-19 virus has already spread to Iran’s neighbouring countries, and if Iran doesn’t act proactively, there is a big risk for the virus to travel more intensely far and beyond,” said Asif Shuja, a senior research fellow at the Middle East Institute at the National University of Singapore.
Turkey, Iraq, Kuwait, the UAE, Pakistan, Afghanistan and Armenia have all closed their borders to Iran or introduced restrictions on travellers.
Parvaiz A Koul, an infectious diseases expert at the Sher-i-Kashmir Institute of Medical Sciences in Srinagar, India, said he believed it was only a matter of time before the virus crossed borders in the Middle East on a grand scale with “disastrous consequences”.
“Poor public health capacity, ill-compensated and uninterested health care workers, inappropriate emphasis on the right measures, wishful thinking, illiterate populace and the like seem challenges for the authorities and despite their efforts, the measures may simply not be enough,” said Koul.
But this year’s haj is threatened by Saudi Arabia’s announcement that it was taking “proactive preventive measures to prevent the arrival of the new coronavirus” by banning foreigners from Mecca and Medina.
“I believe if the cases do not abate in the countries from where pilgrims originate, it might call for a forced stoppage of the pilgrims from attending the haj,” said Koul, who described the pilgrimage as the “ideal environment” for the spread of the virus.
In a study published this week by medRxi, a website that publishes research that has not yet been subject to peer review, a group of Canadian scientists estimated the number of cases in Iran could be upwards of 18,000, basing their analysis in part on cases linked to Iran in other countries.
“This elevated fatality rate could be due to the strain put on their health infrastructure, but it is more likely that only the severe cases are being detected, in which case we may see continued spread throughout the country and region,” said Jeremy Rossman, a lecturer in virology at the University of Kent. “It is too early to tell for sure at this point.”
Rossman added that health care systems across the region appeared to be coping, but would struggle if localised transmission began emerging as it has in China.
“The Iranian political elite were too busy in the parliamentary elections as they were worried about a lower voter turnout threatening their legitimacy and this may have caused them to overlook as well as underplay the threat due to Covid-19,” said Shuja from the Middle East Institute at the National University of Singapore.
In a stark illustration of the government’s credibility issues, deputy health minister Iraj Harirchi and vice-president Masoumeh Ebtekar, President Rowhani’s deputy for women’s affairs, are among seven government officials to have tested positive for the virus.
Harirchi earlier this week held a press conference while visibly ill during which he denied any attempt to cover up the outbreak, only to announce the following day that he himself had been infected.
Kamiar Alaei, an Iranian doctor and co-founder of the Institute for International Health and Education in Albany, New York state, noted that authorities had only announced the first cases of the virus after the death of two patients, “which means they had already been infected for a week or so, but the government didn’t admit that they were infected.”
“In the next several weeks, we will have a lot of new cases in Iran,” Alaei added.